scholarly journals 4226 Poor provider-patient communication, lack of readiness for discharge, and perceived illness threat are associated with quality of life after survival from cardiac arrest

2020 ◽  
Vol 4 (s1) ◽  
pp. 142-142
Author(s):  
Alex Presciutti ◽  
Jonathan Shaffer ◽  
Mary Newman ◽  
Sarah Perman

OBJECTIVES/GOALS: Studies have shown that cardiac arrest survivors have poor quality of life (QoL) secondary to neurologic injury. We hypothesized that poor provider-patient communication, lack of readiness for discharge, and perceived illness threat would be associated with QoL in cardiac arrest survivors. METHODS/STUDY POPULATION: We distributed an online survey to the Sudden Cardiac Arrest Foundation listserv. Survivors completed the Questionnaire for the Quality of Provider-Patient Interactions (QQPPI), Readiness for Hospital Discharge Scale (RHDS), and the Brief Illness Perception Questionnaire (B-IPQ). When completing the QQPPI and RHDS, survivors were asked to think back to their hospitalization and discharge. QoL domains (physical, psychological, social) were measured via the WHO-QOL BREF. Three multiple regression models examined associations between QQPPI, RHDS, and B-IPQ scores with QoL domains, adjusted for age, sex, months since arrest, and understanding of arrest and post-arrest symptoms at discharge. RESULTS/ANTICIPATED RESULTS: A total of 163 survivors (mean age 50.1 years, 50.3% women) provided complete survey data. Greater perceived illness threat (β: −.45, p < .001) and lower readiness for discharge (β: .22, p = .01) were associated with worse physical QoL; greater perceived illness threat (β: −.45, p < .001) was associated with worse psychological QoL; and greater perceived illness threat (β: −.3, p < .001) and poor provider-patient communication (β: .35, p < .001) were associated with worse social QoL. Our models explained 48%, 43%, and 30% of the variance in physical, psychological, and social QoL, respectively (p < .001). DISCUSSION/SIGNIFICANCE OF IMPACT: In-hospital interactions and perceived illness threat have important ramifications for cardiac arrest survivors attempting to return to daily life. Discussions regarding cardiac arrest sequelae, expectations, and specific treatment options during hospitalization could impact future QoL.

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 8590-8590
Author(s):  
T. N. Kirk ◽  
M. A. Moyad

8590 Background: Over 50,000 men developed hormone refractory prostate cancer (HRPC) in 2005 (CancerMetrics 2005). The objective of this analysis is to understand patient attitudes towards advancing prostate cancer (PC) and treatment. Methods: Patients were recruited from NexCura’s database of users and links from PC websites: UsTOO, PCRI, PCF and PAACT. Board certified physicians who treat HRPC were recruited by J. Reckner & Assoc. Responses were collected via online survey and analyzed by TSC, a division of Yankelovich. Grant funding from Abbott. The scale was “agree”, strongly agree”, “disagree” or “strongly disagree.” Results: 409 HRPC patients (P), 236 caregivers (C), 100 urologists (U) and 104 oncologists (O) participated. 45% of patients have metastatic HRPC. Mean patient age was 65.7 and age at diagnosis was 60.2. Conclusions: Many patients and caregivers have difficulty with advancing PC. Respondents recognize the survival benefit associated with chemotherapy, but attitude on its impact on quality of life varies significantly. Disparity exists between patients, caregivers and physicians on the impact of treatment on quality of life. Additional education, enhanced dialogue and additional treatment options are needed for HRPC patients, caregivers and physicians. [Table: see text] [Table: see text]


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Alex Presciutti ◽  
Sarah M Perman ◽  
Mary M Newman ◽  
Jonathan Shaffer

Introduction: Understanding the development of psychological symptoms post-arrest is a major research gap. In qualitative studies, cardiac arrest survivors report being poorly equipped to face the numerous sequelae upon returning home, which could in turn exacerbate acute psychological symptoms from the initial cardiac arrest event. In this study, we examined associations between illness perceptions (i.e. cognitive and emotional appraisals of illness and recovery), readiness for discharge, and provider-patient communication with psychological symptoms in cardiac arrest survivors with good neurologic recovery. Methods: We distributed an online survey to cardiac arrest survivors who were members of the Sudden Cardiac Arrest Foundation. Survivors completed the Brief Illness Perception Questionnaire (B-IPQ), Readiness for Hospital Discharge Scale (RHDS), Questionnaire for the Quality of Provider-Patient Interactions (QQPPI), PTSD Checklist-5 (PCL-5), and Patient Health Questionnaire-4 (PHQ-4) which has anxiety and depression subscales. Three multiple regression models examined associations between B-IPQ, RHDS, and QQPPI scores with PCL-5 and PHQ-4 anxiety and depression sores, adjusted for age, sex, time since arrest, self-reported understanding of cardiac arrest and post-arrest symptoms at discharge, self-reported memory at discharge, functional status via the Lawton Instrumental Activities of Daily Living scale, pre-arrest Charlson Comorbidity Index, and income. Results: We obtained full data from 163 survivors (mean age: 50.1 years, 50.3% women, 95.5% white, mean time since arrest: 63.9 months). More threatening illness perceptions (β: .57, p < .01) and lower readiness for discharge (β: -.22, p = .01) were associated with greater posttraumatic stress symptoms. More threatening illness perceptions was associated with greater anxiety (β: .53, p < .01) and depression (β: .5, p < .01) symptoms. Conclusions: Illness perceptions and readiness for discharge were associated with psychological symptoms in cardiac arrest survivors. Future studies should examine the feasibility of in-hospital assessment of survivors’ illness perceptions, readiness for discharge, and psychological symptoms.


EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
Y Fanous ◽  
P Dorian

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Patients frequently use the internet as an educational resource and sometimes in complete substitution of an expert physician’s consultation. Sudden cardiac arrests (SCA) in athletes are often sensationalised and attract much online readership. No studies have explored the quality of online content relating to SCA in athletes. Purpose To assess the quality of online educational resources on SCA in athletes. Methods The first 200 hits of the search "sudden cardiac arrest in athletes" on Google were analyzed. For each website, reading difficulty was evaluated using 5 validated reading indices. Content quality was assessed with point-based scoring systems established by expert opinion. Results A total of 115 unique web domains met eligibility criteria, only 2 of which were within the limits of national recommended readability level (≤8th grade). 53.9% were from educational institutions. Mean content accuracy scored only 6.5 ± 3.9 out of 15 (43%), and mean school-grade reading level was 13.3 ± 2.9 years (equivalent to a post-secondary level of education). The majority of websites had poor lay appropriate explanations of concepts; 91.3% failed to adequately explain basic principles of treatment; 68.7% failed to mention over half of common etiologies associated with SCA; only 59.1% correctly cited incidence of SCA amongst young athletes; 24.3% did not explore management options and only 28.7% mentioned treatment options beyond immediate resuscitation. Higher reading difficulty correlated with higher accuracy scores (β 1.1, p &lt; 0.001). Conclusion There is a paucity of accurate, lay language appropriate online health information on SCA in athletes. Incomprehensible and incomplete information may lead to inappropriate decisions by patients. A collaborative approach between experts and patients may assist in the creation of resources related to athletes’ health.


2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 18574-18574
Author(s):  
S. D. Mathias ◽  
T. A. Cimms ◽  
H. H. Colwell ◽  
D. P. Lubeck ◽  
K. L. Dawson ◽  
...  

18574 Background: Numerous treatment options are available for indolent lymphoma (IL), including watchful waiting, each with unique, longer term therapeutic and health-related quality of life (HRQL) issues. No validated HRQL questionnaire currently exists to assess the full range of issues that impact an IL patient’s QoL. We sought to fully assess these important areas to inform decisions about the use of a HRQL questionnaire in clinical studies. Methods: Five focus groups (n = 33), supplemented by in-depth one-on-one telephone interviews (n = 19) were conducted with IL patients across the US. Results: A total of 52 IL patients (65% female; mean age 53 years) participated and completed a questionnaire. Mean time since diagnosis was 51 months; 83% had received active treatment since diagnosis. Participants belonged to one of the following treatment categories: Watchful Waiting (17%), Actively Being Treated (50%), and Previously Treated (33%). Patients identified 4 domains and issues (see Table ) common across all patients regardless of treatment category. Treatment-specific issues included lack of control over the disease with watchful waiting vs. taking control, and actively fighting the disease with a specific treatment. Results from the questionnaire will be presented. Conclusions: Further elucidation of these issues is needed to facilitate HRQL evaluation in future studies and better inform treatment decisions. [Table: see text] [Table: see text]


Author(s):  
Emmanouela Cheiloudaki ◽  
Evangelos Alexopoulos

Background: Compliance with medication in patients who have suffered stroke is usually not-optimal. This study aims to measure the level of compliance with the treatment and to identify socio-demographic, clinical, and subjective factors related to the long-term compliance of stroke patients with their treatment. Methods: 140 patients (66.4% males) suffered an ischemic stroke at least six months old, participated in the survey. Compliance was measured using the Medication Adherence Report Scale and the quality of life by the Stroke Specific Quality of Life questionnaire. Furthermore, the Beliefs about Medicines Questionnaire and the Brief Illness Perception Questionnaire on perceptions about the disease were assessed. The doctor–patient relationship was assessed by the Common-Sense Model of Self-Regulation questionnaire and the family support was assessed by the FSS scale. Univariate and multivariate analysis was employed to identify the significant factors affecting compliance in these stroke patients. Results: In 68.6% of patients the compliance was classified as optimal, in 25.7% as partial and as poor in 5.7%; the last two categories were treated as sub-optimal compliance in multivariate analysis. The high compliance was related to patient’s mental state (OR:3.94 95% CI: 1.84–4.46), the perception medication necessity (OR:1.26 95% CI: 1.01–1.56), and the doctor–patient communication (OR:1.76 95% CI: 1.15–2.70). Men showed a lower compliance than women, as well as increased concerns about taking medication (OR: 0.83, 95% CI: 0.69–0.99). Paradoxically, the work /productivity related quality of life was inversely associated with compliance (OR (95% CI): 0.44 (0.23 to 0.82)). Conclusions: The perception of medication necessity and the doctor–patient communication are manageable factors associated with compliance in treating patients who have suffered stroke. In addition, rehabilitation and return to work programs should consider these factors when providing support to those persons.


VASA ◽  
2016 ◽  
Vol 45 (3) ◽  
pp. 201-212 ◽  
Author(s):  
Birgit Linnemann ◽  
Matthias Erbe

Abstract. The primary goal of therapy is to reduce the frequency and intensity of Raynaud’s attacks and to minimize the related morbidity rather than to cure the underlying condition. Treatment strategies depend on whether Raynaud’s phenomenon (RP) is primary or secondary. All patients should be instructed about general measures to maintain body warmth and to avoid triggers of RP attacks. Pharmacologic intervention can be useful for patients with severe and frequent RP episodes that impair the patient’s quality of life. Calcium channel blockers are currently the most prescribed and studied medications for this purpose. There has been limited evidence for the efficacy of alpha-1-adrenergic receptor antagonists, angiotensin receptor blockers, topical nitrates or fluoxetine to treat RP. The intravenously administered prostacyclin analogue iloprost can reduce the frequency and severity of RP attacks and is considered a second-line therapy in patients with markedly impaired quality of life, critical digital ischaemia and skin ulcers who are at risk for substantial tissue loss and amputation. Phosphodiesterase inhibitors (e.g., sildenafil) can also improve RP symptoms and ulcer healing whereas endothelin-1 receptor antagonists (e.g., bosentan) are mainly considered treatment options in secondary prevention for patients with digital skin ulcers related to systemic sclerosis. However, their use in clinical practice has been limited by their high cost. Antiplatelet therapy with low-dose aspirin is recommended for all patients who suffer from secondary RP due to ischaemia caused by structural vessel damage. Anticoagulant therapy can be considered during the acute phase of digital ischaemia in patients with suspected vascular occlusive disease attributed to the occurrence of new thromboses. In patients with critical digital ischaemia, consideration should be given to hospitalisation, optimisation of medical treatment in accordance with the underlying disease and evaluation for a secondary, possibly reversible process that is causing or aggravating the clinical symptoms.


Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2648
Author(s):  
Shila Minari Hargreaves ◽  
Eduardo Yoshio Nakano ◽  
Heesup Han ◽  
António Raposo ◽  
Antonio Ariza-Montes ◽  
...  

This study aimed to evaluate the general quality of life (QoL) of Brazilian vegetarians. A cross-sectional study was conducted with Brazilian vegetarian adults (18 years old and above). Individuals were recruited to participate in a nationwide online survey that comprised the WHOQOL-BREF as well as sociodemographic and characterization questions related to vegetarianism. The WHOQOL-BREF is composed of 24 items which are divided into four domains (domain 1: physical health; domain 2: psychological well-being; domain 3: social relationships; and domain 4: environment), plus two general items which were analyzed separately, totaling 26 items. The answers from the questionnaire were converted into scores with a 0–100 scale range, with separate analyses for each domain. Results were compared among groups based on the different characteristics of the vegetarian population. A total of 4375 individuals completed the survey. General average score results were 74.67 (domain 1), 66.71 (domain 2), 63.66 (domain 3) and 65.76 (domain 4). Vegans showed better scores when compared to the other vegetarians, except in domain four, where the statistical difference was observed only for semi-vegetarians (lower score). Individuals adopting a vegetarian diet for longer (>1 year) showed better results for domains one and two, with no difference for the other domains. Having close people also adopting a vegetarian diet positively influenced the results for all domains. On the other hand, it was not possible to distinguish any clear influence of the motivation for adopting a vegetarian diet on the scores’ results. Adopting a vegetarian diet does not have detrimental effects on one’s QoL. In fact, the more plant-based the diet, and the longer it was adopted, the better the results were.


2021 ◽  
pp. 109634802110115
Author(s):  
Seonjeong (Ally) Lee ◽  
Ning-Kuang Chuang

The physical environment plays an essential role in customers’ hotel stay experiences. Hotels offer a differentiated atmosphere that creates favorable customers’ evaluations. Based on the significant role of environmental cues, this study investigates the effects of an expanded servicescape on customers’ evaluations, including customer satisfaction, quality of life, and customer loyalty, in the context of the hotel industry. To test the proposed research framework, this study collects data from previous hotel customers and conducts a self-administered, online survey. Findings identified ambience, interactions with employees, authenticity, and fascination positively influenced customers’ satisfaction, which further influenced customer loyalty. Only ambience and fascination positively influenced quality of life, which in turn influenced customer loyalty. Results contributed to the application of expanded servicescape in the hotel context. Results also suggested practical implications of the holistic approach of servicescape in the hotel industry.


2020 ◽  
Vol 8 (2) ◽  
pp. e001268
Author(s):  
Angela Koipuram ◽  
Sandra Carroll ◽  
Zubin Punthakee ◽  
Diana Sherifali

IntroductionPersons of South Asian descent have a higher prevalence of type 2 diabetes mellitus (T2DM). The management of T2DM in the South Asian community has required the support of adult children, potentially impacting the quality of life, diabetes-related knowledge, and risk perception among these caregivers.Research design and methodsTo investigate diabetes-related knowledge, quality of life, risk perception, and actual risk of developing diabetes among South Asian young adults whose parents are living with T2DM. A cross-sectional study was conducted (n=150). An online survey was administered. Data were analyzed with descriptive and inferential statistics.ResultsThere was a statistically significant difference in diabetes-related knowledge between males and females (p<0.001). Males (in comparison to females) had a lower risk perception of developing diabetes (p=0.06). Further, risk perception and diabetes-related knowledge were positively associated with caregiver’s physical health (p=0.002).ConclusionFindings highlight the importance of providing gender-specific and culturally tailored diabetes educational interventions.


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