Browsing by Subject "hospitalization"
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Item Bacterial pneumonia hospitalization and pneumonia inpatient mortality in Texas, 1999-2007(2010-05-01) Chuan Hong; Alai Tan; Daniel H. Freeman; Christine P. BakerBacterial pneumonia has a disproportionate impact on the elderly. It is considered as an ambulatory care-sensitive condition by the Agency for Healthcare and Research (AHRQ), for which good outpatient care can potentially prevent the need for hospitalization or for which early intervention can prevent complications or more severe disease that lead to death. This project evaluated the trends in bacterial Pneumonia hospitalization and pneumonia inpatient mortality rates of older Texans during 1999-2007, and identifies the associated individual and contextual factors. \r\nThe data were from the Texas Hospital Discharge data during 1999-2007, linked with US Census data and Area Resource File. Observed and adjusted rates were calculated for Texas counties. Poisson regression and logistic regression models were used to evaluate the individual and contextual factors associated with bacterial pneumonia hospitalization and pneumonia inpatient mortality rates, respectively.\r\nThe study found that both bacterial pneumonia hospitalizations and pneumonia inpatient mortality rates were decreasing during 1999-2007. Population aged 75 years or above and Hispanics had the highest hospitalization and inpatient mortality rates. Increasing percent of Hispanics at the county-level was associated with a significant decrease of hospitalization rate and inpatient mortality rate. More number of non-Federal MDs per capita was associated with lower hospitalization rate and inpatient mortality rate. More hospital beds was associated with lower pneumonia inpatient mortality rates.\r\nThis study suggests interventions at county-level have great potential to improve the quality of pneumonia preventive and inpatient care for older population. \r\nItem Creative coping: a description of experiences of families coping with chronic illness in a child(Texas A&M University, 2006-08-16) McGough, MarniqueChronic illness impacts numerous families in the United States. Children are increasingly among those affected by a chronic illness. The families undergo trials and experiences that tax their coping skills and require extensive coping strategies. This research project explored how families cope with chronic illness in one of the children in the family. The objective of the research project was to use the method of case study to examine the everyday lives, perceptions, and coping strategies of the family members as they deal with the realities of the effects of a child??s illness on a daily basis. Three families were studied using the case study format. Through interviews, observations, and investigation of data, the researcher gathered pertinent information about the participants?? lives and experiences. Emergent themes were identified from the facts gathered. These themes included information and suggestions that various participants offered. Included among the emergent themes were the following titles: alarming environment, redefined realities, relational requests, valuable individual, coping concoctions, as well as awareness and advocacy. The study??s emergent themes were divided into numerous subcategories. The multiple realities that the family members face is evidenced in the number of issues and themes that emerged from the study. This research project gives additional insight into the reality of the lives of families experiencing chronic illness in one of the children. Suggestions and observations by the participants could be useful for family, friends, medical professionals, educational systems, and support groups that interact with families facing similar trials. The descriptive style of the study lends itself to the vicarious interaction of the reader to the circumstances of the participants. This format allows the reader to transfer knowledge to his or her own experiences. The study could further be useful by offering detail to the existing knowledge base, in addition to aiding in the development of theory.Item Hospital depressive symptoms and ADL disability in older adults: A longitudinal analysis of course and associations(2010-04-26) Carrie Ann Ciro; Glenn V. Ostir; Yong-Fang Kuo; Kenneth Ottenbacher; Carl Granger; Beatriz AbreuDepressive symptoms and disability in activities of daily living (ADL) often increase in older adults during hospitalization and for many persist post-discharge. However, little is known about the psychological and functional response of older adults admitted to an Acute Care for Elders (ACE) unit. Questions remain about the association between depressive symptoms and ADL disability and factors that moderate these associations are unknown. Objectives of this study were to investigate: 1) change in depressive symptoms and ADL function from hospital to 3 month follow-up; 2) the association between depressive symptoms in hospital and ADL function 3 months post-discharge; and 3) moderators of the depression-ADL association.\r\n A tri-ethnic (white, black and Hispanic) sample of 403 older adults within an ACE database contributed subjective and objective information related to depressive symptoms, clinical variables and activity/participation measures across two time frames, admission and three months post discharge. A large minority reported high depressive symptoms in hospital and over half reported ADL disability. Across both assessment periods, risk factors for having high depressive symptoms were being unmarried and having any level of ADL disability. Conversely, risk factors for ADL disability were pain and depressive symptoms. At 3 months post discharge, the recovery rate from depression and incident ADL disability was high. Positive change in depression was significantly associated with positive change in ADL status. Increasing severity of hospital depression was associated with increased odds of ADL disability at the 3 month follow-up. Neither gender, marital status, pain nor medical history moderated this relationship. \r\n This study indicates that while older adults experience higher depressive symptoms and ADL disability while hospitalized, resolution of symptoms occur for many. This research contributes to the literature by extending our knowledge of the course and associations between depressive symptoms and ADL disability in hospitalized, older adults. Future research which focuses on interventions to minimize depressive symptoms and ADL disability is warranted. \r\nItem In hospital functional assessments in the elderly and their association to post discharge health outcomes(2008-06-24) Steve Fisher; Glenn Ostir; Yong-fang Kuo; Kenneth Ottenbacher; Kathy Lucke; Jean Herzog; Elizabeth ProtasThe purpose of this study was to investigate the functional status of a sample of older adults during hospitalization for acute illness and to examine associations between functional status measures assessed during hospitalization and post discharge community participation and rehospitalization. Data employed were from a convenience sample of men and women aged 65 years or older admitted to the UTMB Acute Care for Elderly (ACE) during 2007 with a follow up telephone interview at 3 months post discharge. Physical Function was assessed using standard measures that have been used extensively in studies of older persons living in the community: hand grip and knee extensor strength, gait speed, the Short Physical Performance Battery, and self report activities of daily living (ADL) disability. The use of many of these measures among older adults in context of acute illness and hospitalization is relatively novel, however. \r\nThis study showed that multiple measures of physical function can be quickly and easily collected in a broad sample of older adults hospitalized for acute illness. Overall, the functional status of the sample was low when compared to healthy adults of comparable ages. Descriptive analyses showed poor physical function was associated with increased age in all measures. Multivariate analyses showed that slow gait speed and poor performance on the Short Physical Performance Battery were significantly associated with more adverse clinical measures of health status than hand grip strength, knee extensor strength, or ADL disability. Longitudinal analyses showed that only slow gait speed and poor performance on the Short Physical Performance Battery were significantly associated with less post discharge community participation and there was a trend (though not statistically significant) toward decreased functioning and rehospitalizations within 90 days of discharge. \r\n\r\nThis study provides important insight into the functioning of hospitalized elders. With rising health-care costs, the benefits of routinely assessing the functional status of older patients in the hospital environment are potentially enormous. Considering the expected growth of the older population in the coming decades and their high use of hospital services, further research is warranted, especially among those at high risk for loss of functional independence. \r\n