Patient deaths and medical residents: an Asian perspective

2020 ◽  
pp. bmjspcare-2020-002239
Author(s):  
Teresa Tan ◽  
Pei Lin Koh ◽  
Marcia Levetown ◽  
Lisa Wong ◽  
Joanne Lee ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Healthcare Providers ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Support Resources ◽  
Asian Context ◽  
The Impact ◽  
Dying Patient ◽  
Poor Concentration

ObjectivesDeath is a significant event that affects healthcare providers emotionally. We aimed to determine internal medicine (IM) and paediatric (PD) residents’ responses and the impact on the residents following patient deaths, and to compare any differences between IM and PD residents. We also aimed to determine whether sufficient resources and measures were in place to support residents through their grief process.MethodsThis is a single-centre, cross-sectional study involving residents from IM and PD programmes from an academic tertiary hospital in Singapore. The residents completed a questionnaire regarding their responses and emotions after experiencing patient deaths.ResultsA total of 122 residents (85 IM and 37 PD, equally distributed between year 1 to year 4 of residency training) participated, with 100% response rate. Only half (57%) felt they would be comfortable treating a dying patient and 66.4% reported feeling sad following their patient’s death. Most (79.5%) were not aware of support resources that were available and 82% agreed that formal bereavement training should be included in the residency curriculum. PD residents had more negative symptoms than IM residents, with poor concentration (PD 35.1% vs IM 16.5%, p=0.02) and lethargy (PD 35.1% vs IM 9.4%, p<0.01) being the most common.ConclusionIn our Asian context, residents are negatively affected by patient deaths, especially the PD residents. There is a need to incorporate relevant bereavement training for all residents.

scholarly journals Pharmacotherapeutic follow-up in a respiratory intensive care unit: description and analysis of results

2018 ◽  
Vol 16 (2) ◽  
Author(s):  
Ana Carolina de Souza e Silva ◽  
Domingos Sávio de Carvalho Sousa ◽  
Eunice Bobô de Carvalho Perraud ◽  
Fátima Rosane de Almeida Oliveira ◽  
Bruna Cristina Cardoso Martins
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Pharmacist ◽  
Anatomical Therapeutic Chemical ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Respiratory Intensive Care Unit ◽  
The Impact

ABSTRACT Objective: To describe and evaluate the pharmacotherapeutic follow-up by a clinical pharmacist in an intensive care unit. Methods: A descriptive and cross-sectional study carried out from August to October 2016. The data were collected through a form, and pharmacotherapeutic follow-up conducted by a clinical pharmacist at the respiratory intensive care unit of a tertiary hospital. The problems recorded in the prescriptions were quantified, classified and evaluated according to severity; the recommendations made by the pharmacist were analyzed considering the impact on pharmacotherapy. The medications involved in the problems were classified according to the Anatomical Therapeutic Chemical Classification System. Results: Forty-six patients were followed up and 192 pharmacotherapy-related problems were registered. The most prevalent problems were missing information on the prescription (33.16%), and those with minor severity (37.5%). Of the recommendations made to optimize pharmacotherapy, 92.7% were accepted, particularly those on inclusion of infusion time (16.67%), and dose appropriateness (13.02%), with greater impact on toxicity (53.6%). Antimicrobials, in general, for systemic use were drug class most often related to problems in pharmacotherapy (53%). Conclusion: Pharmacotherapeutic follow-up conducted by a pharmacist in a respiratory intensive care unit was able to detect problems in drug therapy and to make clinically relevant recommendations.

scholarly journals Maternity handover in Kerala: a cross sectional study

2018 ◽  
Vol 5 (9) ◽  
pp. 3760 ◽  
Author(s):  
Aadil Sheikh ◽  
Jessica Dunphy ◽  
Claire Humphries ◽  
Christina MacArthur ◽  
Semira Manaseki-Holland
Keyword(s):  
Healthcare Provider ◽  
Tertiary Care ◽  
Obstetric Care ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Community Health Services ◽  
High Rate ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Impact

Background: The objective of the study was to explore the referral system from the community to hospital obstetric care in Kerala, India.Methods: Cross-sectional study. A total of 206 obstetric inpatients in 3 hospitals in Kerala, India completed an orally-administered questionnaire regarding referral and attitudes towards healthcare information.Results: Among 206 respondents, 19 (9%) had been referred from another healthcare provider.  In multivariate analysis, referral was independently associated with being in a tertiary hospital (p<0.001). At total of 17 referred women received a document containing hand-written notes from their previous healthcare provider. Just 3 of the documents available to view were formal referral documents; others were test results and/or hospital notes. A total of 170 (86%) of the 206 women thought that receiving documents such as referral letters was important; mostly because it helped them understand their condition and explain it to others (91%).Conclusions: A high rate of self-referral (91%) was reported by obstetric inpatients. It appears that some women who are referred do not receive a formal referral document. Participants thought that receiving referral documents was important. A strong health system requires transfer of information between primary and secondary/tertiary care services, which India is seeking to develop. Further research is needed into why women are not accessing community health services and the impact of the content of referral documents on patient care. 

Communication Vulnerability within Singapore’s Healthcare Environment

2021 ◽  
pp. 201010582110686
Author(s):  
Teck W. William Go ◽  
Hoi T. Mok ◽  
Sanchalika Acharyya ◽  
Darlin C. Suelo ◽  
Eu C. Ho
Keyword(s):  
Healthcare Providers ◽  
Improve Patient Care ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Healthcare Needs ◽  
Communication Difficulties ◽  
Communication Challenges ◽  
Communication Needs ◽  
Outpatient Settings

Communication difficulties can, and often do, create barriers between patients and healthcare workers (HCWs). We examined the perceptual differences between patients and caregivers; and HCWs with regards to their perceived communication vulnerabilities and identified communication needs in a tertiary hospital. A survey was conducted in selected outpatient settings among patients, their caregivers and HCWs, in a cross-sectional study. Respondents rated the reasons and frequency of encountering the communication difficulties during a hospital visit. Fifty-four percent of patients and caregivers cited poor hearing in the presence of noise, while HCWs cited patient’s poor vision (87%) as their primary communication barrier that requires improvement. Majority of HCWs (90%) had encountered patients who presented multiple communication barriers a quarter of the time. A third of HCWs felt that such encounters were especially challenging during communication, with very limited strategies available to deal with such communication vulnerable individuals. Patients, caregivers and HCWs universally experience communication challenges, even if their perceived barriers to communication happen to differ. Such perceptual difference between patients and HCWs may lead to inconsistent use of communication strategies by HCWs, potentially compromising patient’s healthcare needs. Nonetheless, the onus is on healthcare providers to bridge this communication gap to improve patient care.

Job satisfaction in a group of patients with tinnitus

Work ◽  
2021 ◽  
pp. 1-8
Author(s):  
Katarzyna Bieńkowska ◽  
Elżbieta Gos ◽  
Justyna Kutyba ◽  
Joanna Rajchel ◽  
Piotr Henryk Skarżyński ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Work Performance ◽  
Negative Symptoms ◽  
Cross Sectional Study ◽  
Normal Hearing ◽  
Future Research ◽  
Satisfaction Scale ◽  
Cross Sectional ◽  
Work Related ◽  
The Impact

BACKGROUND: Tinnitus is an auditory impression without any external auditory stimulus. It may cause negative symptoms (anxiety, insomnia, depression) significantly affecting work performance and job satisfaction. OBJECTIVE: To evaluate the job satisfaction in tinnitus sufferers. METHODS: Cross- sectional study were conducted and 51 individuals (23–70 years) were recruited. Participants completed two questionnaires: Tinnitus Handicap Inventory and Job Satisfaction Scale. RESULTS: People affected by tinnitus report higher job satisfaction than healthy people. Job satisfaction was significantly related to age: r = 0.31; p <  0.05 in all tinnitus patients. There was a correlation between job satisfaction and tinnitus severity but only in people with normal hearing (–0.69; p <  0.05). CONCLUSIONS: The results show that job satisfaction is affected by the level of tinnitus annoyance (from both its emotional and functional aspects), but only in people with normal hearing. In future research it is recommended that additional factors be investigated, both work and non-work related, to thoroughly explore the impact of tinnitus on job satisfaction.

Anxiety and depression during pregnancy in the era of COVID-19

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Rasha E. Khamees ◽  
Omima T. Taha ◽  
Tamer Yehia M. Ali
Keyword(s):  
Pregnant Women ◽  
Depression Scale ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Anxiety And Depression ◽  
P Value ◽  
Cross Sectional ◽  
Kuwait University ◽  
Multiparous Women ◽  
The Impact

Abstract Objectives This study aimed to evaluate anxiety and depression in pregnant women during this global disease. Methods This was a cross-sectional study recruiting 120 pregnant women. The study was conducted at the outpatient clinic of a tertiary hospital. We recruited women attending for antenatal care. Anxiety was evaluated using an Arabic validated Kuwait University Anxiety Scale (KUAS). Depression was evaluated using a validated Arabic form of the Edinburgh Postnatal Depression Scale (EPDS). Results The study included 48 (40%) nulliparous and 72 (60%) multiparous women. The mean KUAS scores for nulliparous and multiparous women were 45.27±10.78 and 47.28±10.62. Both nulliparous and multiparous women had a fairly high possibility of depression. Fifty-three (44.2%) of them reported scores ≥ of 14. Ninety-three (77.5%) women thought that COVID-19 pandemic would affect their pregnancies. There was a significant association between the number of women reporting fear related to the COVID-19 pandemic and their KUAS and EPDS scores (p-value <0.001 each). Conclusions COVID-19 affected the mental health of pregnant women to a great extent. Care should be directed to measures that would decrease the impact of this pandemic on vulnerable populations.

scholarly journals Utilisation of and Attitude towards Traditional and Complementary Medicine among Ebola Survivors in Sierra Leone

Medicina ◽  
2019 ◽  
Vol 55 (7) ◽  
pp. 387 ◽  
Author(s):  
Peter Bai James ◽  
Jon Wardle ◽  
Amie Steel ◽  
Jon Adams
Keyword(s):  
Immune System ◽  
Sierra Leone ◽  
Health Care Services ◽  
Conventional Medicine ◽  
Descriptive Analysis ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Healthcare Needs ◽  
The Impact

Background and objectives: In addition to conventional healthcare, Ebola survivors are known to seek traditional and complementary healthcare (T&CM) options to meet their healthcare needs. However, little is known about the general beliefs of Ebola survivors regarding T&CM and the impact of these beliefs in influencing their decisions around T&CM use. This study examines Ebola survivors’ attitudes towards T&CM use in Sierra Leone. Materials and Methods: We conducted a nationwide quantitative cross-sectional study of 358 Ebola survivors in Sierra Leone between January and August 2018. We used descriptive analysis, chi-square tests and backward stepwise binary logistic regression for data analysis. Results: Close to half of the survivors (n = 163, 45.5%) had used T&CM since their discharge from an Ebola treatment centre. Survivors who viewed T&CM as boosting their immune system/resistance were 3.89 times (95%CI: 1.57–9.63, p = 0.003) more likely to use T&CM than those who did not view T&CM as boosting their immune system/resistance. Additionally, survivors who viewed T&CM as having fewer side effects than conventional medicine were more likely to use T&CM [OR = 5.03 (95%CI: 1.92–13.19, p = 0.001)]. Ebola survivors were more influenced to use T&CM based on their personal experience of the effectiveness of T&CM than by clinical evidence [OR = 13.72 (95%CI: 6.10–30.84, P < 0.001)]. Ebola survivors who perceived T&CM as providing them with more control than conventional medicine over their health/body were more likely to use T&CM [OR = 4.15 (95%CI: 1.74–9.89, p = 0.001)] as opposed to those who did not perceive T&CM in this way. Conclusions: Considering the widespread use of T&CM, an understanding of Ebola survivors’ attitudes/beliefs towards T&CM is useful to healthcare providers and policymakers with regard to public education and practitioner–survivors communication, T&CM regulation and research in Sierra Leone. Ebola survivors appear to turn to T&CM not only for treatment, but also to fill gaps in conventional health care services.

scholarly journals A Descriptive Study to Assess Wellbeing, Quality of Life and Satisfaction of Omani Patients with Chronic Wounds

2021 ◽  
Author(s):  
Jansi Rani Natarajan ◽  
Mickael Antoine Joseph ◽  
Rashid Mohammed Al Alawi ◽  
Taimoor Al Balushi ◽  
Ibrahim Al Alawi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Wounds ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Physical Symptoms ◽  
Cross Sectional ◽  
Mean Differences ◽  
The Impact

Abstract Background: A chronic wound is one that has failed to proceed through the normal phases of wound healing in an orderly manner. Chronic wounds are a common problem around the world. They can be distressing to the patients causing physical, social and emotional damage such as decreased activities of daily living, pain, discomfort, unpleasant odor, and insomnia. Wellbeing, quality of life and satisfaction of these patients with chronic wounds can be impaired by a complex set of aspects. The purpose of this article is to describe the impact of chronic wounds on the wellbeing, quality of life and satisfaction of Omani patients with chronic wounds. Methods: This is a descriptive cross-sectional study of 275 patients with chronic wounds attending three tertiary care hospitals in Muscat city, Sultanate of Oman. Adult patients of 18 years and above with wounds of duration of more than 4weeks were chosen by consecutive non-probability sampling. A pre-tested, semi-structured self-reported questionnaire was provided to each patient to complete. Data was analysed using SPSS IBM version 23.Results: The average age of the patients was 47.13±16.917 and the majority of them (64.7%) were males. Most of them (29.1%) had diabetic ulcers and 45.8% of them presented with mildly severe wounds based on Bates-Jensen wound assessment scale. Patients with chronic wounds reported a poor wellbeing scores (M=10.47, SD= 1.813), moderate quality of life (M=5.22, SD= 2.388) and satisfaction scores (M=6.89, SD= 2.388). Significant mean differences were reported with age, gender, educational level, and type of wound at p<.05 levels.Conclusion: These findings demonstrated that chronic wounds could influence the wellbeing, quality of life and overall satisfaction with the quality of life of patients suffering with it. These results also suggest a need to pay increased attention by the healthcare providers to the patients suffering from chronic wounds on the aspects of wellbeing and quality of life along with treating the physical symptoms.

Being a woman, being a soldier, being a mother: a qualitative analysis of perceptions of pregnancy on working lives of women in the Spanish Armed Forces

2021 ◽  
pp. bmjmilitary-2020-001722
Author(s):  
Sheima Hossain-López ◽  
D Ruiz-Berdún
Keyword(s):  
Psychological Health ◽  
Quantitative Research ◽  
Healthcare Providers ◽  
Armed Forces ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Individual Interviews ◽  
Physical And Psychological Health ◽  
Interpretative Approach ◽  
The Impact

IntroductionThirty-two years after Spain first allowed women to join the armed forces, 12% of active troops are women, although there are no data on how many of them are mothers. There is a lack of research related to the impact of motherhood on their careers and the challenges they face as well. Previous quantitative research, within North Atlantic Treaty Organization (NATO) forces, has focused on the increased vulnerability and reduced performance of women returning to service after childbirth. However, no study to date has examined the narratives of these women.MethodsA qualitative, cross-sectional study was carried out by means of individual interviews which were subsequently analysed employing the interpretative approach of hermeneutic phenomenology. All the interviews were conducted by videoconference, being recorded for subsequent transcription and analysis with MAXQDA v.2018.ResultsServicewoman reported experiencing fear of informing their command chain of their pregnancy. Many women described feelings of constantly having to prove their worth, and thus perceived the physical restrictions associated with pregnancy and/or postpartum as a threat to their previous achievements. This sometimes led to behaviours that posed a risk to the health of mothers and babies, or eventually resulted in both acute and chronic conditions.ConclusionsSome restrictions put in place to protect them during their pregnancies become a source of additional anxiety. Returning to active service, we found that women’s desire to fulfil their duties can cause long-term damage to their physical and psychological health. The attitudes servicewomen perceive towards pregnant women and mothers seems to exert a strong influence on the risks they are willing to assume. Understanding and addressing the needs of servicewomen after childbirth, either now, as active members of the Armed Forces, or in the foreseeable future, as veterans, is crucial to both military and civilian healthcare providers.

Factors associated with perceived participation three months after being discharged from a tertiary hospital

2016 ◽  
Vol 31 (9) ◽  
pp. 1257-1266 ◽  
Author(s):  
Xuemei Chen ◽  
Yanan He ◽  
Xianmei Meng ◽  
Lanshu Zhou
Keyword(s):  
Social Relations ◽  
Rating Scale ◽  
Depression Scale ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Stroke Survivors ◽  
Family Role ◽  
Cross Sectional ◽  
Factors Associated ◽  
The Impact

Objectives: To describe how first-stroke survivors perceive their participation and the problems with such participation in life and to determine the factors associated with perceived participation at three months after hospital discharge. Design: A cross-sectional study. Setting: Patients were recruited from a tertiary hospital in Shanghai, China and they were followed up in their homes. Subjects: Two hundred and fifty-seven first-stroke survivors discharged for three months participated in this study. Measures: The Chinese version of the Impact on Participation and Autonomy questionnaire, Barthel Index, Chinese Stroke Scale, Hospital Anxiety and Depression Scale and Social Support Rating Scale. Results: One hundred thirty-four (52.1%) and 147 (57.2%) participants perceived their participation as poor to very poor in the domains of family role and autonomy outdoors, respectively. Conversely, 208 (80.9%) and 228 (88.7%) participants perceived their participation to be fair to good in the domains of social relations and autonomy indoors, respectively. The ability to perform activities of daily life was the strongest correlate of participation in the domains of autonomy indoors, family role, and autonomy outdoors, whereas anxiety was the strongest correlate of participation in the domain of social relations. Conclusions: Activities of daily living were significantly associated with perceived participation in almost all domains. In contrast, anxiety was an important factor in predicting participation in the domain of social relations. These findings suggest the need to explore different strategies of promoting participation for each domain.

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