scholarly journals Non-attendance at psychiatric outpatient clinics: comparison of clinical, risk and demographic factors between attenders and non-attenders

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S35-S35
Author(s):  
Mahum Kiani ◽  
Nilamadhab Kar
Keyword(s):  
Psychological Treatment ◽  
Service Evaluation ◽  
Outpatient Clinics ◽  
Care Programme ◽  
Clinical Risk ◽  
Psychiatric Outpatient ◽  
Significant Difference ◽  
Depot Injections ◽  
Outpatient Appointments ◽  
Demographic Features

AimsWith an overarching aim of decreasing the incidence of non-attendance in psychiatric outpatient clinics, this service evaluation was intended to explore the profile of non-attenders. Specifically, the clinical, risk and demographic features of patients who did not attend their psychiatric outpatient appointments were compared with those of attenders. The outcome of patients who did not attend was also studied.MethodAll the consecutive non-attenders (n = 32) in November 2020 in a psychiatric outpatient clinic were compared with 32 consecutive attenders. The groups were compared based on clinical features (diagnosis, medical treatment, psychological treatment, care programme approach, first contact), risk profile (self or others) and demographic features (age, gender, ethnicity, accommodation, occupation, benefits). The non-attender sample was also analysed to consider the outcome after their missed appointment, following local Trust protocols.ResultThe overall rate of patients who did not attend their appointment was 22%. There was a statistically significant difference between the age and gender of non-attenders. Males were less likely to attend their appointment than females (p = 0.024). The mean age of patients who did not attend their appointment was 36.4 compared with 44.8 years in the attenders (p = 0.005). There were a few clinically relevant findings. Around one third (34%) of patients who did not attend their appointments had a history of risk of self-harm noted in previous appointments. The results also showed that 75% of individuals who did not attend their outpatient appointments were unemployed. There were no significant differences based on the type of treatments (depot injections, lithium, clozapine, antipsychotics or antidepressants) patients received. Patients who did not attend were more likely to have a mood disorder (59% compared with 40%), and less likely to have a psychotic disorder (25% compared with 44%). Of the patients who did not attend, all were appropriately contacted as per the local Trust guidelines via a letter, and were provided with appointments where appropriate; 34% of non-attenders were discharged from services.ConclusionNon-attendance at psychiatric outpatient appointments is a concern, particularly for younger and male patients. Considering the clinical risks associated with this patient population, efforts need to be taken to improve their engagement with mental health services. Future studies may explore patients’ perspectives of non-attendance and how to ameliorate any hindrances to attending.

scholarly journals Factors Associated with Non-Remission in Bipolar Disorder: The Multicenter Treatment Survey for Bipolar Disorder in Psychiatric Outpatient Clinics (MUSUBI)

2020 ◽  
Vol Volume 16 ◽  
pp. 881-890 ◽  
Author(s):  
Takashi Tsuboi ◽  
Takefumi Suzuki ◽  
Takaharu Azekawa ◽  
Naoto Adachi ◽  
Hitoshi Ueda ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Outpatient Clinics ◽  
Factors Associated ◽  
Psychiatric Outpatient

scholarly journals Clinical benefits, referral practice and cost implications of an in-hospital pain service: results of a service evaluation in a London teaching hospital

2016 ◽  
Vol 11 (1) ◽  
pp. 36-45 ◽  
Author(s):  
Maya Sussman ◽  
Elizabeth Goodier ◽  
Izabella Fabri ◽  
Jessica Borrowman ◽  
Sarah Thomas ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Pain Management ◽  
Teaching Hospital ◽  
Rating Scale ◽  
Service Evaluation ◽  
Rank Test ◽  
Future Research ◽  
Binary Logistic Regression Analysis ◽  
Significant Difference ◽  
Referral Practice

Background: In-hospital pain services (IPS) are commonplace, but evidence of efficacy is inadequate, and patients’ pain management in any hospital ward remains problematic. This service evaluation aimed to measure the effect of a contemporary IPS, its appropriate use and cost-efficacy. Methods: Records of 249 adults reviewed by the IPS in an inner London Teaching Hospital over an 8-month period were analysed for demographic data, interventions, workload and change in pain intensity measured by numerical rating scale (NRS). Non-parametric tests were used to evaluate differences between initial and final NRS. Spearman’s rank correlation analysis was used to create a correlation matrix to evaluate associations between all identified independent variables with the change in NRS. All strongly correlated variables (ρ > 0.5) were subsequently included in a binary logistic regression analysis to identify predictors of pain resolution greater than 50% NRS and improvement rather than deterioration or no change in NRS. Finally, referral practice and cost of inappropriate referrals were estimated. Referrals were thought to be inappropriate when pain was not optimised by the referring team; they were identified using a set algorithm. Results: Initial median NRS and final median NRS were significantly different when a Wilcoxon signed-rank test was applied to the whole cohort; Z = –5.5 (p = 0.000). Subgroup analysis demonstrated no significant difference in the ‘mild’ pain group; z = –1.1 (p = 0.253). Regression analysis showed that for every unit increase in initial NRS, there was a 62% chance of general and a 33% chance of >50% improvement in final NRS. An estimated annual cost-saving potential of £1546 to £4558 was found in inappropriate referrals and patients experiencing no benefit from the service. Discussion: Results suggest that patients with moderate to severe pain benefit most from IPS input. Also pain management resources are often distributed inefficiently. Future research is required to develop algorithms for easy identification of potential treatment responders.

Skull Base Factors in Relation to Hearing Impairment in Cleft Palate Children

2000 ◽  
Vol 37 (2) ◽  
pp. 166-171 ◽  
Author(s):  
S. Carrie ◽  
A. Sprigg ◽  
A.J. Parker
Keyword(s):  
Hearing Loss ◽  
Cleft Palate ◽  
Poor Quality ◽  
Normal Hearing ◽  
Outpatient Clinics ◽  
Control Group ◽  
Otologic Surgery ◽  
Soft Tissue Neck ◽  
Significant Difference ◽  
Primary Groups

Objective This investigation was performed to determine if an easily measurable, reproducible, bony parameter could be identified that might predict hearing loss in cleft palate children. Subjects In this prospective study performed at the Sheffield Children's Hospital (U.K.), 34 children with successfully repaired cleft palate who responded to a postal request for volunteers were assessed clinically, audiologically, and by lateral soft tissue neck radiography. Six children were excluded because of previous otologic surgery or poor quality radiographs. Twenty-six children who had the same series of investigations were randomly selected from routine otolaryngological outpatient clinics and acted as controls. Methods The sphenopalatine angle (SPA), which relates the facial and cranial components of the skull, was measured on each child's radiograph. Results The median SPA in the cleft palate group was significantly greater than in the control group (p = 0.01). In those cleft palate children with a hearing loss the sphenopalatine angle was smaller than in their normal hearing counterparts (p = 0.01). No significant difference was found in the SPA between the hearing loss and normal hearing controls. There was no significant difference in age ranges between the hearing and hearing loss subgroups in each of the two primary groups. Conclusions In this study, those cleft palate children with a smaller SPA have a greater incidence of hearing loss.

Cross-Cultural Study of Initial Visits to Psychiatric Outpatient Clinics

1979 ◽  
Vol 28 (2) ◽  
pp. 81???83 ◽  
Author(s):  
Roslyn R. Elms ◽  
John Kevany ◽  
Captane Thomson ◽  
Marcus Webb
Keyword(s):  
Cultural Study ◽  
Cross Cultural ◽  
Outpatient Clinics ◽  
Cross Cultural Study ◽  
Psychiatric Outpatient

scholarly journals Monitoring of Adverse Drug Reaction-Related Parameters in Children and Adolescents Treated With Antipsychotic Drugs in Psychiatric Outpatient Clinics

2021 ◽  
Vol 12 ◽  
Author(s):  
Lenneke Minjon ◽  
Ivona Brozina ◽  
Toine C. G. Egberts ◽  
Eibert R. Heerdink ◽  
Els van den Ban
Keyword(s):  
Children And Adolescents ◽  
Antipsychotic Drug ◽  
Medical Records ◽  
Antipsychotic Drugs ◽  
Patient Characteristics ◽  
Outpatient Clinics ◽  
Physical Parameters ◽  
Laboratory Parameters ◽  
Psychiatric Outpatient ◽  
Antipsychotic Drug Treatment

Aim: To assess the frequency of monitoring of adverse drug reaction (ADR) related parameters in children and adolescents treated with antipsychotic drugs in psychiatric outpatient clinics and the considerations when monitoring was not performed.Methods: This retrospective follow-up study included 100 randomly selected outpatients aged ≤18 years who had a first prescription of an antipsychotic drug recorded in the electronic medical records of psychiatric outpatient clinics between 2014 and 2017. They were followed for up to 3 years. This study assessed the frequency of monitoring for physical parameters (weight, height, body mass index, waist circumference, pulse, blood pressure, and an electrocardiogram) and laboratory parameters (glucose, lipids, and prolactin) before the first prescription of an antipsychotic drug as well as during its use. Monitoring frequencies were stratified by the patient characteristics (sex, age, cardiovascular risk factors, and use of other psychotropic drugs), and by location of antipsychotic drug initiation (psychiatric outpatient clinic or elsewhere). Additionally, this study assessed the considerations mentioned in the medical records for not monitoring ADR-related parameters.Results: Overall, physical parameters were monitored more frequently (weight: 85.9% during the first half-year) than laboratory parameters (glucose and cholesterol: both 23.5%). There were no significant differences in monitoring at least one physical as well as in monitoring at least one laboratory parameter during the baseline period and during the total follow-up of antipsychotic drug treatment between the patient characteristics. In total, 3% of the children and adolescents were never monitored for any physical parameter, and 54% were never monitored for any laboratory parameter. For a minority of the children (14.8%) who were never monitored for laboratory parameters, considerations were recorded in their medical records, including refusal by the child or parents and monitoring performed by the general practitioner or elsewhere.Conclusion: Monitoring frequencies of ADR-related parameters in children and adolescents treated with antipsychotic drugs in psychiatric outpatient clinics varied and especially monitoring of laboratory parameters was infrequent. Considerations why monitoring was not performed were rarely recorded. The optimal method of monitoring and documentation thereof should become clear to optimize the benefit-risk balance of antipsychotic drug treatment for each child.

scholarly journals Effectiveness of Nursing Intervention on Health Locus of Control and Self-Efficacy in Women with Gestational Diabetes

2021 ◽  
Vol 3 (1) ◽  
pp. 12
Author(s):  
Sabah R. H. Ahmed ◽  
Safaa G. Salem ◽  
Nahed M. Saber ◽  
Reda T. A. Abou Elazab ◽  
Merfat M. Atia
Keyword(s):  
Locus Of Control ◽  
Gestational Diabetes ◽  
Self Efficacy ◽  
Health Locus Of Control ◽  
Intervention Group ◽  
Nursing Intervention ◽  
Outpatient Clinics ◽  
Control Group ◽  
Significant Difference ◽  
And Control

the offspring in prenatal and postnatal periods and later life.  Lack of self-care is the most important reason for mortality in diabetic patients. Self-efficacy has a significant role in enhancing successful adherence to healthy behaviors, lifestyle modifications, and diabetes control among gestational diabetes pregnant women. Aim:  The current study aimed to evaluate the nursing intervention (NI) effectiveness on health locus of control (HELOC) and self-efficacy in women with gestational diabetes (GD). Methods: A quasi-experimental design (study and control group) was used. The researchers conducted this study at the Antenatal Outpatient Clinics of Shebin El-Kom Teaching Hospital, Menoufia Governorate, Egypt. A purposive sample of 120 women with GD was carefully chosen from the nominated setting and dispersed accidentally into two identical groups (study and control group). Three tools were used for collecting the study data: A structured self-administered questionnaire, the Multidimensional Health Locus of Control Scale-C Form, and the General Self-efficacy Scale. Results: There is a statistically significant difference between the intervention and control groups in their internal health locus of control (HELOC) scores after the intervention, with a mean difference of 4.70 at CI 95% for the intervention group p<0.001. A non-statistically significant difference was found between the intervention group and the control group in the external health locus of control (HELOC) mean scores before and after the intervention, although there was a significant difference between the change in both groups p=0.032. Also, there is a highly statistically significant difference between the intervention group and the control group in the self-efficacy scores after the intervention in the intervention group, where p<0.001 compared to a non-significant difference between them before the intervention group intervention (p=0.555). Conclusion: The study concluded that the women with GD who attended NI sessions obtained higher HELOC scores (internal and external) and higher self-efficacy scores than those who do not. Educational nursing intervention should become a fundamental part of the total management of gestational diabetes in antenatal outpatient clinics.

scholarly journals Major clinical risk factors for seizures in febrile children aged 6 to 60 months.

2020 ◽  
Vol 27 (05) ◽  
pp. 891-894
Author(s):  
Shahid Ishaq ◽  
Ejaz Mazari ◽  
Fazal ur Rehman
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Febrile Seizures ◽  
Study Groups ◽  
Clinical Risk Factors ◽  
P Value ◽  
Chi Square ◽  
Clinical Risk ◽  
Significant Difference ◽  
History Of

Objectives: Febrile seizures (FS) are the most common type of seizures and typically transpire in children with ages from 6 to 60 months. This study was planned to find out major clinical risk factors for seizures in febrile children who were aged 6 to 60 months. A total of 100 febrile children aged 6 to 60. Study Design: Analytical Study. Setting: Department of Neurology, Children’s Hospital and the Institute of Child Health, Multan. Period: From 1st April 2018 to 31st December 2018. Material & Methods: Group A had 40 children with febrile seizures while group B had 60 febrile children but without seizures. Demographic features along with family history of (H/O) epilepsy as well as family history of febrile seizure, types of seizure and infection diseases were noted and analyzed using SPSS version 20. Odds ratio was calculated for various risk factors. Chi square test was applied and P value < 0.05 was considered as significant. Results: Out of a total of 100 children, there were 54 (54.0%) male and 46 (46.0%) female. There was no statistical difference in terms of gender between the two groups (p value = 0.566). Overall, mean age of the children was 26.02 months with standard deviation of 13.4 months. There were 28 (70.0%) children who reported with simple seizures while complex seizures were found in 12 (30.0%) cases. Statistically significant difference (p value = 0.001) was seen in terms of types of infections between the two study groups. When risk of seizures for various risk factors was calculated, family H/O FS, family H/O epilepsy, and upper RTI were as 14, 7 and 3 times respectively and turned out to be the major risk factors for seizures in febrile children. Conclusions: Family H/O FS, family H/O epilepsy and upper RTIs are the major risk factors related with seizures in febrile children. Measures to prevent these risk factors can decrease the burden of FS in our population.

scholarly journals Organizational Culture Types that Academicians Associate with Their Institutions

2018 ◽  
Vol 7 (6) ◽  
pp. 161 ◽  
Author(s):  
Semra Kiranli Güngör ◽  
Hakan Şahin
Keyword(s):  
Organizational Culture ◽  
Competing Values Framework ◽  
Assessment Instrument ◽  
Central Anatolia ◽  
Competing Values ◽  
Significant Difference ◽  
Framework Model ◽  
The University ◽  
Post Hoc ◽  
Demographic Features

This study, considering the sample of a university located in central Anatolia region, Turkey, aims to identify culture types that the academicians perceive in relevant with their institutions according to the 4 types of cultures (Clan, Adhocracy, Hierarchy, and Market) given in the Competing Values Framework by Cameron and Quinn. The study includes 205 academicians from different faculties and vocational schools as participants. The data was obtained from the Organizational Culture Assessment Instrument (OCAI) that has been prepared particularly for the research group. Analyzes of the data obtained in the study were carried out with statistical package programs as IBM SPSS Statistics 23 and Interactive Lisrel SSI 8.72. The demographic features of the academicians were determined with percentage and frequency analyzes and the mean and standard deviation statistics were used in determining the perception levels of organizational culture types which academicians associate with their universities. For the analysis of the differentiation of culture-type perception levels according to the demographic characteristics of the academicians, t-test, one-way ANOVA test, and post-hoc tests were performed. According to the findings obtained in the research, the most common type of organizational culture that academicians associate with their institution is the hierarchy culture that is presented in Competing Values Framework Model. There is no significant difference between participants' demographic features and their culture perceptions. According to the result of the research, rules, stability, predictability, and sustainable politics are at the forefront of the university. Employees are supervised by managers who tend to be good coordinators.

scholarly journals Medical Diseases in Surgical Patients in Hong Kong

1984 ◽  
Vol 12 (1) ◽  
pp. 33-40
Author(s):  
M. L. Yeung
Keyword(s):  
Internal Medicine ◽  
Respiratory Diseases ◽  
Airway Disease ◽  
Anaesthetic Management ◽  
Outpatient Clinics ◽  
Surgical Patients ◽  
Chronic Obstructive ◽  
Chronic Obstructive Airway Disease ◽  
Significant Difference ◽  
Using Data

The incidence of medical diseases in surgical patients was assessed using data gathered from 5944 consecutive anaesthetics. Medical disease which might affect anaesthetic management was present in 23.2% of patients. The commonest diseases were hypertension, anaemia, chronic obstructive airway disease, diabetes mellitus, and pulmonary tuberculosis. No significant difference was detected in sex incidence for ischaemic heart disease and cerebrovascular disease. There was a disproportionate preponderance of males with respiratory diseases. It is suggested that anaesthetics should be administered only by qualified anaesthetists, that the establishment of anaesthetic outpatient clinics is desirable, and that internal medicine should be included in anaesthetic training.

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