scholarly journals Sociodemographic Factors Associated With Decreased Compliance to Prescribed Rehabilitation After Surgical Treatment of Knee Injuries in Pediatric Patients

2021 ◽  
Vol 9 (11) ◽  
pp. 232596712110520
Author(s):  
Allan K. Metz ◽  
Tami Hart-Johnson ◽  
R. Alexander Blackwood ◽  
Eileen A. Crawford
Keyword(s):  
Sample Size ◽  
Pediatric Patients ◽  
Compliance Rate ◽  
Knee Injuries ◽  
Sociodemographic Factors ◽  
Single Parent ◽  
Knee Surgery ◽  
Activity Level ◽  
Factors Associated ◽  
Rehabilitation Clinic

Background: Rehabilitation is an important component of care in postsurgical knee patients, especially as it pertains to return to preinjury activity level. Despite the established significance of rehabilitation in improving outcomes after certain surgical procedures, there is a lack of investigation into compliance rates and factors that affect compliance in pediatric patients. Purpose/Hypothesis: The purpose of this study was to evaluate sociodemographic factors associated with noncompliance in pediatric patients after knee surgery to characterize health disparities in this population. Our hypothesis was that certain sociodemographic factors would be associated with decreased compliance. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A retrospective review of medical records was used to gather data on compliance rate, demographics, and socioeconomic factors for pediatric patients undergoing rehabilitation after knee surgery. Compliance rate was determined by counting the total scheduled appointments, cancellations, and no-shows (defined as visits for which patients did not show up and did not provide notification of cancellation). Various types of knee injuries were included in this study. Data were evaluated using bivariate analyses in addition to hierarchical linear and binary logistic regression to assess for associations between sociodemographic factors and compliance rate. Results: Our total sample size was 186 patients. When compared with patients from non–single-parent households, patients from single-parent households were found to have a lower rate of physical therapy compliance (72.2% vs 80.1%; P < .001), were less likely to reach the 85% compliance threshold (9.1% vs 42.4%; P < .001), and had an increased amount of cancellations and no-shows (16.7 vs 11.7 visits; P = .02). Although a small sample size, Hispanic/Latino patients were shown to have a lower achievement of the 85% compliance threshold compared with non-Hispanic/Latino patients (0% vs 38.2%; P = .04). Increased distance from the rehabilitation clinic was associated with lower achievement of the 85% compliance threshold ( P = .033). Conclusion: Overall, there were several significant demographic and socioeconomic variables associated with rehabilitation compliance, specifically single-parent status, distance to rehabilitation clinic, and ethnicity. These results suggest potential predictors of decreased compliance that warrant prospective investigation.

Preoperative Factors Associated with 2-Year Postoperative Survey Completion in Knee Surgery Patients

2021 ◽  
Author(s):  
Jagannath Kadiyala ◽  
Tina Zhang ◽  
Ali Aneizi ◽  
Rohan Gopinath ◽  
Dominic J. Ventimiglia ◽  
...  
Keyword(s):  
Physical Activity ◽  
Patient Reported Outcomes ◽  
Knee Surgery ◽  
Activity Level ◽  
Pain Interference ◽  
Black Race ◽  
Factors Associated ◽  
Social Satisfaction ◽  
Patient Reported ◽  
Preoperative Factors

AbstractPatient-reported outcomes, such as the Patient-Reported Outcomes Measurement Information System (PROMIS) measures, have become increasingly valued as measures of treatment. The purpose of the study was to determine preoperative factors associated with survey compliance 2 years after elective knee surgery. Five hundred patients, age 17 years and older, undergoing knee surgery from August 2015 and March 2017 were administered questionnaires preoperatively and 2 years postoperatively. Questionnaires included the International Knee Documentation Committee (IKDC) score, Numeric Pain Scales (NPS), International Physical Activity Questionnaire (IPAQ), and six PROMIS Domains for physical function, pain interference, social satisfaction, fatigue, anxiety, and depression. Three hundred sixty-five patients (73.0%) completed both the preoperative and the 2-year surveys. A decreased likelihood of survey completion was significantly associated with black race, lower income, government-sponsored insurance, smoking, opioid use, fewer previous surgeries, lower expectations, lower PROMIS social satisfaction, higher PROMIS pain interference, and lower IPAQ physical activity. Multivariable logistic regression analysis confirmed that black race and lower IPAQ activity level were independent predictors of lower survey completion at 2-year follow-up with an area under the curve (AUC) of 0.62. A more robust multivariable model that included all variables with p < 0.05 in the bivariate analysis had an AUC of only 0.70. This study identified multiple preoperative factors that were associated with lower survey completion 2 years after elective orthopaedic knee surgery; however, all the factors measured in this study were not strong predictors of survey completion.

scholarly journals HEALTH DISPARITIES IN ADHERENCE WITH PRESCRIBED REHABILITATION FOLLOWING SURGICAL TREATMENT OF KNEE INJURIES IN PEDIATRIC PATIENTS

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0016
Author(s):  
Allan K. Metz ◽  
Tami Hart-Johnson ◽  
R. Alexander Blackwood ◽  
Eileen A. Crawford
Keyword(s):  
Health Disparities ◽  
Physical Therapy ◽  
Linear Regression ◽  
Surgical Repair ◽  
Compliance Rate ◽  
Knee Injuries ◽  
Single Parent ◽  
Bivariate Analysis ◽  
Public Insurance ◽  
Mean Compliance

Background: Rehabilitation is paramount to recovery following surgery for ligamentous and meniscal knee injuries, but there exists little research regarding adherence with rehabilitation in pediatric populations, especially how this relates to health disparities in this population. Hypothesis/Purpose: Our study aimed to evaluate the effect of patient socioeconomic/demographic factors on adherence with physical therapy appointments following surgical repair or reconstruction of knee injuries. This information would be used to raise awareness of health disparities and potentially develop a set of predictors for a higher risk of non-adherence with prescribed rehabilitation. Methods: This study was a retrospective chart review of patients under the age of 18 who underwent physical therapy at the authors’ institution following initial surgical repair or reconstruction of a knee injury (ACL, MCL, LCL, PCL, meniscus, patellar tendon, and tibial eminence injuries included). Surgeries from 1 January 2015 to 31 December 2016 were considered, with physical therapy being considered for dates extending to 1 January 2018. Rate of adherence with physical therapy, reasons for lack of attendance, and socioeconomic/demographic variables were gathered. Data was evaluated utilizing bivariate and separate hierarchical linear regression analyses. Results: Our study population was comprised of 108 individuals with a mean age of 15.15 ± 2.04 years and a mean compliance rate with physical therapy of 80.2 ± 11.8%. Bivariate analysis revealed Hispanic/Latino patients were more likely to cancel/no show (18 ± 22.82) than non-Hispanic/Latino patients (7.55 ± 6.88, p = 0.010). Logistic regression revealed patients were significantly less likely to attend 85% of rehabilitation visits if in single-parent households ( p = 0.024). The interaction of insurance type and residence stability (maintaining a single residence during treatment) found patients with public insurance and stable housing were less likely to reach the 85% compliance threshold (Table 1). At trend level, linear regression revealed an inverse relationship with distance and physical therapy attendance ( p = 0.082), in addition to linear regression showing unstable residence ( p = 0.052) and public insurance ( p = 0.067) as significant at trend level of patients not reaching 85% compliance. Conclusion: Our study revealed single-parent households and Hispanic/Latino patients were significantly correlated with lower rehabilitation adherence, in addition to trends showing distance to physical therapy, unstable housing, and public insurance correlated with lower compliance. Our work highlights potential predictors of rehabilitation noncompliance and allows for targeted efforts to increase adherence in patients with these factors. [Table: see text]

Factors associated with nursing students’ compliance with standard precautions: a self-reported survey

2019 ◽  
Vol 15 (3) ◽  
Author(s):  
Kyoung ja Moon ◽  
Yong Hwan Hyeon ◽  
Kyung Hee Lim
Keyword(s):  
Nursing Students ◽  
Compliance Rate ◽  
Standard Precautions ◽  
Needle Stick ◽  
Factors Associated ◽  
Nursing Curricula ◽  
Compliance Level ◽  
Key Factor ◽  
Nursing College ◽  
Sharps Injury

Adhering to standard precautions is a key factor in reducing the risk of infection among nurses and nursing students. This study identified nursing students’ compliance with standard precautions and the factors associated with their compliance. This descriptive survey included 176 nursing students from a regional nursing college. Compliance with standard precautions was assessed using a 20-item questionnaire. Data were analysed using t-tests, a one-way analysis of variance, and a multiple regression analysis. Participants’ overall compliance rate was 50.5%. Concerning general characteristics, significant differences were found regarding needle-stick or sharps injuries, practicum department (surgical and paediatric), and type of contact (faeces). Needle-stick or sharps injury experience (β = -0.225) and surgery practicum department (β = 0.182; Adj R² = 0.063; p = 0.001) had a significant effect on compliance level. Standard precautions should be emphasized in the nursing curricula, along with systematic continuing education. Educational programs for needle-stick or sharps injury prevention should also be included in standard precautions curricula.

Non-Pediatric Nurses’ Willingness to Provide Care to Pediatric Patients during a Disaster: An Assessment of Pediatric Surge Capacity in Four Midwestern Hospitals

2021 ◽  
pp. 1-6
Author(s):  
Terri Rebmann ◽  
Rachel L. Charney ◽  
Rebecca L. Eschmann ◽  
M. Colleen Fitzpatrick
Keyword(s):  
Pediatric Patients ◽  
Response Rate ◽  
Mass Casualty ◽  
Pediatric Care ◽  
Pediatric Nurses ◽  
Surge Capacity ◽  
Factors Associated ◽  
Pediatric Hospitals ◽  
Survey Response Rate ◽  
Mass Casualty Event

Abstract Objective: To assess non-pediatric nurses’ willingness to provide care to pediatric patients during a mass casualty event (MCE). Methods: Nurses from 4 non-pediatric hospitals in a major metropolitan Midwestern region were surveyed in the fall of 2018. Participants were asked about their willingness to provide MCE pediatric care. Hierarchical logistical regression was used to describe factors associated with nurses’ willingness to provide MCE pediatric care. Results: In total, 313 nurses were approached and 289 completed a survey (response rate = 92%). A quarter (25.3%, n = 73) would be willing to provide MCE care to a child of any age; 12% (n = 35) would provide care only to newborns in the labor and delivery area, and 16.6% (n = 48) would only provide care to adults. Predictors of willingness to provide care to a patient of any age during an MCE included providing care to the youngest-age children during routine duties, reporting confidence in calculating doses and administering pediatric medications, working in the emergency department, being currently or previously certified in PALS, and having access to pediatric-sized equipment in the unit or hospital. Conclusion: Pediatric surge capacity is lacking among nurses. Increasing nurses’ pediatric care self-efficacy could improve pediatric surge capacity and minimize morbidity and mortality during MCEs.

Using an App to monitor postoperative pain at home in pediatric patients

2021 ◽  
pp. 136749352091931
Author(s):  
Emanuela Tiozzo ◽  
Valentina Biagioli ◽  
Matilde Brancaccio ◽  
Riccardo Ricci ◽  
Anna Marchetti ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Intensity ◽  
Health Professionals ◽  
Pediatric Patients ◽  
Pain Scale ◽  
Factors Associated ◽  
Prospective Comparative Study ◽  
Paper And Pencil ◽  
The Impact ◽  
At Home

A prospective comparative study was conducted in 487 pediatric patients (69% male, mean age = 6.4 ± 4.0) to evaluate (a) the incidence, intensity, and characteristics of pain in pediatric patients at home during the first 24 hours and 5 days after surgery and (b) the factors associated with higher pain intensity, including the impact of an application (App) compared to the paper-and-pencil approach. Postoperative pain was assessed by patients or their parents at home using the ‘Bambino Gesù’ Children’s Hospital (Ospedale Pediatrico Bambino Gesù, OPBG) tool for participants aged 4–17 years or the Faces, Legs, Arms, Cry, and Consolability scale for participants less than four years old. Participants were assigned to two groups: those who used the paper-and-pencil version of the pain scale and those who used the App. Overall, 209 of the 472 (44%) participants reported pain during the first 24 hours, and 92 of the 420 (22%) reported pain between one and five days after surgery. Higher pain intensity scores were associated with being in the App group, directly assessing own pain, and using the OPBG tool. The App was effective in facilitating pain assessment. Health professionals could empower pediatric patients and their parents in assessing pain at home through a dedicated App.

scholarly journals Risk Factors of Inadequate Bowel Preparation for Screening Colonoscopy

2021 ◽  
Vol 10 (12) ◽  
pp. 2740
Author(s):  
Efrat L. Amitay ◽  
Tobias Niedermaier ◽  
Anton Gies ◽  
Michael Hoffmeister ◽  
Hermann Brenner
Keyword(s):  
Risk Factors ◽  
Bowel Preparation ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Screening Colonoscopy ◽  
Cross Sectional ◽  
Factors Associated ◽  
Screening Practice ◽  
Abdominal Symptoms ◽  
Inadequate Bowel Preparation

The success of a colonoscopy in detecting and removing pre-cancerous and cancerous lesions depends heavily on the quality of bowel preparation. Despite efforts, 20–44% of colonoscopy participants have an inadequate bowel preparation. We aimed to assess and compare risk factors for inadequate bowel preparation and for the presence of advanced colorectal neoplasms in routine screening practice. In this cross-sectional study, among 8125 participants of screening colonoscopy in Germany with a comprehensive assessment of sociodemographic factors, lifestyle and medical history, we examined factors associated with inadequate bowel preparation and with findings of advanced neoplasms using adjusted log-binomial regression models. Among the identified risk factors assessed, three factors were identified that were significantly associated with inadequate bowel preparation: age ≥ 70 years (adjusted prevalence ratios, aPR, 1.50 95%CI 1.31–1.71), smoking (aPR 1.29 95%CI 1.11–1.50) and abdominal symptoms (aPR 1.14 95%CI 1.02–1.27). The same risk factors were also associated with the prevalence of advanced neoplasms in our study (aPR 1.72, 1.62 and 1.44, respectively). The risk factors associated with inadequate bowel preparation in this study were also associated with a higher risk for advanced neoplasms. Inadequate bowel preparation for colonoscopy might lead to missed colorectal cancer (CRC) precursors and the late diagnosis of CRC. People at high risk of advanced neoplasms are in particular need of enhanced bowel preparation.

scholarly journals Sociodemographic factors associated with COVID-19 in-hospital mortality in Brazil

Public Health ◽  
2021 ◽  
Vol 192 ◽  
pp. 15-20
Author(s):  
I.T. Peres ◽  
L.S.L. Bastos ◽  
J.G.M. Gelli ◽  
J.F. Marchesi ◽  
L.F. Dantas ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Sociodemographic Factors ◽  
Factors Associated

scholarly journals Prevalence and Contributing Factors Associated With Postoperative Pain in Pediatric Patients: A Cross-Sectional Follow-up Study

2021 ◽  
Vol 23 ◽  
pp. 100159
Author(s):  
Zemenay Ayinie Mekonnen ◽  
Debas Yaregal Melesse ◽  
Habitamu Getinet Kassahun ◽  
Tesera Dereje Flatie ◽  
Misganaw Mengie Workie ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pediatric Patients ◽  
Contributing Factors ◽  
Cross Sectional ◽  
Factors Associated ◽  
Follow Up Study

scholarly journals Trajectories of Depressive Symptoms and Anxiety during Pregnancy and Associations with Pregnancy Stress

2021 ◽  
Vol 18 (5) ◽  
pp. 2733 ◽  
Author(s):  
Hyejung Lee ◽  
Ki-Eun Kim ◽  
Mi-Young Kim ◽  
Chang Gi Park ◽  
Jung Yeol Han ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Pregnant Women ◽  
Healthcare Providers ◽  
Sociodemographic Factors ◽  
Survey Questionnaire ◽  
Emotional Status ◽  
Factors Associated ◽  
Latent Trajectory ◽  
Logistic Regressions ◽  
Health Hospital

The purposes of this study were to investigate the trajectory groups of depressive symptoms and anxiety in women during pregnancy and to identify the factors associated with those groups. Participants were recruited from the outpatient clinic of a women’s health hospital in Seoul, Korea. Pregnant women (n = 136) completed a survey questionnaire that included questions on depressive symptoms, anxiety, and pregnancy stress; additionally, their saliva was tested for cortisol hormone levels three times during their pregnancies. The group-based trajectory modeling approach was used to identify latent trajectory groups. Ordinal logistic regressions were used to explore the association of latent trajectory groups with sociodemographic factors and pregnancy stress. Three trajectory groups of depressive symptoms were identified: low-stable (70%), moderate-stable (25%), and increased (5%). Four trajectory groups of anxiety were identified: very low-stable (10%), low-stable (67%), moderate-stable (18%), and high-stable (5%). The only factor associated with both the depressive symptoms and anxiety trajectory groups was pregnancy stress (p < 0.001). Most participants showed stable emotional status; however, some participants experienced higher levels of depressive symptoms and anxiety related to higher pregnancy stress. These pregnant women may need additional care from healthcare providers to promote their wellbeing during pregnancy.

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