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51.
Wenbo Wu PhD Kaes J. Holkeboer Temidun O. Kolawole Lorrie Carbone LMSW Elham Mahmoudi PhD 《Health services research》2023,58(6):1292-1302
Objective
To develop a natural language processing (NLP) algorithm that identifies social determinants of health (SDoH), including housing, transportation, food, and medication insecurities, social isolation, abuse, neglect, or exploitation, and financial difficulties for patients with Alzheimer's disease and related dementias (ADRD) from unstructured electronic health records (EHRs).Data Sources and Study Setting
We leveraged 1000 medical notes randomly selected from 7401 emergency department and inpatient social worker notes generated between 2015 and 2019 for 231 unique patients diagnosed with ADRD at Michigan Medicine.Study Design
We developed a rule-based NLP algorithm for the identification of seven domains of SDoH noted above. We also compared the rule-based algorithm with deep learning and regularized logistic regression approaches. These models were compared using accuracy, sensitivity, specificity, F1 score, and the area under the receiver operating characteristic curve (AUC). All notes were split into 700 notes for training NLP algorithms, and 300 notes for validation.Data Collection/Extraction Methods
Social worker notes used in this study were extracted from the Michigan Medicine EHR database.Principal Findings
Of the 700 notes for training, F1 and AUC for the rule-based algorithm were at least 0.94 and 0.95, respectively, for all SDoH categories. Of the 300 notes for validation, F1 and AUC were at least 0.80 and 0.97, respectively, for all SDoH except housing and medication insecurities. The deep learning and regularized logistic regression algorithms had unsatisfactory performance.Conclusions
The rule-based algorithm can accurately extract SDoH information in all seven domains of SDoH except housing and medication insecurities. Findings from the algorithm can be used by clinicians and social workers to proactively address social needs of patients with ADRD and other vulnerable patient populations. 相似文献52.
Timothy W. Farrell MD AGSF William W. Hung MD MPH Kathleen T. Unroe MD MHA AGSF Teneille R. Brown JD Christian D. Furman MD MSPH AGSF Jane Jih MD MPH MAS Reena Karani MD MHPE Paul Mulhausen MD MHS Anna María Nápoles PhD MPH Joseph O. Nnodim MD PhD FACP AGSF Gina Upchurch RPh MPH Chanel F. Whittaker PharmD BCGP FASCP Anna Kim LMSW Nancy E. Lundebjerg MPA Ramona L. Rhodes MD MPH MSCS AGSF 《Journal of the American Geriatrics Society》2022,70(12):C1-C1
The American Geriatrics Society (AGS) has consistently advocated for a healthcare system that meets the needs of older adults, including addressing impacts of ageism in healthcare. The intersection of structural racism and ageism compounds the disadvantage experienced by historically marginalized communities. Structural racism and ageism have long been ingrained in all aspects of US society, including healthcare. This intersection exacerbates disparities in social determinants of health, including poor access to healthcare and poor outcomes. These deeply rooted societal injustices have been brought to the forefront of the collective public consciousness at different points throughout history. The COVID-19 pandemic laid bare and exacerbated existing inequities inflicted on historically marginalized communities. Ageist rhetoric and policies during the COVID-19 pandemic further marginalized older adults. Although the detrimental impact of structural racism on health has been well-documented in the literature, generative research on the intersection of structural racism and ageism is limited. The AGS is working to identify and dismantle the healthcare structures that create and perpetuate these combined injustices and, in so doing, create a more just US healthcare system. This paper is intended to provide an overview of important frameworks and guide future efforts to both identify and eliminate bias within healthcare delivery systems and health professions training with a particular focus on the intersection of structural racism and ageism. 相似文献
53.
Associations between nursing home performance and hospital 30‐day readmissions for acute myocardial infarction,heart failure and pneumonia at the healthcare community level in the United States 下载免费PDF全文
Michelle M. Pandolfi LMSW MBA LNHA Yun Wang PhD Ann Spenard RN‐BC MSN Florence Johnson RN MSN MHA Alice Bonner PhD RN FAAN Shih‐Yieh Ho PhD MPH Timothy Elwell MBA PhD Anila Bakullari BS Deron Galusha MS Erica Leifheit‐Limson PhD Judith H. Lichtman PhD MPH Harlan M. Krumholz MD SM 《International journal of older people nursing》2017,12(4)
54.
Sheila Weiner MSW LCSW LMSW Nancy G. Kutner PhD Tess Bowles Med Stephanie Johnstone LCSW 《Social work in health care》2013,52(6):513-525
Twenty-two social workers implemented a cognitive-behavioral intervention with 69 patients in 22 dialysis units in Louisiana to improve psychosocial health following Hurricanes Katrina and Rita. Pre- and post-intervention questionnaires measured psychosocial status domains (general health status, social functioning, burden of kidney disease, depressed mood, anxiety, and mastery). Participants rated their general health status (p < .05) and social functioning (p < .05) significantly higher after the intervention. Participants who listened to the class Managing stress through communication and problem solving and discussed it with their social worker, had significant improvement in depressed mood score (p < .05) after completing the program, compared to participants who did not discuss this material with their social worker. Sixty-five percent had scores indicating depressed mood before the program, compared with 56% following. The more positive participants' program evaluation, the higher their quality of life (lower perceived burden of kidney disease [p = .05]). 相似文献
55.
Deborah Waldrop LMSW PhD Abbie M. Kirkendall LMSW PhD 《Social work in health care》2013,52(3):263-289
Most older adults with advanced illnesses express the wish to die at home. Home-based care from home health and hospice agencies makes this possible, but there are great geographic variations in utilization. Interviews and focus groups with key constituents in home health and hospice agencies across the 8-county region of Western New York State were used to explore how rural–urban location and agency type (home health or hospice) influence variations in end-of-life care. Emergent themes were: Rural-Urban Differences (geographic challenges, market forces, and programming issues) and End-of-life Care Issues (macrosocial, mezzosocial, and microsocial factors). Implications for social work practice are discussed. 相似文献
56.
This article presents a case study of one family affected by a cancer diagnosis in both the father and the daughter, who were diagnosed within the same time interval and who underwent treatment at the same time. The article examines the relationship between the caregivers and the oncology patient as well as with one another when the stress of diagnosis is compounded by multiple, simultaneous, and similar diagnoses in a highly condensed period of time. A thorough examination of the literature reveals that there are significant gaps regarding how multiple cancer diagnoses in one family affect the family dynamic, individual and collective coping styles, and caregiver burden. The diagnoses can also dramatically exacerbate economic stressors in a family. The coordination of psychosocial care from the perspectives of the adult and pediatric oncology social workers at an urban academic medical center will be discussed. The social work role, importance of collaboration, and family centered care perspective will be discussed as a method of easing the treatment experience for families in psychosocial distress. 相似文献
57.
Barbara Hackley CNM MSN Chanchal Sharma PsyD Angela Kedzior MD Shared Sreenivasan LMSW 《Journal of Midwifery & Women's Health》2010,55(1):9-19
Depression is one of the most commonly encountered conditions in women's health, but many providers lack the knowledge and skills needed to identify and manage depression in primary care settings. This article discusses strategies that can improve the identification and treatment of depression. In addition, it describes how these strategies were incorporated into an urban inner‐city health center. These strategies used in this setting can be adapted for use in either comprehensive health care centers or in practices providing primarily obstetric and gynecologic services. 相似文献
58.
Janice Firn PhD LMSW Keli DeVries LMSW Dawnielle Morano LMSW Toni Spano-English LMSW 《Social work in health care》2017,56(6):541-555
During inhospital cardiopulmonary resuscitation attempts, a designated family support person (FSP) may provide guidance and support to family members. Research on nurses and chaplains in this role has been published. Social workers also regularly fulfill this service, however, little is known about how they perceive and enact this role. To explore their experiences, qualitative interviews (n = 10) were conducted with FSP social workers. Critical realist thematic analysis identified five themes: walking in cold, promoting family presence, responding to the whole spectrum of grief, going beyond the family support role, and repercussions of bearing witness. Social workers perform a variety of tasks to promote family presence during resuscitation attempts and provide psychosocial support over the continuum of care. The FSP role impacts social workers emotionally and professionally. Implications for hospital policy, staffing, and clinical practice are discussed. 相似文献
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Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent neuropsychiatric disorders of adulthood. Although
clinical guidelines recommend monotherapy with stimulants or atomoxetine, combination pharmacotherapy is a common practice
among clinicians. There are four main situations in which combination medications may be necessary: partial response, dose-limiting
side effects, associated disorders, and comorbid diagnoses. We present data from two chart reviews that support existing research
on combination pharmacotherapy. Adjunct treatment of d-methylphenidate to stimulant medications extended the duration of therapeutic
effect. Adjunct treatment of mirtazapine to stimulant medications reduced associated insomnia. These data support previous
research that validates the use of combination pharmacotherapy for adults with ADHD. 相似文献