Assuntos
Intoxicação por Monóxido de Carbono/epidemiologia , Tempestades Ciclônicas/estatística & dados numéricos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Adolescente , Adulto , Idoso , Intoxicação por Monóxido de Carbono/etiologia , Intoxicação por Monóxido de Carbono/fisiopatologia , Criança , Florida , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto JovemRESUMO
OBJECTIVES: Patients are 30% less likely to be readmitted or visit the emergency department if they have a clear understanding of their discharge instructions. A standardized approach to a hospital discharge plan has not been universally implemented, however. Our goal was to increase patients' comprehension of discharge instructions by implementing a standardized patient-centered discharge planning protocol that uses a physician team member to explain these plans. METHODS: This was a prospective study that included all of the patients discharged from an inpatient medical teaching service in a community-based hospital during the study period. We used two 4-week periods separated by 4 months in which training and practice with the study intervention took place. Patients' understanding of discharge instructions was assessed via a follow-up telephone call from a physician co-investigator within 1 week of each patient's discharge. Differences in patients' understanding between groups were analyzed. RESULTS: A total of 181 patients were enrolled, with 9 lost to follow-up. After implementation of the discharge planning protocol, a statistically significant improvement in patients' understanding was found in study subjects' knowledge of their diagnosis, the adverse effects of their medications, whom to call after discharge, and follow-up appointments. CONCLUSIONS: Institution of a standardized patient-centered discharge planning protocol can improve patients' understanding of several key components of their discharge process, which may lead to improved compliance with instructions and outcomes.
Assuntos
Alta do Paciente/normas , Assistência Centrada no Paciente/normas , Serviço Hospitalar de Emergência , Hospitais Comunitários/normas , Hospitais de Ensino , Humanos , Medicina Interna/educação , Entrevistas como Assunto , Estudos ProspectivosAssuntos
Comportamento Infantil/psicologia , Transtornos Globais do Desenvolvimento Infantil/psicologia , Transtornos Globais do Desenvolvimento Infantil/terapia , Terapia Assistida por Cavalos/métodos , Transtornos das Habilidades Motoras/terapia , Transtornos de Sensação/terapia , Animais , Feminino , Humanos , MasculinoAssuntos
Hipertermia Induzida , Osteoartrite/terapia , Manejo da Dor , Fitoterapia , Poaceae , Feminino , Humanos , MasculinoRESUMO
OBJECTIVES: To investigate the immediate effects of 10 minutes of hippotherapy, compared with 10 minutes of barrel-sitting, on symmetry of adductor muscle activity during walking in children with cerebral palsy (CP) (phase I). To investigate the long-term effects of 12 weeks of hippotherapy on adductor activity, gross motor function, and self-concept (phase II). DESIGN: Pretest/posttest randomized controlled trial plus clinical follow-up. SETTING: Outpatient therapy center. PARTICIPANTS: Children with spastic CP (phase I: n=47; phase II: n=6). INTERVENTIONS: Phase I: 10 minutes of hippotherapy or 10 minutes of barrel-sitting; phase II: 12 weekly hippotherapy sessions. MAIN OUTCOME MEASURES: Phases I and II: adductor muscle activity measured by surface electromyography. Phase II: gross motor function and self-perception profiles. RESULTS: Phase I: hippotherapy significantly improved adductor muscle asymmetry (P<.001; d=1.32). Effects of barrel-sitting were not significant (P>.05; d=.10). Phase II: after 12 weeks of hippotherapy, testing in several functional domains showed improvements over baseline that were sustained for 12 weeks posttreatment. CONCLUSIONS: Hippotherapy can improve adductor muscle symmetry during walking and can also improve other functional motor skills.
Assuntos
Paralisia Cerebral/reabilitação , Técnicas de Exercício e de Movimento/métodos , Cavalos , Movimento , Caminhada , Adolescente , Animais , Paralisia Cerebral/fisiopatologia , Criança , Pré-Escolar , Eletromiografia , Feminino , Humanos , MasculinoAssuntos
Neoplasias da Mama , Vínculo Humano-Animal , Odorantes , Neoplasias da Próstata , Olfato , Animais , Cães , Feminino , Humanos , MasculinoAssuntos
Centros Médicos Acadêmicos/organização & administração , Serviços de Saúde da Criança/organização & administração , Terapias Complementares/organização & administração , Centros Médicos Acadêmicos/economia , Centros Médicos Acadêmicos/normas , Criança , Serviços de Saúde da Criança/economia , Serviços de Saúde da Criança/normas , Relações Comunidade-Instituição , Terapias Complementares/economia , Terapias Complementares/normas , Humanos , Estados UnidosRESUMO
OBJECTIVE: To evaluate the effect of hippotherapy (physical therapy utilizing the movement of a horse) on muscle activity in children with spastic cerebral palsy. DESIGN: Pretest/post-test control group. SETTING/LOCATION: Therapeutic Riding of Tucson (TROT), Tucson, AZ. SUBJECTS: Fifteen (15) children ranging from 4 to 12 years of age diagnosed with spastic cerebral palsy. INTERVENTIONS: Children meeting inclusion criteria were randomized to either 8 minutes of hippotherapy or 8 minutes astride a stationary barrel. OUTCOME MEASURES: Remote surface electromyography (EMG) was used to measure muscle activity of the trunk and upper legs during sitting, standing, and walking tasks before and after each intervention. RESULTS: After hippotherapy, significant improvement in symmetry of muscle activity was noted in those muscle groups displaying the highest asymmetry prior to hippotherapy. No significant change was noted after sitting astride a barrel. CONCLUSIONS: Eight minutes of hippotherapy, but not stationary sitting astride a barrel, resulted in improved symmetry in muscle activity in children with spastic cerebral palsy. These results suggest that the movement of the horse rather than passive stretching accounts for the measured improvements.