Influencing Factors Associated with Implementation of INTERACT (Interventions to Reduce Acute Care Transfers) in VA Community Living Centers (CLCs) Using the Consolidated Framework

OBJECTIVEDischarge to an inpatient rehabilitation facility or another acute-care facility not only constitutes a postoperative challenge for patients and their care team but also contributes significantly to healthcare costs. In this era of changing dynamics of healthcare payment models in which cost overruns are being increasingly shifted to surgeons and hospitals, it is important to better understand outcomes such as discharge disposition. In the current article, the authors sought to develop a predictive model for factors associated with nonroutine discharge after surgery for grade I spondylolisthesis.METHODSThe authors queried the Quality Outcomes Database for patients with grade I lumbar degenerative spondylolisthesis who underwent a surgical intervention between July 2014 and June 2016. Only those patients enrolled in a multisite study investigating the impact of fusion on clinical and patient-reported outcomes among patients with grade I spondylolisthesis were evaluated. Nonroutine discharge was defined as those who were discharged to a postacute or nonacute-care setting in the same hospital or transferred to another acute-care facility.RESULTSOf the 608 patients eligible for inclusion, 9.4% (n = 57) had a nonroutine discharge (8.7%, n = 53 discharged to inpatient postacute or nonacute care in the same hospital and 0.7%, n = 4 transferred to another acute-care facility). Compared to patients who were discharged to home, patients who had a nonroutine discharge were more likely to have diabetes (26.3%, n = 15 vs 15.7%, n = 86, p = 0.039); impaired ambulation (26.3%, n = 15 vs 10.2%, n = 56, p < 0.001); higher Oswestry Disability Index at baseline (51 [IQR 42–62.12] vs 46 [IQR 34.4–58], p = 0.014); lower EuroQol-5D scores (0.437 [IQR 0.308–0.708] vs 0.597 [IQR 0.358–0.708], p = 0.010); higher American Society of Anesthesiologists score (3 or 4: 63.2%, n = 36 vs 36.7%, n = 201, p = 0.002); and longer length of stay (4 days [IQR 3–5] vs 2 days [IQR 1–3], p < 0.001); and were more likely to suffer a complication (14%, n = 8 vs 5.6%, n = 31, p = 0.014). On multivariable logistic regression, factors found to be independently associated with higher odds of nonroutine discharge included older age (interquartile OR 9.14, 95% CI 3.79–22.1, p < 0.001), higher body mass index (interquartile OR 2.04, 95% CI 1.31–3.25, p < 0.001), presence of depression (OR 4.28, 95% CI 1.96–9.35, p < 0.001), fusion surgery compared with decompression alone (OR 1.3, 95% CI 1.1–1.6, p < 0.001), and any complication (OR 3.9, 95% CI 1.4–10.9, p < 0.001).CONCLUSIONSIn this multisite study of a defined cohort of patients undergoing surgery for grade I spondylolisthesis, factors associated with higher odds of nonroutine discharge included older age, higher body mass index, presence of depression, and occurrence of any complication.

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Knowledge, attitudes, practices, and influencing factors of anxiety among pregnant women in Wuhan during the outbreak of COVID-19: a cross-sectional study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03561-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wenping Ding ◽

Jianmei Lu ◽

Yan Zhou ◽

Weizhong Wei ◽

Zhihong Zhou ◽

...

Keyword(s):

Logistic Regression ◽

Pregnant Women ◽

Influencing Factors ◽

Information Source ◽

Influential Factors ◽

Public Health Issue ◽

Cross Sectional ◽

Factors Associated ◽

Attitudes And Practices ◽

Prenatal Anxiety

Abstract Background Prenatal anxiety has been a significant public health issue globally, leading to adverse health outcomes for mothers and children. The study aimed to evaluate the sociodemographic characteristics, knowledge, attitudes, and practices (KAP), and anxiety level of pregnant women during the coronavirus disease 2019 (COVID-19) epidemic in Wuhan and investigate the influencing factors for prenatal anxiety in this specific context. Methods Pregnant subjects’ KAP towards COVID-19 and their sociodemographics and pregnancy information were collected using questionnaires. The Zung Self-Rating Anxiety Scale (SAS) was used to assess anxiety status. Factors associated with the level of prenatal anxiety were analyzed by Pearson’s chi-square test and multivariable logistic regression analyses. Results The prenatal anxiety prevalence in this population was 20.8%. The mean score of knowledge was 13.2 ± 1.1 on a 0 ~ 14 scale. The attitudes and practices data showed that 580/ 817 (71.0%) were very concerned about the news of COVID-19, 455/817 (55.7%) considered the official media to be the most reliable information source for COVID-19, and 681/817 (83.4%) were anxious about the possibility of being infected by COVID-19. However, only 83/817 (10.2%) worried about contracting COVID-19 infection through the ultrasound transducer during a routing morphology scan. About two-thirds 528/817 (64.6%) delayed or canceled the antenatal visits. Approximately half of them 410/817 (50.2%) used two kinds of personal protection equipments (PPEs) during hospital visits. Logistic regression analysis revealed that the influential factors for prenatal anxiety included previous children in the family, knowledge score, media trust, worry of contracting the COVID-19 infection and worry about getting infected with COVID-19 from the ultrasound probe antenatal care (ANC) schedule. Conclusion Prenatal anxiety was prevalent among pregnant women in Wuhan during the outbreak of COVID-19. The current findings identified factors associated with the level of prenatal anxiety that could be targeted for psychological care.

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Reliability and Validity of a Person-Centered Care Staff Survey in Veterans Health Administration Community Living Centers

The Gerontologist ◽

10.1093/geront/gns140 ◽

2012 ◽

Vol 53 (4) ◽

pp. 596-607 ◽

Cited By ~ 13

Author(s):

J. L. Sullivan ◽

M. Meterko ◽

E. Baker ◽

K. Stolzmann ◽

O. Adjognon ◽

...

Keyword(s):

Reliability And Validity ◽

Veterans Health Administration ◽

Care Staff ◽

Community Living ◽

Veterans Health ◽

Health Administration ◽

Person Centered Care ◽

Centered Care ◽

Community Living Centers

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Systematic review of beliefs, behaviours and influencing factors associated with disclosure of a mental health problem in the workplace

BMC Psychiatry ◽

10.1186/1471-244x-12-11 ◽

2012 ◽

Vol 12 (1) ◽

Cited By ~ 133

Author(s):

Elaine Brohan ◽

Claire Henderson ◽

Kay Wheat ◽

Estelle Malcolm ◽

Sarah Clement ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Influencing Factors ◽

Mental Health Problem ◽

Health Problem ◽

Factors Associated

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Factors associated with unplanned readmissions in a major Australian health service

Australian Health Review ◽

10.1071/ah16287 ◽

2019 ◽

Vol 43 (1) ◽

pp. 1 ◽

Cited By ~ 8

Author(s):

Julie Considine ◽

Karen Fox ◽

David Plunkett ◽

Melissa Mecner ◽

Mary O'Reilly ◽

...

Keyword(s):

Health Service ◽

Hospital Admission ◽

Acute Care ◽

Index Admission ◽

Unplanned Readmission ◽

Factors Associated ◽

Australian Health ◽

Increased Risk ◽

Patient Groups ◽

Comorbidity Index

Objective The aim of the present study was to gain an understanding of the factors associated with unplanned hospital readmission within 28 days of acute care discharge from a major Australian health service. Methods A retrospective study of 20575 acute care discharges from 1 August to 31 December 2015 was conducted using administrative databases. Patient, index admission and readmission characteristics were evaluated for their association with unplanned readmission in ≤28 days. Results The unplanned readmission rate was 7.4% (n=1528) and 11.1% of readmitted patients were returned within 1 day. The factors associated with increased risk of unplanned readmission in ≤28 days for all patients were age ≥65 years (odds ratio (OR) 1.3), emergency index admission (OR 1.6), Charlson comorbidity index >1 (OR 1.1–1.9), the presence of chronic disease (OR 1.4) or complications (OR 1.8) during the index admission, index admission length of stay (LOS) >2 days (OR 1.4–1.8), hospital admission(s) (OR 1.7–10.86) or emergency department (ED) attendance(s) (OR 1.8–5.2) in the 6 months preceding the index admission and health service site (OR 1.2–1.6). However, the factors associated with increased risk of unplanned readmission ≤28 days changed with each patient group (adult medical, adult surgical, obstetric and paediatric). Conclusions There were specific patient and index admission characteristics associated with increased risk of unplanned readmission in ≤28 days; however, these characteristics varied between patient groups, highlighting the need for tailored interventions. What is known about the topic? Unplanned hospital readmissions within 28 days of hospital discharge are considered an indicator of quality and safety of health care. What does this paper add? The factors associated with increased risk of unplanned readmission in ≤28 days varied between patient groups, so a ‘one size fits all approach’ to reducing unplanned readmissions may not be effective. Older adult medical patients had the highest rate of unplanned readmissions and those with Charlson comorbidity index ≥4, an index admission LOS >2 days, left against advice and hospital admission(s) or ED attendance(s) in the 6 months preceding index admission and discharge from larger sites within the health service were at highest risk of unplanned readmission. What are the implications for practitioners? One in seven discharges resulted in an unplanned readmission in ≤28 days and one in 10 unplanned readmissions occurred within 1 day of discharge. Although some patient and hospital characteristics were associated with increased risk of unplanned readmission in ≤28 days, statistical modelling shows there are other factors affecting the risk of readmission that remain unknown and need further investigation. Future work related to preventing unplanned readmissions in ≤28 days should consider inclusion of health professional, system and social factors in risk assessments.

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The Influencing Factors associated Cultural Awareness of Immigrants for Marriage, Foreign Workers in Korean Nursing Students

Korean Journal of Adult Nursing ◽

10.7475/kjan.2012.24.5.531 ◽

2012 ◽

Vol 24 (5) ◽

pp. 531-539 ◽

Cited By ~ 8

Author(s):

Kyung Sook Kim ◽

Mi Yu

Keyword(s):

Nursing Students ◽

Influencing Factors ◽

Cultural Awareness ◽

Foreign Workers ◽

Factors Associated

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Exploring the multi-dimensional influencing factors associated with sub-health status for residents: a cross-sectional study from China

10.21203/rs.2.19224/v1 ◽

2019 ◽

Author(s):

Jiaojiao Ren ◽

Xiling Yin ◽

Guangyou Li ◽

Jun Li ◽

Liju Zhang ◽

...

Keyword(s):

Health Status ◽

Influencing Factors ◽

Intervention Program ◽

Cross Sectional Study ◽

Health Intervention ◽

Sectional Study ◽

Place Of Residence ◽

Health Measurement ◽

Cross Sectional ◽

Factors Associated

Abstract Background: The high incidence of sub-health and its impact on life and work have attracted wide attention. Sub-health status has been studied in China; however, there remains a lack of studies on multi-dimensional factors affecting sub-health status. This study aims to explore the sub-health status of residents, and its influencing factors in Zhuhai city of Guangdong Province of China. Methods: Data were originated from the baseline survey of Zhuhai WHO Healthy Cities Index System in 2015, which was a cross-sectional study for the influencing factors associated with sub-health status. Finally, 3,313 participants aged 16-65 years were recruited. The study used the Sub-health Measurement Scale (SHMS V1.0), and the multivariate logistic regression model was to examine their possible associations with sub-health status. Data were analyzed using the SPSS version 22.0. Results: Sub-health and non-sub-health groups accounted for 56.8% and 43.2% of the study population, respectively. There existed significant differences in terms of all items of SHMS V1.0 between the two groups. In the multivariate model, the place of residence was statistically significantly associated with sub-health, followed by having many close neighbors, relatives or friends, and happy feelings. Conclusion: There are significant differences in many items of SHMS V1.0 between sub-health and non-sub-health groups. The leading determinants of sub-health included place of residence; having close neighbors, relatives or friends; having happy feelings; and negative emotions. To develop an effective sub-health intervention program, these factors should be taken into consideration. To develop an effective sub-health intervention program, the influencing factors should be taken into consideration.

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The occurrence and timing of delirium in acute care hospitalizations in the last year of life: A population-based retrospective cohort study

Palliative Medicine ◽

10.1177/0269216320929545 ◽

2020 ◽

Vol 34 (8) ◽

pp. 1067-1077

Author(s):

Colleen Webber ◽

Christine L Watt ◽

Shirley H Bush ◽

Peter G Lawlor ◽

Robert Talarico ◽

...

Keyword(s):

Cohort Study ◽

Confidence Interval ◽

Acute Care ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Prevalence Ratio ◽

Acute Care Hospitals ◽

Population Based ◽

Care Hospital ◽

Factors Associated

Background: Delirium is a distressing neurocognitive disorder that is common among terminally ill individuals, although few studies have described its occurrence in the acute care setting among this population. Aim: To describe the prevalence of delirium in patients admitted to acute care hospitals in Ontario, Canada, in their last year of life and identify factors associated with delirium. Design: Population-based retrospective cohort study using linked health administrative data. Delirium was identified through diagnosis codes on hospitalization records. Setting/participants: Ontario decedents (1 January 2014 to 31 December 2016) admitted to an acute care hospital in their last year of life, excluding individuals age of <18 years or >105 years at admission, those not eligible for the provincial health insurance plan between their hospitalization and death dates, and non-Ontario residents. Results: Delirium was recorded as a diagnosis in 8.2% of hospitalizations. The frequency of delirium-related hospitalizations increased as death approached. Delirium prevalence was higher in patients with dementia (prevalence ratio: 1.43; 95% confidence interval: 1.36–1.50), frailty (prevalence ratio: 1.67; 95% confidence interval: 1.56–1.80), or organ failure–related cause of death (prevalence ratio: 1.23; 95% confidence interval: 1.16–1.31) and an opioid prescription (prevalence ratio: 1.17; 95% confidence interval: 1.12–1.21). Prevalence also varied by age, sex, chronic conditions, antipsychotic use, receipt of long-term care or home care, and hospitalization characteristics. Conclusion: This study described the occurrence and timing of delirium in acute care hospitals in the last year of life and identified factors associated with delirium. These findings can be used to support delirium prevention and early detection in the hospital setting.

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