Comparing baseline factors associated with met within 48, 72 and 168 h of admission to an acute care hospital

Background: Due to the establishment of a nationwide certification system for cancer centers in Germany, the availability of psycho-oncological services for cancer patients has increased substantially. However, little is known about the specific intervention techniques that are applied during sessions in an acute care hospital, since a standardized taxonomy is lacking. With this study, we aimed at the investigation of psycho-oncological intervention techniques and the development of a comprehensive and structured taxonomy thereof. Methods: In a stepwise procedure, a team of psycho-oncologists generated a data pool of interventions and definitions that were tested in clinical practice during a pilot phase. After an adaptation of intervention techniques, interrater reliability (IRR) was attained by rating 10 previously recorded psycho-oncological sessions. A classification of interventions into superordinate categories was performed, supported by cluster analysis. Results: Between April and June 2017, 980 psycho-oncological sessions took place. The experts agreed on a total number of 22 intervention techniques. An IRR of 89% for 2 independent psycho-oncological raters was reached. The 22 techniques were classified into 5 superordinate categories. Discussion/Conclusion: We developed a comprehensive and structured taxonomy of psycho-oncological intervention techniques in an acute care hospital that provides a standardized basis for systematic research and applied care. We expect our work to be continuously subjected to further development: future research should evaluate and expand our taxonomy to other contexts and care settings.

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Factors associated with the decision to prescribe and administer antipsychotics for older people with delirium: a qualitative descriptive study

BMJ Open ◽

10.1136/bmjopen-2020-047247 ◽

2021 ◽

Vol 11 (7) ◽

pp. e047247

Author(s):

Emily J Tomlinson ◽

Helen Rawson ◽

Elizabeth Manias ◽

Nicole (Nikki) M Phillips ◽

Peteris Darzins ◽

...

Keyword(s):

Decision Making ◽

Older People ◽

Health Professionals ◽

Acute Care Hospital ◽

Nursing Workload ◽

Care Hospital ◽

Antipsychotic Medications ◽

Factors Associated ◽

Multiple Factors ◽

Qualitative Descriptive

ObjectivesTo explore factors associated with decision-making of nurses and doctors in prescribing and administering as required antipsychotic medications to older people with delirium.DesignQualitative descriptive.SettingTwo acute care hospital organisations in Melbourne, Australia.ParticipantsNurses and doctors were invited to participate. Semi-structured focus groups and individual interviews were conducted between May 2019 and March 2020. Interviews were audio-recorded and transcribed verbatim. Data were analysed using thematic analysis.ResultsParticipants were 42 health professionals; n=25 nurses and n=17 doctors. Themes relating to decisions to use antipsychotic medication were: safety; a last resort; nursing workload; a dilemma to medicate; and anticipating worsening behaviours. Nurses and doctors described experiencing pressures when trying to manage hyperactive behaviours. Safety was a major concern leading to the decision to use antipsychotics. Antipsychotics were often used as chemical restraints to ‘sedate’ a patient with delirium because nurses ‘can’t do their job’. Results also indicated that nurses had influence over doctors’ decisions despite nurses being unaware of this influence. Health professionals’ descriptions are illustrated in a decision-making flowchart that identifies how nurses and doctors navigated decisions regarding prescription and administration of antipsychotic medications.ConclusionsThe decision to prescribe and administer antipsychotic medications for people with delirium is complex as nurses and doctors must navigate multiple factors before making the decision. Collaborative support and multidisciplinary teamwork are required by both nurses and doctors to optimally care for people with delirium. Decision-making support for nurses and doctors may also help to navigate the multiple factors that influence the decision to prescribe antipsychotics.

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Cognitive and Functional Impairment of Hospitalized Patients over 65 Years of Age

European Journal of Investigation in Health, Psychology and Education ◽

10.3390/ejihpe4010001 ◽

2013 ◽

Vol 4 (1) ◽

pp. 5-18

Author(s):

Mª José Calero-García ◽

Alfonso J. Cruz Lendínez

Keyword(s):

Cognitive Impairment ◽

Marital Status ◽

Acute Care ◽

Functional Impairment ◽

Acute Care Hospital ◽

Education Level ◽

Care Hospital ◽

Elderly Men ◽

Time Of Admission ◽

The Relationship

The first objective of this research is to establish and study how the different stages of cognitive impairment and the levels of dependence evolve in patients over 65 years of age, admitted to an acute care hospital, as well as the relationship between these factors and the different social and demographical variables. The results show that the level of dependence decreases suddenly at the time of admission and undergoes a slight recovery at the time of discharge. Although this recovery continues at home after discharge, patients do not get the same level of independence that they used to have before admission. In addition, significant differences in terms of age, marital status and education level were found. In general, our results show that elderly men over 80 years of age, without no education and widowers are more likely to suffer from severe cognitive impairment and be more functionally dependent when admitted to hospital.

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