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Needs assessment survey of 268 polio survivors explored incidence of postpolio syndrome and perceived need for and access to social and health care services. Large proportion of respondents reported experiencing postpolio syndrome. Most perceived that they had no access to knowledgeable physicians or social and health care services, and most were having difficulty coping. (Author/NB)

A needs assessment survey of 268 polio survivors residing in Maine explored the incidence of postpolio syndrome as well as perceived need for and access to social and health care services. A large proportion reported experiencing postpolio syndrome. Although knowledgeable of their condition, a majority perceived that they had no access to knowledgeable physicians or social and health care services and most were having difficulty coping. Findings indicate that polio survivors' self-appraisal of their illness status is related to their perceived need for and access to social and health care services. The need for community-based services, including medical, rehabilitative, educational, and social work services, is indicated., The success of modern medicine in preventing poliomyelitis has left both health care professionals and polio survivors largely unprepared to respond to late effects of the disease, which are now [...]

A retrospective study of 82 elderly “failure to thrive” (FTT) inpatients suggests that FTT is diagnosed when the elderly patient's functional ability to live with multisystem diseases, cope with the ensuing problems, and manage his/her own care are remarkably diminished and no longer responsive to health care interventions. In an attempt to clarify the clinical picture of FTT, we used standardized questionnaires to abstract data from medical charts. [ABSTRACT FROM PUBLISHER]

Hospital social workers (N = 255) from ten urban teaching hospitals in seven states were surveyed regarding their practice responses and training needs in bioethics. Responses to twenty-one practice situations in bioethics were analyzed in terms of levels of encountering ethical concerns, clinical participation and preparedness to handle ethical concerns. Whereas worker responses were greater in practice situations appearing more psychosocial than biomedical in nature, training needs were greater in those situations appearing more biomedical than psychosocial in nature. Rationing of health care, the number one training need across service specialities, stands out as the practice situation in which ethical concerns were encountered with the least preparation and participation. Prior training in ethical principles and analysis and service on a hospital ethics committee associated significantly with higher levels of worker responses. Implications for social work education and practice in today's health care environment are presented. [ABSTRACT FROM AUTHOR]

This narrative reflects on a paradigm case for understanding how in an era of managed care when values and economics appear so indivisible, one health care team united and provided non-costworthy care to a terminally ill patient who needed to live until the first day of the month. The ethical dilemma of treatment effect vs. treatment benefit in end of life decision making becomes a drama. The article chronicles events leading to the first day of the month and underscore the power of story and metaphor in creating common ground and common understanding in patient care. [ABSTRACT FROM AUTHOR]