scholarly journals Mindfulness training during brief periods of hospitalization in multiple sclerosis (MS): beneficial alterations in fatigue and the mediating role of depression

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Torsten Sauder ◽  
Sascha Hansen ◽  
Carina Bauswein ◽  
Roy Müller ◽  
Sonja Jaruszowic ◽  
...  
Keyword(s):  
Acute Care ◽  
Negative Relationship ◽  
Hospital Setting ◽  
Mindfulness Training ◽  
Self Report ◽  
Mediation Effect ◽  
Care Hospital ◽  
Trait Mindfulness ◽  
Short Term ◽  
Change Scores

Abstract Objectives Persons with MS (PwMS) are frequently affected by fatigue and depression. Mindfulness-based interventions may reduce these symptoms in PwMS and consequently their application has been extended to various settings. Only few efforts have been made to explore effects of short-term mindfulness training during brief periods of hospitalization. In the current study, the feasibility and potential effects of short-term mindfulness training on depression, fatigue, rumination and cognition were explored in PwMS in an acute-care hospital setting. Based on previous work, it was further examined whether the relation between trait mindfulness and fatigue prior to and following the intervention was mediated by depression and whether a mediation effect was also observable throughout the intervention. Methods A short-term mindfulness training protocol was developed, tailored to the requirements of the acute-care setting. Subsequently, 30 PwMS were recruited sequentially and received mindfulness training during the routine clinical process (median duration in hospital: eight days, number of sessions: four). Participants completed relevant self-report measures (depression, fatigue, rumination) and a neuropsychological assessment before and after training. Results Participants reported significantly increased trait mindfulness and decreased depression and fatigue following the intervention. Respective change scores were highly correlated so that increased trait mindfulness was associated with decreased symptoms. In the rumination domain, patients reported a tendency for an increased adaptive ability to engage in distractive behavior during arising negative mood. Other measures of trait rumination and cognition remained relatively stable. Results of the mediation analyses indicated that depression mediated the negative relationship between trait mindfulness and fatigue symptoms at pre and post assessments. With regards to the change scores, an association between mindfulness and cognitive fatigue ceased to be significant when depression was controlled, albeit in this case, the mediation effect did not reach significance. Conclusion Results of the current study indicate that short-term mindfulness training during brief periods of hospitalization may be beneficial for PwMS. They further complement previous work by identifying depression as a potential mediator of the antagonistic relationship between mindfulness and fatigue. Based on the current exploratory study, future trials are warranted to address this mechanism of mindfulness training in more detail.

A RANDOMIZED TRIAL TO MEASURE THE OPTIMAL ROLE OF THE PHARMACIST IN PROMOTING EVIDENCE-BASED ANTIBIOTIC USE IN ACUTE CARE HOSPITALS

2001 ◽  
Vol 17 (2) ◽  
pp. 171-180 ◽  
Author(s):  
George Dranitsaris ◽  
Diana Spizzirri ◽  
Monique Pitre ◽  
Allison McGeer
Keyword(s):  
Acute Care ◽  
Broad Spectrum ◽  
Randomized Clinical Trials ◽  
Intervention Group ◽  
Hospital Setting ◽  
Control Group ◽  
Evidence Based ◽  
Care Hospital ◽  
Broad Spectrum Antibiotics ◽  
The Impact

Background: There is a considerable gap between randomized clinical trials and implementing the results into practice. This is particularly relevant in the use of broad-spectrum antibiotics in hospitals. Hospital pharmacists can be effective vehicles for bridging this gap and promoting evidence-based medicine. To determine the most effective way of using the pharmacist in this role, a prospective cefotaxime intervention study was conducted with randomization incorporated into the design as well as patient-related therapeutic outcomes.Methods: A total of 323 patients who were prescribed cefotaxime were randomized into an intervention or nonintervention group where only the former was challenged by pharmacists for inappropriate cefotaxime usage relative to hospital guidelines. The primary outcome was the appropriateness of cefotaxime prescribing between groups. Logistic regression analysis was then used to identify factors that were associated with successful clinical response.Results: Overall, 94% of orders in the intervention group met cefotaxime dosage criteria compared with 86% in the control group (p = .018). However, there was no impact with respect to promoting cefotaxime use for an appropriate indication (81% vs. 80%; p = .67). There was a trend for improved clinical outcomes in patients who received cefotaxime within hospital guidelines (OR = 1.73; p = .31).Conclusions: The pharmacist as a vehicle for promoting the appropriate use of broad-spectrum antibiotics in the acute care hospital setting can improve the dosing of such agents. However, several barriers to optimizing the impact of the pharmacist were implied by the data. Removing these barriers could increase the pharmacists' utility as an agent for improved patient care.

scholarly journals Psychometric Validation and Demographic Differences in Two Recently Developed Trait Mindfulness Measures

2021 ◽  
Author(s):  
◽  
Margaret A Sturgess
Keyword(s):  
Large Body ◽  
Negative Relationship ◽  
Self Report ◽  
Psychometric Validation ◽  
Future Research ◽  
Trait Mindfulness ◽  
Older Individuals ◽  
Five Facet Mindfulness Questionnaire ◽  
Demographic Differences ◽  
Psychometric Validity

<p>Although in recent years an increasingly large body of mindfulness research has accrued, there continues to be a lack of information about how to measure trait mindfulness, as well as whether it varies across demographic variables such as age and gender. Four hundred and six participants from across New Zealand completed a battery of self-report measures in order to examine demographic differences in mindfulness, as well as to look at how mindfulness predicts outcome variables such as happiness and depression. Additionally, psychometric validation was undertaken on two new trait measures of mindfulness: the Toronto Mindfulness Scale, which did not demonstrate good psychometric validity, and the Five Facet Mindfulness Questionnaire, which did demonstrate good psychometric validity. This study found that females reported higher levels of mindfulness than males, though males demonstrated a stronger mediating relationship between mindfulness and happiness. In addition, higher levels of mindfulness were reported by older individuals; however, young adults manifested the strongest negative relationship between mindfulness and depression across the lifespan. These findings are then discussed in the context of clinical utility and future research.</p>

Short-Term Training in Mindfulness Predicts Helping Behavior Toward Racial Ingroup and Outgroup Members

2021 ◽  
pp. 194855062110530
Author(s):  
Daniel R. Berry ◽  
Catherine S. J. Wall ◽  
Justin D. Tubbs ◽  
Fadel Zeidan ◽  
Kirk Warren Brown
Keyword(s):  
Controlled Trial ◽  
Helping Behavior ◽  
Mindfulness Training ◽  
Trait Mindfulness ◽  
Short Term ◽  
Randomized Controlled ◽  
Ecological Momentary ◽  
First Time ◽  
Momentary Assessment

A randomized controlled trial tested whether mindfulness training would increase lab-based and in vivo spontaneous helping behaviors toward racial outgroup members. First, across conditions, those scoring higher in baseline trait mindfulness showed higher levels of preintervention lab-based and ecological momentary assessment (EMA)-based helping behavior. Next, short-term (4-day) training in mindfulness, relative to a well-matched sham meditation training, increased interracial helping behavior in a lab-based simulation. Finally, among people scoring lower in a basic form of trait mindfulness at baseline—that is, with greater room for improvement—mindfulness training predicted higher postintervention in vivo helping behavior reported via EMA. However, neither training condition alone attenuated preferential helping toward racial ingroup members. These findings indicate, for the first time, that mindfulness and its training fosters helping behavior toward strangers and acquaintances regardless of their racial ingroup or outgroup status, but preferential helping of racial ingroup members remains.

Fall Prevention in a Swiss Acute Care Hospital Setting: Reducing Multiple Falls

2006 ◽  
Vol 32 (3) ◽  
pp. 13-22 ◽  
Author(s):  
Koen Milisen ◽  
Courtney W. Brown ◽  
Sabina De Geest
Keyword(s):  
Acute Care ◽  
Fall Prevention ◽  
Hospital Setting ◽  
Acute Care Hospital ◽  
Care Hospital

scholarly journals Profiling of Oropharyngeal Dysphagia in an Acute Care Hospital Setting

2020 ◽  
pp. 014556132091779 ◽  
Author(s):  
Nayla Matar ◽  
Hussein Smaily ◽  
Patrick Cherfane ◽  
Cyril Hanna
Keyword(s):  
Acute Care ◽  
Treatment Plan ◽  
Oropharyngeal Dysphagia ◽  
Hospital Setting ◽  
Diagnostic Tools ◽  
Admission Diagnosis ◽  
Medical Setting ◽  
Care Hospital ◽  
Sensitivity Testing ◽  
Swallowing Evaluation

Purpose: To identify the main complaints, diagnostic tools, as well as the treatment plan in patients presenting with oropharyngeal dysphagia in the acute care settings. Methods: The electronic medical chart of 100 consecutive hospitalized patients who presented an oropharyngeal dysphagia were retrospectively reviewed from January 2017 to January 2019. Results: The mean age of patients was 76.03 (standard deviation = 16.06) years old with 71% of patients being males. The most common admission diagnosis was pneumonia (30%), followed by stroke (28%). The swallowing evaluation was performed on the regular floor in 85% of patients and in the intensive care unit in 15% of patients. The main reasons for the swallowing evaluation are suspicion of aspiration by the medical or nursing teams (60%), systematic evaluation (20%), ear, nose and throat (ENT) complaints by the patient (14%), and aspiration pneumonia (6%). Fiberoptic endoscopic evaluation of swallowing with sensitivity testing was the most common diagnostic tool used alone in 88% of patients. Diet and postural modifications were prescribed to 71% and 62% of the patients, respectively. Swallowing exercises were performed in 43% of patients. Overall, otolaryngologist interventions resulted in an increased rate of patients getting oral intake compared to nonoral feeding routes ( P = .05). Conclusions: This study adds knowledge about the causes and characteristics of oropharyngeal dysphagia in an acute tertiary medical setting. It also provides insights regarding the role, and the consequences of a swallowing intervention led by an ENT specialist in collaboration with the members of the health team.

scholarly journals Communication behavior of cognitively impaired older inpatients

2019 ◽  
Vol 52 (S4) ◽  
pp. 264-272
Author(s):  
Eva-Luisa Schnabel ◽  
Hans-Werner Wahl ◽  
Susanne Penger ◽  
Julia Haberstroh
Keyword(s):  
Cognitive Impairment ◽  
Psychometric Properties ◽  
Acute Care ◽  
Older Patients ◽  
Hospital Setting ◽  
Acute Care Hospital ◽  
Acute Care Hospitals ◽  
Well Being ◽  
Communication Behavior ◽  
Care Hospital

Abstract Background and objective Acutely ill older patients with cognitive impairment represent a major subgroup in acute care hospitals. In this context, communication plays a crucial role for patients’ well-being, healthcare decisions, and medical outcomes. As validated measures are lacking, we tested the psychometric properties of an observational instrument to assess Communication Behavior in Dementia (CODEM) in the acute care hospital setting. As a novel feature, we were also able to incorporate linguistic and social-contextual measures. Material and methods Data were drawn from a cross-sectional mixed methods study that focused on the occurrence of elderspeak during care interactions in two German acute care hospitals. A total of 43 acutely ill older patients with severe cognitive impairment (CI group, Mage ± SD = 83.6 ± 5.7 years) and 50 without cognitive impairment (CU group, Mage ± SD = 82.1 ± 6.3 years) were observed by trained research assistants during a standardized interview situation and rated afterwards by use of CODEM. Results Factor analysis supported the expected two-factor solution for the CI group, i.e., a verbal content and a nonverbal relationship aspect. Findings of the current study indicated sound psychometric properties of the CODEM instrument including internal consistency, convergent, divergent, and criterion validity. Conclusion CODEM represents a reliable and valid tool to examine the communication behavior of older patients with CI in the acute care hospital setting. Thus, CODEM might serve as an important instrument for researcher and healthcare professionals to describe and improve communication patterns in this environment.

scholarly journals Adopt-a-Hospital Project: An instructional tool for hospital administration

2016 ◽  
Vol 5 (6) ◽  
pp. 63
Author(s):  
Asa B. Wilson
Keyword(s):  
Experiential Learning ◽  
Acute Care ◽  
Hospital Setting ◽  
Acute Care Hospital ◽  
Hospital Administration ◽  
Care Hospital ◽  
Health Administration ◽  
Hospital Operations ◽  
Specific Career ◽  
Healthcare Finance

Backgournd: More often than not, university health administration curriculums are generic and are not foundational to a specific career track. This is especially true in relation to the transition from graduation to a hospital administration career progression. The overarching question is, “How does one prepare themselves for senior leadership in an acute care hospital setting?”Objective: A semester-long assignment – Adopt-a-Hospital Project – is discussed in the context of a healthcare finance course as tool for preparing students to think administratively regarding hospital operations. This Project is presented as an academic foundation preparing students for the required semester-long internship placement in an acute care hospital.Results: The Project-Internship sequence has, over a four-year period, demonstrated its value as an academic and experiential learning bridge from the academy to the world of work. Informal, qualitative findings are discussed in terms of a future quantitative study incorporating: (1) preceptor surveys, (2) intern surveys, and (3) focus group feedback.Conclusions: The Project-Internship sequence fosters a link between academic content and experiential learning in an acute care hospital – thereby augmenting one’s post-graduation readiness to pursue a hospital administration career track.

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