scholarly journals Distress in delirium: causes, assessment and management

2019 ◽  
Vol 11 (1) ◽  
pp. 63-70 ◽  
Author(s):  
Sophie T. Williams ◽  
Jugdeep K. Dhesi ◽  
Judith S. L. Partridge
Keyword(s):  
At Risk ◽  
Quantitative Research ◽  
Management Strategies ◽  
Psychological Impact ◽  
Healthcare Providers ◽  
Clinical Syndrome ◽  
Assessment Tools ◽  
Psychological Morbidity ◽  
Psychological Harm

Abstract Purpose Delirium is a common clinical syndrome associated with increased physical and psychological morbidity, mortality, inpatient stay and healthcare costs. There is growing interest in understanding the delirium experience and its psychological impact, including distress, for patients and their relatives, carers and healthcare providers. Methods This narrative review focuses on distress in delirium (DID) with an emphasis on its effect on older patients. It draws on qualitative and quantitative research to describe patient and environmental risk factors and variations in DID across a number of clinical settings, including medical and surgical inpatient wards and end of life care. The article provides an overview of the available distress assessment tools, both for clinical and research practice, and outlines their use in the context of delirium. This review also outlines established and emerging management strategies, focusing primarily on prevention and limitation of distress in delirium. Results Both significant illness and delirium cause distress. Patients who recall the episode of delirium describe common experiential features of delirium and distress. Relatives who witness delirium also experience distress, at levels suggested to be greater than that experienced by patients themselves. DID results in long-term psychological sequelae that can last months and years. Preventative actions, such pre-episode educational information for patients and their families in those at risk may reduce distress and psychological morbidity. Conclusions Improving clinicians’ understanding of the experience and long term psychological harm of delirium will enable the development of targeted support and information to patients at risk of delirium, and their families or carers.

Fatigue

2015 ◽  
pp. 154-166 ◽  
Author(s):  
Edith O’Neil-Page ◽  
Paula R. Anderson ◽  
Grace E. Dean
Keyword(s):  
End Of Life ◽  
Life Experience ◽  
Management Strategies ◽  
Psychological Impact ◽  
Healthcare Providers ◽  
Human Suffering ◽  
Complex Phenomenon ◽  
Illness Trajectory ◽  
Cancer Related Fatigue ◽  
Chronic Progressive Disease

This chapter provides an overview of fatigue as it spans the illness trajectory and end-of-life experience for patients with chronic progressive disease. While fatigue is a complex phenomenon that has been widely studied, there is still no universally accepted definition. Individuals with cancer and many other chronic, progressive diseases continue to experience fatigue and its costs, not only in the economic sense but also in its physical, emotional, and psychological impact on life. Cancer-related fatigue is a serious problem that interferes with physical, psychological, emotional, social, and economic functions. The need for healthcare providers to recognize and identify symptoms and explore management strategies is crucial to the lessening of human suffering.

scholarly journals Addressing Social Determinants of Health in the Care of Patients With Heart Failure: A Scientific Statement From the American Heart Association

Circulation ◽  
2020 ◽  
Vol 141 (22) ◽  
Author(s):  
Connie White-Williams ◽  
Laura P. Rossi ◽  
Vera A. Bittner ◽  
Andrea Driscoll ◽  
Raegan W. Durant ◽  
...  
Keyword(s):  
Heart Failure ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Healthcare Providers ◽  
Clinical Syndrome ◽  
Assessment Tools ◽  
Determinants Of Health ◽  
Number Of Patients ◽  
Patients With Heart Failure ◽  
Scientific Statement

Heart failure is a clinical syndrome that affects >6.5 million Americans, with an estimated 550 000 new cases diagnosed each year. The complexity of heart failure management is compounded by the number of patients who experience adverse downstream effects of the social determinants of health (SDOH). These patients are less able to access care and more likely to experience poor heart failure outcomes over time. Many patients face additional challenges associated with the cost of complex, chronic illness management and must make difficult decisions about their own health, particularly when the costs of medications and healthcare appointments are at odds with basic food and housing needs. This scientific statement summarizes the SDOH and the current state of knowledge important to understanding their impact on patients with heart failure. Specifically, this document includes a definition of SDOH, provider competencies, and SDOH assessment tools and addresses the following questions: (1) What models or frameworks guide healthcare providers to address SDOH? (2) What are the SDOH affecting the delivery of care and the interventions addressing them that affect the care and outcomes of patients with heart failure? (3) What are the opportunities for healthcare providers to address the SDOH affecting the care of patients with heart failure? We also include a case study ( Data Supplement ) that highlights an interprofessional team effort to address and mitigate the effects of SDOH in an underserved patient with heart failure.

scholarly journals Healthcare Providers’ Knowledge of Disordered Sleep, Sleep Assessment Tools, and Nonpharmacological Sleep Interventions for Persons Living with Dementia: A National Survey

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Cary A. Brown ◽  
Patricia Wielandt ◽  
Donna Wilson ◽  
Allyson Jones ◽  
Katelyn Crick
Keyword(s):  
Healthcare Providers ◽  
Assessment Tools ◽  
Assessment Practices ◽  
Term Care ◽  
Translation Strategies ◽  
Sleep Diaries ◽  
Knowledge Translation Strategies ◽  
Sleep Assessment ◽  
The Relationship

A large proportion of persons with dementia will also experience disordered sleep. Disordered sleep in dementia is a common reason for institutionalization and affects cognition, fall risk, agitation, self-care ability, and overall health and quality of life. This report presents findings of a survey of healthcare providers’ awareness of sleep issues, assessment practices, and nonpharmacological sleep interventions for persons with dementia. There were 1846 participants, with the majority being from nursing and rehabilitation. One-third worked in long-term care settings and one-third in acute care. Few reported working in the community. Findings revealed that participants understated the incidence of sleep deficiencies in persons with dementia and generally lacked awareness of the relationship between disordered sleep and dementia. Their knowledge of sleep assessment tools was limited to caregiver reports, self-reports, and sleep diaries, with few using standardized tools or other assessment methods. The relationship between disordered sleep and comorbid conditions was not well understood. The three most common nonpharmacological sleep interventions participants identified using were a regular bedtime routine, increased daytime activity, and restricted caffeine. Awareness of other evidence-based interventions was low. These findings will guide evidence-informed research to develop and test more targeted and contextualized sleep and dementia knowledge translation strategies.

scholarly journals A Qualitative Enquiry into the Lived Experiences of Adults with Atopic Dermatitis

2020 ◽  
pp. 78-84
Author(s):  
Gurkiran Birdi ◽  
Michael Larkin ◽  
Rebecca C Knibb
Keyword(s):  
Atopic Dermatitis ◽  
Quantitative Research ◽  
Sense Of Self ◽  
Psychological Impact ◽  
Structured Interviews ◽  
Term Condition ◽  
Related Quality ◽  
Health Related ◽  
The Impact

Background: atopic dermatitis (AD) has been related to poorer health-related quality of life (HRQoL) in adults and there is lack of qualitative research that explores how this long-term condition affects the lives of adults. The purpose of this study was to explore the impact of AD on the HRQoL of adults through semi-structured interviews. Study design: this was a qualitative study using semi-structured interviews. Methods: adults with a clinical diagnosis of AD were recruited by advertising on a university campus and through social media sites. All participants completed a screening questionnaire on AD diagnosis, treatment, duration, and severity. Semi-structured interviews were conducted either face-to-face or on the telephone then audio-taped, transcribed verbatim, and analysed using thematic analysis. Results: the study group (n=19) consisted of 10 White and nine Black and ethnic minority participants, aged 19–52, of whom 18 were female. Three superordinate themes emerged from the analysis: 1) visibility of AD; 2) threats to inner sense of self; and 3) contrasting reactions and support from others. There were qualitative differences in the narratives of those who were diagnosed with AD at an early age compared to a later age, and across ethnic groups. Conclusions: AD has a great impact on the QoL of adults. Participants in this study discussed issues that have not been reported in quantitative research, particularly around the lack of understanding of the psychological impact of AD and the stigma attached to it. Consideration of these factors may enhance disease management and improve HRQoL. Understanding and recognition of AD as a complex long-term condition involving significant psychosocial impact is crucial. The findings from this study suggest more integrated and accessible psychological support is required for people with AD. Males were under-represented in this study, and further exploration of the impact on AD in males is needed.

scholarly journals Parkinson's Disease - Levodopa Complications

1999 ◽  
Vol 26 (S2) ◽  
pp. S13-S20 ◽  
Author(s):  
David B. King
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Management Strategies ◽  
Clinical Syndrome ◽  
Motor Fluctuations ◽  
Current Management ◽  
Resting Tremor ◽  
Wearing Off ◽  
Psychiatric Complications

Parkinson's disease is a readily recognized clinical syndrome, characterized by resting tremor, rigidity, bradykinesia and loss of postural reflexes. The introduction of levodopa transformed our management of this disease. As our experience has increased the long term side effects of levodopa have become more apparent. Levodopa complications comprise: wearing off, motor fluctuations, and psychiatric complications. The complexity of these clinical phenomena has been worked out with time and is now well-recognized. A number of management strategies can ameliorate these long-term complications. This article reviews the current management of late-stage Parkinson's disease.

Parents' long-term adjustment to the genetic test results of minors at risk for Long QT Syndrome

2004 ◽  
Author(s):  
K. S. W. H. Hendriks ◽  
F. J. M. Grosfeld ◽  
A. A. M. Wilde ◽  
J. van den Bout ◽  
I. M. van Langen ◽  
...  
Keyword(s):  
At Risk ◽  
Long Qt Syndrome ◽  
Genetic Test ◽  
Test Results ◽  
Long Qt ◽  
Genetic Test Results ◽  
Qt Syndrome

Connecting Crop Nutrient Use Efficiency to Future Soil Productivity

2018 ◽  
Vol 102 (4) ◽  
pp. 8-10
Author(s):  
Fernando García ◽  
Andrés Grasso ◽  
María González Sanjuan ◽  
Adrián Correndo ◽  
Fernando Salvagiotti
Keyword(s):  
Nutrient Management ◽  
Nutrient Use Efficiency ◽  
Management Strategies ◽  
Crop Productivity ◽  
Soil Productivity ◽  
Nutrient Use ◽  
Grain Crop ◽  
Wide Scale ◽  
Use Efficiency

Trends over the past 25 years indicate that Argentina’s growth in its grain crop productivity has largely been supported by the depletion of the extensive fertility of its Pampean soils. Long-term research provides insight into sustainable nutrient management strategies ready for wide-scale adoption.

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