Can The Drinking Problem Index Provide Valuable Therapeutic Information For Recovering Alcoholic Adults?
age; early-onset; elderly people; epidemiology; Geriatrics & Gerontology; men; nonproblem; older persons; prevalence; problem drinkers; psychiatric-disorders; Psychiatry
This study investigated the use of the Drinking Problems Index (DPI; Finney et al., 1991) with middle-aged and older adults in treatment for alcohol abuse. Created to screen for middle-aged and older problem drinkers in the community, the DPI is a 17-item inventory assessing the frequency of alcohol-related problems. Our interest was to explore a new purpose for this tool: that of identifying adverse consequences from drinking which can be targeted in treatment planning for this group. Seventy-one participants with a primary diagnosis of alcohol dependence were individually administered the DPI along with additional measures of psychosocial functioning. As predicted, our recovering alcoholic adults did endorse a similar pattern of adverse consequences as compared to the normative group, but at notably higher frequencies. Further, the older adult sub-group endorsed fewer total items on the DPI relative to our middle-aged sub-group, with a differential pattern of frequent items evident. Significant relationships were observed between the DPI and age, education, psychological distress, history of prior drug use and number of prior treatments for alcohol use. Hierarchical multiple regression analysis revealed age, psychological distress and time in treatment significantly accounted for 51% of the variance in DPI scores, with emotional distress and younger age contributing sizeable unique variance over and above the other examined predictors. The findings suggest that the DPI may be useful not only in classifying older problem drinkers, but also as a means to suggest possible avenues for individualized therapeutic interventions.
Kopera-Frye K; Wiscott R; Sterns H L
Aging & Mental Health
1999
1999-08
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1080/13607869956217" target="_blank" rel="noreferrer noopener">10.1080/13607869956217</a>
RESIDENT TRAINING IN NURSING-HOME CARE - SURVEY OF SUCCESSFUL EDUCATIONAL-STRATEGIES
experience; physicians; Geriatrics & Gerontology; programs; internal-medicine; geriatric-medicine; older persons
OBJECTIVE: To identify educational strategies for resident training in nursing home care deemed successful by a large number of programs. DESIGN: A mail survey with three follow-up mailings. PARTICIPANTS: Directors of accredited internal medicine and family practice residency programs. MEASUREMENTS: Open- and closed-ended questionnaire eliciting curricular content, instructional strategies, and evaluation techniques from programs offering a nursing home experience. Identification of barriers to implementation of a nursing home curriculum and recommendations for success were requested. MAIN RESULTS: Of the 814 surveys mailed, 537 were returned for a response rate of 66%. Nursing home experiences were required in 86% of family practice residency programs but in only 25% of internal medicine programs. Most geriatric medicine curricular content areas were taught in the nursing home; however, relatively little emphasis was given to rehabilitation, organization, and financing of health care, and coordination of care between acute and chronic settings. Direct patient care, bedside rounds, and lectures were the most common instructional strategies reported. Evaluation approaches included faculty observations, resident attendance, and chart reviews with written and skill based examinations infrequent. Availability of faculty and conflict with other rotations were identified as the principal barriers to implementation of nursing home rotations. An organized nursing home curriculum supervised by enthusiastic faculty using a longitudinal rotation format with resident involvement in an interdisciplinary team was recommended. CONCLUSIONS: Educational strategies exist for successful implementation of a residency nursing home curriculum. Greater priority must be given to training residents in nursing home care and developing nursing home faculty to substantially increase the number and quality of physicians who practice in this setting.
Counsell S R; Katz P R; Karuza J; Sullivan G M
Journal of the American Geriatrics Society
1994
1994-11
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1111/j.1532-5415.1994.tb06988.x" target="_blank" rel="noreferrer noopener">10.1111/j.1532-5415.1994.tb06988.x</a>