Characteristics of elderly nursing home residents: data from the 1995 National Nursing Home Survey

OBJECTIVE

This report presents the sociodemographic characteristics, functional dependencies in the activities of daily living (ADL) and instrumental activities of daily living (IADL), dental status, primary admission diagnosis, types of services used, and source of payment of elderly nursing home residents.

METHODS

The data used for this report are from the National Center for Health Statistics' 1995 National Nursing Home Survey's (NNHS) sample of current residents age 65 years and above. The 1995 NNHS is the fourth annual survey of nursing homes. The first survey was conducted from August 1973 through April 1974, the second was conducted from May through December 1977, and the third was conducted from August 1985 through January 1986. The 1995 NNHS was conducted from July 1995 through December 1995.

RESULTS

The overall results of the survey indicate that elderly nursing home residents were predominantly women, 75 years old and over, white, non-Hispanic, and widowed. A large portion of residents needed assistance in their ADL's and IADL's. A shifting of the primary source of payment to Medicaid occurred among residents who used Medicare as their source of payment at the time of admission.

Characteristics of elderly home health care users: data from the 1994 National Home and Hospice Care Survey

OBJECTIVE

This report presents the demographic characteristics, service utilization, and primary admission diagnosis of elderly current home health care patients and discharges.

METHODS

The data used for this report are from the National Center for Health Statistics' 1994 National Home and Hospice Care Survey's (NHHCS) sample of current patients and discharges age 65 years and over. The 1994 NHHCS is the third annual survey of home health care agencies and hospices and their current patients and discharges.

RESULTS

The overall results of the survey indicate that the elderly in both the current patient and discharge samples were predominantly women, 75-84 years old, white, non-Hispanic, widowed, and lived in a private residence with their family. For both elderly men and women, the most commonly used home health care service was skilled nursing services and the primary admission diagnosis was heart disease.

A Cocaine Negative Consequences Checklist: development and validation

Awareness of negative consequences of cocaine use is theoretically important for motivation for treatment and relapse prevention. This study reports on the development of an instrument designed to assess cocaine users' self-reported negative consequences of cocaine use. Two samples of cocaine users in treatment for substance abuse completed the Cocaine Negative Consequences Checklist (CNCC). The measure, which is unidimensional in nature with four content area subscales that may be scored, was found to possess excellent reliability across the two samples. The convergent and discriminant validity of the CNCC was supported by the pattern of relationships with other measures of cocaine consequences, cocaine use, the Addiction Severity Index, and with demographic measures. Further research is needed on the utility of this measure in treatment and research.

An investigation of self-efficacy, partner support and daily stresses as predictors of relapse to smoking in self-quitters

Six hundred and thirty smokers who intended to quit smoking themselves completed pre-cessation measures of self-efficacy, partner support, daily stresses and demographics. Subjects were contacted at 2, 7, 14, 30, 90 and 180 days post-cessation to determine smoking status and to re-administer the measures at 7, 14 and 30 days post-cessation. A series of logistic regression examined which prospective factors best predicted relapse between 0-2 days, 3-7 days, 8-14 days, 15-30 days, 31-90 days and 91-180 days. Relapse was predicted by different variables at different times; however, self-efficacy was a consistent predictor of relapse over time.

Interrelationship of smoking and alcohol dependence, use and urges to use

OBJECTIVE

The relationship between tobacco dependence and alcohol dependence has received little empirical scrutiny. The present study of alcoholics in treatment for alcoholism investigated pretreatment tobacco and alcohol history and dependence, as well as subjective responsivity to alcohol cues.

METHOD

Eighty-three male alcoholics underwent a questionnaire assessment of smoking and drinking pretreatment followed by a laboratory assessment of reactivity to alcohol cues.

RESULTS

The analyses demonstrate that (1) pretreatment tobacco dependence and pretreatment alcohol dependence are related, (2) alcohol dependence predicts urges to smoke during alcohol treatment, (3) exposure to alcohol cues results in increased urge to smoke, (4) smoking when ill predicts urge to drink during alcohol cue exposure and (5) urge to smoke is positively correlated with urge to drink.

CONCLUSIONS

These data, collected in a population of alcoholics not currently receiving smoking interventions, indicate that smoking may be a factor to address during alcohol treatment. The clinical importance of these data is discussed.

Factors associated with help seeking and perceived dependence among cocaine users

Motivational and decisional models suggest that those who seek help for substance use problems may differ from those who do not seek help in terms of their belief that substance use is creating social and personal negative consequences and their perceived dependence. In this study, help seeking for cocaine use was hypothesized to be a function of the negative consequences from cocaine, perceiving oneself as dependent on cocaine, quantity and frequency of use, cost of use, and route of administration. A sample of 161 substance abusers in treatment who had used any cocaine in the last 6 months completed questionnaires regarding the quantity, frequency, history, and perceptions of the consequences of their cocaine use. Of the 161 subjects, 113 (70.2%) had at some time sought help from someone for their cocaine use. After controlling for marital and employment status, a logistic regression revealed that the number of negative consequences experienced, feeling dependent on cocaine, and the amount of cocaine used were associated with seeking help for cocaine use. Additionally, a logistic regression was performed to determine factors associated with cocaine users' reporting that they feel dependent on cocaine. Significant variables included number of negative consequences experienced and frequency of use. Consistent with motivational and decisional models, results suggest that clients' motivation to seek help for cocaine use is related primarily to adverse consequences of use. Theoretical and clinical implications of results are discussed.

Prognostic value of clinical and radiological status on day 28 of life for subsequent course in very low birthweight (< 1,500g) babies with bronchopulmonary dysplasia

To test the hypothesis that the short-term (approximately 6 months) course of babies with bronchopulmonary dysplasia (BPD) could be predicted from the clinical and radiological status on day 28 of life, we retrospectively examined the medical records of 79 infants born between 1985 and 1988 who required supplemental oxygen and/or ventilatory support on day 28. Chest roentgenographs taken close to day 28 (+/- 7 days) were scored on a scale of 0-10. Four babies died from causes not related to BPD. Four of the remaining 75 died from BPD, and the rest are alive. Forty-six of 71 were weaned from supplementary oxygen by 37 weeks corrected gestational age, and only 13/71 remained on supplemental oxygen after 40 weeks gestational age. To determine which variables contributed most to the outcome, defined as total days on supplemental oxygen, a multiple regression analysis was performed, including only those variables the tolerance of which exceeded 0.7 (sex, FiO2, ventilatory mode, and infectious status). FiO2 and ventilatory mode together predicted 15% of the variability in outcome, so that a high FiO2 and ventilator dependence on day 28 of life were highly correlated with a prolonged need for supplemental oxygen (F = 4.28, P < 0.05).