scholarly journals Diabetes distress in Indonesian patients with type 2 diabetes: a comparison between primary and tertiary care

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Bustanul Arifin ◽  
Antoinette D. I. van Asselt ◽  
Didik Setiawan ◽  
Jarir Atthobari ◽  
Maarten J. Postma ◽  
...  
Keyword(s):  
Primary Care ◽  
Tertiary Care ◽  
Demographic Characteristics ◽  
Diabetes Distress ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Increased Risk ◽  
Clinical Conditions ◽  
Distress Scale ◽  
Bahasa Indonesia

Abstract Background The number of people living with diabetes mellitus (DM) in Indonesia has continued to increase over the last 6 years. Four previous studies in U.S have found that higher DD scores were associated with worse psychological outcomes, lower health-related quality of life (HRQoL) and increased risk of T2DM complications. In this study, we aimed to firstly compare DD scores in Indonesian T2DM outpatients treated in primary care versus those in tertiary care. Subsequently, we investigated whether socio-demographic characteristics and clinical conditions explain potential differences in DD score across healthcare settings. Methods A cross-sectional study was conducted on Java island in three primary care (n = 108) and four tertiary care (n = 524) facilities. The participants completed the Bahasa Indonesia version of the Diabetes Distress Scale questionnaire (DDS17 Bahasa Indonesia). Ordinal regression analysis was conducted with the quartile of the summation of the DD score as the dependent variable to investigate how the association between the level of healthcare facilities and DD altered when adding different variables in the model. Results The final adjusted model showed that the level of healthcare facilities was strongly associated with DD (p < .001), with participants in primary care having a 3.68 times (95% CI 2.46–5.55) higher likelihood of being more distressed than the participants in tertiary care. This association was detected after including the socio-demographic characteristics and clinical conditions as model confounders. Conclusions This is the first study in Indonesia to compare DD scores within different healthcare facilities. We recommend a regular DD assessment, possibly closely aligned with health-literacy partner programs, especially for T2DM patients in primary care settings.

scholarly journals Suicidal Ideation and Predictors of Psychological Distress during the COVID-19 Pandemic in Eswatini: A Population-Based Household Telephone Survey

2021 ◽  
Vol 18 (13) ◽  
pp. 6700
Author(s):  
Mduduzi Colani Shongwe ◽  
Song-Lih Huang
Keyword(s):  
Mental Health ◽  
Psychological Distress ◽  
Suicidal Ideation ◽  
Telephone Survey ◽  
Population Based ◽  
Cross Sectional ◽  
Increased Risk ◽  
Psychological Distress Scale ◽  
The Government ◽  
Distress Scale

The unpredictability of the COVID-19 pandemic can induce psychological distress in individuals. We investigated perceived stressors, prevalence of psychological distress and suicidal ideation, and predictors of psychological distress among adults during the COVID-19 pandemic in Eswatini. This study was a cross-sectional, population-based household telephone survey of 993 conveniently sampled adults (18+ years) from all the four administrative regions of Eswatini. Data were collected between 9 June and 18 July 2020 during the first wave of the COVID-19 pandemic, when the country was under a partial lockdown. COVID-19-related psychological distress was assessed using the Kessler 6-item Psychological Distress Scale (K6). We performed weighted modified Poisson regression analyses to identify significant predictors of moderate/severe psychological distress (K6 scores: ≥5). The weighted prevalences of moderate (K6 scores: 5–12) and severe psychological distress (K6 scores: ≥13) were 41.7% and 5.4%, respectively. Participants reported several perceived COVID-19-related stressors, including worries and fears of the contagion-specific death, serious need for food and money, and concerns about loss of income or business. The weighted prevalence of suicidal ideation was 1.5%. Statistically significant predictors of increased risk for moderate/severe psychological distress included living in the Hhohho and Manzini regions; feeling not well informed about COVID-19; feeling lonely; having received COVID-19 food or financial relief from the government; feeling burdened by the lockdown; being married; and being youth (18–24 years). The results call for the government to urgently augment the provision of mental health services during the pandemic. Mental health practitioners and programs may use several stressors and risk factors identified in this study to inform interventions and government policies aimed at reducing psychological distress induced by the pandemic.

A Comparison of Falls and Dizziness Handicap by Vestibular Diagnosis

2021 ◽  
pp. 1-10
Author(s):  
Ryan J. Huang ◽  
Sherri L. Smith ◽  
Libor Brezina ◽  
Kristal M. Riska
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Demographic Variables ◽  
Vestibular Migraine ◽  
Cross Sectional ◽  
Positional Vertigo ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Paroxysmal Positional Vertigo

Purpose There is a paucity of data that directly compares the falls rate and dizziness handicap of different vestibular diagnoses. The purpose of this study is to compare the falls rate and dizziness handicap of common vestibular diagnoses encountered among a cohort of vestibular patients at a single institution. Method We conducted a retrospective cross-sectional study of patients evaluated for dizziness at a tertiary care center vestibular clinic between August 1, 2017, and March 19, 2019. Vestibular diagnosis, demographic variables, comorbidities, falls status, and Dizziness Handicap Inventory (DHI) were extracted from the medical record for analysis. Associations between vestibular diagnosis and falls history or DHI were evaluated using multivariate logistic and linear regression, respectively. Results A total of 283 patients met our inclusion criteria with the following diagnoses: benign paroxysmal positional vertigo (BPPV; n = 55), acoustic neuroma ( n = 30), Ménière's disease ( n = 28), multiple vestibular diagnoses ( n = 15), vestibular migraine ( n = 135), or vestibular neuritis ( n = 20). After adjusting for age, sex, race, medications, and comorbidities, the odds of falling was 2.47 times greater (95% CI [1.08, 6.06], p = .039) and the DHI score was 11.66 points higher (95% CI [4.99, 18.33], p < .001) in those with vestibular migraine compared to those with BPPV. Other diagnoses were comparable to BPPV with respect to odds of falling and dizziness handicap. Conclusions Patients with vestibular migraine may suffer an increased risk of falls and dizziness handicap compared to patients with BPPV. Our findings highlight the need for timely evaluation and treatment of all patients with vestibular disease.

Diabetes-related Distress and Self-care Practices among Patients attending two Secondary Care Hospitals in Lagos - A strategy for tailored Interventions

2019 ◽  
Vol 1 (1) ◽  
pp. 22-29
Author(s):  
E.E. Onwuchuluba ◽  
◽  
B.A. Aina ◽  
C.P. Ngolube ◽  
B.O. Ogbonna ◽  
...  
Keyword(s):  
Glycaemic Control ◽  
Self Care ◽  
Health Care Facilities ◽  
Diabetes Distress ◽  
Cross Sectional ◽  
Emotional Burden ◽  
Targeted Interventions ◽  
Special Diet ◽  
Care Practices ◽  
Distress Scale

Background: The challenges of diabetes mellitus are huge. Keeping up with the daily requirements of a life-long chronic illness is rigorous.Objectives: This study assessed diabetes-related distress and self-care practices and determined the extent to which they impact each other. Methods: This was a cross-sectional descriptive study carried out among patients attending follow-up diabetic clinic of two secondary health care facilities in Lagos over a three-month period. One hundred and seventy-six type 2 diabetes patients that met the inclusion criteria were consecutively recruited.Patients’ diabetes-related distress and self-care practices were assessed using a interviewer-administered questionnaire that incorporated two validated measures - The Diabetes Distress Scale (DDS17) and the Summary of Diabetes Self-care Activities (SDSCA: 11 items). Data were analyzed using descriptive and inferential statistics. P-values of < 0.05 was considered significant. Results: Of the 176 respondents, 70% were females, 73.9% were 51 years and above and 67% had poor glycaemic control (FBS=135.7 ± 47.48mg/dl). The mean score for Total Diabetes Distress (TDD) is 2.89 ± 0.90. Majority (64%) viewed emotional burden (3.30± 1.38) and regimen-related distress (3.35± 1.45) as moderate distress. Dieting was adequate among respondents with “Special diet” being the most frequently practiced (3.58±1.73 days/week). Dieting is associated with total diabetes distress, emotional burden, regimen-related distress and physician-related distress (˂0.001). Regimen-related distress is also associated with glycaemic control (p=0.037). Conclusion: Diabetes distress and low self-care practices are common and impact each other. Targeted interventions incorporating emotional support and effective communication is critical.

scholarly journals Patient and provider attitudes to emergency department-based HIV counselling and testing in South Africa

2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Bhakti Hansoti ◽  
Sarah E. Hill ◽  
Madeleine Whalen ◽  
David Stead ◽  
Andy Parrish ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Hiv Knowledge ◽  
Provider Attitudes ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Hiv Counselling And Testing ◽  
Privacy And Confidentiality

Background: The national South African HIV Counselling and Testing (HCT) guidelines mandate that voluntary counselling and testing (VCT) should be offered in all healthcare facilities. Emergency departments (EDs) are at the forefront of many healthcare facilities, yet VCT is not routinely implemented in this setting.Methods: We conducted a cross-sectional study that surveyed patients and healthcare providers at a tertiary care ED in the spring and summer of 2016 to ascertain their attitudes to VCT in the ED. We also used two previously validated survey instruments to gather data on patients’ HIV knowledge and providers’ stigma against patients living with HIV, as we anticipated that these may have an impact on providers’ and patients’ attitudes to the provision of HIV testing within the ED, and may offer insights for future intervention development.Results: A total of 104 patients and 26 providers were enrolled in the study. Overall, patients responded more favourably to ED-based HIV testing (92.3%) compared to providers (only 40% responded favourably). When asked about potential barriers to receiving or providing HIV testing, 16.4% of patients and 24% of providers felt that the subject of HIV was too sensitive and 58.7% of patients and 80% of providers indicated that privacy and confidentiality issues would pose major barriers to implementing ED-based HIV testing.Conclusion: This study shows that while ED-based HIV testing is overall highly acceptable to patients, providers seem less willing to provide this service. The survey data also suggest that future development of ED-based testing strategies should take into consideration privacy and confidentiality concerns that may arise within a busy emergency care setting. Furthermore, every effort should be made to tackle HIV stigma among providers to improve overall attitudes towards HIV-positive individuals that present for care in the ED.

scholarly journals Stress gradation of medical practitioners during the pandemic (covid-19) along with ways to de-stress; a cross sectional study at tertiary care hospitals using Kessler’s 10 psychological distress scale.

2021 ◽  
Vol 28 (09) ◽  
pp. 1239-1244
Author(s):  
Umair Toqueer ◽  
Muhammad Usama Zardad ◽  
Mahwish Toqueer ◽  
Anila Riyaz ◽  
Sana Khan ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Junior Doctors ◽  
Sectional Study ◽  
Cross Sectional ◽  
Psychological Distress Scale ◽  
Tertiary Care Hospitals ◽  
Distress Scale ◽  
The Impact

Objectives: To determine stress grades of doctors working in tertiary care  hospitals by using a standard measuring tool i.e. Kessler 10 psychological distress scale along with finding out different coping methods adopted by doctors during the COVID-19 pandemic. Study Design: Cross Sectional study. Setting: Tertiary Care Hospitals of Khyber Pakhtunkhwa (KPK), Pakistan. Period: 15 March 2020 to 20 June 2020. Material & Methods: A structured questionnaire was sent online to the junior and senior doctors working during the pandemic. The data was automatically collected with the help of Google docs and then analysed using SPSS 26. Results: Of the 219 doctors who completed the questionnaire 142 were males (64.8%) and 77 were females (35.2%). Interestingly, analysis of the score revealed that 38.8% of the doctors were found likely to be well, 16.4% of the doctors were likely to have mild disease and 20.5% were likely to have a moderate disorder while 24.2% were likely to have a severe disorder. Further analysis showed that the mean of  Kessler’s score was greater for junior doctors as  compared to Consultants which was found to be statistically significant (p=0.044). Conclusion: The impact of Corona virus disease (COVID-19) on the stress levels of health workers warrants considerable attention as it was declared a pandemic. Assessing the psychological impact and ways to tackle them will not only help the health care workers during this pandemic but will be beneficial in future pandemics as well.

scholarly journals Diabetes and hypertension in patients with psoriasis: a cross sectional and case control study in a tertiary care hospital of Bangladesh

2021 ◽  
Vol 9 (8) ◽  
pp. 2217
Author(s):  
Samira Jamal ◽  
Sheikh Anwarul Karim ◽  
Sheikh Mahee Ridwan Raihan ◽  
Rajat Biswas ◽  
Mansurul Alam
Keyword(s):  
Case Control Study ◽  
Skin Diseases ◽  
Tertiary Care ◽  
Case Control ◽  
Control Group ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Increased Risk ◽  
Control Study

Background: In this study our main goal was to evaluate the association of psoriasis as a risk predictor for the occurrence of diabetes mellitus (DM) and hypertension (HTN).Methods: This case control study was carried out in the department of dermatology and venereology, Chittagong medical college hospital (CMCH), Chittagong, Bangladesh from 15 June 2011 to 14 May 2012. Where 60 patients with psoriasis and 60 patients with skin diseases other than psoriasis were included according to availability within the study period.Results: During study, among the psoriatic patients, most of the patients with DM and HTN had body mass index (BMI) within normal limit. During analysis of different clinical findings in psoriatic patients scaling was present in all the cases followed by Auspitz sign, koebnerization, itching, scalp involvement and nail changes. Patients with psoriasis were found to have higher incidence of DM and HTN in comparison to their non-psoriatic control group. It was also observed that psoriatic patients having DM and HTN had longer duration of diseases (p<0.05).Conclusions: In conclusion, our study indicates that patients with psoriasis have an increased risk of DM and HTN, confirming the findings from previous several case control and cross sectional studies. These data illustrate the importance of considering psoriasis as a systemic disorder rather than simply a skin disease. Awareness of concurrent diseases will provide the clinician an opportunity of screening .for others systemic diseases.

scholarly journals Estimation of Anti-HBs Titer in Health Care Professionals of a Tertiary Care Centre of Southern Assam

2021 ◽  
Vol 8 (8) ◽  
pp. 510-515
Author(s):  
Debadatta Dhar Chanda ◽  
Atanu Chakravarty ◽  
Barnamoy Bhattacharjee
Keyword(s):  
Diabetes Mellitus ◽  
Health Care ◽  
Health Care Professionals ◽  
Tertiary Care ◽  
Protective Level ◽  
Serum Samples ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Chewing Tobacco ◽  
Increased Risk

Background- Due to occupational exposure to blood, body fluids and sharps, the health care professionals are at increased risk of contracting the Hepatitis B virus infection than general population. To combat this, all the health care professionals must be immunized with protective level of anti-HBs but anti-HBs titer gradually wanes with passage of time and may be influenced by gender, smoking or chewing tobacco, diabetes mellitus etc. This study was thus carried out to find the percentage of health care professionals with protective titer of anti-HBs and find the association (if any) of low anti-HBs titer and factors like gender, smoking, diabetes mellitus and time elapsed post vaccination. Method- This cross-sectional study has been carried out with proper ethical clearance from May2018- September2019 in Serology section of VRDL under Department of Microbiology in a Medical College of Southern Assam on serum samples collected from 150 health care professionals vaccinated with 3 doses of recombinant HBsAg vaccine atleast 5years back. Anti-HBs IgG concentration was measured by conventional ELISA in multistandard mode. Result- Out of 150 participants,95 were males and 55 were females.27 participants smoked/chewed tobacco,8 had diabetes mellitus. Booster dose was received by 23. Protective level of anti-HBs IgG (>10 IU/ml) was found in 66% (98/150) of HCP only. Low anti-HBs titer has been found to be significantly associated with Diabetes mellitus (p–0.03) and passage of more than 10 years post primary vaccination(p-0.005) but no significant association has been found with gender, smoking and history of blood transfusion. Conclusion- HBsAg vaccine doesn’t impart everlasting protection. So, all HCP, especially those with co-morbidities should get their anti-HBs titer estimated after vaccination to check out for adequate seroconversion and attainment of protective titer. If found inadequate, they should go for repeat vaccination /booster doses. Keywords: Healthcare professionals, Vaccinated, Anti HBs IgG, Assam,

scholarly journals Prescription pattern of patients admitted in the intensive care unit of a tertiary care hospital in Puducherry, India: a cross sectional study

2017 ◽  
Vol 6 (12) ◽  
pp. 2822
Author(s):  
B. Maharani ◽  
A. Lourdu Jafrin ◽  
M. Prakash ◽  
P. Priyadarshini
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Drug Use ◽  
Tertiary Care ◽  
Research Work ◽  
Essential Medicine ◽  
Demographic Characteristics ◽  
Care Hospital ◽  
Cross Sectional ◽  
Prescription Pattern

Background: Patients with varied demographic characteristics, admission criteria and heterogeneous group are admitted to medical Intensive Care Unit (ICU) and are usually associated with co-morbid illnesses. Instituting rational pharmacotherapy is the need of the hour for saving the life of critically-ill patients while irrational drug use may be life threatening. Drug use patterns and prescribing behaviour are the essential tools to measure drug use in health care facilities.Methods: A record based, cross-sectional, observational study was done at medical ICU, IGMC and RI, Puducherry after obtaining IEC approval. Systemic random sampling was followed and data was collected for a period of one year. Data were analysed based on demographic characteristics, prescribing pattern and WHO drug use indicators.Results: The data of 151 patients were analysed. Mean age of the patients admitted in ICU was 52.9±17.7 years. Percentage of male patients (57.6) admitted in ICU were more when compared to female patients (42.4). Infective etiology was the most common factor for ICU admission followed by cardiac disorders. Diabetes mellitus and hypertension were the most common co-morbidities. The average length of stay in ICU was 4.11±2.99 days. Duration of stay in ICU ranged from 1-5 days (78.8% patients) to 15-20 days (0.1% patients). On an average 10.6±4.3 drugs were prescribed for each patient. Percentage of drugs prescribed by generic name was 45.8%. Majority of the drugs (87.4%) were from essential medicine list. Antibiotics in the prescription was 13.8% and 44.4% of drugs were administered in parenteral route. The prescription was complete in 145 case sheets (96%). Majority of the patients (68.9%) were discharged with improvement in the condition for which they were admitted.Conclusions: This drug utilization study has highlighted the strengths and shortcomings of the prescription pattern of patients who were admitted in the critical care setup. The information derived from this research work will be transmitted to the stakeholders for implementing the modifications wherever applicable for the betterment of the patient and the community.

scholarly journals A cross sectional observational study to evaluate the maternal and fetal outcome in postdated pregnancies

2020 ◽  
Vol 10 (1) ◽  
pp. 159
Author(s):  
Ritika Narayan ◽  
Sheela S. R.
Keyword(s):  
Observational Study ◽  
Cesarean Section ◽  
Tertiary Care ◽  
Significant Risk ◽  
Fetal Distress ◽  
Perinatal Complications ◽  
Tertiary Care Centre ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Increased Risk

Background: Post-dated pregnancy is when the gestation is more than 40 weeks or 280 days. They last longer than the estimated date of delivery. Postdated pregnancies are associated with increased perinatal and maternal complications. These risks are greater than it was originally thought. Risks have been underestimated in the past leading to increasing number of complicated postdated pregnancies which appears to be otherwise low risk. The maternal risks are very often underappreciated resulting in increased maternal morbidity.Methods: This cross sectional observational study was done to evaluate maternal and fetal complications associated with Postdated pregnancies was carried out in the department of obstetrics and gynecology in a tertiary care centre, Sir Devraj Urs Medical College and RL Jalappa Hospital, Kolar between July 2018 and July 2019, fulfilling all the inclusion and exclusion criteria.Results: 50 out of 100 patients had full term normal deliveries where as 45% patients required cesarean section. Most common indication for cesarean section was meconium stained liquor with fetal distress (25%). 42% of the babies born needed NICU admission. Most common maternal complication seen was Postpartum Hemorrhage.Conclusions: The present study we conclude that postdated pregnancy was associated with significant risk of perinatal complications such as fetal distress, meconium aspiration syndrome and IUGR. There was increased risk of obstetric complications as well like atonic PPH, oligohydramnios, obstructed labor.

Sign in / Sign up

Export Citation Format

Share Document