scholarly journals Factors associated with involuntary psychiatric hospitalization in Portugal

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Manuela Silva ◽  
Ana Antunes ◽  
Sofia Azeredo-Lopes ◽  
Adriana Loureiro ◽  
Benedetto Saraceno ◽  
...  
Keyword(s):  
Generalized Linear Model ◽  
Psychiatric Hospitalization ◽  
Contextual Factors ◽  
Male Gender ◽  
Preventive Interventions ◽  
Involuntary Hospitalization ◽  
Factors Associated ◽  
Psychiatric Hospitalizations ◽  
Risk Patients ◽  
One Year

Abstract Background Identifying which factors contribute to involuntary psychiatric hospitalization may support initiatives to reduce its frequency. This study examines the sociodemographic, clinical, and contextual factors associated with involuntary hospitalization of patients from five Portuguese psychiatric departments in 2002, 2007 and 2012. Methods Data from all admissions were extracted from clinical files. A Poisson generalized linear model estimated the association between the number of involuntary hospitalizations per patient in one year and sociodemographic, clinical, and contextual factors. Results An increment of involuntary hospitalizations was associated with male gender [exp($$\widehat{\upbeta }$$ β ^ ) = 1.31; 95%CI 1.06–1.62, p < 0.05], having secondary and higher education [exp($$\widehat{\upbeta }$$ β ^ ) = 1.45; 95%CI 1.05–2.01, p < 0.05, and exp($$\widehat{\upbeta }$$ β ^ ) = 1.89; 95%CI 1.38–2.60, p < 0.001, respectively], a psychiatric diagnosis of psychosis [exp($$\widehat{\upbeta }$$ β ^ ) = 2.02; 95%CI 1.59–2.59, p < 0.001], and being admitted in 2007 and in 2012 [exp($$\widehat{\upbeta }$$ β ^ ) = 1.61; 95%CI 1.21–2.16, p < 0.01, and exp($$\widehat{\upbeta }$$ β ^ ) = 1.73; 95%CI 1.31–2.32, p < 0.001, respectively]. A decrease in involuntary hospitalizations was associated with being married/cohabitating [exp($$\widehat{\upbeta }$$ β ^ ) = 0.74; 95%CI 0.56–0.99, p < 0.05], having experienced a suicide attempt [exp($$\widehat{\upbeta }$$ β ^ ) = 0.26; 95%CI 0.15–0.42, p < 0.001], and belonging to the catchment area of three of the psychiatric services evaluated [exp($$\widehat{\upbeta }$$ β ^ ) = 0.65; 95%CI 0.49–0.86, p < 0.01, exp($$\widehat{\upbeta }$$ β ^ ) = 0.67; 95%CI 0.49–0.90, p < 0.01, and exp($$\widehat{\upbeta }$$ β ^ ) = 0.67; 95%CI 0.46–0.96, p < 0.05 for Hospital de Magalhães Lemos, Centro Hospitalar Psiquiátrico de Lisboa and Unidade Local de Saúde do Baixo Alentejo, respectively]. Conclusions The findings suggest that involuntary psychiatric hospitalizations in Portugal are associated with several sociodemographic, clinical, and contextual factors. This information may help identify high-risk patients and inform the development of better-targeted preventive interventions to reduce these hospitalizations.

scholarly journals Factors Associated With Involuntary Psychiatric Hospitalization in Portugal

2020 ◽  
Author(s):  
Manuela Silva ◽  
Ana Antunes ◽  
Sofia Azeredo-Lopes ◽  
Adriana Loureiro ◽  
Benedetto Saraceno ◽  
...  
Keyword(s):  
Generalized Linear Model ◽  
Psychiatric Hospitalization ◽  
Contextual Factors ◽  
Preventive Interventions ◽  
Involuntary Hospitalization ◽  
Factors Associated ◽  
Psychiatric Hospitalizations ◽  
Psychiatric Units ◽  
Risk Patients ◽  
One Year

Abstract BackgroundIdentifying which factors contribute to involuntary psychiatric hospitalization may support initiatives to reduce its frequency. This study examines the sociodemographic, clinical, and contextual factors associated with involuntary hospitalization of patients from five Portuguese psychiatric departments in 2002, 2007 and 2012.MethodsData from all admissions were extracted from clinical files. A Poisson generalized linear model estimated the association between the number of involuntary hospitalizations per patient in one year and sociodemographic, clinical, and contextual factors.ResultsMale gender [exp(β̂) = 1.31; 95%CI:1.06-1.62, p<0.05], having secondary and higher education [exp(β̂) = 1.45; 95%CI:1.05-2.01, p<0.05, and exp(β̂) = 1.89; 95%CI:1.38-2.60, p<0.001, respectively], a psychiatric diagnosis of psychosis [exp(β̂) = 2.02; 95%CI:1.59-2.59, p<0.001], and being admitted in 2007 and in 2012 [exp(β̂) = 1.61; 95%CI:1.21-2.16, p<0.01, and exp(β̂) = 1.73; 95%CI:1.31-2.32, p<0.001, respectively] were associated with an increment of involuntary hospitalizations. Being married/cohabitating [exp(β̂) = 0.74; 95%CI:0.56-0.99, p<0.05], having experienced a suicide attempt [exp(β̂) = 0.26; 95%CI:0.15-0.42, p<0.001], and belonging to the catchment area of three of the psychiatric units evaluated [exp(n) =0.65; 95%CI:0.49-0.86, p<0.01, exp(β̂) = 0.67; 95%CI:0.49-0.90, p<0.01, and exp(β̂) = 0.67; 95%CI:0.46-0.96, p<0.05 for Hospital de Magalhães Lemos, Centro Hospitalar Psiquiátrico de Lisboa and Unidade Local de Saúde do Baixo Alentejo, respectively] were associated with a decrease in involuntary hospitalizations.ConclusionsThe findings suggest that involuntary psychiatric hospitalizations in Portugal are associated with sociodemographic, clinical, and contextual factors. This information may help to recognize high-risk patients, and to inform the development of better-targeted preventive interventions to reduce these hospitalizations.

Considering the Social Variable in Psychiatric Hospitalization: A Case for Structural Competency

2018 ◽  
Vol 20 (3) ◽  
pp. 127-132
Author(s):  
Elan Cohen ◽  
Christina Wusinich ◽  
Phoebe Friesen
Keyword(s):  
Mental Health ◽  
New York ◽  
Psychiatric Hospitalization ◽  
Community Mental Health Service ◽  
Structural Factors ◽  
Involuntary Hospitalization ◽  
Psychiatric Hospitalizations ◽  
Structural Competency ◽  
The Social ◽  
The Individual

Through the presentation of a case from a community mental health service in New York City, several structural factors that can influence decisions related to involuntary psychiatric hospitalizations are highlighted. A case is made for expanding debates related to involuntary hospitalization beyond the individual and for training those working in mental health care in structural competency.

The Probability of A1C Goal Attainment in Patients with Uncontrolled Type-2 Diabetes in a Large Integrated Delivery System: A Prediction Model

2020 ◽  
Author(s):  
Kevin M Pantalone ◽  
Anita D Misra-Hebert ◽  
Todd M Hobbs ◽  
Sheldon X Kong ◽  
Xinge Ji ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Goal Attainment ◽  
Index Date ◽  
Cleveland Clinic ◽  
Patient Characteristics ◽  
Psychiatric Disease ◽  
Lower Probability ◽  
Factors Associated ◽  
One Year

<b>Objective:</b> To assess patient characteristics and treatment factors associated with uncontrolled type 2 diabetes (T2D) and the probability of A1C goal attainment. <p><b>Research Design and Methods</b>: Retrospective cohort study using the electronic health record at Cleveland Clinic. Patients with uncontrolled T2D (A1C>9%) were identified on the index date of 12/31/2016 (n=6,973), grouped by attainment (n=1,653 [24.7%) or non-attainment (n=5,320 [76.3%]) of A1C<8% by 12/31/2017, and subgroups compared on a number of demographic and clinical variables. Based on these variables, a nomogram was created for predicting probability of A1C goal attainment. </p> <p><b>Results:</b> For the entire population, median age at index date was 57.7 years (53.3% male), and the majority were white (67.2%). Median A1C was 10.2%. Obesity (50.6%), cardiovascular disease (46.9%) and psychiatric disease (61.1%) were the most common comorbidities. Metformin (62.7%) and sulfonylureas (38.7%) were the most common anti-diabetes medications. Only 1,653 (24%) patients achieved an A1C <8%. Predictors of increased probability of A1C goal attainment were older age, white/non-Hispanic race/ethnicity, Medicare health insurance, lower baseline A1C, higher frequency of endocrinology/primary care visits, DPP-4i use, thiazolidinedione use, metformin use, GLP-1RA use, and fewer classes of anti-diabetes drugs. Factors associated with lower probability included insulin use and longer time in the T2D database (both presumed as likely surrogates for duration of T2D). </p> <p><b>Conclusions:</b> A minority of patients with an A1C>9% achieved an A1C<8% at one year. While most identified predictive factors are non-modifiable by the clinician, pursuit of frequent patient engagement and tailored drug regimens may help improve A1C goal attainment. </p>

Demographic factors associated with missed follow-up among solid tumor patients treated at a large multi-site academic institution

2020 ◽  
Vol 16 (32) ◽  
pp. 2635-2643
Author(s):  
Samantha L Freije ◽  
Jordan A Holmes ◽  
Saleh Rachidi ◽  
Susannah G Ellsworth ◽  
Richard C Zellars ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Odds Ratio ◽  
Regression Models ◽  
Tumor Patients ◽  
Logistic Regression Models ◽  
Factors Associated ◽  
Follow Up Care ◽  
Risk Patients ◽  
African American Race

Aim: To identify demographic predictors of patients who miss oncology follow-up, considering that missed follow-up has not been well studies in cancer patients. Methods: Patients with solid tumors diagnosed from 2007 to 2016 were analyzed (n = 16,080). Univariate and multivariable logistic regression models were constructed to examine predictors of missed follow-up. Results: Our study revealed that 21.2% of patients missed ≥1 follow-up appointment. African–American race (odds ratio [OR] 1.33; 95% CI: 1.17–1.51), Medicaid insurance (OR 1.59; 1.36–1.87), no insurance (OR 1.66; 1.32–2.10) and rural residence (OR 1.78; 1.49–2.13) were associated with missed follow-up. Conclusion: Many cancer patients miss follow-up, and inadequate follow-up may influence cancer outcomes. Further research is needed on how to address disparities in follow-up care in high-risk patients.

Applying Bowen Theory to Psychiatric Assessment and Disposition in the ED

2021 ◽  
pp. 107839032098763
Author(s):  
Kathleen B. Kerr
Keyword(s):  
Psychiatric Hospitalization ◽  
Theoretical Orientation ◽  
Admission Rate ◽  
Hospitalization Rate ◽  
The Other ◽  
Psychiatric Evaluation ◽  
Bowen Theory ◽  
Management Service ◽  
Psychiatric Assessment ◽  
Psychiatric Hospitalizations

BACKGROUND: A number of variables have been shown to influence whether an individual who experiences an emergency psychiatric assessment is admitted to a psychiatric hospital. This study focused on the theoretical orientation of the assessing clinician as a possibly influential variable. The theoretical orientation being studied was Bowen family systems theory or Bowen theory (Bt). Overall the Bt perspective looks at the family as the primary crucible that generates symptoms but at the same time as the natural unit and the best built-in resource to deal with those symptoms. AIMS: This study examined whether the theoretical orientation of the nurse psychiatric assessor would affect her inpatient admission rate of patients seen for psychiatric evaluation in an emergency department (ED). METHOD: A clinician/researcher with extensive experience applying Bt in clinical practice worked in a Crisis Management Service providing psychiatric evaluation and disposition in a busy community hospital ED. Given Bt’s emphasis on the system rather than individual pathology, the clinician researcher hypothesized that her psychiatric hospitalization rate would be lower than the other clinical nurse specialists. A retrospective chart review analyzed 1 year of cases from all referrals that might have resulted in psychiatric hospitalizations ( n = 1,801). RESULTS: The clinician/researcher’s psychiatric hospitalization rate was significantly lower ( p = .004) than the other clinicians. CONCLUSION: An approach to psychiatric assessment in the ED applied a Bt perspective in a way that significantly reduced psychiatric hospitalizations.

scholarly journals Understanding the Enablers and Barriers to Appropriate Infants and Young Child Feeding Practices in India: A Systematic Review

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 825
Author(s):  
Mansi Dhami ◽  
Felix Ogbo ◽  
Blessing Akombi-Inyang ◽  
Raphael Torome ◽  
Kingsley Agho ◽  
...  
Keyword(s):  
Young Child ◽  
Dietary Diversity ◽  
Meta Analysis ◽  
Bottle Feeding ◽  
Bibliographic Databases ◽  
Child Feeding ◽  
Factors Associated ◽  
Young Child Feeding ◽  
Semi Solid ◽  
One Year

Despite efforts to promote infant and young child feeding (IYCF) practices, there is no collective review of evidence on IYCF enablers and barriers in India. This review was conducted using 2015 Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. Six computerized bibliographic databases, Scopus, PubMed, PsycINFO, CINAHL, Embase, and Ovid MEDLINE, were searched for published studies on factors associated with IYCF practices in India from 1 January 1993, to 30 April 2020. IYCF practices examined were early initiation of breastfeeding, exclusive breastfeeding, continued breastfeeding at one year, introduction to solid semi-solid or soft foods, minimum dietary diversity, minimum meal frequency, minimum acceptable diet, continued breastfeeding at two years, predominant breastfeeding, and bottle feeding. In total, 6968 articles were retrieved, and 46 studies met the inclusion criteria. The common enablers of IYCF were higher maternal socioeconomic status (SES) and more frequent antenatal care visits (ANC) (≥3). Common barriers to IYCF practices were low SES and less frequent ANC. The review showed that the factors associated with IYCF practices in India are largely modifiable and multi-factorial. Improving IYCF practices would require the adoption of both facilities- and community-based policy interventions at the subnational and national levels in India.

scholarly journals Parental, child and socio-contextual factors associated with parenting self-efficacy among parents of children aged 0–7 years old: the CIKEO study

2021 ◽  
Author(s):  
Yuan Fang ◽  
Amy van Grieken ◽  
Irene N. Fierloos ◽  
Dafna A. Windhorst ◽  
Harrie Jonkman ◽  
...  
Keyword(s):  
Family Functioning ◽  
Self Efficacy ◽  
Contextual Factors ◽  
Cross Sectional ◽  
Mothers And Fathers ◽  
Factors Associated ◽  
Number Of Children ◽  
Effective Policy ◽  
Potential Factors ◽  
Sectional Analysis

Abstract Background A high parenting self-efficacy (PSE) has been associated with positive parenting and positive child development. However, there is limited and inconsistent information on factors associated with PSE. Objective To investigate factors associated with PSE in parents of children aged 0–7 years old, and to explore whether the associations were different between mothers and fathers. Methods We performed a cross-sectional analysis of the baseline data from a prospective cohort study: the CIKEO study. A total of 1012 parents (mean age = 33.8, SD = 5.0) completed self-reported measure of PSE and 18 potential factors associated with PSE. Results Multivariable models revealed that lower parenting stress, fewer child behavior problems, better eating behavior, better parental and child general health, a smaller number of children living in the household, higher perceived level of social support and having a migration background were associated with higher levels of PSE (p < 0.05). The association between family functioning and PSE differed between mothers and fathers (p for interaction = 0.003): with beta and 95% confidence interval being: 1.29 (− 2.05, 0.87), and 0.23 (− 0.46, 3.29), respectively. Conclusions A range of parental, child and social-contextual factors in relation to PSE were identified. The patterns of associations for most of the factors were similar among mothers and fathers. However, the association between family functioning and PSE might differ for mothers and fathers. Our findings are relevant for tailoring and implementing successful interventions and effective policy making in child care. Trial registration Netherlands National Trial Register number NL7342. Date of registration: 05-November-2018, retrospectively registered.

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