scholarly journals A cross-sectional audit of distress in patients undergoing adjuvant therapy or follow-up in central nervous system malignancies

2018 ◽  
Vol 6 (4) ◽  
pp. 305-310
Author(s):  
Vijay M Patil ◽  
Mridul Malhotra ◽  
Raees Tonse ◽  
Jayita Deodhar ◽  
Arun Chandrasekharan ◽  
...  

Abstract Background Unaddressed high distress leads to noncompliance with treatment, negatively affects quality of life, and may also have a negative impact on the prognosis of cancer patients. Patients with brain tumors have higher levels of distress than the general population and hence we hypothesize that even routine visits during adjuvant treatment or follow-up are likely to be stressful. This analysis was performed to identify the incidence of distress and factors affecting it. Methods This was an audit of 84 consecutive patients seen in an adult neuro-medical oncology outpatient department who were either receiving adjuvant chemotherapy or were on follow-up. Distress screening with the National Comprehensive Cancer Network (NCCN) distress thermometer was performed. Patients in whom distress was scored as 4 or above were considered as having high distress. Descriptive statistics and logistic regression analysis were performed to identify factors affecting distress. Results The median age of the cohort was 40 years (interquartile range, 28.3 to 50 years). Actionable distress defined as a distress score of 4 or more was seen in 52 patients (61.9%, 95% CI 51.2% to 71.5%). Presence of physical deficit (odds ratio [OR] = 3.412, P = .020) and treatment under the private category (OR = 5.273, P = .003) had higher odds of having high distress. Conclusion A high proportion of brain tumor patients either on adjuvant chemotherapy or on follow-up have high distress levels that need to be addressed even during follow-up.

2020 ◽  
Vol 7 (48) ◽  
pp. 2879-2884
Author(s):  
Pravitha M. Kumar ◽  
Naina Jabeen Hyder ◽  
Shaji A ◽  
Sunil M.S ◽  
Pappa P

BACKGROUND The term amblyopia literally means dullness of vision. It is defined as unilateral or bilateral reduction of visual acuity due to pattern vision deprivation or abnormal binocular interaction for which no ocular causes can be detected by ocular examination and can be reversed by therapeutic measures. The study was undertaken to estimate the proportion of non-compliance and factors affecting it in children undergoing occlusion therapy for amblyopia. METHODS The study was designed as a hospital based cross sectional study. Children aged 5 - 12 years undergoing occlusion therapy for amblyopia due to strabismus, anisometropia or both, who had been prescribed occlusion for a period of minimum 3 months were included in the study. Children with developmental or neurological disorders and other ocular conditions causing visual impairment, whose parents were not willing to participate in the study or follow up, and uncooperative children were also excluded from the study. RESULTS 52.5 % were non-compliant to occlusion therapy, 31.1 % were partially compliant and only 16.4 % were compliant. 38.5 % had final visual acuity in the range of 6 / 60 - 6 / 24 and 6 / 18 – 6 / 12, 20 % had 6 / 9 - 6 / 6. Different variables were assessed against compliance to check for any association. Significant association was found between compliance to occlusion and socioeconomic status (p = .006), visual acuity at presentation (p = .026), type of amblyopia (p = .038) and final visual acuity (p < .01) and association with educational status were found to be borderline (p = .059). CONCLUSIONS Occlusion therapy for amblyopia is a long drawn process which needs strict compliance and regular follow up. Compliance is a major factor affecting final visual outcome. Poor compliance leads to unsuccessful amblyopia therapy which in turn can have negative impact on child’s learning ability and psychosocial wellbeing. For this reason it is critical that care givers leave the clinic with clear knowledge of how and why patching is being recommended and its importance in improving child’s vision. KEYWORDS Amblyopia, Occlusion, Compliance


2021 ◽  
Author(s):  
Pia Cassanello ◽  
Ruiz-Botia Irene ◽  
Sala-Castellvi Pere ◽  
Martin Juan Carlos ◽  
Jose Martínez-Sanchez ◽  
...  

Abstract IntroductionRecent literature has shown that sleep patterns are shaped during the first years of life, playing a relevant role in children’s functioning. We focused on comparing sleep patterns in infants and toddlers in Spain before and during COVID-19 home confinement to assess the immediate impact on sleep patterns. Methodse compared data from two cross-sectional surveys from parents of 1,658 children three to 36 months of age from Spain. One conducted before COVID-19 (2017-2018, n=1,380) and another during COVID-19 pandemic (March-May of 2020, n=254). We used an internet self-administrated questionnaire using the Brief Infant Sleep Questionnaire (BISQ) criteria in both surveys.ResultsDuring confinement infants and toddlers went to sleep later (median bedtime 21.5 before confinement vs. 21.6 during confinement p=0.004). We found a statistically significant increase in infants’ and toddlers’ sleep latency by >30 minutes during confinement (p<0.001). Based on the recommended BISQ criteria for classifying inadequate sleep patterns, we observed a statistically significant increase in poor sleepers meeting at least one criterion during confinement (p<0.001). ConclusionsParents during COVID-19 home confinement reported several factors affecting the quality of their children’s sleep. Follow-up studies can help understand the potential long-term effects of the COVID-19 pandemic on sleep patterns.


2015 ◽  
Vol 3 (2) ◽  
pp. 116-120
Author(s):  
A Kumar ◽  
S Neupane ◽  
PR Shrestha ◽  
J Pun ◽  
P Thapa ◽  
...  

Background: Psoriasis may have negative impact on a patient’s quality of life. Very few studies have examined this aspect in Nepalese population. Aim of this study was to evaluate the Quality of life (QOL) in chronic psoriatic patients by modified version of psoriasis disability index (PDI).Methods: Present cross sectional study was conducted in three major hospitals in western Nepal. One hundred chronic psoriatic patients of 18 years or more of age, with disease duration of six months or more and body surface area involvement of 10% or more were recruited. Clinical assessment was done with psoriasis area severity index (PASI) and quality of life was measured by modified version of PDI. Patients were managed as per indication. At the follow up at four weeks, improvement in PASI and improvement in QOL was measured. Statistical analysis by Chisquare test was done to assess the relation between severity of psoriasis and different items of quality of life.Results: Psoriasis has negative impact on all aspect of quality of life in Nepalese patients, as shown by score of modified version of PDI, which was 39.27% of total. There was significant improvement in PASI at follow up visit, from 23.29% to 15.35% of total. There was significant improvement in quality of life after treatment (modified version of PDI) from 39.27% to 32.66% of total.Conclusions: Psoriasis has negative impact on all aspect of quality of life in Nepalese patients.Nepal Journal of Medical Sciences Vol.3(2) 2014: 116-120


2020 ◽  
Vol 26 (1) ◽  
pp. 31-36
Author(s):  
Md Zakaria Sarkar ◽  
AHM Ferdows Nur ◽  
Utpal Kumar Dutta ◽  
Muhammad Rafiqul Islam ◽  
Debabrota Roy ◽  
...  

Objective: The aim of this study was to evaluate hearing outcome after stapedotomy in patients with Otosclerosis. Methods: This cross sectional study was carried out from July 2017 to January 2019 in National Institute of ENT, Unit V. About 22 patients with Otosclerosis were included in this study. Diagnosis of Otosclerosis was based on the history, medical status with Otoscopy, Tuning fork tests and Audiometric tests. We compiled data on the pre and post operative air-bone gap (ABG) at 0.5, 1, 2 KHZ. The ABG was Calculated using AC and BC thresholds on the same audiogram. Post operative hearing gain was then Calculated from the ABG before the operation minus the ABG of the last follow up examination Results: In this study most of the cases were age group 14-30 years (72.7%), female (54.5%). Most common symptoms was progressive hearing loss, tinnitus (77.8%).The average preoperative hearing loss in this study was (AC) was 48.31±7.68. The average post opt. hearing (AC) at follow up was 28.95±10.30 with an average hearing gain of 15.40±8.53 dB which was significant. The average pre-operative ABG was 28.99 dB ± 8.10. The average post opt. ABG was analyzed at 1 follow up showed ABG 13.18±8.09 dB which was found to be significant. Conclusion: Stapedotomy is an effective surgical procedure for the treatment of otosclerosis which leads to improvement in patient’s quality of life. A favorable hearing outcome can be obtained by the combination of experienced hands with minimal surgical trauma and appropriate surgical technique. Bangladesh J Otorhinolaryngol; April 2020; 26(1): 31-36


2021 ◽  
Vol 28 (4) ◽  
pp. 2789-2800
Author(s):  
Stephanie Lelond ◽  
Julie Ward ◽  
Pascal J. Lambert ◽  
Christina A. Kim

Patients with advanced pancreatic cancer (APC) experience many disease-related symptoms. ESAS-r measures the severity of 9 symptom domains and has been validated for use in the ambulatory oncology setting. We aimed to describe symptom burden at baseline for patients with APC treated with modern chemotherapy (CT), and to determine whether symptom burden at baseline is prognostic. Patients diagnosed with APC between 2012–2016, treated with ≥1 cycle of CT, who completed ≥1 ESAS-r were identified. Descriptive statistics were used to report symptom burden and common moderate-to-severe symptoms. A joint model was used to describe the trajectory of ESAS-r during follow-up while controlling for death. Multivariable Cox regression was used to identify independent predictors of death. Of 123 patients identified, the median age was 65 and 61% had metastatic disease. The median baseline ESAS-r total symptom distress score (TSDS) was 24. A total of 86% of patients had at least one symptom score of ≥4 at baseline, with the most common being: fatigue, nausea, anxiety, and shortness of breath. Median overall survival was 10.2 months. Baseline TSDS was not predictive for worse survival in the era of modern CT. Patients with APC have a high burden of cancer-associated symptoms and a high prevalence of moderate-to-severe symptoms. Early intervention has the potential to improve quality of life in this group of patients and should be investigated.


Author(s):  
Zuzana Škodová ◽  
Ľubica Bánovčinová ◽  
Eva Urbanová ◽  
Marián Grendár ◽  
Martina Bašková

Background: Postpartum depression has a negative impact on quality of life. The aim of this study was to examine the factor structure and psychometric properties of the Slovak version of the Edinburgh Postnatal Depression Scale (EPDS). Methods: A paper and pencil version of the 10-item EPDS questionnaire was administered personally to 577 women at baseline during their stay in hospital on the second to fourth day postpartum (age, 30.6 ± 4.9 years; 73.5% vaginal births vs. 26.5% operative births; 59.4% primiparas). A total of 198 women participated in the online follow-up 6–8 weeks postpartum (questionnaire sent via e-mail). Results: The Slovak version of the EPDS had Cronbach’s coefficients of 0.84 and 0.88 at baseline (T1) and follow-up, respectively. The three-dimensional model of the scale offered good fit for both the baseline (χ2(df = 28) = 1339.38, p < 0.001; CFI = 0.99, RMSEA = 0.02, and TLI = 0.99) and follow-up (χ2(df = 45) = 908.06, p < 0.001, CFI = 0.93, RMSEA = 0.09, and TL = 0.90). A risk of major depression (EPDS score ≥ 13) was identified in 6.1% in T1 and 11.6% in the follow-up. Elevated levels of depression symptoms (EPDS score ≥ 10) were identified in 16.7% and 22.7% of the respondents at baseline and follow-up, respectively. Conclusions: The Slovak translation of the EPDS showed good consistency, convergent validity, and model characteristics. The routine use of EPDS can contribute to improving the quality of postnatal health care.


2021 ◽  
Vol 33 (3) ◽  
pp. 249-264
Author(s):  
Gert Scheerder ◽  
Sandra Van den Eynde ◽  
Patrick Reyntiens ◽  
Ria Koeck ◽  
Jessika Deblonde ◽  
...  

This cross-sectional survey explored the quality of life in 505 people living with HIV in Belgium. Several domains of quality of life were impaired: 26% had been diagnosed with depression and 43% had weak social support. HIV-related stigma is still widespread, with 49% believing most people with HIV are rejected and 65% having experienced discrimination due to HIV. The impact of HIV was limited on professional life, but 40% experienced a negative impact on life satisfaction and 41% a negative impact on sexual life. For several domains, people with a recent diagnosis of HIV and long-term survivors had significantly worse scores. This survey also uncovered strengths of people living with HIV, such as positive coping and HIV self-image. Expanding the scope of quality of life in people living with HIV may provide a more complete picture of relevant life domains that may be impacted by living with HIV, but this needs further validation.


2017 ◽  
Vol 4 (2) ◽  
pp. 110-114 ◽  
Author(s):  
Nabila Kanwal ◽  
Ghazala Riaz ◽  
Muhammad Shahid Riaz ◽  
Shoumaila Safdar

Absenteeism is a usual pattern of absence from a duty or responsibility. Usually, absenteeism is considered as an indication of person poor performance. In this study a descriptive cross sectional study design was used. A close ended questionnaire was used as a research tool. Convenient sampling technique was used. Data was analyzed on SPSS 20 version. Nurses are absent from their duties because they suffer from minor ailments e.g. headache and backache? In response of this question, 42.5% responded said that they are strongly agreed, 17.5% were agreed, 8.8% were neutral, 21.3% were disagreed, and 10% were strongly agreed. Nurses do absent from their work because workload is too heavy, 42.5% were agreed, 30% were strongly agreed, 12.5% were neutral,7.5% were disagreed and 7.5% were also strongly disagreed. The lack of appropriate recognition and reward could lead to dissatisfaction and absenteeism among nurses, in response of this question nurses asked that they do absent 31.3% agreed, 41.3% strongly agreed, 15.0% are neutral, 12.5%are disagreed and 0% are strongly disagreed. Staff absenteeism is a growing management concern. It can contribute to sickness absence, staffing instability, work overload and job dissatisfaction that could have a negative impact on patient care. The rate of absenteeism can be reduced by productive management, and loyal leadership. It will not only reduce absenteeism rate but also improve quality of care toward the patients. In return of good performance nurses need appraisal.Int. J. Soc. Sc. Manage. Vol. 4, Issue-2: 110-114


2021 ◽  
Vol 2 (2) ◽  
pp. 58-68
Author(s):  
Dherma Wati Bangun ◽  
Dherma Wati Bangun ◽  
Vivi Eulis Diana

Patients in health services have different behaviors in deciding to take advantage of health services. Patients used various considerations to make decisions based on the health products or services for re-treatment. The study aimed to analyze the factors that influence the patient's decision in using health services for re-treatment. This research was quantitative with cross-sectional design and conducted at Tanjung Pura Regional Hospital. The population was 3.946 people, and the sample were 247 respondents taken by using purposive sampling. Data analysis was univariate and bivariate using chi-square and multivariate using multiple logistic regression at the 95% confidence level (a= .05). The results showed that the factors that influenced the patient's decision to use health services for re-treatment at the Tanjung Pura Regional Hospital were the service quality of doctors / nurses (p= .000), distance (p=.049), facilities (p=0.000), and service speed (p = .000). The factors that did not influence we age (p=.461). gender (p=.895), education (p=.371), occupation (p=.593). The most dominant factor influencing is facilities with Exp (B)/OR =14.477, meaning that respondents who stated that the hospital facilities were good, had the opportunity to use health services for re-treatment by 14.4 times higher the respondents who stated that the hospital facilities were not good. It is suggested to Tanjung Pura Regional Hospital to propose and allocate a budget for improving hospital facilities that are still lacking and adding new service facilities so that it can increase public confidence for repeat treatment


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