scholarly journals New tip-apex distance and calcar-referenced tip-apex distance cut-offs may be the best predictors for cut-out risk after intramedullary fixation of proximal femur fractures

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Gaetano Caruso ◽  
Nicola Corradi ◽  
Antonio Caldaria ◽  
Daniele Bottin ◽  
Dario Lo Re ◽  
...  
Keyword(s):  
Weight Bearing ◽  
Cross Sectional Study ◽  
Screw Head ◽  
Cross Sectional ◽  
Femur Fractures ◽  
Tip Apex Distance ◽  
Minimal Reduction ◽  
Shed Light

AbstractCut-out is one of the most common mechanical failures in the internal fixation of trochanteric hip fractures. The tip-apex distance (TAD), and the calcar-referenced tip apex distance (CalTAD) are the radiographic parameters that most predict the risk of cut-out. The optimal CalTAD value has not yet been defined, but the optimal TAD value is reported as 25 mm or less. However, this cut-off is highly specific but poorly sensitive. The aim of this study was to determine highly specific and sensitive TAD and CalTAD values and shed light on the role of other clinical variables. A total of 604 patients were included in this retrospective cross-sectional study. For each patient the following data were recorded: number of cut-out, AO/OTA classification, quality of the reduction, type of nail, cervicodiaphyseal angle, type of distal locking, post-operative weight-bearing, TAD and CalTAD values, and the position of the screw head in the femoral head according to the Cleveland system. The incidence of cut-out across the sample was 3.1%. The median TAD in the cut-out group was 38.72, while in the no cut-out group it was 22.16. The median CalTAD in the cut-out group was 39.34, while in the no cut-out group it was 22.19. The cut-off values for TAD and CalTAD with highest value of sensitivity and specificity for the risk of cut-out were 34.8 and 35.2, respectively. The incidence of cut-out can be reduced by performing careful minimal reduction and ensuring stable fixation by avoiding TAD > 34.8 mm and CalTAD > 35.2 mm.

scholarly journals Which TAD and CALTAD Cut-Offs Best Predict Cut-Out Risk for Intramedullary Fixation of Proximal Femur Fractures?

2021 ◽  
Author(s):  
Gaetano Caruso ◽  
Nicola Corradi ◽  
Antonio Caldaria ◽  
Daniele Bottin ◽  
Dario Lo Re ◽  
...  
Keyword(s):  
Weight Bearing ◽  
Cross Sectional Study ◽  
Screw Head ◽  
Cross Sectional ◽  
Femur Fractures ◽  
Tip Apex Distance ◽  
Minimal Reduction ◽  
Shed Light

Abstract Purpose: Cut-out is one of the most common mechanical failures in the internal fixation of trochanteric hip fractures. The tip-apex distance (TAD), and the calcar-referenced tip apex distance (CalTAD) are the radiographic parameters that most predict the risk of cut-out. The optimal CalTAD value has not yet been defined, but the optimal TAD value is reported as 25 mm or less. However, this cut-off is highly specific but poorly sensitive. The aim of this study was to determine highly specific and sensitive TAD and CalTAD values and shed light on the role of other clinical variables.Methods: A total of 604 patients were included in this retrospective cross-sectional study. For each patient the following data were recorded: number of cut-out, AO/OTA classification, quality of the reduction, type of nail, cervicodiaphyseal angle, type of distal locking, post-operative weight-bearing, TAD and CalTAD values, and the position of the screw head in the femoral head according to the Cleveland system.Results: The incidence of cut-out across the sample was 3.1%. The median TAD in the cut-out group was 38.72, while in the no cut-out group it was 22.16. The median CalTAD in the cut-out group was 39.34, while in the no cut-out group it was 22.19. The cut-off values for TAD and CalTAD with highest value of sensitivity and specificity for the risk of cut-out were 34.8 and 35.2, respectively. Conclusions: The incidence of cut-out can be reduced by performing careful minimal reduction and ensuring stable fixation by avoiding TAD>34.8mm and CalTAD>35.2 mm.

Burden, quality of life, anxiety, and depressive symptoms among caregivers of hemodialysis patients: The role of social support

2020 ◽  
Vol 55 (6) ◽  
pp. 397-407
Author(s):  
Madihah Shukri ◽  
Mohd Azman Mustofai ◽  
Md Aris Safree Md Yasin ◽  
Tuan Sharipah Tuan Hadi
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Depressive Symptoms ◽  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Cross Sectional ◽  
Caregiving Burden ◽  
Low Levels

Objective The purpose of this study was to determine how burden and quality of life predict anxiety and depressive symptoms among caregivers of hemodialysis patients. Social support was included in the model as a proposed moderator in the above relationships. Methods This cross-sectional study involved 340 caregivers of chronic kidney patients undergoing hemodialysis. The setting was in Terengganu, Malaysia. The caregivers completed the measures of caregiving burden, quality of life, social support, and symptoms of anxiety and depression. Results About 28.8% and 52.4% of caregivers showed clinically moderate levels of anxiety and depressive symptoms, respectively. Furthermore, 35.9% and 3.8% of them showed clinically high levels of anxiety and depressive symptoms, respectively. Analyses showed that general quality of life was a significant predictor of both anxiety and depressive symptoms. Burden and psychological domains of quality of life significantly predicted anxiety. In addition, a lack of social support was a determinant of depressive symptoms. Evidence suggested that social support moderated the burden–anxiety relationship. Specifically, caregivers with low levels of social support showed more elevated levels of anxiety symptoms when their burden was higher. Conclusion There is an urgent need for early detection to initiate prompt treatment in this population. The study provides some important insights into offering comprehensive intervention to help caregivers cope more effectively through the provision of sufficient social support to buffer the effects of caregiving burden and improve mental health.

scholarly journals A szégyen mediációs szerepe a stigma és az életminőség kapcsolatában coeliakiában szenvedő betegek körében.

2021 ◽  
Vol 162 (49) ◽  
pp. 1968-1976
Keyword(s):  
Quality Of Life ◽  
Coeliac Disease ◽  
Psychological Symptoms ◽  
Well Being ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Mediation Analyses ◽  
Mediating Role

Összefoglaló. Bevezetés: A coeliakia és a kapcsolódó terhek befolyásolják az érintettek életminőségét. A krónikus betegségekkel járó stigmatizáció hozzájárul a fizikai tünetek és a lelki panaszok fokozódásához, valamint az egészségmagatartás csökkenéséhez. Mindez szükségessé teszi a krónikus megbetegedések kapcsán a stigmatizáció felismerését, felmérését és kezelését. Célkitűzések: Fő célunk a 8 tételes Stigmatizáció Krónikus Betegségekben Kérdőív (SSCI-8) magyar adaptációja és pszichometriai vizsgálata volt coeliakiások körében. További célunk volt megvizsgálni a szégyen közvetítő szerepét a stigmatizáció és a jóllét között. Módszerek: A kutatás önbeszámolós, online kérdőíves, keresztmetszeti vizsgálatként zajlott (n = 85, átlagéletkor: 37,64, 91,8% nő). Az SSCI-8 mellett felvételre kerültek a szégyenélményt, a coeliakiás életminőséget, a jóllétet mérő kérdőívek. A kutatási célok tesztelése megerősítő faktorelemzéssel, korrelációs és mediációs elemzésekkel történt. Eredmények: Az SSCI-8 faktorelemzése során az egydimenziós modell megfelelő illeszkedést mutatott magas belső konzisztenciaértékek mellett. A mediációs modellek szerint a magasabb stigmatizáció a magasabb szégyenélményen keresztül járulhat hozzá a pszichés jóllét (coeliakiás életminőség, jóllét) csökkenéséhez. Megbeszélés: Az SSCI-8 rövid, átfogó kérdőívként megbízhatóan és érvényesen mérte a krónikus betegségben tapasztalt stigmatizációt a jelen coeliakiás mintán. Eredményeink alátámasztják, hogy a stigmatizáció és a szégyen fontos szerepet tölt be a jóllét csökkenésében. Következtetés: A nemzetközileg széles körben alkalmazott SSCI-8 adaptálására került sor, mely hazai kutatásokban és az egészségügyi ellátásban is hasznos mérőeszköz lehet. Az eredmények rávilágítanak, hogy a stigmatizáció és a szégyenélmény további kutatása szükséges, különösen a hatékony pszichoszociális intervenciók kifejlesztését megcélozva. Hatékony pszichológiai segítség révén a szégyen és a stigmatizáltság mérséklésével javulhat a coeliakiával élők fizikai és lelki állapota, ami a gluténmentes diéta betartása révén hozzájárulhat a betegség okozta tünetek és szövődmények mérsékléséhez. Orv Hetil. 2021; 162(49): 1968–1976. Summary. Introduction: Coeliac disease can detrimentally affect well-being. Stigmatization related to a chronic disease can enhance physical and psychological symptoms and negatively influence health behaviour, hence, stigma in chronic diseases needs to be addressed. Objectives: Our main goal was to psychometrically evaluate the Hungarian adaptation of the Stigma Scale for Chronic Illness-8 (SSCI-8). Further aim was to examine the mediating role of shame on the relationship between stigmatization and well-being aspects among individuals with coeliac disease. Methods: This cross-sectional study collected data using online questionnaires based on self-reports (n = 85, mean age: 37.64 years, 91.8% women). Instruments assessed levels of stigmatization, shame experience, quality of life in coeliac disease and well-being. Confirmatory factor, correlation and mediation analyses were used. Results: Factor analysis showed adequate fit for a unidimensional model with high internal consistency. Mediation models showed that higher levels of stigmatization can contribute to decreased levels of quality of life in coeliac disease and well-being via increased levels of shame. Discussion: The SSCI-8 is a short, valid, reliable instrument measuring stigmatization in the current sample of people with coeliac disease. The results highlight the role of stigma and shame in the decrease of well-being. Conclusion: The adapted version of the SSCI-8 can be a useful tool in Hungarian research and healthcare. The results suggest that stigmatization and shame need further attention to develop effective intervention which can reduce their effect and enhance adherence to gluten-free diet and improve physical and psychological well-being. Orv Hetil. 2021; 162(49): 1968–1976.

Toepassing van richtlijnen voor depressiezorg in verpleeghuizen en door professionals ervaren competentie, autonomie en verbondenheid

2020 ◽  
Keyword(s):  
Nursing Homes ◽  
Longitudinal Research ◽  
Self Determination Theory ◽  
Cross Sectional Study ◽  
Psychosocial Needs ◽  
Depression Care ◽  
Cross Sectional ◽  
The Relationship ◽  
Shed Light

Depression is highly prevalent in nursing homes residents and affects their quality of life. Both prevalence and impact of depression may decrease when effective guidelines or depression care programs are used, but this appears to be a challenging task. The Self Determination Theory postulates that the realization of complex tasks is being facilitated by meeting three basic human psychosocial needs: autonomy, competence and relatedness to others. This cross-sectional study investigates the relationship between the experienced autonomy, competence and relatedness and the extent to which depression care is given according to guidelines in 46 doctors, 49 psychologists and 53 nurses from 71 Dutch nursing homes. Although autonomy and competence were significantly related to depression care according to guidelines, hierarchical multiple regression analyses with all three basic needs showed a statistically significant result for competence only. The associations don’t allow conclusions about causal relationships, longitudinal research will shed light on the direction of the association for competence.

scholarly journals Assessment of the practicability of implementing the EULAR recommendations for the role of nurses in the management of chronic inflammatory arthritis in China

2020 ◽  
Vol 18 ◽  
pp. 205873922093522
Author(s):  
Ling Ma ◽  
Yan Liang ◽  
Sheng-nan Yu ◽  
Ying Wang ◽  
Susan M Oliver ◽  
...  
Keyword(s):  
Inflammatory Arthritis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Chronic Inflammatory Arthritis ◽  
Eular Recommendations ◽  
European League Against Rheumatism

Chronic inflammatory arthritis (CIA) severely impacts quality of life in over 100 million people in China. In 2011, the European League Against Rheumatism (EULAR) developed recommendations for the role of nurses in the management of CIA. However, it remains unknown whether these recommendations could be fully implemented in China. Therefore, we aimed to solve the problem in this study. We conducted a nationwide cross-sectional study among 485 nurses in rheumatology and immunology departments based on an online questionnaire. The agreement of the recommendations by the subjects and the feasibility of the recommendations they believe were assessed by visual analogue scale (VAS). Our results showed that over 80% of the subjects agreed with each recommendation (VAS 5–10), and over 80% of the subjects considered the recommendations feasible (VAS 5–10). This study indicates that the EULAR recommendations can also be well implemented in China.

scholarly journals Association between Patient Satisfaction and the Willingness to Return for Rehabilitation- A Pilot Study

2021 ◽  
Vol 14 (1) ◽  
pp. 455-461
Author(s):  
Nguyen Thi Thu Thao ◽  
Trinh Thanh Xuan ◽  
Nguyen Bao Tran ◽  
Bui Thi Huong ◽  
Nguyen Tuan Anh ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Cross Sectional Study ◽  
Average Score ◽  
Multivariate Logistic Regression ◽  
Cost Of Treatment ◽  
Cross Sectional ◽  
Rehabilitation Treatment ◽  
Satisfaction Index

Background: Patient satisfaction has played an important role in the development of health systems. However, the information on patient satisfaction and the returning of the patients for rehabilitation is limited. This study aims to explore the role of different domains in patient satisfaction with the willingness to return for further rehabilitation. Methods: The cross-sectional study was conducted among all 163 patients who were treated at different departments but needed a combination of treatment with rehabilitation at Viettiep hospital, Haiphong city. The Patient Satisfaction Index (PSI) Questionnaire was applied to record the average score of satisfaction. Multivariate logistic regression was used to determine the association between each domain of the PSI and the return for rehabilitation treatment. Results: Among the PSI scale, the strongest correlation was observed between the attitude of medical staff and the equipment and infrastructure of the hospital (r=0.305). The linear regression model indicated that patient satisfaction was associated significantly with the willingness to return for further rehabilitation (OR= 58.442). There were significant associations between the accessibility, equipment and infrastructure, quality of care and treatment, and cost of treatment with the returning for treatment of the patients. Conclusion: The patient satisfaction regarding individual domains should be considered in more detail in order to enhance the rehabilitation treatment of patients after discharging them from the hospital.

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