The family health maintenance demonstration : a controlled long term investigation of family health. Proceedings of a round table at the 1953 Annual Conference of the Milbank Memorial Fund.

  • Milbank Memorial Fund.
Date:
1954
Catalogue details

Licence: Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)

Credit: The family health maintenance demonstration : a controlled long term investigation of family health. Proceedings of a round table at the 1953 Annual Conference of the Milbank Memorial Fund. Source: Wellcome Collection.

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    cepted as equally reliable. Another source of error to be consid ered is the possibility that standards for the four points on the scor ing scale may be unconsciously changed during the four or five year course of the program. Although criteria are given for each score for each item, the rater’s judgment as to whether those criteria are met in any given case might be somewhat different at the end of the Demonstration than at the beginning. The existence of bias in the ratings cannot be discounted since, if a patient has been under treatment or, on the other hand, has refused therapy, that may in fluence the score however much the rater may strive for objectivity. Although the need for the Individual Evaluation Summary was recognized at the beginning of the program and a tentative form established, it took longer than anticipated to evolve an acceptable version. During this process of revision, Summaries for many fami lies were not filled out at the conclusion of the intake process and a large backlog of uncompleted Summaries accumulated that was only recently eliminated. As a result of this delay, the initial rat ings for some individuals were not made until they had been on the program for over a year, and, although by reference to the records the team members attempted to rate each person as to his status on entrance, they do not feel that they were entirely successful. Thus the Summaries on a portion of the population cannot be consid ered as evaluating their condition on entrance as well as is being done for the families coming into the study more recently. Despite these limitations it is believed that the Summary is an approach to the problem of securing an estimate of changes in emo tional health which is worth trying, and unless the criticisms stated turn out to be more serious than anticipated, these ratings should afford a measure, however crude, of such change among the Dem onstration families. These, then, are the records which we consider of primary impor tance in evaluating changes in the health of members of the study. However, there are several other sources of information which are expected to be of use in more intensive analysis of certain portions of the program. One such source is the nutrition schedule which is filled out by the housewife following instructions by the nurse.