What to do with screening for distress scores? Integrating descriptive data into clinical practice

2013 ◽  
Vol 12 (1) ◽  
pp. 25-38 ◽  
Author(s):  
Marie-Claude Blais ◽  
Alexandre St-Hilaire ◽  
Lise Fillion ◽  
Marie De Serres ◽  
Annie Tremblay
Keyword(s):  
Cancer Care ◽  
Tertiary Care ◽  
Well Being ◽  
Assessment System ◽  
Routine Screening ◽  
Cutoff Score ◽  
Care Hospital ◽  
Descriptive Data ◽  
Nurse Navigator ◽  
Screening For Distress

AbstractObjective:Implementation of routine Screening for Distress constitutes a major change in cancer care, with the aim of achieving person-centered care.Method:Using a cross-sectional descriptive design within a University Tertiary Care Hospital setting, 911 patients from all cancer sites were screened at the time of their first meeting with a nurse navigator who administered a paper questionnaire that included: the Distress Thermometer (DT), the Canadian Problem Checklist (CPC), and the Edmonton Symptom Assessment System (ESAS).Results:Results showed a mean score of 3.9 on the DT. Fears/worries, coping with the disease, and sleep were the most common problems reported on the CPC. Tiredness was the most prevalent symptom on the ESAS. A final regression model that included anxiety, the total number of problems on the CPC, well-being, and tiredness accounted for almost 50% of the variance of distress. A cutoff score of 5 on the DT together with a cutoff of 5 on the ESAS items represents the best combination of specificity and sensitivity to orient patients on the basis of their reported distress.Significance of results:These descriptive data will provide valuable feedback to answer practical questions for the purpose of effectively implementing and managing routine screening in cancer care.

scholarly journals Gender-wise Comparative Assessment of Lifestyle Patterns and Well-being Status among Healthcare Employees at a Tertiary Care Hospital

2021 ◽  
Author(s):  
Vanajakshamma Velam ◽  
Vyshnavi Kancherla ◽  
Latheef Kasala ◽  
Anusha Kancherla ◽  
Mounica Reddy Pillaram
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Well Being ◽  
Care Hospital ◽  
Cross Sectional ◽  
Significant Difference ◽  
Female Employees ◽  
The Mean ◽  
Lifestyle Patterns ◽  
Comprehensive Study

Abstract Background This study was an attempt to assess and compare the gender-wise lifestyle patterns and well-being status among the employees of a tertiary care teaching hospital. Material and Methods This is a cross-sectional, questionnaire-based study conducted at a tertiary care hospital between May and August 2019. A total of 777 employees belonging to both genders (male and female) and working at different professional levels were assessed. All the enrolled employees were subjected to a comprehensive study tool consisting of various dimensions of their health, which included physical, mental, social, spiritual and intellectual health dimensions. Results Among the participants, 327 (42.1%) were male and 450 (57.9%) were female. There was no significant difference in the mean age of male (37.91 ± 7.52) and female (36.85 ± 8.16) employees (p = 0.07). A significantly higher proportion of diabetes and hypertension were seen in male employees (9.8% and 14.4%, respectively) than in female (5.6% and 6.2% respectively). The overall well-being was better in male employees than in females and was statistically significant (p < 0.0001). We found that male employees had statistically significant better well-being in terms of physical, mental and social health whereas female employees had intellectual health. Conclusion The overall well-being in healthcare staff was good at our tertiary care hospital, and the outstanding/good well-being rate was higher in male employees than in female employees. Female employees experienced risks with regard to their physical health.

scholarly journals Family-Centered Approach to Monitoring Children’s Development in a Paediatric Outpatient Setting: Feasibility Study from Pakistan

2021 ◽  
Author(s):  
Muneera A. Rasheed ◽  
Waliyah Mughis ◽  
Kinza N Elahi ◽  
Babar S. Hasan
Keyword(s):  
Service Providers ◽  
Psychosocial Support ◽  
Tertiary Care ◽  
Wait Time ◽  
Well Being ◽  
Parent Report ◽  
Outpatient Setting ◽  
Theory Of Change ◽  
Care Hospital ◽  
Family Centered

Abstract Background: The purpose of the study was to design and test the feasibility of a recent guideline of family-centered psychosocial support as an approach to developmental monitoring in a pediatric outpatient setting.Methods: The patient experience team at a private tertiary care hospital leveraged an on-going patient and family-centric initiative in the service to implement the intervention. The intervention delivery model was designed using the theory of change model and entailed the following i) the service providers: paediatricians but with support from psychology trainee volunteers to address time constraints; ii) monitoring form: Survey of Well-Being of Young Children (SWYC) being feasible and designed for regular developmental monitoring as parent report; iii) family support intervention: the Care for Child Development module to enhance parent-child interactions given team’s successful experience with inpatient children; iv) timing: utilize wait time to also enhance families’ experience and v) reinforcement: reinforced by the paediatrician in the consultation visit to capitalize on the established rapport and relationship with families. All families with children under 5 years 5 months of age in selected clinics (acute care, complex care, developmental issues) were eligible. The study was evaluated for acceptability and implementation feasibility. Families were interviewed about their experience; trainees provided a written narrative while physicians provided feedback on email. These were thematically analyzed using an inductive approach.Results: A total 182 families were administered the SWYC with 54% children detected for further review on cognitive milestones and 76% on social-emotional milestones. Forty-eight families were interviewed regarding their experience with the intervention. They reported the monitoring process to be useful and important for them as parents indicating acceptability. Paediatricians and trainees found the intervention to be important for parents and children’s health also requesting further understanding about child’s functioning. The trainees further expressed the experience to be significant for their own learning.Conclusion: The authors conclude that the intervention model for a family-centric approach to monitoring was acceptable to the families and the service providers. The intervention when implemented using a robust behaviour change framework can enhance feasibility.

scholarly journals Development of immunohistochemistry services for cancer care in western Kenya: Implications for low- and middle-income countries

2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Kirtika Patel ◽  
R. Matthew Strother ◽  
Francis Ndiangui ◽  
David Chumba ◽  
William Jacobson ◽  
...  
Keyword(s):  
Cancer Care ◽  
Cost Model ◽  
Tertiary Care ◽  
Care Hospital ◽  
Middle Income ◽  
Western Kenya ◽  
Middle Income Countries ◽  
Resource Limited ◽  
Limited Setting ◽  
Low And Middle Income

Background: Cancer is becoming a major cause of mortality in low- and middle-income countries. Unlike infectious disease, malignancy and other chronic conditions require significant supportive infrastructure for diagnostics, staging and treatment. In addition to morphologic diagnosis, diagnostic pathways in oncology frequently require immunohistochemistry (IHC) for confirmation. We present the experience of a tertiary-care hospital serving rural western Kenya, which developed and validated an IHC laboratory in support of a growing cancer care service.Objectives, methods and outcomes: Over the past decade, in an academic North-South collaboration, cancer services were developed for the catchment area of Moi Teaching and Referral Hospital in western Kenya. A major hurdle to treatment of cancer in a resource-limited setting has been the lack of adequate diagnostic services. Building upon the foundations of a histology laboratory, strategic investment and training were used to develop IHC services. Key elements of success in this endeavour included: translation of resource-rich practices to are source-limited setting, such as using manual, small-batch IHC instead of disposable- and maintenance-intensive automated machinery, engagement of outside expertise to develop reagent-efficient protocols and supporting all levels of staff to meet the requirements of an external quality assurance programme.Conclusion: Development of low- and middle-income country models of services, such as the IHC laboratory presented in this paper, is critical for the infrastructure in resource-limited settings to address the growing cancer burden. We provide a low-cost model that effectively develops these necessary services in a challenging laboratory environment.

scholarly journals Study of referral pattern for psychiatric evaluation in psychiatric OPD in a rural tertiary care hospital

KYAMC Journal ◽  
2013 ◽  
Vol 2 (1) ◽  
pp. 128-131
Author(s):  
Muhammad Abdul Kayum Shaikh ◽  
Md Zulfikar Ali ◽  
Md Saiful Islam ◽  
AKM Mokhlesuzzaman
Keyword(s):  
Somatoform Disorders ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Well Being ◽  
Rural Setting ◽  
Psychiatric Evaluation ◽  
Care Hospital ◽  
Major Depressive ◽  
Outpatient Departments ◽  
Level Hospital

Health includes both physical and psychological well being of an individual. There is strong chance that every physical illness has psychological component and in many cases psychological disorders present with somatic symptoms; so psychiatric referral is very important to the proper management of a patient. The aim of this study was to find out the pattern of referral from different outpatient departments in a tertiary level hospital in rural setting of Bangladesh. In this descriptive study total 237 patients were evaluated in 7 months period and most of the diagnoses were anxiety disorders (40%), major depressive disorder (35%) and somatoform disorders (17%). Departments of medicine (cardiology 34%, internal medicine 28% and neurology 26%) referred most of the patients than the surgical or gynecological departments.DOI: http://dx.doi.org/10.3329/kyamcj.v2i1.13517 KYAMC Journal Vol.2(1) 2011 pp.128-131

scholarly journals Family-centered Approach to Monitoring Children’s Development in a Paediatric Outpatient Setting: Feasibility Study From Pakistan

2021 ◽  
Author(s):  
Muneera A. Rasheed ◽  
Waliyah Mughis ◽  
Kinza N Elahi ◽  
Babar S. Hasan
Keyword(s):  
Service Providers ◽  
Psychosocial Support ◽  
Tertiary Care ◽  
Wait Time ◽  
Well Being ◽  
Parent Report ◽  
Outpatient Setting ◽  
Theory Of Change ◽  
Care Hospital ◽  
Family Centered

Abstract Background: The purpose of the study was to design and test the feasibility of a recent guideline of family-centered psychosocial support as an approach to developmental monitoring in a pediatric outpatient setting.Methods: The patient experience team at a private tertiary care hospital leveraged an on-going patient and family-centric initiative in the service to implement the intervention. The intervention delivery model was designed using the theory of change model and entailed the following i) the service providers: paediatricians but with support from psychology trainee volunteers to address time constraints; ii) monitoring form: Survey of Well-Being of Young Children (SWYC) being feasible and designed for regular developmental monitoring as parent report; iii) family support intervention: the Care for Child Development module to enhance parent-child interactions given team’s successful experience with inpatient children; iv) timing: utilize wait time to also enhance families’ experience and v) reinforcement: reinforced by the paediatrician in the consultation visit to capitalize on the established rapport and relationship with families. All families with children under 5 years 5 months of age in selected clinics (acute care, complex care, developmental issues) were eligible. The study was evaluated for acceptability and implementation feasibility. Families were interviewed about their experience; trainees provided a written narrative while physicians provided feedback on email. These were thematically analyzed using an inductive approach.Results: A total 182 families were administered the SWYC with 54% children detected for further review on cognitive milestones and 76% on social-emotional milestones. Forty-eight families were interviewed regarding their experience with the intervention. They reported the monitoring process to be useful and important for them as parents indicating acceptability. Paediatricians and trainees found the intervention to be important for parents and children’s health also requesting further understanding about child’s functioning. The trainees further expressed the experience to be significant for their own learning.Conclusion: The authors conclude that the intervention model for a family-centric approach to monitoring was acceptable to the families and the service providers. The intervention when implemented using a robust behaviour change framework can enhance feasibility.

scholarly journals Comparative Study of Length and Diameter of Umbilical Cord in Normal Vs Gestational Hypertensive cases in a Tertiary Care Hospital in Eastern Nepal

2019 ◽  
Vol 7 (2) ◽  
pp. 68-71
Author(s):  
Abhishek Karn ◽  
Subodh Kumar Yadav ◽  
Renu Yadav ◽  
Rakesh Kumar Adhikari
Keyword(s):  
Umbilical Cord ◽  
Gestational Hypertension ◽  
Tertiary Care ◽  
Well Being ◽  
Care Hospital ◽  
Medical College ◽  
Number Of Factors ◽  
Significant Difference ◽  
The Difference ◽  
Umbilical Cords

INTRODUCTION :- The well being of the fetus and hence the baby is influenced by a number of factors among which the length and diameter of umbilical cord is one important aspect. Studies have found association between gestational hypertension and the structure of umbilical cord. The objective of this study was to determine the effects of gestational hypertension on the length and diameter of umbilical cord.  MATERIAL AND METHODS :- A total of 70 umbilical cords with placenta were collected in Nobel Medical College and Teaching Hospital for comparison of umbilical cords length and diameter between normotensives and patients with gestational hypertension. Data were statistically analyzed.  RESULTS :- The difference in umbilical cords' diameter was statistically significant between normotensives and patients with gestational hypertension whereas the length of the umbilical cord had no statistically significant difference.  CONCLUSION :- We concluded that gestational hypertension affects the diameter of umbilical cord by decreasing it significantly which may affect normal fetal development.

scholarly journals Admission test as a screening test for fetal distress in labour

2018 ◽  
Vol 7 (3) ◽  
pp. 870
Author(s):  
Smitha B. Rao ◽  
Reena D’Souza ◽  
Bhavana Sherigar ◽  
Soumya R ◽  
Vismaya Kaveri ◽  
...  
Keyword(s):  
Screening Test ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Fetal Distress ◽  
Well Being ◽  
P Value ◽  
Care Hospital ◽  
Foetal Heart ◽  
Singleton Pregnancy ◽  
Admission Test

Background: This study was undertaken with the purpose of evaluating the efficacy of labour admission test as a screening test to identify the compromised fetus or fetus at risk and to correlate with perinatal outcome.Methods: This was a retrospective cohort study of 300 patients in 1st stage of labour admitted to labour room at tertiary care hospital over a period of one and a half years. Patients with Singleton pregnancy, Cephalic presentation & Gestational age beyond 34 weeks were included in this study. A BPL electronic foetal heart monitor was used to perform the admission test. With the patient in left lateral position a 20 minute continuous electronic recording (paper speed of 3 cm per minute) of foetal heart rate and uterine activity was obtained, on a cardiotocograph.Results: Statistical significance was calculated between different categories for different parameters too. A p value of of<0.05 was considered to be statistically significant. Fetal distress was seen 64.71% in Category III group 33.33% with Category II group and 4.74 % in Category I trace. admission test has 97.75% specificity and 95.5% negative predictive value.Conclusions: Admission test makes screening convenient. Since it is non-invasive, patients also cooperate. Admission test helps to plan subsequent management of labour. It is a good predictor of foetal well-being at the time of admission and for the next few hours.

scholarly journals Awareness of ultrasonography among antenatal mothers attending the tertiary care hospital in Bundelkhand region of UP

2018 ◽  
Vol 6 (1) ◽  
pp. 277
Author(s):  
Varsha Singh ◽  
Amit Mohan Varshney ◽  
Samarjeet Kaur
Keyword(s):  
Pregnant Women ◽  
Tertiary Care ◽  
Lower Class ◽  
Well Being ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Obstetric Department

Background: Ultrasound examination during pregnancy has become an integral part of antenatal care throughout the world. This technology is an important tool for the obstetricians, to reassure their patients regarding the well-being of their fetus in utero. The objective of this study was to assess the awareness of USG among pregnant women.Methods: This cross-sectional study was carried out among pregnant women attending the ANC clinic of Obstetric department of MLB Medical College Hospital, Jhansi, UP from March to May 2018. The study included 300 pregnant women and data was collected by using pre tested questionnaire.Results: The study reveals that 51.3% of participants were in the age group of 20-25 yr and 50% of them belong to upper lower class, most of them unskilled (83.4%), 63.3% of participants depicted that USG is done only to confirm the pregnancy and 81% of women considered that it is beneficial during pregnancy and 65% was known that USG can be used to determine sex of the foetus.Conclusions: Awareness regarding the uses of ultrasonography during pregnancy was found to be average. There is need to create more awareness in community about the USG uses and PCPNDT act and its provisions. There is need of creating more awareness about the safety, utility and frequency of USG during antenatal period to avoid misuse.

scholarly journals Exploring healthcare providers’ perceptions of mental health amid COVID-19 pandemic in obstetrics and gynaecology department of a tertiary care public sector hospital of Karachi, Pakistan: an exploratory qualitative study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e054010
Author(s):  
Haleema Yasmin ◽  
Afreen Sadia ◽  
Areesha Qamar ◽  
Anam Shahil Feroz
Keyword(s):  
Mental Health ◽  
Public Sector ◽  
Medical Center ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
Well Being ◽  
Care Hospital ◽  
Obstetrics And Gynaecology ◽  
Study Results ◽  
Qualitative Descriptive

IntroductionIn the wake of the unprecedented public health challenge of the COVID-19 pandemic, it is highly significant to recognise the mental health impact of this mounting threat on healthcare providers (HCPs) working in the obstetrics and gynaecology department. Experience from epidemics and emerging literature around COVID-19 show that the unparalleled amount of stress that HCPs are dealing with is linked with the increased burden of mental health conditions. We aim to conduct an exploratory qualitative descriptive study to assess HCPs’ perceptions of mental health amid the COVID-19 pandemic in the obstetrics and gynaecology department of a public sector tertiary care hospital of Karachi, Pakistan.Methods and analysisThis study will use a qualitative descriptive approach where approximately 20–25 HCPs from the obstetrics and gynaecology department will be recruited using a purposive sampling approach. Data will be collected through semistructured interviews and it will be analysed thematically using NVivo V.12 Plus software.Ethics and disseminationEthical approval for this study has been obtained from the Institutional Review Board Committee of Jinnah Postgraduate Medical Center hospital. The study results will be disseminated to the scientific community and the HCPs participating in the study. The findings will help us to explore the doctor’s perceptions of mental health during the current pandemic of COVID-19 and its impact on their daily lives and mental well-being.

scholarly journals COVID-19 Pandemic and Mental Health of Doctors: An Observational Analytical Study from a Dedicated COVID Hospital.

2021 ◽  
Vol 5 (3) ◽  
pp. 297
Author(s):  
F Khatoon ◽  
A Singh ◽  
AQ Jilani ◽  
A Ahmad ◽  
M Haq ◽  
...  
Keyword(s):  
Mental Health ◽  
Inverse Relationship ◽  
Tertiary Care ◽  
Well Being ◽  
Psychological Outcomes ◽  
Care Hospital ◽  
Cross Sectional ◽  
Susceptibility To Infection ◽  
Frontline Healthcare Workers ◽  
The Impact

Objective:Doctors experienced unprecedented levels of workload and pressure since the outbreak of COVID-19, making them more vulnerable to adverse psychological outcomes. While frontline healthcare workers face a substantially higher risk of susceptibility to infection due to excessive COVID-19 exposure, little is known about its impact on doctors not directly posted with COVID-19 patients. Our study was focused on studying the impact of COVID-19 pandemic on mental health of this subgroup of doctors.Materials and Methods: From April 1st to July 31st, 2020, a cross sectional web-based survey was conducted at a COVID-19 dedicated tertiary care hospital. The study was conducted using standard questionnaires measuring adverse psychological outcomes including DASS-21 and WHO-5. Univariate and multivariate logistic regression were used to examine the determinants of adverse psychological outcomes.Results and Discussion: 145 doctors completed the survey questionnaire with over 71% females and 29% males. The overall prevalence of anxiety, depression and stress among doctors was 38.6%, 41.37% and 32.42% respectively. The overall well-being score was found to be 52.77 + 24.19 with a median [IQR] of 52.Conclusion: A high incidence of adverse psychological outcomes are observed amongst doctors during COVID-19 pandemic, even when they are not directly involved in the care of COVID-19 patients. Stress, anxiety and depression have an inverse relationship with age and marital status. Anxiety has an inverse relationship with religious beliefs.International Journal of Human and Health Sciences Vol. 05 No. 03 July’21 Page: 297-306

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