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1.
Crit Care ; 25(1): 347, 2021 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-34563234

RESUMO

BACKGROUND: Restricted visitation policies in acute care settings because of the COVID-19 pandemic have negative consequences. The objective of this scoping review is to identify impacts of restricted visitation policies in acute care settings, and describe perspectives and mitigation approaches among patients, families, and healthcare professionals. METHODS: We searched Medline, Embase, PsycINFO, Healthstar, CINAHL, Cochrane Central Register of Controlled Trials on January 01/2021, unrestricted, for published primary research records reporting any study design. We included secondary (e.g., reviews) and non-research records (e.g., commentaries), and performed manual searches in web-based resources. We excluded records that did not report primary data. Two reviewers independently abstracted data in duplicate. RESULTS: Of 7810 citations, we included 155 records. Sixty-six records (43%) were primary research; 29 (44%) case reports or case series, and 26 (39%) cohort studies; 21 (14%) were literature reviews and 8 (5%) were expert recommendations; 54 (35%) were commentary, editorial, or opinion pieces. Restricted visitation policies impacted coping and daily function (n = 31, 20%) and mental health outcomes (n = 29, 19%) of patients, families, and healthcare professionals. Participants described a need for coping and support (n = 107, 69%), connection and communication (n = 107, 69%), and awareness of state of well-being (n = 101, 65%). Eighty-seven approaches to mitigate impact of restricted visitation were identified, targeting families (n = 61, 70%), patients (n = 51, 59%), and healthcare professionals (n = 40, 46%). CONCLUSIONS: Patients, families, and healthcare professionals were impacted by restricted visitation polices in acute care settings during COVID-19. The consequences of this approach on patients and families are understudied and warrant evaluation of approaches to mitigate their impact. Future pandemic policy development should include the perspectives of patients, families, and healthcare professionals. TRIAL REGISTRATION: The review was registered on PROSPERO (CRD42020221662) and a protocol peer-reviewed prior to data extraction.


Assuntos
COVID-19/prevenção & controle , Cuidados Críticos , Família , Política de Saúde , Pacientes Internados , Distanciamento Físico , Visitas a Pacientes , COVID-19/psicologia , COVID-19/transmissão , Comunicação , Família/psicologia , Pessoal de Saúde/psicologia , Humanos , Pacientes Internados/psicologia , Serviços de Saúde Mental , Pandemias , Angústia Psicológica , SARS-CoV-2 , Telefone , Visitas a Pacientes/psicologia
2.
Nursing ; 51(8): 62-66, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34347757

RESUMO

PURPOSE: To determine the impact of music on the physiologic and psychological stress experienced by hospital inpatients. METHODS: This pilot study monitored vital signs; utilized pain, anxiety, and agitation rating scales; and gathered verbal feedback from 50 participating inpatients at the authors' healthcare facility as they listened to music via an audiovisual interactive patient engagement technology system. RESULTS: After listening to music for 30 minutes, patients reported significantly lower pain and anxiety. CONCLUSION: Music offered a helpful tool to reduce pain and anxiety for patients in the ICU and telemetry units at the authors' healthcare facility. Future research may be geared toward incremental expansion and monitoring of this music intervention in other units.


Assuntos
Pacientes Internados/psicologia , Musicoterapia , Estresse Fisiológico , Estresse Psicológico/prevenção & controle , Idoso , Ansiedade/enfermagem , Ansiedade/prevenção & controle , Feminino , Unidades Hospitalares , Humanos , Pacientes Internados/estatística & dados numéricos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Dor/enfermagem , Dor/prevenção & controle , Projetos Piloto , Estresse Psicológico/enfermagem , Telemetria , Resultado do Tratamento
3.
Med J Malaysia ; 76(4): 461-465, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34305105

RESUMO

INTRODUCTION: COVID-19 pandemic has a substantial impact on human life including the tourism sector (TS). Bali as a tourism destinations and the TS as major incomes of its population is greatly impacted, causing many to be jobless among those involved in TS. This situation may give psychological impact causing anxiety disorder (AD). OBJECTIVE: To investigate the association between severe anxiety disorder and other factors with COVID-19 disease severity. METHODS: This was cross-sectional study during March - November 2020. The diagnosis of SARS-CoV-2 was done by using RT-PCR from throat swabs, based on WHO's interim guidelines. AD was measured using self-reporting Generalized Anxiety Disorder-7 (GAD-7). All participants underwent, history taking, physical examinations, blood routine examination and chest radiography. Association between severe AD and other factors with COVID-19 disease severity were analyzed. Chi-square test (bivariate) and Logistic regression (multivariate) with the precision value of 95% was done and p-value less than 5% was considered significant. RESULTS: Positive rate of Covid-19 patients was 43% (292 / 678). Among those 292 with Covid-19, 74 (25.3%) participants had severe disease. Multivariate analysis showed severe anxiety (OR 696.11; 95%CI: 78.54 to 6169.98; p<0.001), hypertension (OR 37.02; 95%CI: 4.49 to 305.39; p=0.001) and neutrophyl lymphocyte ratio (NLR) less than 2.89 (OR 0.15; 95%CI: 0.04 to 0.62; p=0.009). CONCLUSION: Severe anxiety, hypertension and NLR less than 2.89 are potential independent risk factors for severe infection of SARS-CoV-2 (COVID-19).


Assuntos
Transtornos de Ansiedade/complicações , COVID-19/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/complicações , COVID-19/patologia , Estudos Transversais , Feminino , Humanos , Indonésia/epidemiologia , Pacientes Internados/psicologia , Pacientes Internados/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença , Adulto Jovem
4.
Psychiatry Res ; 302: 114045, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34126461

RESUMO

OBJECTIVE: People with mental disorders might be differentially affected by the COVID-19 pandemic. The aim of the current study was to evaluate the impact of the pandemic on patients with various psychiatric disorders who were admitted to inpatient treatment. METHODS: Five-hundred thirty-eight inpatients with mental disorders participated in a survey about psychological consequences of the pandemic between March-December 2020. We examined the perceived burden by restrictions and worries, changes in health care utilization, and helpfulness of coping strategies. RESULTS: More than 50% reported any worsening of symptoms, 40% stated increased need of therapeutic support. High rates of symptom deterioration were observed for depressive symptoms (>55%), anxiety (>40%), and sleeping behavior (>40%). Treatment impairment was stated by 27.9%. Patients with anxiety disorders were less affected by contact restrictions compared with eating disorders and depression. Patients with anorexia nervosa and post-traumatic stress disorder experienced higher helpfulness by daily structuring than patients with depression. DISCUSSION: About half of our sample of psychiatric patients experienced symptom deterioration due to the pandemic and about one quarter reported impairment of treatment modalities. Especially patients with eating disorders and depressive disorders were more frequently affected. The results indicate a needed improvement of treatment options during a pandemic.


Assuntos
COVID-19/psicologia , Pacientes Internados/psicologia , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Pandemias , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , Criança , Feminino , Alemanha/epidemiologia , Hospitais , Humanos , Pacientes Internados/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
6.
Epidemiol Health ; 43: e2021043, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34126705

RESUMO

OBJECTIVES: This study aimed to identify relapse patterns in smokers who participated in an inpatient treatment program and to investigate factors related to relapse. METHODS: The participants comprised 463 smokers who participated in an inpatient treatment operated by the Daejeon Tobacco Control Center from 2015 to 2018. Participants received high-intensity smoking cessation intervention for 5 consecutive days, including pharmacotherapy and behavioral support, and continued with follow-up for 1 year to determine whether they maintained smoking cessation after discharge from inpatient treatment. Kaplan-Meier and Cox proportional hazard models were used in the analysis. RESULTS: Participants' relapse rate within 1 year was 72.8%, and 59.8% of participants smoked again within 6 months after participation. A higher number of counseling sessions was significantly associated with a lower risk of relapse (hazard ratio [HR], 0.23; 95% confidence interval [CI], 0.17 to 0.32 for ≥9 vs. ≤5 counseling sessions). Conversely, higher relapse rates were significantly associated with the use of nicotine replacement therapy (NRT) (HR, 1.91; 95% CI, 1.43 to 2.55 for use vs. no use), and higher levels of baseline expired carbon monoxide (CO) (HR, 1.58; 95% CI, 1.21 to 2.06 for expired CO concentrations of 10-19 ppm vs. expired CO concentrations <10 ppm). CONCLUSIONS: High-intensity smoking cessation interventions in hospital settings can be effective for smoking cessation in smokers with high nicotine dependence. In addition, the results suggest that for quitters to maintain long-term abstinence, they should receive regular follow-up counseling for 1 year after completing a high-intensity smoking cessation intervention.


Assuntos
Pacientes Internados/psicologia , Fumantes/psicologia , Abandono do Hábito de Fumar/métodos , Fumar/epidemiologia , Adulto , Idoso , Feminino , Seguimentos , Humanos , Pacientes Internados/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Recidiva , República da Coreia/epidemiologia , Fatores de Risco , Fumantes/estatística & dados numéricos
8.
Clin Nurse Spec ; 35(4): 199-207, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34077161

RESUMO

PURPOSE/AIM: The aim of this study was to explore the perceived quality of sleep and sleep disturbances in hospitalized patients. DESIGN: A prospective descriptive, exploratory, cross-sectional study was conducted at a 172-bed community hospital in Northeast Ohio. A convenient sample of 100 hospitalized patients was recruited from medical/surgical, progressive care, and intensive care units. METHODS: Participants used the Richards-Campbell Sleep Questionnaire to report sleep. A quality of sleep assessment survey was used to collect information regarding 17 factors leading to decreased quality of sleep. RESULTS: Mean sleep score was 47.92 for each question regarding sleep depth, latency, awakenings, time spent awake, and overall sleep quality. Pearson's correlation showed a significantly positive correlation between measure of noise and sleep score. Five environmental factors were identified as most disruptive to sleep: pain, laboratory draws, staff, blood pressure checks, and intravenous alarms. CONCLUSION: The positive correlation between sleeping well and higher noise levels is noteworthy. Raising awareness about the importance of sleep in the hospital setting and introducing interventions to promote a quiet environment and minimize sleep-disturbing factors may increase patient satisfaction scores and improve healing.


Assuntos
Pacientes Internados/psicologia , Ruído/efeitos adversos , Transtornos do Sono-Vigília/epidemiologia , Sono , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Hospitalização , Hospitais Comunitários , Humanos , Pacientes Internados/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Ohio/epidemiologia , Estudos Prospectivos , Fatores de Risco , Adulto Jovem
9.
Public Health Res Pract ; 31(2)2021 Jun 09.
Artigo em Inglês | MEDLINE | ID: mdl-34104935

RESUMO

Objective and importance of study: Considerable evidence suggests that adverse social determinants of health (SDH), such as poor education, unemployment, food and housing insecurity, interpersonal violence, inadequate social support and poverty, are key determinants of health and wellbeing. This prospective cohort study piloted a screening tool to collect individual SDH data in a South Australian hospital inpatient population. We explored participants' attitudes to SDH screening in brief follow-up interviews. METHODS: This mixed-methods study used an SDH screening tool to collect individual-level SDH data from inpatients living in a highly disadvantaged socio-economic area. Participants had a primary diagnosis of chronic obstructive pulmonary disease (COPD), heart failure (HF) or diabetes mellitus. Follow-up interviews were completed post discharge via telephone. Descriptive statistics were employed to examine the prevalence and type of adverse SDH reported by the sample. Thematic analysis was applied to explore participants' attitudes to the screening. RESULTS: The sample population (N = 37) reported a substantial burden of a range of adverse SDH (mean 4.7 adverse SDH experienced per participant, standard deviation 2.8). Participants involved in follow-up interviews (n = 8) believed screening might enhance communication between healthcare providers and patients and assist in identifying underlying social problems. CONCLUSION: A screening tool for SDH was successfully used to collect individual-level data in a hospital setting. An array of adverse SDH was common in the sample population. Participants believed screening for SDH may potentially benefit doctors and patients. A larger study is required to more robustly characterise the adverse SDH affecting individuals in this population and to explore how the healthcare system might effectively intervene.


Assuntos
Diabetes Mellitus/epidemiologia , Insuficiência Cardíaca/epidemiologia , Pacientes Internados/estatística & dados numéricos , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Determinantes Sociais da Saúde/estatística & dados numéricos , Idoso , Atitude Frente a Saúde , Austrália/epidemiologia , Escolaridade , Feminino , Habitação/estatística & dados numéricos , Humanos , Pacientes Internados/psicologia , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Pobreza/estatística & dados numéricos , Estudos Prospectivos , Inquéritos e Questionários , Desemprego/estatística & dados numéricos , Violência/estatística & dados numéricos
10.
Biomolecules ; 11(5)2021 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-34064997

RESUMO

Schizophrenia is a serious mental disorder requiring lifelong treatment. While medications are available that are effective in treating some patients, individual treatment responses can vary, with some patients exhibiting resistance to one or multiple drugs. Currently, little is known about the causes of the difference in treatment response observed among individuals with schizophrenia, and satisfactory markers of poor response are not available for clinical practice. Here, we studied the changes in the levels of 322 blood plasma lipids between two time points assessed in 92 individuals diagnosed with schizophrenia during their inpatient treatment and their association with the extent of symptom improvement. We found 20 triglyceride species increased in individuals with the least improvement in Positive and Negative Syndrome Scale (PANSS) scores, but not in those with the largest reduction in PANSS scores. These triglyceride species were distinct from the rest of the triglyceride species present in blood plasma. They contained a relatively low number of carbons in their fatty acid residues and were relatively low in abundance compared to the principal triglyceride species of blood plasma.


Assuntos
Antipsicóticos/efeitos adversos , Sintomas Comportamentais/epidemiologia , Biomarcadores/sangue , Lipidômica/métodos , Esquizofrenia/tratamento farmacológico , Triglicerídeos/sangue , Adolescente , Adulto , Sintomas Comportamentais/sangue , Sintomas Comportamentais/induzido quimicamente , Sintomas Comportamentais/diagnóstico , Feminino , Humanos , Pacientes Internados/psicologia , Pacientes Internados/estatística & dados numéricos , Masculino , Federação Russa/epidemiologia , Esquizofrenia/patologia , Resultado do Tratamento , Adulto Jovem
11.
Medicine (Baltimore) ; 100(24): e26259, 2021 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-34128854

RESUMO

ABSTRACT: The aim of this study was to translate and cross-culturally adapt the Rehabilitation Complexity Scale-Extended version 13 (RCS-E v13) to develop the Korean version of the Rehabilitation Complexity Scale (KRCS), and to explore its reliability, and concurrent and construct validity.This research was an observational study of a series of consecutive rehabilitation inpatients who were previously assessed with KRCS and grouped with the Korean rehabilitation patient group version 1.1 (KRPG v1.1). Translation and cross-cultural adaptation of the RCS-E v13 were implemented according to internationally recognized standards. Four hundred thirty inpatients diagnosed with complex neurological or musculoskeletal disabilities were enrolled. Physiatrists were asked to finish the KRCS at admission and to complete a second time with an interval of a minimum of 3 weeks to a maximum of 4 weeks for reliability evaluation. At discharge, the KRCS was completed a third time to explore constructive validity.The Cronbach-α was 0.63. The intraclass correlation coefficient values of the total score, Medical, Nursing, Care, Therapy Disciplines, Therapy Intensity, and Especial Needs domains were 0.86, 0.69, 0.84, 0.83, 0.74, 0.74, and 0.79, respectively (P < .01). The scale was repeatable (Spearman rho 0.69-0.86) and correlated strongly with disability measures (Spearman rho 0.37-0.50). Exploratory factor analysis revealed 2 clear factors ("Medical/Nursing" and "Care/Therapy Disciplines/Therapy Intensity/Equipment"). The goodness-of-fit index in the confirmatory factor analysis was 0.87. The KRCS was associated with a higher explanatory power for rehabilitation resources and length of stay than the KRPG v1.1.Our data suggest that the KRCS is a feasible, reliable, and valid tool that is appropriate for the measurement of clinical complexity in Korean intensive rehabilitation units. Further, it may provide case-mix adjustment to improve the rehabilitation delivery system in Korea.


Assuntos
Avaliação da Deficiência , Medicina Física e Reabilitação/normas , Inquéritos e Questionários/normas , Adulto , Comparação Transcultural , Análise Fatorial , Estudos de Viabilidade , Feminino , Humanos , Pacientes Internados/psicologia , Idioma , Masculino , Pessoa de Meia-Idade , Fisiatras , Psicometria , Reprodutibilidade dos Testes , República da Coreia , Risco Ajustado/métodos , Traduções
12.
Orthopedics ; 44(3): e427-e433, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34039209

RESUMO

Patient satisfaction measures are commonly used to evaluate clinical performance. However, research on the correlation between patient satisfaction scores and actual patient experience is limited. This study aimed to determine the concordance between patient satisfaction reported as an inpatient and patient satisfaction reported after discharge. The study enrolled 231 adult orthopedic patients at least 48 hours after admission to an academic hospital. Study participants rated their overall inpatient experience on a scale of 0 to 10, followed by open-ended questions on their hospital experience. Participants were then randomized to a second survey by either phone or mail at 4 to 6 weeks after discharge. Statistical and qualitative techniques were used to assess concordance in satisfaction scores and the agreement and association between patient experiences and patient satisfaction scores. The median overall patient satisfaction scores were 9.5 as inpatients (interquartile range [IQR], 8-10) and 10 at follow-up (IQR, 8-10), with a poor concordance between the inpatient and follow-up satisfaction scores (ρc=0.28). This study raises concerns regarding the validity of patient satisfaction measures to accurately quantify inpatient experience and the limitations related to its modes of administration. The authors observed poor agreement between the reported experience as an inpatient and the recollection of the inpatient experience after discharge. [Orthopedics. 2021;44(3):e427-e433.].


Assuntos
Pacientes Internados/psicologia , Alta do Paciente/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Ortopédicos/psicologia , Inquéritos e Questionários
13.
PLoS Med ; 18(5): e1003595, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34003832

RESUMO

BACKGROUND: Hospitals, clinics, and health organizations have provided psychosocial support interventions for medical patients to supplement curative care. Prior reviews of interventions augmenting psychosocial support in medical settings have reported mixed outcomes. This meta-analysis addresses the questions of how effective are psychosocial support interventions in improving patient survival and which potential moderating features are associated with greater effectiveness. METHODS AND FINDINGS: We evaluated randomized controlled trials (RCTs) of psychosocial support interventions in inpatient and outpatient healthcare settings reporting survival data, including studies reporting disease-related or all-cause mortality. Literature searches included studies reported January 1980 through October 2020 accessed from Embase, Medline, Cochrane Library, CINAHL, Alt HealthWatch, PsycINFO, Social Work Abstracts, and Google Scholar databases. At least 2 reviewers screened studies, extracted data, and assessed study quality, with at least 2 independent reviewers also extracting data and assessing study quality. Odds ratio (OR) and hazard ratio (HR) data were analyzed separately using random effects weighted models. Of 42,054 studies searched, 106 RCTs including 40,280 patients met inclusion criteria. Patient average age was 57.2 years, with 52% females and 48% males; 42% had cardiovascular disease (CVD), 36% had cancer, and 22% had other conditions. Across 87 RCTs reporting data for discrete time periods, the average was OR = 1.20 (95% CI = 1.09 to 1.31, p < 0.001), indicating a 20% increased likelihood of survival among patients receiving psychosocial support compared to control groups receiving standard medical care. Among those studies, psychosocial interventions explicitly promoting health behaviors yielded improved likelihood of survival, whereas interventions without that primary focus did not. Across 22 RCTs reporting survival time, the average was HR = 1.29 (95% CI = 1.12 to 1.49, p < 0.001), indicating a 29% increased probability of survival over time among intervention recipients compared to controls. Among those studies, meta-regressions identified 3 moderating variables: control group type, patient disease severity, and risk of research bias. Studies in which control groups received health information/classes in addition to treatment as usual (TAU) averaged weaker effects than those in which control groups received only TAU. Studies with patients having relatively greater disease severity tended to yield smaller gains in survival time relative to control groups. In one of 3 analyses, studies with higher risk of research bias tended to report better outcomes. The main limitation of the data is that interventions very rarely blinded personnel and participants to study arm, such that expectations for improvement were not controlled. CONCLUSIONS: In this meta-analysis, OR data indicated that psychosocial behavioral support interventions promoting patient motivation/coping to engage in health behaviors improved patient survival, but interventions focusing primarily on patients' social or emotional outcomes did not prolong life. HR data indicated that psychosocial interventions, predominantly focused on social or emotional outcomes, improved survival but yielded similar effects to health information/classes and were less effective among patients with apparently greater disease severity. Risk of research bias remains a plausible threat to data interpretation.


Assuntos
Pacientes Internados/estatística & dados numéricos , Longevidade , Pacientes Ambulatoriais/estatística & dados numéricos , Sistemas de Apoio Psicossocial , Ensaios Clínicos Controlados Aleatórios como Assunto , Humanos , Pacientes Internados/psicologia , Pacientes Ambulatoriais/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos
14.
Medicine (Baltimore) ; 100(21): e24763, 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34032691

RESUMO

BACKGROUND: We carried out a randomized trial of an emergency department (ED)-based nursing intervention to evaluate the impact of an ED nursing intervention on ED revisits, patient perceptions of continuity of care, illness perceptions, self-care capacities and psychological symptoms. METHOD: We conducted a randomized controlled trial to compare the ED-based intervention with usual care. The protocol was reviewed and approved by the Research Ethics Board of the Huzhou Central Hospital & Affiliated Central Hospital Huzhou University (K901923-021), each participant signed a written consent before participating, and SPIRIT guidelines were followed throughout. To be eligible, patients ready for discharge from the ED had to be at risk for ED return based on 2 criteria: at least one ED visit during the year prior to the initial visit, and current treatment with at least 6 medications. Exclusion criteria included cognitive problems (e.g., dementia) that would preclude provision of informed consent either noted in the medical chart or identified based on the clinical judgment of the project nurse. To avoid multiple interveners for the same patient, we also excluded patients already receiving other regular follow-up (e.g., at a specialized clinic in the hospital or from external resources). The major outcomes were assessed with the Heart Continuity of Care Questionnaire, the Illness Perception Questionnaire-Revised, the Therapeutic Self-Care Tool, the Hospital Anxiety and Depression Scale, and the Self-Reported Medication-Taking Scale. RESULTS: Two hundred patients who met the inclusion criteria were included in our study, Table 1 showed the effects of nursing intervention on measures of clinical outcomes. DISCUSSION: The ED is a major entry point into the health care system of many countries. Unnecessary ED revisits may result in overcrowding, increased waiting time, and failure to provide appropriate emergency care. The ED-based interventions literature focuses primarily on service use and ways to reduce ED revisits, with very little focus on impacting secondary outcomes. Because of their potential link with health service utilization, secondary outcomes such as perceived continuity of care, illness perceptions, self-care capacities, psychological symptoms and medication adherence might influence ED revisits. Future research was needed to better understand the complex relationship between ED utilization and a variety of intermediary factors in order to develop interventions that will optimize ED utilization.


Assuntos
Enfermagem em Emergência/métodos , Serviço Hospitalar de Emergência/organização & administração , Pacientes Internados/psicologia , Alta do Paciente , Autocuidado , Adulto , Ansiedade/diagnóstico , Ansiedade/prevenção & controle , Ansiedade/psicologia , Continuidade da Assistência ao Paciente/organização & administração , Depressão/diagnóstico , Depressão/prevenção & controle , Depressão/psicologia , Feminino , Humanos , Masculino , Questionário de Saúde do Paciente/estatística & dados numéricos , Readmissão do Paciente/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde , Resultado do Tratamento
15.
PLoS One ; 16(4): e0249168, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33878129

RESUMO

INTRODUCTION: Improving the quality of services is the primary goal of the Ethiopia reform program to satisfy patients. Patient satisfaction is an attitude resulting from a person's general orientation towards a total experience of health care. According to world health organization consumer satisfaction is playing an increasingly important role in the quality of care reforms and health-care delivery more generally. OBJECTIVE: To assess patient's satisfaction and associated factors with health care services among admitted patients in Pawie General Hospital, Benishangul Gumuze Region, West Ethiopia, 2020. METHODS: Institution based cross-sectional study was conducted among adult patients admitted to Pawie General Hospital. A systematic random sampling technique was employed to recruit 334 participants and a structured interviewer-administered questionnaire was used to collect data. Data were entered into Epi Data version 3.1, analyzed using SPSS version 23, and presented in tables and graphs. Bivariable and multivariable logistic regressions were computed to identify factors associated with patient satisfaction. P-values < 0.05 and adjusted odds ratios were used to declare the significance and strength of the association. RESULT: The overall patient's satisfaction towards inpatient health care services at Pawie General Hospital was 60.8% with 95% CI (55.4, 65.9). Factors like admission ward [AOR = 2.60; 95% CI (1.34, 5.03)] and privacy [AOR = 12.5; 95% C I (2.89, 54.1)] were significantly associated with patient's satisfaction. CONCLUSION: The satisfaction level of patients admitted to Pawie General Hospitals was low. Admission ward and perceived privacy assured were factors significantly associated with patient satisfaction among patients admitted to Pawie General Hospital. The hospital administration system is better to work together to fill the gaps identified and improve the level of patient satisfaction.


Assuntos
Pacientes Internados/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Adulto , Etiópia , Feminino , Hospitais Gerais , Humanos , Pacientes Internados/psicologia , Masculino , Pessoa de Meia-Idade , Admissão do Paciente , Fatores Socioeconômicos
16.
Acta Psychiatr Scand ; 143(6): 526-534, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33792912

RESUMO

OBJECTIVE: To determine how mental disorders and psychopharmacological treatments before and during COVID-19 hospital admissions are related to mortality. METHODS: Subjects included in the study were all adult patients with a diagnosis of COVID-19, confirmed clinically and by PCR, who were admitted to a tertiary university hospital in Badalona (Spain) between March 1 and November 17, 2020. Data were extracted anonymously from computerized clinical records. RESULTS: 2,150 subjects were included, 57% males, mean age 61 years. History of mental disorders was registered in 957 (45%). Throughout admission, de novo diagnosis of mood or anxiety, stress, or adjustment disorder was made in 12% of patients without previous history. Delirium was diagnosed in 10% of cases. 1011 patients (47%) received a psychotropic prescription during admission (36% benzodiazepines, 22% antidepressants, and 21% antipsychotics). Mortality rate was 17%. Delirium during admission and history of mood disorder were independently associated with higher mortality risk (hazard ratios, 1.39 and 1.52 respectively), while previous year's treatments with anxiolytics/hypnotics and antidepressants were independently associated with lower mortality risk (hazard ratios, 0.47 and 0.43, respectively). CONCLUSION: Mental symptoms are very common in patients hospitalized for COVID-19 infection. Detecting, diagnosing, and treating them is key to determining the prognosis of the disease and functional recovery.


Assuntos
COVID-19 , Pacientes Internados , Transtornos Mentais , Psicotrópicos , COVID-19/diagnóstico , COVID-19/mortalidade , COVID-19/psicologia , COVID-19/reabilitação , Teste de Ácido Nucleico para COVID-19 , Feminino , Registros Hospitalares/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Humanos , Pacientes Internados/psicologia , Pacientes Internados/estatística & dados numéricos , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/tratamento farmacológico , Transtornos Mentais/epidemiologia , Transtornos Mentais/virologia , Pessoa de Meia-Idade , Prognóstico , Psicotrópicos/classificação , Psicotrópicos/uso terapêutico , Recuperação de Função Fisiológica , Medição de Risco , SARS-CoV-2/isolamento & purificação , Espanha/epidemiologia
17.
J Am Geriatr Soc ; 69(7): 1836-1845, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33837953

RESUMO

BACKGROUND: Older patients with acute decompensated heart failure (ADHF) have severely impaired physical function (PF) and quality of life (QOL). However, relationships between impairments in PF and QOL are unknown but are relevant to clinical practice and trial design. METHODS: We assessed 202 consecutive patients hospitalized with ADHF in the multicenter Rehabilitation Therapy in Older Acute HF Patients (REHAB-HF) Trial. PF measures included Short Physical Performance Battery (SPPB) and 6-min walk distance (6MWD). Disease-specific QOL was assessed by the Kansas City Cardiomyopathy Questionnaire (KCCQ). General QOL was assessed by the Short Form-12 (SF-12) and EuroQol-5D-5L. PF was evaluated as a predictor of QOL using stepwise regression adjusted for age, sex, race, and New York Heart Association class. RESULTS: Participants were 72 ± 8 years, 54% women, 55% minority race, 52% with reduced ejection fraction, and body mass index 33 ± 9 kg/m2 . Participants had severe impairments in PF (6MWD 185 ± 99 m, SPPB 6.0 ± 2.5 units) and disease-specific QOL (KCCQ Overall Score 41 ± 21 and Physical Score 47 ± 24) and general QOL (SF-12 Physical Score 28 ± 9 and EuroQol Visual Analog Scale 57 ± 23). There were modest, statistically significant correlations between 6MWD and KCCQ Overall, KCCQ Physical Limitation, and SF-12 Physical Scores (r = 0.23, p < 0.001; r = 0.30, p < 0.001; and r = 0.24, p = 0.001, respectively); and between SPPB and KCCQ Physical and SF-12 Physical Scores (r = 0.20, p = 0.004, and r = 0.19, p = 0.007, respectively). Both 6MWD and SPPB were correlated with multiple components of the EuroQol-5D-5L. 6MWD was a significant, weak predictor of KCCQ Overall Score and SF-12 Physical Score (estimate = 0.05 ± 0.01, p < 0.001 and estimate = 0.05 ± 0.02, p = 0.012, respectively). SPPB was a significant, weak predictor of KCCQ Physical Score and SF-12 Physical Score (estimate = 1.37 ± 0.66, p = 0.040 and estimate = 0.54 ± 0.25, p = 0.030, respectively). CONCLUSION: In older, hospitalized ADHF patients, PF and QOL are both severely impaired but are only modestly related, suggesting that PF and QOL provide complementary information and assessment of both should be considered to fully assess clinically meaningful patient-oriented outcomes.


Assuntos
Estado Funcional , Insuficiência Cardíaca/fisiopatologia , Insuficiência Cardíaca/psicologia , Pacientes Internados/psicologia , Qualidade de Vida , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Feminino , Humanos , Masculino , Análise de Regressão , Volume Sistólico , Teste de Caminhada
18.
Nutrients ; 13(3)2021 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-33799928

RESUMO

BACKGROUND: Avoidant/Restrictive Food Intake Disorder (ARFID) is characterized by persistent failure to meet nutritional needs, absence of body image distortion and often low body weight. Weight restorative treatment in ARFID-adults is provided for as in Anorexia Nervosa (AN), while the effect is unknown. The aim was to compare weight gain between ARFID and restrictive subtype of AN (AN-R), including exploring impact of medical factors and psychopathology. METHODS: Individuals with ARFID (n = 7; all cases enrolled over 5 years) and AN-R (n = 80) were recruited from the Prospective Longitudinal All-comers inclusion study in Eating Disorders (PROLED) during 5 years. All underwent weight restorative inpatient treatment. Clinical characteristics at baseline and weekly weight gain were recorded and compared. RESULTS: There were no significant differences at baseline weight, nor in weight gain between groups. Anxiety was statistically significantly higher in AN-R at baseline. CONCLUSIONS: Although there were differences in several clinical measures at baseline (Autism Quotient, symptom checklist, mood scores and Morgan Russel Outcome Scale), only anxiety was higher in AN-R. No differences in weight gain were observed, although mean values indicate a faster weight gain in the ARFID group. Standard weight restorative treatment in this study in adults with ARFID has similar weight gaining effect as in AN-R.


Assuntos
Anorexia Nervosa/dietoterapia , Anorexia Nervosa/psicologia , Transtorno da Evitação ou Restrição da Ingestão de Alimentos , Transtornos da Alimentação e da Ingestão de Alimentos/dietoterapia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Adulto , Feminino , Seguimentos , Humanos , Pacientes Internados/psicologia , Pacientes Internados/estatística & dados numéricos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Psicopatologia , Resultado do Tratamento , Ganho de Peso , Adulto Jovem
19.
BMJ Open Qual ; 10(2)2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33820758

RESUMO

BACKGROUND: Mealtimes occur six times a day on eating disorder (ED) inpatient units and are a mainstay of treatment for EDs. However, these are often distressing and anxiety provoking times for patients and staff. A product of patients' distress is an increase in ED behaviours specific to mealtimes. The aim of this quality improvement project was to decrease the number of ED behaviours at mealtimes in the dining room through the implementation of initiatives identified through diagnostic work. METHODS: The Model for Improvement was used as the systematic approach for this project. Baseline assessment included observations in the dining room, gathering of qualitative feedback from staff and patients and the development of an ED behaviours form used by patients and staff. The first change idea of a host role in the dining room was introduced, and the impact was assessed. RESULTS: The introduction of the host role has reduced the average number of ED behaviours per patient in the dining room by 35%. Postintervention feedback demonstrated that the introduction of the host role tackled the disorganisation and chaotic feeling in the dining room which in turn has reduced distress and anxiety for patients and staff. CONCLUSIONS: This paper shows the realities of a quality improvement (QI) project on an ED inpatient unit during the COVID-19 pandemic. The results are positive for changes made; however, a large challenge, as described has been staff engagement.


Assuntos
COVID-19 , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Serviço Hospitalar de Nutrição/normas , Refeições/psicologia , Melhoria de Qualidade , Adulto , Ansiedade/psicologia , Técnicas de Observação do Comportamento , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Feminino , Humanos , Pacientes Internados/psicologia , Masculino , Recursos Humanos em Hospital/psicologia , Pesquisa Qualitativa , SARS-CoV-2 , Estresse Psicológico/psicologia
20.
Health Qual Life Outcomes ; 19(1): 98, 2021 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-33743742

RESUMO

OBJECTIVE: The aim of this systematic review was to summarize and assess the literature on quality of life (QoL) among cancer patients 80 years and older admitted to hospitals and what QoL instruments have been used. METHODS: We searched systematically in Medline, Embase and Cinahl. Eligibility criteria included studies with any design measuring QoL among cancer patients 80 years and older hospitalized for treatment (surgery, chemotherapy or radiation therapy). EXCLUSION CRITERIA: studies not available in English, French, German or Spanish. We screened the titles and abstracts according to a predefined set of inclusion criteria. All the included studies were assessed according to the Critical Appraisal Skills Programme checklists, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement checklist was used to ensure rigor in conducting and reporting. This systematic review was registered in PROSPERO (CRD42017058290). RESULTS: We included 17 studies with 2005 participants with various cancer diagnoses and Classification of Malignant Tumors stages (TNM). The included studies used a range of different QoL instruments and had different aims and outcomes. Both cancer-specific and generic instruments were used. Only one of the 17 studies used an age-specific instrument. All the studies included patients 80 years and older in their cohort, but none specifically analyzed QoL outcomes in this particular subgroup. Based on findings in the age-heterogeneous population (age range 20-100 years), QoL seems to be correlated with the type of diagnosed carcinoma, length of stay, depression and severe symptom burden. CONCLUSION: We were unable to find any research directly exploring QoL and its determinants among cancer patients 80 years and older since none of the included studies presented specific analysis of data in this particular age subgroup. This finding represents a major gap in the knowledge base in this patient group. Based on this finding, we strongly recommend future studies that include this increasingly important and challenging patient group to use valid age- and diagnosis-specific QoL instruments.


Assuntos
Pacientes Internados/psicologia , Neoplasias/psicologia , Qualidade de Vida , Idoso de 80 Anos ou mais , Hospitalização , Humanos , Neoplasias/terapia , Inquéritos e Questionários
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