A postal questionnaire was carried out in 1984 to determine the career pattern of United Kingdom women medical graduates of 1974. The response rate was 57%. The median age was 33 and 82% were married. Eighty-nine per cent were employed in a vast range of specialties; most of those not working at the time of the survey planned to return to work within 6 months. Many expressed a need for more career advice at all stages, and for more training in the community-based specialties.
A prospective study of morbidity among 55 lower limb amputees was carried out by multiprofessional teams in two rehabilitation units in Lothian. The aim of treatment was the restoration of independence rather than concentration solely on walking training, although this was important in that 90% of patients were fitted with a temporary artificial limb. The problems and progress of these patients varied, but 90% returned successfully to the community where they made moderate demands on community services. Important differences in professional assessment were noted. The physiotherapists judged that 73% of the patients studied were mobile without help prior to discharge, whereas nurses placed only 46% of the same group at this level of independence. The occupational therapist assessed more of the patients (68%) as fully independent in selfcare than the nurses (44%). This difference between what the patient can do when assessed in therapy and what he actually does when observed in the ward was resolved in case conferences.
In 1984 two parallel arms of a rehabilitation service for elderly people were established using the resources of two geriatric wards and an adjacent rehabilitation centre. In the first four years 143 patients (median age 74) whose ultimate outcome for resettlement in the community was doubtful were managed jointly by the geriatric and rehabilitation services and were given a fully integrated programme of intensive rehabilitation in the rehabilitation centre (rehabilitation group). The majority of this group had suffered a cerebrovascular accident. A more frail group of 328 patients (median age 81) with various diagnoses received physiotherapy and occupational therapy in the ward setting (ward group). By the end of the first four years 63% of the rehabilitation group and 48% of the ward group had been discharged to the community. Only 3% of the former and 4% of the latter required long-term hospital care. Median attendance at the rehabilitation centre was 10 weeks and the median total inpatient stay for the rehabilitation group was 13 weeks, compared with seven weeks for the ward group.
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