scholarly journals Estimate dynamic changes of dysfunction and lifelong spent for psychiatric care needs in patients with schizophrenia

2018 ◽  
Vol 54 ◽  
pp. 65-70 ◽  
Author(s):  
Chien-Chou Su ◽  
Ya Mei Bai ◽  
Ming-Hui Chou ◽  
Jung-Der Wang ◽  
Yen Kuang Yang
Keyword(s):  
Social Relationships ◽  
Dynamic Change ◽  
Average Lifetime ◽  
Care Needs ◽  
Cross Sectional Survey ◽  
Primary Analysis ◽  
Global Functioning ◽  
Dynamic Changes ◽  
Cross Sectional ◽  
Healthcare Needs

AbstractBackground:Disturbance of functionality is one of the core features of schizophrenia, and has deleterious effects on a patient’s employment, increased healthcare costs, and a large societal burden. Thus, if a patient’s disability status could be predicted, and interventions needed identified in advance, poor outcomes could be prevented. To achieve this aim, we developed a method by which to assess dynamic changes of dysfunction and estimate the lifetime duration of disability in patients with schizophrenia, as a proxy for assessing their specialized healthcare needs.Methods:The proposed method was developed based on a nationwide database and a cross-sectional survey. The primary analysis investigated the dynamic change in the proportion of patients with manifested disability over time, while the secondary analysis estimated the lifetime duration of disability, obtained as the proportion of patients with manifested disability multiplied by the survival probability throughout the life of patients.Results:The average lifetime duration of manifested disability of global functioning was estimated to be 20.9 years, which represents approximately 73% of the whole lifetime of patients. The duration of disability in socially-useful activities was estimated to be 15.6 years, while that in personal and social relationships was 17.5 years. The female patients had a longer duration of manifested disability (22.9 years) than the male patients (19.5 years).Conclusions:The developed method of analysis indicated that the longest lifetime durations of manifest disability were observed in the areas of socially-useful activities and personal and social relationships, and the proportions of patients with these disabilities rapidly increased at 200 months after diagnosis.

scholarly journals Budding nurses readiness for clinical practice: the future is now

2019 ◽  
Vol 8 (1) ◽  
pp. 215
Author(s):  
Vivanjeet Kaur ◽  
Varsha Dhama ◽  
Karamjeet Kaur ◽  
Malar Kodi S. ◽  
Rashmi Rawat
Keyword(s):  
Nursing Education ◽  
Clinical Practice ◽  
Nursing Students ◽  
Demographic Data ◽  
Clinical Settings ◽  
Care Needs ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Healthcare Needs ◽  
Graduate Nursing

Background: Freshly registered nurses’ experience of conversion from student to skilled professionals calls for making significant adjustments to shifting personal and professional roles at the beginning of their career as a nurse. Nursing education is aimed to help students to become beginning practitioners in the field of nursing. This study was taken up to explore the perception of the outgoing nursing students about their readiness to work in the clinical settings after graduation. On completion of graduation, these budding practitioners are anticipated to adjust in the clinical settings rapidly and be proficient of providing innocuous care for patients with multifaceted care needs. It is expected from graduate nurses to be well equipped for clinical practice, but reality may be different and there could be numerous barriers associated with it.Methods: It was a descriptive cross-sectional survey. A total of 176 outgoing graduate nursing students were selected using total enumerative sampling from different colleges of state of Uttarakhand and were asked to complete a demographic data sheet and self- reported readiness to clinical practice questionnaire.Results: Results have shown that more than half of the outgoing graduate nursing students were not ready for clinical practice. Most of them recognized sleep disturbance, low salary, lack of time and documenting error as barrier for their readiness to clinical practice.Conclusions: The findings of the study show that 63.3% of outgoing graduate nursing students were not ready to work in clinical area which is a matter of concern with the rising healthcare needs and increasing demands of the consumers of health. The results call for a change in the working condition for the nursing staff and a raise in wages worth making them to opt for clinical practice.

scholarly journals Support received by family members before, at and after an ill person’s death

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Anna O’Sullivan ◽  
Anette Alvariza ◽  
Joakim Öhlén ◽  
Cecilia Larsdotter
Keyword(s):  
Survey Design ◽  
Family Members ◽  
Time Of Death ◽  
Healthcare Staff ◽  
Care Needs ◽  
Advanced Illness ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Bereaved Family

Abstract Background It is widely recognised, that family members are central to care of people with advanced illness, and that support should be provided to all family members in need thereof. The aim of this study was to investigate family members’ experiences of support received during the last three months of life, at the time of death and after the death of a person with advanced illness. Methods A retrospective cross-sectional survey design was employed, using the VOICES(SF) questionnaire and multiple methods for data analyses. The sample consisted of 485 bereaved family members (aged: 20–90 years old, 70% women) of people who died in hospital between August 2016-April 2017. Results Of the family members, 58,8% reported they had received enough help and support during the illness, whereas 30,2% had not. Family members’ comments about support during the illness were mainly related to care the ill person had or had not received, rather than about support they themselves received. Of all family members, 52,8% reported having had enough support at the time of the ill person’s death. Related to support at death, 14,6% reported that the imminence of death was not clear, which was described as having affected their opportunity to be with the dying person at the time of death. Of all, 25,2% had a follow-up conversation after the death, 48% did not and did not want to, and 21% had no follow-up conversation, but would have liked one. A follow-up conversation was described as helpful for the bereavement process, and disappointment was expressed when not receiving support after the death. Conclusions Family members’ experiences of support were partly related to whether the ill person’s care needs were fulfilled. Healthcare staff expressing empathy and respect in the care of dying people and their family members were important for family members’ experiences of support. Family members’ difficulty recognising that death was imminent and the importance of healthcare staff providing them with clear information were expressed in connection with support at death. Follow-up conversations were valued by family members, especially if with a healthcare professional who was present at the time of death.

Redeveloping Secure Psychiatric Services for Women

2005 ◽  
Vol 45 (4) ◽  
pp. 331-339 ◽  
Author(s):  
Stuart D M Thomas ◽  
Mairead Dolan ◽  
Jenny Shaw ◽  
Samantha Thomas ◽  
Graham Thornicroft ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Psychiatric Hospitals ◽  
Antisocial Behaviour ◽  
Care Needs ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Suitable Alternative ◽  
High Security ◽  
Risk Treatment ◽  
The Individual

Historically, a substantial proportion of women have been unduly detained in conditions of high security in England due to the lack of suitable alternative facilities. There have been no studies that have comprehensively examined the individual needs of these women in relation to their placement needs. A cross sectional survey was undertaken of the individual and placement needs of all females detained in the three high security psychiatric hospitals (HSPHs) in England on 18th October 1999. Whilst there are clearly differences in accommodation needs among the women, those requiring lower secure services are significantly less likely to have needs in relation to violence (OR 0.29, 95% CI 0.14-0.62) and drugs (OR 0.29, 95% CI 0.12-0.67) when length of stay is taken into account. They also have lower security, treatment and dependency needs than women still requiring HSPH treatment. A significant reorganisation of services is required. There is a need to gain further understanding of the relationships between traumatic histories, clinical presentation and antisocial behaviour and how these impact on assessed risk, treatment and care needs and outcome. The special needs of these women should be considered a priority when developing treatment and care packages.

Perceptions of Role Transition into Practice among Advanced Practice Providers and Physicians

2020 ◽  
pp. 019394592093543
Author(s):  
Colleen J. Klein ◽  
Lisa Pierce ◽  
Melinda Cooling ◽  
Wen Che ◽  
Shannon Lizer
Keyword(s):  
Time Management ◽  
Survey Design ◽  
First Year ◽  
Advanced Practice ◽  
Care Needs ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Transition Into Practice ◽  
Physician Support ◽  
Workforce Composition

This study sought to examine the experiences of advanced practice providers (APPs) as an approach to inform the development of formalized programs for transition into practice and to compare APP ( N = 122) and physician ( N = 84) perceptions of the novice practitioners’ acclimation into a provider role within the first year of practice. Using a cross-sectional survey design, two separate web-based questionnaires were distributed to APPs and physicians. The APPs’ perspectives echoed findings of earlier studies with regard to perceived confidence, feelings of anxiety/fear, and inadequacy. In 16 of 23 paired items, physicians and APPs had similar perspectives about confidence/competence after orientation. Significant differences in their perceptions included amount of physician support, time management, length of time to become a fully functional APP, and independence. Better understanding of the perceptions of APPs and physicians can augment APP preparation for a shifting workforce composition and team-based, interprofessional practice designed to meet the population’s health care needs.

High HIV prevalence among transgender women in Paraguay

2020 ◽  
Vol 31 (13) ◽  
pp. 1308-1314
Author(s):  
Gloria Aguilar ◽  
Tania Samudio ◽  
Gladys Lopez ◽  
Liliana Jimenez ◽  
Erin C Wilson ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Odds Ratio ◽  
Transgender Women ◽  
Hiv Prevalence ◽  
Care Needs ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Cocaine Use ◽  
Related Risk ◽  
Trans Women

Transgender women have been understudied and underserved in Paraguay; data are urgently needed to understand their HIV prevention and care needs. To estimate HIV prevalence and related risk and preventive behaviors among trans women in Paraguay, we conducted a cross-sectional survey in 2017. We employed starfish sampling – a hybrid venue-based and peer-referral method combining recruitment at randomly sampled venues and randomly selected clients from program lists, followed by short-chain referrals of eligible peers. Among 304 trans women enrolled, HIV prevalence was 24.8% (95% confidence interval [CI] 18.5–31.2%), with risk increasing with age (adjusted odds ratio [AOR] 1.06 per year, 95% CI 1.03–1.10), residence in Asunción department (AOR 4.75, 95% CI 1.57–14.36), and cocaine use (AOR 2.09, 95% CI 1.11–3.95). Trans women in Paraguay need to be prioritized for interventions with high HIV prevention efficacy. Substance use interventions to address cocaine use may also yield prevention benefits for trans women in our context.

scholarly journals Temporal Profile of Olfactory Dysfunction in COVID-19

OTO Open ◽  
2020 ◽  
Vol 4 (4) ◽  
pp. 2473974X2097813
Author(s):  
Patricia A. Loftus ◽  
Lauren T. Roland ◽  
Jose G. Gurrola ◽  
Steven W. Cheung ◽  
Jolie L. Chang
Keyword(s):  
Health Status ◽  
Dynamic Change ◽  
Olfactory Dysfunction ◽  
General Health Status ◽  
Dynamic Changes ◽  
Cross Sectional ◽  
Olfactory Loss ◽  
Viral Illness ◽  
Time Of Infection

Objective Coronavirus disease 2019 (COVID-19) is associated with olfactory dysfunction, but the evolution of the olfactory loss and timeline to recovery are largely unknown. This study examines changes in smell sensitivity in COVID-19–positive (COVID+) and COVID-19–negative (COVID–) viral illness during the initial weeks after infection. Study Design Cross-sectional cohort comparison. Setting National anonymous surveys. Methods Survey participants were queried about smell sensitivity and general health status at the time of COVID-19 testing and in the weeks that followed. Results In total, 375 (174 COVID+, 201 COVID–) participants completed the survey and 132 (62 COVID+, 70 COVID–) participants completed the 2-week follow-up survey. Normal smell in the COVID+ cohort was less frequent at the time of testing and at follow up ( P < .05). Dynamic changes in smell sensitivity in the COVID+ cohort were more frequent in the initial weeks ( P < .001). In those with normosmia at the start of infection, 38% of the COVID+ cohort reported worsening smell compared to only 8% in the COVID– cohort ( P < .05). Recovery of overall health was associated with normosmia at the time of infection and improvement of smell sensitivity within weeks of infection. Conclusion The COVID+ cohort showed greater dynamic change in smell sensitivity and a higher rate of persistent olfactory dysfunction in the weeks after infection. Normal smell at the time of COVID-19 infection may still worsen before recovery. Overall health recovery after viral illness is associated with improvement in smell sensitivity and the absence of initial anosmia or hyposmia.

scholarly journals Screening Patients With Cancer Admitted to Hanoi Medical University Hospital for Palliative Care Needs

2020 ◽  
pp. 1321-1327
Author(s):  
Quang V. Le ◽  
Huy L. Trinh ◽  
Kim Ngan T. Mai ◽  
Manh D. Pham ◽  
Paul A. Glare
Keyword(s):  
Palliative Care ◽  
Screening Tool ◽  
Performance Status ◽  
Locally Advanced ◽  
Eastern Cooperative Oncology Group ◽  
University Hospital ◽  
Care Needs ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical University

PURPOSE To evaluate a screening tool for identifying which patients admitted to the oncology ward of a Vietnamese hospital should be referred to specialist palliative care (PC). METHODS We performed a cross-sectional survey of consecutive patients hospitalized in the Department of Oncology and Palliative Care at Hanoi Medical University Hospital between June 2019 and September 2019. We translated a validated 11-item screening tool into Vietnamese and used a total score of ≥ 5 as a positive screen. RESULTS One hundred participants were recruited. Forty-four patients (44%) screened positive. Of these, 37 (84%) had locally advanced or metastatic disease, 31 (70%) had uncontrolled symptoms, and 43 (98%) requested a PC consultation. A score ≥ 5 was significantly more common in patients with stage IV disease versus earlier stage, performance status of Eastern Cooperative Oncology Group (ECOG) 2 versus ECOG 0, and when life-limiting complications of cancer were present. Screening identified four patients overlooked by oncologists as needing referral, and 34% of patients requesting a referral had scores < 5. CONCLUSION This screening tool provided oncologists with easy-to-use criteria for referring patients for PC. At the same time, it relieved the work load for under-resourced PC physicians by screening out requests with low-level need. This tool should be part of routine assessment on admission in all oncology units in Vietnam.

scholarly journals Assessing a national policy on strengthening chronic care in primary care settings of a low-resource country using patients' perspectives.

2020 ◽  
Author(s):  
Paibul Suriyawongpaisal ◽  
Wichai Aekplakorn ◽  
Samrit Srithamrongsaw ◽  
Phanuwich Kaewkamjonchai
Keyword(s):  
Primary Care ◽  
Chronic Care ◽  
Care Quality ◽  
Local Health ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Mixed Effect ◽  
Multiprofessional Team ◽  
Primary Care Settings ◽  
Healthcare Needs

Abstract Background To improve care for patients with chronic diseases, a recent policy initiative in Thailand focuses on strengthening primary care including training of the team to deliver healthcare based on the concept of Chronic Care Model(CCM). This study conducted a cross-sectional survey of 4,071 patients with hypertension and/or diabetes registered to 25 primary care units and 16 hospital NCD clinics in 11 provinces (76 in total) to examine the effects of provider training and local health systems settings on patients’ perception of the chronic care quality.Methods A home-based interview with questionnaire was conducted on the patients in primary care settings. The questionnaire was adopted from the Thai version of the Patient Assessment of Chronic Illness Care (PACIC+) developed by the MacColl Institute for Healthcare Innovation. The questionnaire contains 20 items from the original PACIC, which measure different parts of the CCM, and an additional 6 items assess the 5A Model.Mixed effect models were employed to compare subscale of patient perception of the care quality between trained upgraded PCUs, upgraded PCUs, ordinary PCUs and NCD clinics. Upgraded PCUs were ordinary PCUs with the multiprofessional team including a physician. Trained upgraded PCUs were upgraded PCUs with the training input.Results Mixed effect models depicted an independent association between every PACIC subscale (as a measure of CCM) and facility type with the maximum likelihood for patients of ordinary PCU reporting high to highest scores (ORs: 1.52-1.76; p<0.05) compared to hospital NCD clinics. This is also the case for patients: seeing the same doctor on repeated visits (ORs: 1.66-1.87; p<0.05) or having phone contacts of the providers (ORs:1.42-1.63; p<0.05). Similarly, across all of the 5A model subscales, ORs for patients attending ordinary PCU responded with high to highest scores were 1.4-2.0 times compared to those for patients attending hospital NCD clinics(p<0.05). Conclusions We could not find evidence to support effectiveness of the training approach. The training failure might indicate a need to address mismatch between health workforce and workload. It also indicates a need to incorporate fidelity check into any training program for chronic care addressing the complex healthcare needs.

scholarly journals Access of Migrant Youths in Sweden to Sexual and Reproductive Healthcare: A Cross-sectional Survey

2020 ◽  
Author(s):  
Mazen Baroudi ◽  
Faustine Nkulu Kalengayi ◽  
Isabel Goicolea ◽  
Robert Jonzon ◽  
Miguel San Sebastian ◽  
...  
Keyword(s):  
Waiting Times ◽  
Economic Stress ◽  
Cross Sectional Survey ◽  
Residence Permit ◽  
Cross Sectional ◽  
Healthcare Needs ◽  
Youth Clinics ◽  
Stage Process ◽  
Met Needs ◽  
Reproductive Healthcare

Background: This study aims to assess migrant youths’ access to sexual and reproductive healthcare (SRHC) in Sweden, to examine the socioeconomic differences in their access, and to explore the reasons behind not seeking SRHC. Methods: A cross-sectional survey was conducted for 1739 migrant youths 16 to 29 years-old during 2018. The survey was self-administered through: ordinary post, web survey and visits to schools and other venues. We measured access as a 4-stage process including: healthcare needs, perception of needs, utilisation of services and met needs. Results: Migrant youths faced difficulties in accessing SRHC services. Around 30% of the participants needed SRHC last year, but only one-third of them fulfilled their needs. Men and women had the same need (27.4% of men [95% CI: 24.2, 30.7] vs. 32.7% of women [95% CI: 28.2, 37.1]), but men faced more difficulties in access. Those who did not categorise themselves as men or women (50.9% [95% CI: 34.0, 67.9]), born in South Asia (SA) (39% [95% CI: 31.7, 46.4]), were waiting for residence permit (45.1% [95% CI: 36.2, 54.0]) or experienced economic stress (34.5% [95% CI: 30.7, 38.3]) had a greater need and found more difficulties in access. The main difficulties were in the step between the perception of needs and utilisation of services. The most commonly reported reasons for refraining from seeking SRHC were the lack of knowledge about the Swedish health system and available SRHC services (23%), long waiting times (7.8%), language difficulties (7.4%) and unable to afford the costs (6.4%). Conclusion: There is an urgent need to improve migrant youths’ access to SRHC in Sweden. Interventions could include: increasing migrant youths’ knowledge about their rights and the available SRHC services; improving the acceptability and cultural responsiveness of available services, especially youth clinics; and improving the quality of language assistance services.

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