scholarly journals Quality of dying in hospital general wards: a cross-sectional study about the end-of-life care

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Filippo Binda ◽  
Marco Clari ◽  
Gabriella Nicolò ◽  
Simone Gambazza ◽  
Barbara Sappa ◽  
...  
Keyword(s):  
Palliative Care ◽  
Multiple Correspondence Analysis ◽  
Cross Sectional Study ◽  
Poor Quality ◽  
University Teaching ◽  
Sectional Study ◽  
Unexpected Death ◽  
Cross Sectional ◽  
Quality Of Dying

Abstract Background In the last decade, access to national palliative care programs have improved, however a large proportion of patients continued to die in hospital, particularly within internal medicine wards. Objectives To describe treatments, symptoms and clinical management of adult patients at the end of their life and explore whether these differ according to expectation of death. Methods Single-centre cross-sectional study performed in the medical and surgical wards of a large tertiary-level university teaching hospital in the north of Italy. Data on nursing interventions and diagnostic procedure in proximity of death were collected after interviewing the nurse and the physician responsible for the patient. Relationship between nursing treatments delivered and patients’ characteristics, quality of dying and nurses’ expectation about death was summarized by means of multiple correspondence analysis (MCA). Results Few treatments were found statistically associated with expectation of death in the 187 patients included. In the last 48 h, routine (70.6%) and biomarkers (41.7%) blood tests were performed, at higher extent on patients whose death was not expected. Many symptoms classified as severe were reported when death was highly expected, except for agitation and respiratory fatigue which were reported when death was moderately expected. A high Norton score and absence of anti-bedsore mattress were associated with unexpected death and poor quality of dying, as summarized by MCA. Quality of dying was perceived as good by nurses when death was moderately and highly expected. Physicians rated more frequently than nurses the quality of dying as good or very good, respectively 78.6 and 57.8%, denoting a fair agreement between the two professionals (k = 0.24, P <  0.001). The palliative care consultant was requested for only two patients. Conclusion Staff in medical and surgical wards still deal inadequately with the needs of dying people. Presence of hospital-based specialist palliative care could lead to improvements in the patients’ quality of life.

scholarly journals Quality of Dying in Hospital General Wards: A Cross-Sectional Study About the End of Life Care

2021 ◽  
Author(s):  
Filippo Binda ◽  
Marco Clari ◽  
Gabriella Nicolò ◽  
Simone Gambazza ◽  
Barbara Sappa ◽  
...  
Keyword(s):  
Palliative Care ◽  
Multiple Correspondence Analysis ◽  
Cross Sectional Study ◽  
Primary Diagnosis ◽  
University Teaching ◽  
Nursing Interventions ◽  
Sectional Study ◽  
Cross Sectional ◽  
Quality Of Dying

Abstract BACKGROUND In the last decade, access to national palliative care programs have improved, however a large proportion of patients continued to die in hospital, particularly within internal medicine wards. OBJECTIVES To describe how adult patients die in the medical and surgical wards of a large tertiary-level university teaching hospital in the north of Italy, comparing the care and treatments between patients whose death was rated as highly, moderately or not expected by nurses. METHODS Single-centre cross-sectional study. Data on nursing interventions and diagnostic procedure in proximity of death were collected after interviewing the nurse and the physician responsible for the patient. Relationship between qualitative variables involving nursing procedures was summarized by means of multiple correspondence analysis (MCA). RESULTS Death was highly expected by nurses in 108 out of 187 patients included, whose primary diagnosis was respiratory (33.7%). Symptoms control was inadequate for the most severely ill patients: the most prevalent were asthenia (88.3%), mild or severe pain (69.0%), urinary incontinence (66.3%) and respiratory fatigue (64.8%). Physicians rated more frequently than nurses the quality of dying as good or very good, respectively 78.6% and 57.8%. The best quality of dying seems associated to the number of nursing interventions (mostly related to ensure comfort and to prevent pressure ulcers), female sex and low Norton scoring, as suggested by MCA. CONCLUSION Staff in medical and surgical wards still deal inadequately with the needs of dying people. Presence of hospital-based specialist palliative care could lead to improvements in the patients’ quality of life

scholarly journals The prevalence and associated factors of depression among patients with schizophrenia in Addis Ababa, Ethiopia, cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tolesa Fanta ◽  
Desalegn Bekele ◽  
Getinet Ayano
Keyword(s):  
Quality Of Life ◽  
Substance Use ◽  
Suicide Attempt ◽  
Associated Factors ◽  
Cross Sectional Study ◽  
Poor Quality ◽  
Sectional Study ◽  
Comorbid Depression ◽  
Cross Sectional

Abstract Background Depression is common among people with schizophrenia and associated with severe positive and negative symptoms, higher rates of disability, treatment resistance and mortality related to suicide, physical and drug-related causes. However, to our knowledge, no study has been conducted to report the magnitude of depression among people with schizophrenia in Ethiopia. Therefore, this study aimed to determine the prevalence and associated factors of depression among people with schizophrenia. Method A hospital-based cross-sectional study was conducted among 418 patients with schizophrenia selected by systematic sampling technique. Patient Health Questionnaire 9 (PHQ-9) was used to measure depression among the study participants. To identify the potential contributing factors, we performed binary and multivariable logistic regression analysis adjusting the model for the potential confounding factors. Odds ratios (OR) with the corresponding 95% confidence interval (95%CI)) was determined to evaluate the strength of association. Result The prevalence estimate of depression among people with schizophrenia was found to be 18.0% [95% confidence interval: 14.50–22.30]. Our multivariable analysis revealed that current substance use (AOR 2.28, 95%CI (1.27, 4.09), suicide attempt (AOR 5.24, 95%CI (2.56, 10.72), duration of illness between 6 and 10 years (AOR 2.09, 95%CI (1.08, 4.04) and poor quality of life (AOR 3.13, 95%CI (1.79, 5.76) were found to be the factors associated with depression among people with schizophrenia. Conclusion The current study revealed that comorbid depression was high among people with schizophrenia and associated with current substance use, suicide attempt, and long duration of the illness as well as poor quality of life. Attention needs to be given to address comorbid depression among people with schizophrenia.

scholarly journals REASONS WHY PATIENTS BYPASS LOWER LEVEL PUBLIC FACILITIES: A CROSS SECTIONAL STUDY FROM UGANDA

2019 ◽  
Author(s):  
SAMUEL OKORI ◽  
INNOCENT BESIGYE ◽  
JANE FRANCIS NAMATOVU
Keyword(s):  
Health Care Providers ◽  
Tertiary Education ◽  
Cross Sectional Study ◽  
Poor Quality ◽  
Health Facilities ◽  
Care Providers ◽  
Sectional Study ◽  
Cross Sectional ◽  
Validated Questionnaire

Abstract Background The quality of services in Uganda at higher level health facilities are usually affected negatively by congestion when patients bypass care from their primary care health facilities (PCHF). The reason behind this bypass phenomenon in Uganda is limited. This study was conducted among patients receiving care at Lira Regional Referral Hospital in northern Uganda to identify reasons why patients bypass their PCHF. Methods We performed a descriptive cross-sectional study between 29/12/2014 & 30/1/2015, 484 respondents attending the outpatient department were recruited by systematic random sampling. Four focus group discussions (FGDs) each involving 10 participants were conducted. Quantitative data was collected using a validated questionnaire, entered, analysed by Epidata Entry 3.1 and SPSS 18 versions respectively. Descriptive statistics and chi square test for differences in the study population were used. For qualitative data, thematic analysis of transcripts was done. Codes and categories were developed and interrogated following an iterative process based on grounded theory. Results The majority (80.4%) of respondents (71.7% females, mean age 18-35 years, SD 0.85) bypassed their PCHF. Factors associated with bypass were: marital status, distance travelled of >10 km and tertiary education. FGDs reported lack of trust in the health care providers, lack of medicines and diagnostic equipment. Conclusions Poor quality of health services at PCHF encourages seeking care from higher-level facilities. Utilization of PCHF is limited due to poor infrastructure, shortage of medicines and human resource. Improvement of these issues will support PCHF which in turn can help reverse bypass phenomenon.

scholarly journals Complementary and Alternative Medicine Use and Quality of Life among Filipino Adult Psoriasis Vulgaris Patients Seen in a Tertiary Center: A Cross-sectional Study

2021 ◽  
Vol 55 (5) ◽  
Author(s):  
Marie Len A. Camaclang-Balmores ◽  
Ma. Lorna F. Frez ◽  
Patricia A. Nacianceno ◽  
Jay-V James G. Barit
Keyword(s):  
Quality Of Life ◽  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Psoriasis Vulgaris ◽  
Cross Sectional Study ◽  
Poor Quality ◽  
Sectional Study ◽  
Cross Sectional ◽  
Cam Use

Objective. To determine the prevalence of complementary and alternative medicine (CAM) use and its association with quality of life (QOL) among Filipino adult psoriasis vulgaris patients. Methods. A cross-sectional study was conducted in an outpatient dermatology department of a tertiary hospital, using a semi-structured, interview-guided questionnaire, and a self-administered QOL questionnaire, the dermatology life quality index (DLQI). Results. A total of 135 Filipino adult patients with psoriasis vulgaris were included. The prevalence of CAM use was 47%, with most CAM users being female and single. Completion of tertiary education was found significantly associated with CAM use (p < 0.05). A greater body surface area involvement and longer disease duration were more common among CAM users but these were not statistically significant. Special diet (56.3%) was the most commonly used type of CAM, followed by herbal medicine (46.9%), bath therapy (18.9%) and faith healing (12.5%). Major sources of CAM information were families (43.8%), internet/social media (28.1%) and health professionals (25%). Around 40% of the participants used CAM out of curiosity. The mean DLQI score of the respondents was 11.3 (±7.3) corresponding to poor quality of life. CAM use was significantly associated with negative impact on physical symptoms and feelings, daily activities, and work and school (P = 0.044; P = 0.019; P = 0.047). After adjusting for confounding variables, patients with poor QOL were twice more likely to use CAM but this was not statistically significant (odds ratio [OR], 1.76; 95% confidence interval [CI], 0.78-3.95; P = 0.17). Conclusions. The use of CAM is prevalent among Filipino adult patients with psoriasis vulgaris. The significant association between CAM use and a poor quality of life may reflect the unmet physical and psychosocial needs of patients. A patient-perspective approach should acknowledge the reasons for CAM use, which could guide the physicians in imparting available scientific evidence, or the lack thereof, for the use of CAM to these patients.

scholarly journals Documentary quality versus veracity of information of the websites on syphilis and gonorrhea

2021 ◽  
Author(s):  
María Sanz-Lorente ◽  
Natalia Moles-Caballero ◽  
Carmina Wanden-Berghe ◽  
Javier Sanz-Valero
Keyword(s):  
Mass Media ◽  
Cross Sectional Study ◽  
Poor Quality ◽  
Web Pages ◽  
Sectional Study ◽  
Cross Sectional

AbstractObjective: Analyze the possible relation between the documentary quality (DQ) versus the veracity of information (VI) on the syphilis and gonorrhea web pages. Methods: Descriptive cross-sectional study of websites containing information about syphilis and gonorrhea, by accessing this population through a Google. The quality was studied by using 8 variables belonging to DQ and 7 variables of the VI. Results: A total of 440 active websites mainly belonging to mass media and private entities was assessed. The fulfillment of DQ gave the following results: Mean 3.46 ± 0.07, median 4 and range from 0 to 7. The VI result was: median 4.07 ± 0.09, median 4 and range from 0 to 7. According to the search athwart syphilis or gonorrhea, the contrast of the median of the two indicators was: 3.55 vs 3.37 p = 0.181 and 4.14 vs 4.00 p = 0.442. No correlation was verified amid the data of DQ and VI (R = 0.04); p = 0.368. Similarly, no significance was observed when segregating data by disease, in the case of syphilis R = -0.03; p = 0.625 and on gonorrhea R = 0.12; p = 0.064. Conclusions: The DQ and VI bestowed low outcomes, which implies poor quality of syphilis and gonorrhea websites. According to infection (syphilis or gonorrhea), there were no meaningful differences amid the median values of the two indicators. Being acquainted with the authorship and affiliation of a website and the fact that it is tied to a prestigious web may be a factor to be deemed when predicting the VI of a website. The correlation amid the two indicators did not demonstrate an association, thus, knowing the DQ does not imply having the security of an adequate VI.

scholarly journals Poor quality of life is associated with obesity and sedentary life style in atherosclerotic disease: a cross-sectional study / A má qualidade de vida está associada à obesidade e ao estilo de vida sedentário na doença aterosclerótica: um estudo transversal

2021 ◽  
Vol 4 (5) ◽  
pp. 20118-20131
Author(s):  
Elisa Maia Dos Santos ◽  
Grazielle Vilas Bôas Huguenin ◽  
Paulo Rogério Melo Rodrigues ◽  
Bernardete Weber ◽  
Annie Seixas Bello De Moreira
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Risk Factors ◽  
Cross Sectional Study ◽  
Poor Quality ◽  
Atherosclerotic Disease ◽  
Sectional Study ◽  
Cross Sectional ◽  
Sf 36

The Health-related quality of life (HRQoL) is an important measure of the health status of a population. It can be related to nutritional status and risk factors of cardiovascular disease.This study aimed to assess the quality of life and the association with nutritional status and other modifiable risk factors in patients with atherosclerotic disease.This is a cross-sectional study carried out in two public health centers in Rio de Janeiro, Brazil. A total of 273 participants with a documented history of atherosclerotic disease in the last ten years from their entry to the study. Quality of life (SF-36 questionnaire); physical activity; food intake (food frequency questionnaire), blood pressure; anthropometric and biochemical measures were assessed. Poor quality of life scores were identified, women had lower scores (p0.05) for all SF-36 domains. Obesity was associated with a decreased score of SF-36 physical and mental health domains. Sedentary lifestyle was associated with poorer quality of life in almost all domains assessed. The adoption of healthy weight and appropriate physical activity was associated with better quality of life in patients with atherosclerotic disease.

scholarly journals Caregivers’ quality of life and psychological health in response to functional, cognitive, neuropsychiatric and social deficits of patients with brain tumour: protocol for a cross-sectional study

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e016308 ◽  
Author(s):  
Carole Ramirez ◽  
Véronique Christophe ◽  
Charlotte Dassonneville ◽  
Delphine Grynberg
Keyword(s):  
Quality Of Life ◽  
Psychological Health ◽  
Social Impact ◽  
Cross Sectional Study ◽  
Poor Quality ◽  
Poor Mental Health ◽  
Healthy Controls ◽  
Sectional Study ◽  
Cross Sectional

IntroductionPatients with gliomas generally present cognitive, neuropsychiatric and functional deficits. Although previous research has shown that their caregivers present a poor quality of life and poor mental health, only a few studies have tested in a comprehensive way which deficits/preserved abilities of patients predominantly impact their caregivers. Furthermore, only a few studies have focused on the social impact of gliomas, which may also damage the caregivers’ quality of life. Therefore, this cross-sectional study aims to investigate which patients’ impairments are particularly deleterious for the caregivers and whether the histological characteristics of the gliomas also affect their quality of life.Methods and analysisIn order to examine these research questions, this study intends to include 180 patients (60 patients with grade II gliomas, 60 patients with grade III gliomas and 60 patients with grade IV gliomas), their caregivers and 60 healthy controls. While patients will complete a full battery of cognitive, neuropsychiatric, functional and social tests, caregivers will complete questionnaires about their quality of life, depression, anxiety and burden. Patients’ performances and caregivers’ reports of depression and anxiety will be compared with the scores of healthy controls. Eventually, our aim will be to provide specific care support both to reduce patients’ deficits and alleviate caregivers’ difficulties.Ethics and disseminationThe study has obtained the approval of the local faculty ethics committee (‘Comité d’éthique en sciences comportementales’; 2016–5 S41 and 2015–3 S37). On completion of the study, data will be kept by Lille University for 5 years before they are destroyed. Study findings will be disseminated through peer-reviewed journal publications and conference presentations with no reference to a specific individual.

Psychiatric Impairment, Physical Health and Work Values among Unemployed and Apprenticed Young Men

1983 ◽  
Vol 17 (4) ◽  
pp. 335-340 ◽  
Author(s):  
Andrew McPherson ◽  
Wayne Hall
Keyword(s):  
Physical Health ◽  
Cross Sectional Study ◽  
Linear Analysis ◽  
Poor Quality ◽  
Sectional Study ◽  
Cross Sectional ◽  
Case Rate ◽  
Log Linear ◽  
The Unemployed

A cross-sectional study was carried out to compare psychiatric impairment in young unemployed men and apprentices from Sydney's western suburbs. The unemployed men were found to have a psychiatric case rate (as defined by the GHQ) of 48% as against a rate of 28% for the apprentices. Comparisons of the unemployed men and apprentices on other measures indicated that they did not differ in physical health nor in the value they attached to work. The unemployed, however, were older on average, less well educated and had experienced a poorer quality of parental upbringing than the apprentices. A log-linear analysis revealed that the adverse effects of unemployment on mental health were not attributable to poor quality of upbringing.

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