scholarly journals 10-year follow-up study on attendance pattern after dental treatment in primary oral health care clinic for fearful patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Taina Kankaala ◽  
Heikki Laine ◽  
Marja-Liisa Laitala ◽  
Päivi Rajavaara ◽  
Hannu Vähänikkilä ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Care ◽  
Dental Treatment ◽  
Dental Fear ◽  
Missed Appointments ◽  
Emergency Visits ◽  
Care Clinic ◽  
Dental Attendance ◽  
The City

Abstract Background Dental fear may lead to avoidance of regular dental treatment. The scope of this long-term practe-based study was to monitor the dental attendance of patients who received chair-side dental and fear treatment. Methods In 2000–2006, patients in the City of Oulu, Finland, received treatment for dental fear in the Clinic for Fearful Dental Patients (CFDP) from primary health care dentists trained on this subject. Of the originally treated patients (n = 163), 152 (93%) with sufficient information in dental records made up the study population. Information on their age and sex was available. The number of dental examinations, emergency visits and missed appointments was collected covering the follow-up period of 10 years 2006–2016. For analyses, data were dichotomized according to age at baseline and preliminary outcome baseline condition of dental fear treatment evaluated in 2006. To investigate association further, Poisson regression as well as binary logistic regression models were conducted. As register keeper, the City of Oulu gave permission for this retrospective data-based study. Results Patients receiving dental fear treatment at younger age (2–10 y) had significantly more dental examinations than those treated at > 10 years. Preliminary success was associated with the number of examinations, but not with emergency visits and missed appointments. Sex was not a significant factor in later dental attendance. There was an association between few dental examinations and dental emergency care need with unsuccessful baseline outcome of dental fear treatment. Conclusions Successful dental fear treatment especially at an early age is beneficial for future dental attendance measured by the number of examinations and consequently, less need for emergency care than in the opposite case. Successful fear treatment has positive impact on later dental care and regular dental attendance.

scholarly journals Outcome of illustrated information leaflet on correct usage of asthma-metered dose inhaler

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Wendy Wrench ◽  
Lynette Van Dyk ◽  
Sunitha Srinivas ◽  
Ros Dowse
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Dose Inhaler ◽  
Metered Dose Inhaler ◽  
Low Literacy ◽  
Post Intervention ◽  
Care Clinic ◽  
Metered Dose ◽  
Asthma Patients

Background: Research globally has shown that metered dose inhaler (MDI) technique is poor, with patient education and regular demonstration critical in maintaining correct use of inhalers. Patient information containing pictorial aids improves understanding of medicine usage; however, manufacturer leaflets illustrating MDI use may not be easily understood by low-literacy asthma patients.Aim: To develop and evaluate the outcome of a tailored, simplified leaflet on correct MDI technique in asthma patients with limited literacy skills.Setting: A rural primary health care clinic in the Eastern Cape, South Africa.Methods: Pictograms illustrating MDI steps were designed to ensure cultural relevance. The design process of the leaflet was iterative and consultative involving a range of health care professionals as well as patients. Fifty-five rural asthma patients were recruited for the pre-post design educational intervention study. Metered dose inhaler technique was assessed using a checklist, and patients were then educated using the study leaflet. The principal researcher then demonstrated correct MDI technique. This process was repeated at follow-up 4 weeks later.Results: The number of correct steps increased significantly post intervention from 4.6 ± 2.2 at baseline to 7.9 ± 2.7 at follow-up (p 0.05). Statistically significant improvement of correct technique was established for 10 of the 12 steps. Patients liked the pictograms and preferred the study leaflet over the manufacturer leaflet.Conclusion: The tailored, simple, illustrated study leaflet accompanied by a demonstration of MDI technique significantly increased correct MDI technique in low-literacy patients. Patients approved of the illustrated, simple text leaflet, and noted its usefulness in helping them improve their MDI technique.

scholarly journals Going home with baby: innovative and comprehensive support for new mothers

2018 ◽  
Vol 20 ◽  
Author(s):  
Tonia Olson ◽  
Angela Bowen ◽  
Julie Smith-Fehr ◽  
Swagata Ghosh
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Newborn Care ◽  
Community Services ◽  
Screening Tests ◽  
Physical And Mental Health ◽  
New Mothers ◽  
Care Clinic ◽  
Primary Health

AbstractShorter length of stay for postpartum mothers and their newborns necessitates careful community follow-up after hospital discharge. The vast amount of information given during the initial postpartum period can be overwhelming. New parents often need considerable support to understand the nuances of newborn care including newborn feeding. Primary health care and community services need to ensure there is a seamless continuum of care to support, empower, and educate new mothers and their families to prevent unnecessary hospital readmission and other negative health outcomes. The Healthy & Home postpartum community nursing program provides clinical communication and supports to bridge the gap between acute hospital and community follow-up care through home visits, a primary health care clinic, a breastfeeding center, a breastfeeding café, a postpartum anxiety and depression support group, bereavement support, and involvement in a Baby-Friendly Initiative™ coalition. Nurses working in the program have the acute care skills and resources to complete required health care assessments and screening tests. They are also international board-certified lactation consultants able to provide expert breastfeeding and lactation care. This paper describes how the Healthy & Home program has evolved over the past 25 years and offers suggestions to other organizations wanting to develop a postpartum program to meet the physical and mental health needs of postpartum families to promote maternal and infant wellbeing.

scholarly journals The Success Of Behavioral Economics In Improving Patient Retention Within An Intensive Primary Care Practice

2021 ◽  
Author(s):  
Phillip Groden ◽  
Alexandra Capellini ◽  
Erica Levine ◽  
Ania Wajnberg ◽  
Maria Duenas ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Behavioral Economics ◽  
Patient Outcomes ◽  
Care Practice ◽  
Missed Appointments ◽  
Care Clinic ◽  
Visit Adherence ◽  
One Year ◽  
Patient Retention

Abstract BackgroundA minority of the U.S. population comprises a majority of health care expenses. Health system interventions for high-cost populations aim to improve patient outcomes while reducing costly over-utilization. Missed and inconsistent appointments are associated with poor patient outcomes and increased health care utilization. PEAK Health— Mount Sinai’s intensive primary care clinic for high-cost patients— employed a novel behavioral economics-based intervention to reduce the rate of missed appointments at the practice. Behavioral economics has accomplished numerous successes across the health care field; the effect of a clinic-based behavioral economics intervention on reducing missed appointments has yet to be assessed.MethodsThis was a single-arm, pre-post trial conducted over one year involving all active patients (286) at PEAK Health. The intervention consisted of: a) clinic signage, and b) appointment reminder cards containing behavioral economics messaging designed to increase the likelihood patients would complete their subsequent visit; appointment cards (t1) were transitioned to an identical EMR template (t2) at 6 months to boost utilization of this component. The primary objective, the success of scheduled appointments, was assessed with visit adherence: the proportion of successful over all scheduled appointments, excluding those cancelled or rescheduled. The secondary objective, the consistency of appointments, was assessed with a 2-month visit constancy rate: the percentage of patients with at least one successful visit every two months for one year. Both metrics were assessed via a χ² analysis and together define patient retention. ResultsThe visit adherence rate increased from 74.7% at baseline to 76.5% (p= .22) during t1 and 78.0% (p= .03) during t2. The 2-month visit constancy rate increased from 59.5% at baseline to 74.3% (p= .01) post-intervention.ConclusionsA low-resource, clinic-based behavioral economics intervention was capable of improving patient retention within a traditionally high-cost population. A renewed focus on patient retention— employing the metrics described here— could bolster chronic care efforts and significantly improve the outcomes of high-cost programs by reducing the deleterious effects of missed and inconsistent appointments.

scholarly journals Barriers to Hepatitis C Virus Treatment in a Canadian HIV-Hepatitis C Virus Coinfection Tertiary Care Clinic

2008 ◽  
Vol 22 (2) ◽  
pp. 133-137 ◽  
Author(s):  
Meaghan McLaren ◽  
Gary Garber ◽  
Curtis Cooper
Keyword(s):  
Health Care ◽  
Substance Abuse ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Care Delivery ◽  
Tertiary Care ◽  
Hcv Treatment ◽  
Care Clinic ◽  
Hcv Therapy

BACKGROUND: Despite demonstrated efficacy in HIV-hepatitis C virus (HCV) coinfection, not all patients initiate, complete or achieve success with HCV antiviral therapy.PATIENTS AND METHODS: All HIV-HCV coinfected patient consults received at The Ottawa Hospital Viral Hepatitis Clinic (Ottawa, Ontario) between June 2000 and September 2006 were identified using a clinical database. A descriptive analysis of primary and contributing factors accounting for why patients did not initiate HCV therapy, as well as the therapeutic outcomes of treated patients, was conducted.RESULTS: One hundred two consults were received. Sixty-seven per cent of patients did not initiate HCV therapy. The key primary reasons included: HIV therapy was more urgently needed (22%), loss to follow-up (12%), patients were deemed unlikely to progress to advanced liver disease (18%) and patient refusal (12%). Many patients had secondary factors contributing to the decision not to treat, including substance abuse (23%) and psychiatric illness (14%). Overall, 59% of untreated patients (40 of 68) were eventually lost to follow-up. Thirty-three per cent of referred patients started HCV therapy. Twenty-seven of 42 courses (64%) were interrupted prematurely for reasons such as virological nonresponse (48%), psychiatric complications (10%) and physical side effects (7%). Of all treatment recipients, 12 of 42 full courses of therapy were completed and three remained on HCV medication. Overall, eight of the 102 coinfected patients studied (8%) achieved a sustained virological response.DISCUSSION: Not all HIV-HCV coinfected patients who are deemed to be in need of HCV treatment are initiating therapy. Only a minority of patients who do receive treatment achieve success. Implementation of HIV treatment, patient retention, attention to substance abuse and mental health care should be the focus of efforts designed to increase HCV treatment uptake and success. This can be best achieved within a multidisciplinary model of health care delivery.

scholarly journals Reliability and validity of Serbian version of children's dental fear questionnaire

2015 ◽  
Vol 72 (7) ◽  
pp. 602-607 ◽  
Author(s):  
Maja Lalic ◽  
Ema Aleksic ◽  
Jasmina Milic ◽  
Adam Malesevic ◽  
Bojan Jovicic
Keyword(s):  
Oral Health ◽  
Dental Treatment ◽  
Dental Anxiety ◽  
Reliability And Validity ◽  
Oral Health Status ◽  
Dental Fear ◽  
Old Patients ◽  
Psychometric Instrument ◽  
Dental Attendance ◽  
Serbian Version

Background/Aim. Dental anxiety leads to avoidance of dental treatment and could lead to impaired oral health. The aim of this study was to determine the reliability of the Serbian version of Children?s Fear Survey Schedule Dental Subscale (CFSS-DS) and the relations between dental anxiety and oral health status in a sample of Serbian schoolchildren. Methods. The CFSS-DS scale was translated into Serbian and administered to 231 (12-year old) patients of the Pediatric Dental Department, Public Health Center Cukarica, Belgrade. The number of healthy, decayed, missing and filled teeth (DMFT score) in children was determined by a clinical exam. Results. The average CFSS-DS score was 26.47 ? 10.33. The girls reported higher anxiety than the boys (p < 0.05). Most common fears were drilling, choking, going to the hospital and anesthesia. Lower CFSS-DS scores were recorded in children with all healthy teeth (p < 0.05). Children with higher CFSS-DS scores mostly visit the dentist due to pain or parental insistence, and those with lower anxiety scores more often visited dentist due to regular check-ups or non-invasive treatments (p < 0.01). A high value of the Cronbach's coefficient of internal consistency (? = 0.88) was found in the entire scale. Conclusion. The Serbian version of CFSS-DS questionnaire is reliable and valid psychometric instrument for evaluation of dental fear in Serbian children. Dental anxiety negatively affects dental attendance and oral health of the examined schoolchildren.

scholarly journals Distance effects on the accessibility to emergency departments in Portugal

2014 ◽  
Vol 23 (4) ◽  
pp. 1154-1161 ◽  
Author(s):  
Sofia Vaz ◽  
Pedro Ramos ◽  
Paula Santana
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Emergency Care ◽  
Emergency Departments ◽  
Health Centers ◽  
Emergency Visits ◽  
High Severity ◽  
Primary Health ◽  
Distance Effects

Distance patients have to travel has shown to influence demand for several health services. Our work looks at this effect on the utilization of Emergency Departments (ED) in Portugal. We build upon previous works by taking into account both the severity of emergency visits and the type of ED and by including a set of other variables that have shown to influence ED utilization. Overall, we find distance-elasticity for emergency care that ranges from -1 to -2 (a 10% increase in distance to ED results in a 10-20% decrease in ED utilization), with low-severity demand having the highest distance-elasticity and high-severity demand the lowest. We also show that Primary Health Care, and particularly some new typology of health centers in Portugal, negatively affects ED utilization. Our results provide evidence that distance enters in the budget constraints patients face when seeking health care.

Long-term Effects of Two Different Treatments for Dental Fear and Avoidance

1986 ◽  
Vol 65 (6) ◽  
pp. 874-876 ◽  
Author(s):  
U. Berggren
Keyword(s):  
Avoidance Behavior ◽  
Dental Treatment ◽  
Behavioral Therapy ◽  
Dental Anxiety ◽  
Initial Therapy ◽  
Dental Fear ◽  
Long Term Effects ◽  
Community Based

Follow-up clinical studies of treatment for dental fear and avoidance behavior are infrequent in the literature. The present investigation reports follow-up results over more than two years from 84 out of 99 patients treated for dental fear in a Swedish community-based dental fear clinic. Broad-based behavioral therapy (BT) or general anesthesia (GA), both in combination with adjusted conventional dental treatment, were used. The frequency of patients' attendance for regular dental care after two years was unchanged or even somewhat increased and was significantly higher in those who had received the BT therapy. Most patients stated that they had no problems after leaving the dental fear clinic. Among patients reporting such problems, the change of dentist was most frequently reported. The level of dental anxiety as measured by Corah's DAS was still at a low level, in spite of a slight increase over the two years since initial therapy.

scholarly journals Elderly people’s experiences in emergencies through access to other levels of health care

2021 ◽  
Vol 74 (suppl 2) ◽  
Author(s):  
Ana Luíza Barreto de Oliveira ◽  
Tânia Maria de Oliva Menezes ◽  
Adriana Valéria da Silva Freitas ◽  
Luana Araújo dos Reis ◽  
Marta Gabriele Santos Sales ◽  
...  
Keyword(s):  
Health Care ◽  
Elderly Patients ◽  
Elderly People ◽  
Emergency Care ◽  
Phenomenological Study ◽  
Elderly Person ◽  
The City

ABSTRACT Objective: to understand elderly people’s experiences in emergencies through access to other levels of health care. Methods: a phenomenological study in the light of Heidegger, conducted with 19 elderly patients admitted to an Emergency Care Unit of the city of Salvador, between April and October 2019. Results: ontic primacy: Disposition of the experience of elderly people waiting for regulation; Constitutional anguish and fear in the willingness to be an elderly person waiting for regulation in an Emergency Care Unit; Inappropriate elderly being suppressed while waiting for regulation; Being an elderly person unveiled in the existential modality of being for death. Ontological primacy: Heal how to be the presence of elderly people waiting for regulation. Final considerations: elderly people being anguished and afraid, feelings that allow the questioning of their own being, who want a healing and seeks ways that allows an active and proper participation in care.

scholarly journals Promoting Caries-Free Program by having Regular 6-Month Dental Check-up in Ketabang Area, Surabaya

2020 ◽  
Vol 3 (1) ◽  
pp. 13
Author(s):  
Agung Sosiawan ◽  
Karina Awanis Adla ◽  
Nadya Adina Zuhdi ◽  
Zalfa Karimah ◽  
Gita Alethea Kristi Maharani ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Oral Health ◽  
Dental Treatment ◽  
Dental Health ◽  
Oral Health Status ◽  
Education Level ◽  
Local Public Health ◽  
To Come

Background: An epidemiological study conducted in two kindergartens located in Ketabang and Embong Kaliasinreported that 63% of kindergarteners were affected by dental caries. The study also found that only 8% of them receiveddental treatment. The remaining 92% of kindergarteners never had dental treatment due to uncovered health insurance,unavailability of parents during working days and hours, mother’s education level, mother’s medical history, paternalsupport in dental and oral health care. Promotive, preventive, and referral efforts for dental and oral health can be doneby empowering UKGS teachers in the kindergarten concerned and in collaboration with local public health center routine6-month dental check-up. Purpose: To promote dental health education for children and forming the habit of visitingdentist for dental check-up. Methods: This program was intended to support UKGS teachers’ roles and encourage themother to admit their children for a dental check-up. The dental check-up results of Dharma Putra kindergarteners werethen recorded to the report. The report consisted of the prioritized tooth to treat, treated tooth, and treatment fee. Results:The dentists have recorded the examination results on the report sheet and informed the parents about their children’sdental and oral health status. The UKGS teacher then scheduled follow-up appointment per group per week for dentaltreatment. 3 out of 3 kindergarteners attended the follow-up appointment. Conclusion: This program is effective topromote children to come to dentist.

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