scholarly journals A Client Oriented Scale of Improvement in Tinnitus for Therapy Goal Planning and Assessing Outcomes

2019 ◽  
Vol 30 (04) ◽  
pp. 327-337 ◽  
Author(s):  
Grant D. Searchfield
Keyword(s):  
Convergent Validity ◽  
Treatment Success ◽  
Specific Treatment ◽  
Treatment Goals ◽  
Retrospective Evaluation ◽  
Functional Index ◽  
Tinnitus Treatment ◽  
The University ◽  
Goal Planning ◽  
Audiologic Rehabilitation

AbstractThere is a need to develop methods to help clinicians work with clients to select and personalize tinnitus therapies. The use of validated measures to determine treatment success is also essential for research and clinical practice. A goal planning method widely used in audiologic rehabilitation is the client oriented scale of improvement (COSI). A modified version of the COSI has been used to identify tinnitus treatment goals and outcomes (client oriented scale of improvement in tinnitus [COSIT]).The aims of this study were to identify treatment goals in a clinic sample and ascertain the convergent validity of the COSIT to three widely used standardized questionnaires.A retrospective evaluation of client treatment goals using thematic analysis and correlational analysis of secondary research data comparing the COSIT to tinnitus handicap questionnaire (THQ), tinnitus handicap inventory (THI), and tinnitus functional index (TFI).One hundred and twenty-two adult patients and research participants attending the University of Auckland Hearing and Tinnitus Clinic.Specific treatment goals were categorized into 11 themes. The most common treatment goals (>10% of responses) were: (1) Reducing tinnitus’ effects on Hearing. (2) Improved wellbeing and being less depressed. (3) Coping with or controlling the tinnitus. (4) Managing the effect of the environment (context) on tinnitus. (5) Improving sleep. (6) Understanding tinnitus. Individuals differed in their complaints and priorities for treatment. The COSIT showed moderate convergent validity with the THQ, THI, and TFI indicating that the total scores measured similar constructs.The COSIT is a pragmatic method for determining tinnitus treatment goals and priorities in a format that should be familiar to audiologists.

CURE OF THREE PATIENTS WHO HAD SKELETAL METASTASES IN DISSEMINATED NEUROBLASTOMA

PEDIATRICS ◽  
1968 ◽  
Vol 41 (1) ◽  
pp. 47-51
Author(s):  
Douglas Reilly ◽  
Mark E. Nesbit ◽  
William Krivit
Keyword(s):  
Overall Survival ◽  
Survival Data ◽  
Specific Treatment ◽  
Skeletal Metastases ◽  
University Of Minnesota ◽  
Term Survival ◽  
Long Term Survival ◽  
Skeletal Involvement ◽  
The University

The long-term survival of three children with disseminated skeletal metastases due to neuroblastoma is reported. These three patients are added to eight other patients reported in the literature who have survived longer than 2 years after the development of their metastatic osseous lesions. A review of the cases did not reveal a specific treatment regime which provided the success in these cases. The presence of skeletal involvement, therefore, should not indicate a hopeless prognosis. A review of 33 patients with neuroblastoma at the University of Minnesota from 1956-1966 is also given to provide overall survival data.

Goals of care and treatment in terminal delirium: A qualitative study of the views and experiences of healthcare professionals caring for patients with cancer

2018 ◽  
Vol 17 (04) ◽  
pp. 403-408
Author(s):  
Megumi Uchida ◽  
Tatsuya Morita ◽  
Yoshinori Ito ◽  
Kazuko Koga ◽  
Tatsuo Akechi
Keyword(s):  
Healthcare Workers ◽  
Healthcare Professionals ◽  
Specific Treatment ◽  
Clinical Psychologist ◽  
Treatment Goals ◽  
Goals Of Care ◽  
Symptom Alleviation ◽  
Qualitative Interview Study ◽  
Care And Treatment ◽  
Views Of Healthcare Professionals

AbstractObjectiveThis study explores the views of healthcare professionals regarding care and treatment goals in irreversible terminal delirium and their effect on patients and caregivers.MethodWe conducted a qualitative interview study of healthcare professionals (palliative care physician, oncologist, psycho-oncologist, and clinical psychologist) engaged in the treatment of terminally ill cancer patients. We assessed the views of healthcare workers regarding treatment goals in terminal delirium and their effect on patients and their families.ResultOf the 21 eligible healthcare professionals, 20 agreed to participate in this study. Three of the professionals had experience with treating terminal delirium as family caregivers. We identified five important aspects of treatment goals in terminal delirium based on the views of healthcare professionals: (1) adequate management of symptoms/distress, (2) ability to communicate, (3) continuity of self, (4) provision of care and support to families, and (5) considering a balance (between symptom alleviation and maintaining communication; between symptom alleviation and family preparations for the death of patients; balance between specific treatment goals for delirium and general treatment goals).Significance of resultsAccording to the views of healthcare workers questioned in this study, goals of care and treatment in terminal delirium are multidimensional and extend beyond simply controlling patient symptoms.

Adherence and Efficacy of Olfactory Training as a Treatment for Persistent Olfactory Loss

2019 ◽  
Vol 34 (2) ◽  
pp. 238-248 ◽  
Author(s):  
Marco Aurélio Fornazieri ◽  
Ellen Cristine Duarte Garcia ◽  
Natália Medeiros Dias Lopes ◽  
Isabela Naomi Iha Miyazawa ◽  
Gislene dos Santos Silva ◽  
...  
Keyword(s):  
Treatment Success ◽  
Olfactory Function ◽  
University Of Pennsylvania ◽  
Adherence Rate ◽  
Olfactory Loss ◽  
Emerging Therapies ◽  
Spontaneous Improvement ◽  
Clinically Significant ◽  
The University ◽  
Olfactory Training

Background Among emerging therapies, olfactory training (OT) has been proposed as a potential treatment for persistent olfactory loss. This treatment has been suggested to improve olfactory function via sensorineural modulation from repeated odor exposure. However, due to the long treatment period that is required, many patients discontinue the treatment or do not follow the treatment regimen appropriately, potentially biasing estimates of treatment success. Moreover, spontaneous improvement is known to occur without any interventions. Objectives We evaluated both the adherence rates and the efficacy of OT in patients with persistent postinfectious, posttraumatic, or idiopathic olfactory loss. Methods Prospective observational study. Twenty-five patients with persistent olfactory loss underwent OT. Protocol adherence and olfactory function (scores on the University of Pennsylvania Smell Identification Test or UPSIT) were assessed 3 and 6 months after the initiation of treatment. A minimum improvement of 5 UPSIT points was considered clinically significant and adherence throughout the study. Results The adherence rate of the patients after 3 months was 88% and after 6 months was 56%. The corresponding percentages of clinical improvement were 23.5% and 25%. There was no relation of age, sex, time of olfactory loss, race, the degree of olfactory loss, etiology, education, and type of training to the adherence rate or treatment efficacy. Conclusions In this patient population, adherence to training remained high in the first 3 months of OT but declined moderately thereafter. The observed prevalence and degree of improvement were similar to that reported a number of studies, including some studies whose patients did not receive OT.

Convergent Validity of the Depression-Happiness Scale with Measures of Happiness and Satisfaction with Life

1995 ◽  
Vol 76 (3) ◽  
pp. 876-878 ◽  
Author(s):  
Christopher Alan Lewis ◽  
Stephen Joseph
Keyword(s):  
Undergraduate Students ◽  
Convergent Validity ◽  
Satisfaction With Life ◽  
The Other ◽  
Internal Reliability ◽  
The University

The aim of the present paper was to investigate the internal reliability and convergent validity of the McGreal and Joseph (1993) Depression-Happiness Scale with measures of happiness and satisfaction with life. Subjects were 63 undergraduate students attending the University of Ulster. Internal reliability of the scale was .91, and higher scores on the scale were associated with scores on the other measures indicating greater happiness and satisfaction with life.

Feline cryptococcosis: a retrospective evaluation

1997 ◽  
Vol 33 (2) ◽  
pp. 118-122 ◽  
Author(s):  
S Gerds-Grogan ◽  
B Dayrell-Hart
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Cryptococcus Neoformans ◽  
Clinical Pathology ◽  
Fungal Disease ◽  
University Of Pennsylvania ◽  
Retrospective Evaluation ◽  
Cns Involvement ◽  
The University ◽  
Veterinary Hospital

Cryptococcus neoformans causes the most common form of feline systemic fungal disease. Nineteen cats with cryptococcosis were seen at the Veterinary Hospital of the University of Pennsylvania between April 1986 and May 1995. Compared to other studies, these 19 cases showed increased neurological and ophthalmological involvement. Males were affected more often than females. Season and environment appeared to influence time of onset or presentation to the hospital. Clinical pathology did not show typical changes. It is possible that the organism was present frequently in the urine but was mistaken for fat droplets. Treatment with ketoconazole was unrewarding in cases with central nervous system (CNS) involvement.

Expectations for Tinnitus Treatment and Outcomes: A Survey Study of Audiologists and Patients

2018 ◽  
Vol 29 (04) ◽  
pp. 313-336 ◽  
Author(s):  
Fatima T. Husain ◽  
Phillip E. Gander ◽  
Jaclyn N. Jansen ◽  
Sa Shen
Keyword(s):  
Patient Satisfaction ◽  
Treatment Options ◽  
Treatment Success ◽  
Survey Study ◽  
Hierarchical Regression ◽  
Current State ◽  
Tinnitus Treatment ◽  
Definition Of ◽  
Improve Patient ◽  
Scale Format

AbstractRoughly 10–15% of the general population is affected by tinnitus and this percentage is estimated to rise in future. Because there is currently no cure for tinnitus, treatment is limited and is primarily achieved through management of symptoms and counseling.This study compared audiologists’ and patients’ responses to related survey questions about their expectations regarding tinnitus treatment. Two separate surveys were created, one for patients with tinnitus, and one for practicing audiologists who may treat such patients. The surveys included several related questions, such that comparison of the two could reveal where patients’ and audiologists’ expectations for tinnitus care were in agreement and areas in which they differed.The surveys for audiologists and adults with tinnitus were 31- and 38-item questionnaires, respectively. Both surveys comprised demographic questions followed by several tinnitus-related questions in either multiple-choice or Likert-scale format.We received 230 completed Patient Surveys and 68 completed Audiologist Surveys.All survey recruitment was completed online. Responses were collected via the Survey Monkey web tool (http://www.surveymonkey.com/). Responses were analyzed within and between surveys and grouped into topical categories (assessment, counseling, current available tinnitus information, satisfaction and expectations, improving tinnitus management). For data within each survey, descriptive statistics and correlation analyses were used. For selected comparisons between surveys, cross-tabulations were used. Hierarchical regression modeling was conducted to further explore (1) the perceived effectiveness of treatment received, and (2) how each group defined treatment success.Differences were noted between the two groups’ responses to the question on the definition of treatment success; audiologists reported decreased awareness (77%), stress/anxiety relief (63%), and increased knowledge of tinnitus (63%) most commonly, whereas patients reported reduction of tinnitus loudness (63%) and complete elimination of tinnitus (57%) most often. The topic of greatest agreement was the desire for more information on tinnitus; 62% of patients felt more information from their healthcare provider would be the most important factor for improved tinnitus management, and 67% of audiologists reported currently having “some access” or less to appropriate resources for tinnitus treatment. Modeling results for effective tinnitus management and definitions of treatment success highlighted the importance of resource access and information sharing for both audiologists and patients.Patients and audiologists differed in terms of their expectations for successful treatment, with the patients focusing on perceptual factors and the audiologists on the reaction to the sound. Patient satisfaction with tinnitus treatment may be improved through access to more information, specifically, more information about current tinnitus treatment options and how these focus on the patient’s reaction to the tinnitus rather than the percept itself. Providing credible tinnitus information resources to audiologists, and focusing resources on training a small number of tinnitus specialist audiologists could greatly improve patient satisfaction with the current state of tinnitus palliative care.

Measuring Clinician–Client Relationships in Speech-Language Treatment for School-Age Children

2017 ◽  
Vol 26 (1) ◽  
pp. 146-152 ◽  
Author(s):  
Kerry Danahy Ebert
Keyword(s):  
Convergent Validity ◽  
Treatment Success ◽  
Reliability And Validity ◽  
School Age Children ◽  
School Age ◽  
Speech Language Pathology ◽  
Treatment Progress ◽  
Client Relationships ◽  
Client Relationship ◽  
Language Pathology

Purpose Clinician–client relationships may influence treatment success in speech-language pathology, but there are no established tools for measuring these relationships. This study describes the development and application of a set of scales for assessing clinician–client relationships in children's speech-language treatment. Method Twenty-two triads of participants completed a longitudinal study. Each triad had 1 school-age child enrolled in speech-language treatment, 1 caregiver, and 1 speech-language pathologist (SLP). The clinician–client relationship scales were administered to all 3 types of participants at study onset and again 2 weeks later. Treatment progress measures were collected 4 months later. Analyses established the reliability and validity of the clinician–client relationship scales. Results Adequate internal consistency reliability and test–retest reliability were established for all 3 versions of the scale (child, caregiver, and SLP). Convergent validity was moderate between SLPs and children but lower when caregivers were included. Predictive validity analyses established significant relationships between caregiver and SLP ratings of the clinician–client relationship and future treatment progress. Conclusions This exploratory study established the viability of the clinician–client relationship scales for further development and application. The importance of establishing and utilizing measures of the clinician–client relationship in speech-language pathology is discussed.

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