scholarly journals Predictors of length of stay in psychiatric inpatient units: Does their effect vary across countries?

2018 ◽  
Vol 48 (1) ◽  
pp. 6-12 ◽  
Author(s):  
Giorgia Dimitri ◽  
Domenico Giacco ◽  
Michael Bauer ◽  
Victoria Jane Bird ◽  
Lauren Greenberg ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Psychiatric Inpatient ◽  
Patient Characteristics ◽  
Clinical Severity ◽  
Face To Face ◽  
History Of ◽  
The Given ◽  
Inpatient Units ◽  
Previous Admission ◽  
Complex Influence

AbstractBackgroundPrevious studies in individual countries have identified inconsistent predictors of length of stay (LoS) in psychiatric inpatient units. This may reflect methodological inconsistencies across studies or true differences of predictors. In this study we assessed predictors of LoS in five European countries and explored whether their effect varies across countries.MethodsProspective cohort study. All patients admitted over 14 months to 57 psychiatric inpatient units in Belgium, Germany, Italy, Poland and United Kingdom were screened. Putative predictors were collected from medical records and in face-to-face interviews and tested for their association with LoS.ResultsAverage LoS varied from 17.9 days in Italy to 55.1 days in Belgium. In the overall sample being homeless, receiving benefits, social isolation, diagnosis of psychosis, greater symptom severity, substance use, history of previous admission and being involuntarily admitted predicted longer LoS. Several predictors showed significant interaction effects with countries in predicting LoS. One variable, homelessness, predicted a different LoS even in opposite directions, whilst for other predictors the direction of the association was the same, but the strength of the association with LoS varied across countries.ConclusionsThe same patient characteristics have a different impact on LoS in different contexts. Thus, although some predictor variables related to clinical severity and social dysfunction appear of generalisable relevance, national studies on LoS are required to understand the complex influence of different patient characteristics on clinical practice in the given contexts.

The effect of limited English proficiency and interpreter service use on clinical outcomes in psychiatric inpatient units

2019 ◽  
Vol 27 (5) ◽  
pp. 465-468
Author(s):  
Conor Daly ◽  
Karen Phillips ◽  
Richard Kanaan
Keyword(s):  
Length Of Stay ◽  
Clinical Outcomes ◽  
Limited English Proficiency ◽  
Service Use ◽  
English Proficiency ◽  
Psychiatric Inpatient ◽  
Psychiatric Units ◽  
Adult Inpatient ◽  
Interpreter Service ◽  
Inpatient Units

Objective: The effects of limited English and interpreter use on clinical outcomes in mental health are poorly understood. This paper describes an exploratory study examining those effects across three adult inpatient psychiatric units, predicting it would lead to increased length of stay. Methods: Forty-seven patients with limited English proficiency (LEP) were retrospectively identified and compared with 47 patients with proficient English. Length of stay, number of consultant reviews and discharge diagnosis were recorded and compared. Results: An increased length of stay for those with LEP was not statistically significant ( p=0.155). The LEP group did undergo more consultant reviews ( p=0.036), however, and attracted different discharge diagnoses, with no primary discharge diagnoses of personality disorder made ( p=0.018). Conclusions: This study provides evidence of significant effects of limited English on both service burden and outcome.

scholarly journals Do outcomes of psychiatric hospital treatment differ for migrants and non-migrants?

2021 ◽  
Author(s):  
Kimberley Anderson ◽  
Domenico Giacco ◽  
Victoria Bird ◽  
Michael Bauer ◽  
Andrea Pfennig ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Psychotic Disorders ◽  
Suicide Attempts ◽  
Psychiatric Treatment ◽  
Psychiatric Inpatient ◽  
Patient Characteristics ◽  
Hospital Treatment ◽  
Migrant Populations ◽  
Significant Difference ◽  
Objective Outcomes

Abstract Purpose Providing effective treatment for immigrants is an increasing challenge for mental health services across Europe. Yet, little is known as to whether current practice is associated with different outcomes in migrant and non-migrant patients. We compared outcomes of inpatient psychiatric treatment for migrants and non-migrants in a sample from five European countries. Methods Patients with psychotic disorders, affective disorders or anxiety/somatisation disorders admitted to routine psychiatric inpatient treatment were assessed in hospitals in Belgium, Germany, Italy, Poland and the United Kingdom. Treatment outcomes were satisfaction with care during hospitalisation, length of stay, readmission to hospital (any and, specifically, involuntary re-hospitalisation), as well as untoward incidents in a 1-year follow-up period. Outcomes were compared between patients born inside (non-migrants) and outside (migrants) the country of treatment, through mixed regression models. Results Across all sites, 985 migrant patients and 6298 non-migrant patients were included. After accounting for the influence of confounding patient characteristics, migrants reported significantly lower treatment satisfaction, but there were no significant differences for length of stay and re-hospitalisations, in general and involuntary ones. Migrants had a lower rate of suicide attempts, but there was no significant difference in other types of untoward incidents in the year following the index admission. Conclusion The study suggests that migrants are less satisfied with their hospital treatment, there is no evidence that routine inpatient care as currently provided results overall in poorer objective outcomes for migrants than in non-migrant populations.

scholarly journals Associations between length of stay and municipal characteristics for a large Norwegian stroke unit

2020 ◽  
Author(s):  
Mathias Barra ◽  
Fredrik A. Dahl ◽  
Kashif Waqar Faiz ◽  
Hilde Lurås
Keyword(s):  
Length Of Stay ◽  
Stroke Unit ◽  
Patient Characteristics ◽  
University Hospital ◽  
Time Of Arrival ◽  
Full Time ◽  
Data Set ◽  
Strong Focus ◽  
Hospital Wards ◽  
The Given

Abstract BackgroundDeterminants of length of stay (LOS) on hospital wards is important in many planning, policy, and decision problems. Furthermore, LOS is an important parameter for cost containment, and health managers maintain a strong focus on monitoring and reducing hospital LOS. In addition to being costly, excess LOS also expose the patient to unnecessary risk of in-hospital complications. MethodsWe analysed a data set of N = 1922 admissions to the stroke unit (SU) at Akershus University Hospital between February 2012 and March 2013, which contains high quality variables pertaining to each stay, including patient characteristics and municipality residency. We explored regression models with (log-)LOS as the dependent variable, economic and demographic characteristics of the patients’ municipalities as the main predictors, controlling for several patient and admission parameters, like sex, age, and time of arrival. ResultsThe analyses showed that the municipality variables ‘share of inhabitants below the age of 67 years who are female’ and ‘nurse full time equivalents per 1000 inhabitants’ were negatively associated with LOS. ConclusionsAlthough a regression model cannot prove causal relations, a reasonable interpretation is that the given predictors capture some aspects of a municipality’s capacity for home care, which makes it possible for the SU to discharge patients relatively early.

scholarly journals Mobile Mindfulness Intervention on an Acute Psychiatric Unit: Feasibility and Acceptability Study

2017 ◽  
Vol 4 (3) ◽  
pp. e34 ◽  
Author(s):  
Lisa A Mistler ◽  
Dror Ben-Zeev ◽  
Elizabeth Carpenter-Song ◽  
Mary F Brunette ◽  
Matthew J Friedman
Keyword(s):  
State Hospital ◽  
Mindfulness Meditation ◽  
Psychiatric Inpatient ◽  
Psychiatric Inpatients ◽  
Psychotic Symptoms ◽  
Lengths Of Stay ◽  
Before And After ◽  
History Of ◽  
History Of Violence ◽  
Inpatient Units

Background Aggression and violence on acute psychiatric inpatient units is extensive and leads to negative sequelae for staff and patients. With increasingly acute inpatient milieus due to shorter lengths of stay, inpatient staff is limited in training and time to be able to provide treatments. Mobile technology provides a new platform for offering treatment on such units, but it has not been tested for feasibility or usability in this particular setting. Objective The aim of this study was to examine the feasibility, usability, and acceptability of a brief mindfulness meditation mobile phone app intended to reduce anger and aggression in acute psychiatric inpatients with schizophrenia, schizoaffective disorder, or bipolar disorder, and a history of violence. Methods Participants were recruited between November 1, 2015 and June 1, 2016. A total of 13 inpatients at an acute care state hospital carried mobile phones for 1 week and were asked to try a commercially available mindfulness app called Headspace. The participants completed a usability questionnaire and engaged in a qualitative interview upon completion of the 7 days. In addition, measures of mindfulness, state and trait anger, and cognitive ability were administered before and after the intervention. Results Of the 13 enrolled participants, 10 used the app for the 7 days of the study and completed all measures. Two additional participants used the app for fewer than 7 days and completed all measures. All participants found the app to be engaging and easy to use. Most (10/12, 83%) felt comfortable using Headspace and 83% (10/12) would recommend it to others. All participants made some effort to try the app, with 6 participants (6/12, 50%) completing the first 10 10-minute “foundation” guided meditations. Conclusions This is the first known study of the use of a commercially available app as an intervention on acute psychiatric inpatient units. Acutely ill psychiatric inpatients at a state hospital found the Headspace app easy to use, were able to complete a series of meditations, and felt the app helped with anxiety, sleep, and boredom on the unit. There were no instances of an increase in psychotic symptoms reported and there were no episodes of aggression or violence noted in the record.

scholarly journals Utilisation of tracheostomy in patients with COVID-19 in England: patient characteristics, timing and outcomes

2021 ◽  
Author(s):  
Annakan Navaratnam ◽  
William Gray ◽  
Josh Wall ◽  
Arun Takhar ◽  
Taran Tatla ◽  
...  
Keyword(s):  
Critical Care ◽  
Length Of Stay ◽  
Multilevel Modelling ◽  
Patient Characteristics ◽  
Exploratory Analysis ◽  
Administrative Dataset ◽  
History Of ◽  
Hospital Administrative ◽  
Multivariable Modelling ◽  
Critical Care Patients

Objectives: We aimed to characterise the use of tracheostomy procedures for all COVID-19 critical care patients in England and to understand how patient factors and timing of tracheostomy affected outcomes. Design: A retrospective observational study using exploratory analysis of hospital administrative data. Setting: All 500 National Health Service hospitals in England. Participants: All hospitalised COVID-19 patients aged ≥ 18 years in England between March 1st and October 31st, 2020 were included. Main outcomes and measures: This was a retrospective exploratory analysis using the Hospital Episode Statistics administrative dataset. Multilevel modelling was used to explore the relationship between demographic factors, comorbidity and use of tracheostomy and the association between tracheostomy use, tracheostomy timing and the outcomes. Results: In total, 2,200 hospitalised COVID-19 patients had a tracheostomy. Tracheostomy utilisation varied substantially across the study period, peaking in April-June 2020. In multivariable modelling, for those admitted to critical care, tracheostomy was most common in those aged 40-79 years, in males and in people of Black and Asian ethnic groups and those with a history of cerebrovascular disease. In critical care patients, tracheostomy was associated with lower odds of mortality (OR: 0.514 (95% CI 0.443 to 0.596), but greater length of stay (OR: 41.143 (95% CI 30.979 to 54.642). In patients that survived, earlier timing of tracheostomy (≤ 14 days post admission to critical care) was significantly associated with shorter length of stay. Conclusions: Tracheostomy is safe and advantageous for critical care COVID-19 patients. Early tracheostomy may be associated with better outcomes, such as shorter length of stay, compared to late tracheostomy.

ПАТОЛОГИЯ ЛИЧНОСТИ В ТЕОРЕТИЧЕСКИХ ПОСТРОЕНИЯХ ПРЕДСТАВИТЕЛЕЙ ОТЕЧЕСТВЕННОЙ МЕТАФИЗИЧЕСКОЙ ТРАДИЦИИ В ПСИХОЛОГИИ

1970 ◽  
Vol 7 (1) ◽  
pp. 208-215
Author(s):  
Александр Бреусенко-Кузнецов
Keyword(s):  
Clinical Practice ◽  
Subject Matter ◽  
Clinical Psychology ◽  
History Of Psychology ◽  
History Of ◽  
Metaphysical Tradition ◽  
The Given

Статья посвящена проблеме восстановления искусственно прерванной метафизической традиции в отечественной персонологии. Данная проблема принадлежит областям истории психологии и психологии личности, но имеет выходы и в предметные области многих других психологических наук, в частности – клинической психологии. Указана важность соотнесения персонологических концептуализаций учёных-метафизиков с клинической практикой в процессе их опытной верификации. Проведена реконструкция и анализ взглядов на психопатологию и психотерапию представителей метафизической традиции в отечественной психологии личности. Согласно данным взглядам, суть патологии личности – в её уклонении от своего назначения, от подлинного бытия ради неподлинных, онтологически неоправданных форм жизнедеятельности. The article is devoted to the problem of restoration of artificialy interrupted metaphysical tradition in domestic personology. The given problem belongs to the areas of history of psychology and psychology of personality, but provides outcomes in subject matter of many other psychological sciences, in clinical psychology in particular. Importance of correlation between personological conceptualizations of scientists-metaphysicists and clinical practice in the process of their skilled verification is pointed out. The reconstruction and analysis of views at psychopathology and psychotherapy by representatives of metaphysical tradition in domestic psychology of personality have been made. According to the mentioned views, the essence of pathology of personality is in its evasion from the purpose, from original life for the sake of not original, ontologically unjustified forms of ability to live.

ACHIEVEMENT OF SINGAPORE'S INDEPENDENCE AND DIFFICULTIES ON THE INITIAL PERIOD OF DEVELOPMENT

2019 ◽  
Vol 17 (2) ◽  
pp. 75-84
Author(s):  
Ilyas Shakirov ◽  
Keyword(s):  
Initial Period ◽  
Historical Sources ◽  
History Of ◽  
The Given

In the article considered events between 1945-1965 years in Singapore. On the ground of historical sources author of the given article learned the history of gaining independence by Singapore, as well, difficulties country carried out over 20 years

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