Thesis--Wisconsin. / Vita. Includes bibliographical references (leaves 332-363).

Thesis--Ohio State University. / Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (Ph. D.)--University of Chicago, the School of Social Service Administration, August 1999. / Includes bibliographical references. Also available on the Internet.

Class of 2005 Abstract / Objectives: To describe the dosing of atypical antipsychotics among outpatients diagnosed with schizophrenia at a community mental health center in Tucson, AZ, and to contrast this to dosing recommendations set by the manufacturer during clinical trials. Methods: A prescription database from January 01, 2004 to July 31, 2004 was used to evaluate the dosing of atypical antipsychotics (Abilify®, Clozaril®, Geodon®, Seroquel®, and Zyprexa®) in patients with schizophrenia. The average daily doses were evaluated for differences from recommended dosing using the physician desk reference. Differences in dosing were also analyzed for gender and monotherapy vs. patients taking multiple atypical antipsychotics. Results: Overall differences in dosing when comparing gender and monotherapy vs. patients on multiple atypicals were not significant for all five atypical antipsychotics studied. Overall, Geodon® had the highest percentage (51.9%) of patients above recommended guidelines while Clozaril® and Seroquel® had the highest percentage (70.6% and 47.4% respectively) below recommended guidelines. Implications: This study illustrates that dosing of these atypical antipsychotics at this outpatient community mental health center differs for many patients with schizophrenia from the guidelines set by the companies during clinical trials. This information will aid in the prescribing of physicians at this community mental health center and will possibly lead to larger studies to further look at reasons for these differences in dosing.

At the present time there is very little informational data available relating to the adult psychiatric day treatment centers in the province of British Columbia. In recent years the trend in psychiatric care has been to treat people within their family and community setting. Within the past five years, four new day care centers have been established at various hospitals throughout the province of British Columbia. The purpose of this descriptive survey was to provide a composite picture of the currently functioning adult psychiatric day care centers. A total of five official and two unofficial day care programs were surveyed and 290 patient records were examined. The specific areas of interest in day care functioning centered around; the family and community involvement in the treatment program, the types of treatment that were used, the type of role the staff carried out, the total program evaluation and a profile of the patients who were treated by this modality. To collect the data, the researcher used; a questionnaire which was answered in a taped interview, observational visits to each center, and an examination of the patients' records. The results of the questionnaire indicated that family involvement in the total day program was generally limited, group methods of treatment were used which gave the patients a sense of community, and patients were followed-up either by the day care center or by the referral source. Referral of patients to these centers were mainly from in-patient wards, other psychiatrists and psychiatric clinics. The criteria that was used to terminate a patient's treatment was on the basis of his actual performance in the program and his level of functioning at home and in the community. This was also the prevalent method used to evaluate the effectiveness of the total treatment program. Staff in these day care centers were both permanent and rotating with their role function being both specific and generalized. An examination of the patients' records revealed that the average patient was 33 years old, generally female, single, diagnosed as being depressed, above Grade 11 in education and presently unemployed. Seventy-seven per cent of the patients had previously received psychiatric treatment and the length of stay in the treatment program was 54 days. Findings from this study indicated that a wide variety of patients were treated in day care, which, had these centers not been available, would have been admitted to an in-patient ward. Day care is not only an alternative to hospitalization, but it may be the choice method of treatment for many patients. / Applied Science, Faculty of / Nursing, School of / Graduate

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This thesis examines the effects of community mental health care on the quality of life of mental health service users in Britain - especially Scotland - and Germany. The analysis is based on current developments in community care policy and practice in the countries of comparison and the perspective of mental health service users in relation to this. The research strategies adopted include qualitative and quantitative methods, in particular a questionnaire survey among mental health service users in Scotland and in Germany. The examination of outcomes in community care with a specific focus on the concept 'quality of life' shows that quality of life is useful as an outcome measure for the comparative evaluation of community care from a user perspective. The study develops a model of quality of life which highlights significant components of community care identified as health, housing, employment, finances, support and social contacts. The examination of some of the foundations of health care and social care in Britain and in Germany, and the comparison of specific mental health care policies and legislation emphasise distinct national characteristics and fundamental differences concerning themes and issues in mental health care. Most significantly, the analysis shows a different national emphasis on major policy objectives and concepts such as quality of life or on the role of the service user. Furthermore, the examination of significant components of community care shows how different national policies can affect support options and general availability in community mental health care. The analysis of the views of mental health service users indicates that their quality of life is directly affected by specific national developments and different national approaches in mental health care. This concerns the availability (or absence) of different support options, but also the role of service users as participants in service provision (Scotland) or rather as recipients of service provision (Germany). The comparison of different national support options and the analysis of user views in relation to this highlights specifically positive and negative effects on the quality of life of mental health service users. Most appreciated by service users are support options that provide opportunity for choice, independence, personal autonomy and fulfilment. The study shows that community based service provision and especially professional support is extremely important to mental health service users and has a direct and vital impact on their quality of life.

Thesis (M.S.W.)--University of Hong Kong, 1985.