Quality of clinical aspects of call handling at Dutch out of hours centres: cross sectional national study

ObjectiveTo assess the association between flooding/repeat flooding and: (1) psychological morbidity (anxiety, depression, post-traumatic stress disorder (PTSD)) and (2) health-related quality of life (HRQoL) at 6 months post-flooding.DesignCross-sectional analysis of data from the English National Study of Flooding and Health.SettingCumbria, England.ParticipantsQuestionnaires were sent to 2500 residential addresses at 6 months post-flooding; 590 people responded.OutcomesProbable depression was assessed using the Patient Health Questionnaire, probable anxiety using the Generalised Anxiety Disorder scale and probable PTSD using the short-form PTSD checklist (PCL-6). HRQoL was assessed using the EQ-5D-5L. Mental health outcomes were analysed using logistic regression; HRQoL dimensions using ordinal regression; and summary index/Visual Analogue Scale scores using linear regression.ResultsOne hundred and nineteen participants had been flooded, over half of whom were experiencing a repeat flooding event (54%; n=64). Mental health outcomes were elevated among flooded compared with unaffected participants (adjusted OR for probable depression: 7.77, 95% CI: 1.51 to 40.13; anxiety: 4.16, 95% CI: 1.18 to 14.70; PTSD: 14.41, 95% CI: 3.91 to 53.13). The prevalence of depression was higher among repeat compared with single flooded participants, but this was not significant after adjustment. There was no difference in levels of anxiety or PTSD. Compared with unaffected participants, those flooded had lower EQ-5D-5L index scores (adjusted coefficient: −0.06, 95% CI: −0.12 to −0.01) and lower self-rated health scores (adjusted coefficient: −6.99, 95% CI: −11.96 to −2.02). There was, however, little difference in HRQoL overall between repeat and single flooded participants.ConclusionsInterventions are needed to help minimise the impact of flooding on people’s mental health and HRQoL.

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Communication quality in telephone triage conducted by general practitioners, nurses or physicians: a quasi-experimental study using the AQTT to assess audio-recorded telephone calls to out-of-hours primary care in Denmark

BMJ Open ◽

10.1136/bmjopen-2019-033528 ◽

2020 ◽

Vol 10 (3) ◽

pp. e033528

Author(s):

Dennis Schou Graversen ◽

Linda Huibers ◽

Morten Bondo Christensen ◽

Flemming Bro ◽

Helle Collatz Christensen ◽

...

Keyword(s):

General Practitioners ◽

Assessment Tool ◽

Telephone Triage ◽

Communication Quality ◽

Cross Sectional ◽

Out Of Hours ◽

Computerised Decision Support System ◽

Quasi Experimental ◽

Medical Specialities

ObjectivesTo compare the quality of communication in out-of-hours (OOH) telephone triage conducted by general practitioners (GPs), nurses using a computerised decision support system and physicians with different medical specialities, and to explore the association between communication quality and efficiency, length of call and the accuracy of telephone triage.DesignNatural quasi-experimental cross-sectional study.SettingTwo Danish OOH services using different telephone triage models: a GP cooperative and the medical helpline 1813.Participants1294 audio-recorded randomly selected OOH telephone triage calls from 2016 conducted by GPs (n=423), nurses using CDSS (n=430) and physicians with different medical specialities (n=441).Main outcome measuresTwenty-four physicians assessed the calls. The panel used a validated assessment tool (Assessment of Quality in Telephone Triage, AQTT) to measure nine aspects of communication, overall perceived communication quality, efficiency and length of call.ResultsThe risk ofpoorquality was significantly higher in calls triaged by GPs compared with calls triaged by nurses regarding ‘allowing the caller to describe the situation’ (GP: 13.5% nurse: 9.8%), ‘mastering questioning techniques’ (GP: 27.4% nurse: 21.1%), ‘summarising’ (GP: 33.0% nurse: 21.0%) and ‘paying attention to caller’s experience’ (GP: 25.7% nurse: 17.0%). The risk ofpoorquality was significantly higher in calls triaged by physicians compared with calls triaged by GPs in five out of nine items. GP calls were significantly shorter (2 min 57 s) than nurse calls (4 min 44 s) and physician calls (4 min 1 s). Undertriaged calls were rated lower than optimally triaged calls for overall quality of communication (p<0.001) and all specific items.ConclusionsCompared with telephone triage by GPs, the communication quality was higher in calls triaged by nurses and lower in calls triaged by physicians with different medical specialities. However, calls triaged by nurses and physicians were longer and perceived less efficient. Quality of communication was associated with accurate triage.

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Clinical aspects and the quality of life among women with endometriosis and infertility: a cross-sectional study

BMC Women s Health ◽

10.1186/s12905-020-00987-7 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 2

Author(s):

Marina Pessoa de Farias Rodrigues ◽

Fabia Lima Vilarino ◽

Alessandra de Souza Barbeiro Munhoz ◽

Laércio da Silva Paiva ◽

Luiz Vinicius de Alcantara Sousa ◽

...

Keyword(s):

Quality Of Life ◽

Cross Sectional Study ◽

Clinical Aspects ◽

Sectional Study ◽

Cross Sectional

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Older persons are frailer after an emergency care visit to the out-of-hours General Practitioner Cooperative in the Netherlands: a cross-sectional descriptive TOPICS-MDS study

10.21203/rs.3.rs-18176/v2 ◽

2020 ◽

Author(s):

Anneke Bloemhoff ◽

Yvonne Schoon ◽

Kien Smulders ◽

Reinier Akkermans ◽

Lilian Vloet ◽

...

Keyword(s):

Quality Of Life ◽

Home Care ◽

Emergency Care ◽

Older Persons ◽

Reference Group ◽

Mean Difference ◽

Cross Sectional ◽

Out Of Hours ◽

Care Visit

Abstract Background: In the Netherlands, community-dwelling older people with primary care emergency problems contact the General Practitioner Cooperative (GPC) after hours. However, frailty remains an often unobserved hazard with adverse health outcomes. The aim of this study was to provide insight into differences between older persons with or without GPC emergency care visits (reference group) regarding frailty and healthcare use.Methods: A cross-sectional descriptive study design was based on data from the public data repository of The Older Persons and Informal Caregivers Survey Minimum Dataset (TOPICS-MDS). Frailty in older persons (65+ years, n=32,149) was measured by comorbidity, functional and psychosocial aspects, quality of life and a frailty index. Furthermore, home care use and hospital admissions of older persons were identified. We performed multilevel logistic and linear regression analyses. A random intercept model was utilised to test differences between groups, and adjustment factors (confounders) were used in the multilevel analysis.Results: Compared to the reference group, older persons with GPC contact were frailer in the domain of comorbidity (mean difference 0.52; 95% CI 0.47-0.57, p <0.0001) and functional limitations (mean difference 0.53; 95% CI 0.46-0.60, p <0.0001), and they reported less emotional wellbeing (mean difference -4.10; 95% CI -4.59- -3.60, p <0.0001) and experienced a lower quality of life (mean difference -0.057; 95% CI -0.064- -0.050, p <0.0001). Moreover, older persons more often reported limited social function (OR = 1.50; 95% CI 1.39-1.62, p <0.0001) and limited perceived health (OR = 1.50, 95% CI 1.39-1.62, p <0.0001). Finally, older persons with GPC contact more often used home care (OR = 1.37; 95% CI 1.28-1.47, p <0.0001) or were more often admitted to the hospital (OR = 2.88; 95% CI 2.71-3.06, p <0.0001).Conclusions: Older persons with out-of-hours GPC contact for an emergency care visit were significantly frailer in all domains and more likely to use home care or to be admitted to the hospital compared to the reference group. Potentially frail older persons seemed to require adequate identification of frailty and support (e.g., advanced care planning) both before and after a contact with the out-of-hours GPC.

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Atopic dermatitis in adults from sub-Saharan Africa: epidemiological and clinical patterns, severity, and quality of life

Our Dermatology Online ◽

10.7241/ourd.20211.1 ◽

2021 ◽

Vol 12 (1) ◽

pp. 1-6

Author(s):

Emmanuel Armand Kouotou

Keyword(s):

Quality Of Life ◽

Atopic Dermatitis ◽

Urban Areas ◽

Cross Sectional Study ◽

Lower Limbs ◽

Sub Saharan Africa ◽

Clinical Aspects ◽

Cross Sectional ◽

Sub Saharan

Background: Atopic dermatitis (AD) is a chronic and recurrent inflammatory dermatitis often associated with other atopic manifestations, such as asthma and allergic rhinitis. This study aimed to determine the epidemiological and clinical aspects of AD and to assess the quality of life (QoL) of patients suffering from AD in our setting. Materials and Methods: This was a cross-sectional study conducted from February through April 2017 in seven hospitals in Cameroon. The study included patients above 18 who presented themselves to a dermatology consultation, were diagnosed with AD, and gave their consent. To assess the severity of AD and evaluate the QoL of the patients, standardized scales, such as SCORAD and QoLIAD, were employed. Results: The study enrolled 46 patients between 18 and 69 years of age with a mean age of 31 ± 12 years and the prevalence of AD at 1.5%. Most of the participants were females, with a sex ratio of 0.4:1, living in urban areas (93.5%). Food (34.8%) and cosmetic products (21.7%) were found as the main risk factors in the occurrence of AD. Upon physical examination, the upper and lower limbs were found to be the most affected in 84.8% and 54.3% of cases, respectively; in addition to cutaneous xerosis (45.7%), lichenification (43.5%), and excoriations (37%). Of the 46 patients, 9 (20%) had severe AD, 32 (70%) had moderate AD, and 5 (10%) had mild AD. QoL was impaired in 43 of the 46 patients (93.5%). Conclusion: Atopic dermatitis is a pathology that impacts the QoL of adults. A QoL assessment is, therefore, an important step in the management of AD.

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Mental health in hospital emergency departments: cross-sectional analysis of attendances in England 2013/2014

Emergency Medicine Journal ◽

10.1136/emermed-2019-209105 ◽

2020 ◽

pp. emermed-2019-209105

Author(s):

Simona Baracaia ◽

David McNulty ◽

Simon Baldwin ◽

Jemma Mytton ◽

Felicity Evison ◽

...

Keyword(s):

Mental Health ◽

Emergency Departments ◽

National Study ◽

Hospital Emergency ◽

Cross Sectional ◽

Out Of Hours ◽

Psychiatric Conditions ◽

Sectional Analysis ◽

Hospital Emergency Departments ◽

Index Of Multiple Deprivation

ObjectiveTo describe the population of patients who attend emergency departments (ED) in England for mental health reasons.MethodsCross-sectional observational study of 6 262 602 ED attendances at NHS (National Health Service) hospitals in England between 1 April 2013 and 31 March 2014. We assessed the proportion of attendances due to psychiatric conditions. We compared patient sociodemographic and attendance characteristics for mental health and non-mental health attendances using logistic regression.Results4.2% of ED attendances were attributable to mental health conditions (median 3.2%, IQR 2.6% to 4.1%). Those attending for mental health reasons were typically younger (76.3% were aged less than 50 years), of White British ethnicity (73.2% White British), and resident in more deprived areas (59.9% from the two most deprived Index of Multiple Deprivation quintiles (4 and 5)). Mental health attendances were more likely to occur ‘out of hours’ (68.0%) and at the weekend (31.3%). Almost two-thirds were brought in by ambulance. A third required admission, but around a half were discharged home.ConclusionsThis is the first national study of mental health attendances at EDs in England. We provide information for those planning and providing care, to ensure that clinical resources meet the needs of this patient group, who comprise 4.2% of attendances. In particular, we highlight the need to strengthen the availability of hospital and community care ‘out of hours.’

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Cigarette and Waterpipe Smoking Decrease Respiratory Quality of Life in Adults: Results from a National Cross-Sectional Study

Pulmonary Medicine ◽

10.1155/2012/868294 ◽

2012 ◽

Vol 2012 ◽

pp. 1-10 ◽

Cited By ~ 16

Author(s):

Salamé Joseph ◽

Salameh Pascale ◽

Khayat Georges ◽

Waked Mirna

Keyword(s):

Quality Of Life ◽

Disease Status ◽

Cross Sectional Study ◽

National Study ◽

Chronic Obstructive ◽

Validity And Reliability ◽

Cross Sectional ◽

Obstructive Pulmonary Disease ◽

High Consistency

Background. Chronic obstructive pulmonary disease (COPD) is gaining an importance over the world, and its effect on quality of life is better grasped. Our objective was to use the Clinical COPD Questionnaire (CCQ) to describe the respiratory quality of life in the Lebanese population, stressing on differences between smokers and nonsmokers.Methods. Using data from a cross-sectional national study, we checked the construct validity and reliability of the CCQ. Factors and items correlation with postbronchodilator FEV1/FVC were reported, in addition to factors and scale association with COPD and its severity. We then conducted a multiple regression to find predictors of quality of life.Results. The CCQ demonstrated excellent psychometric properties, with adequacy to the sample and high consistency. Smokers had a decreased respiratory quality of life versus nonsmokers, independently of their respiratory disease status and severity. This finding was confirmed in COPD individuals, where several environmental factors, lower education, and cumulative smoking of cigarette and of waterpipe were found to be independent predictors of a lower quality of life, after adjusting for COPD severity.Conclusions. Smoking decreases the respiratory quality of life of Lebanese adults; this issue has to be further emphasized during smoking cessation and patients’ education.

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Influence of sociodemographic and clinical characteristics on the quality of life of patients with schizophrenia

Revista da Escola de Enfermagem da USP ◽

10.1590/s1980-220x2016031903244 ◽

2017 ◽

Vol 51 (0) ◽

Cited By ~ 1

Author(s):

Lara Guedes de Pinho ◽

Anabela Pereira ◽

Cláudia Chaves

Keyword(s):

Quality Of Life ◽

Clinical Characteristics ◽

Cross Sectional Study ◽

Clinical Aspects ◽

Short Version ◽

Cross Sectional ◽

12Th Grade ◽

Quality Of Life Scale ◽

Life Scale

Abstract OBJECTIVE Evaluating the quality of life of Portuguese patients with schizophrenia and linking it to sociodemographic and clinical aspects. METHOD A quantitative cross-sectional study carried out with individuals affected by schizophrenia, living in the entire continental territory of Portugal, through application of a sociodemographic and clinical questionnaire and the Quality of Life Scale short version (QLS7PT). Parametric and non-parametric tests were performed to evaluate the correlation between variables. RESULTS The sample consisted of 282 participants. The results point to a better quality of life for individuals living in autonomous residences or with their parents, who are employed/students, who have had the disorder for less time and are younger, who have completed the 12th grade of schooling and who are not medicated with first-generation neuroleptics. CONCLUSION The results indicate that some sociodemographic and clinical characteristics influence the quality of life of patients with schizophrenia and should be considered in the patient evaluation and in planning appropriate and effective strategies for their psychosocial rehabilitation.

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Importance of Client Orientation Domains in Non-Clinical Quality of Care: A Household Survey in High and Low Income Districts of Mashhad

Global Journal of Health Science ◽

10.5539/gjhs.v8n7p228 ◽

2015 ◽

Vol 8 (7) ◽

pp. 228

Author(s):

Somayeh Fazaeli ◽

Mehdi Yousefi ◽

Seyed Hasan Banikazemi ◽

Seyed Amir Hossein Ghazizadeh Hashemi ◽

Ali Khorsand Vakilzadeh ◽

...

Keyword(s):

Quality Of Care ◽

Low Income ◽

Household Survey ◽

World Health ◽

Clinical Aspects ◽

Cross Sectional ◽

Key Indicator ◽

Health Organization ◽

Self Assessed Health

Responsiveness introduced by WHO as a key indicator to assess the performance of health systems and measures by common set of domains that are categorized in to two main categories “Respect for persons” and “client orientation”. This study measured importance of client orientation domains in high and low income districts of Mashhad. In this cross-sectional and explanatory study, Sample of 923 households were selected randomly from two high and low income districts of Mashhad. World Health Organization (WHO) questionnaire was used for data collection. Standard frequency analyses and Ordinal logistic regression (OLR) was employed for data analysis. In general, respondents selected quality of basic amenities as the most important domain and access to social support networks was identified as the least important domain. Households in high income area scored higher domains of prompt attentions and choice Compared to low income. There was a significant relationship between variables of ages, having member that need to care and self-assessed health with the ranking of client orientation domains.Study of households’ view on ranking of non-clinical aspects of quality of care, especially when faced with limited resources, can help to conduct efforts towards subjects that are more important, and lead to improve the health system performance and productivity.

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