RESUMO
This health economic evaluation simulated a cohort to compare hydrophilic-coated to non-coated catheters for intermittent catheterization. By using a Markov model, lifetime costs and catheter-related complications were investigated. Results determined that the use of hydrophilic-coated catheters save money and reduce treatment-related complications.
Assuntos
Bacteriemia/epidemiologia , Infecções Relacionadas a Cateter/epidemiologia , Epididimite/epidemiologia , Custos de Cuidados de Saúde , Estreitamento Uretral/epidemiologia , Cálculos da Bexiga Urinária/epidemiologia , Bexiga Urinaria Neurogênica/enfermagem , Cateterismo Urinário/métodos , Cateteres Urinários/economia , Infecções Urinárias/epidemiologia , Adulto , Idoso , Bacteriemia/economia , Infecções Relacionadas a Cateter/economia , Estudos de Coortes , Epididimite/economia , Feminino , Humanos , Masculino , Cadeias de Markov , Pessoa de Meia-Idade , Modelos Econômicos , Autocuidado , Estados Unidos , Estreitamento Uretral/economia , Cálculos da Bexiga Urinária/economia , Cateterismo Urinário/instrumentação , Infecções Urinárias/economia , Adulto JovemRESUMO
Botulinum toxin type A injections represent an important therapeutic option for patients with neurogenic urinary dysfunction in whom conservative treatment has not been effective. The nurse's role in ensuring that these patients receive appropriate assessment and treatment is discussed.
Assuntos
Toxinas Botulínicas Tipo A/uso terapêutico , Fármacos Neuromusculares/uso terapêutico , Bexiga Urinaria Neurogênica/tratamento farmacológico , Bexiga Urinaria Neurogênica/enfermagem , Administração Intravesical , Toxinas Botulínicas Tipo A/economia , Toxinas Botulínicas Tipo A/farmacologia , Custos de Medicamentos , Humanos , Fármacos Neuromusculares/economia , Fármacos Neuromusculares/farmacologia , Papel do Profissional de Enfermagem , Avaliação em Enfermagem , Uso Off-Label , Educação de Pacientes como Assunto , Seleção de Pacientes , Qualidade de Vida , Mecanismo de Reembolso , Resultado do Tratamento , Bexiga Urinaria Neurogênica/etiologiaRESUMO
STUDY DESIGN: Cross-sectional survey. OBJECTIVES: To describe the care received, care needs and preventability of secondary conditions according to persons with long-term spinal cord injury (SCI) living at home. SETTING: The Netherlands. METHODS: A questionnaire was sent to all members of the Dutch SCI Patient Organisation. From a list of 26 SCI secondary conditions, participants chose the five conditions they perceived as most important. For each of these conditions, they described the type of care they received, their need for (extra) care and its preventability. RESULTS: Response rate was 45% (n=453) and mean time after injury was 13.3 years. In case of secondary conditions, participants were more likely to visit their general practitioner (58%) than another medical specialist (29%) or rehabilitation specialist (25%). For all most-important secondary conditions, care was received in 47% and care, or extra care, was needed in 41.3%. Treatment was the type of care most often received (29.5%) and needed (17.2%). However, for information and psychosocial care, the care needed (12.2 and 9.9%, respectively) was higher than the care received (7.6 and 5.9%, respectively). Thirty-four percent of all most-important secondary conditions were perceived as preventable, the rate increasing to 52.8% for pressure sores, of which 29.9% were considered to be preventable by the participants themselves. CONCLUSIONS: This study showed substantial unmet care needs in persons with long-term SCI living at home and underlines the further improvement of long-term care for this group. Information, psychosocial care and self-efficacy seem to be the areas to be enhanced.
Assuntos
Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Serviços de Assistência Domiciliar/estatística & dados numéricos , Qualidade da Assistência à Saúde/estatística & dados numéricos , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/enfermagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Cuidadores/estatística & dados numéricos , Cuidadores/tendências , Estudos Transversais , Feminino , Pesquisas sobre Atenção à Saúde , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/tendências , Necessidades e Demandas de Serviços de Saúde/tendências , Serviços de Assistência Domiciliar/tendências , Humanos , Masculino , Medicina/estatística & dados numéricos , Medicina/tendências , Pessoa de Meia-Idade , Países Baixos , Dor/etiologia , Dor/enfermagem , Dor/psicologia , Satisfação do Paciente/estatística & dados numéricos , Úlcera por Pressão/etiologia , Úlcera por Pressão/enfermagem , Úlcera por Pressão/psicologia , Qualidade da Assistência à Saúde/tendências , Qualidade de Vida/psicologia , Apoio Social , Espasmo/etiologia , Espasmo/enfermagem , Espasmo/psicologia , Traumatismos da Medula Espinal/psicologia , Inquéritos e Questionários , Bexiga Urinaria Neurogênica/etiologia , Bexiga Urinaria Neurogênica/enfermagem , Bexiga Urinaria Neurogênica/psicologia , Adulto JovemRESUMO
OBJECTIVES: To assess the nurses' workload in care of the neurological patients operated in a department of urology and compare it to the nurses' workload of oncological patients. METHOD: Between 2006 and 2007, a prospective study was realized in 15 consecutive patients with neurogenic voiding dysfunction managed by laparoscopic cystectomy and ileal conduit urinary diversion. The nurses' workload was assessed by the soins infirmiers individualisés à la personne soignée (SIIPS) indicator. Three types of care were so estimated: basic care, technical care and relational care. Results were compared with the first 15 patients in whom, during the same period, a laparoscopic cystectomy and ileal conduit urinary diversion was performed to treat a bladder cancer. RESULTS: The nurses' workload in basic care was higher for the neurological patient's compared to the oncological patients the day before the intervention and from the third postoperative day until the 8th postoperative day. The nurses' workload in relational care was higher in the neurological patient's the 2nd, 3rd, 6th and 7th postoperative days. No difference was noted in terms of technical care between both groups. CONCLUSION: Except the operative day and the first postoperative day, the nurses' workload in relational and basic care is higher in the neurological patient's than in the oncological patients. No difference was noted in terms of technical care between both groups.