Annual physical health checks within a forensic inpatient service

AimsPatients prescribed antipsychotics are at risk of ill effects to their physical health. Our aims were to assess whether inpatients within a forensic service, on antipsychotic medications, were receiving annual physical health monitoring in accordance with current NICE and SIGN Guidelines. Based on these Guidelines the following objectives were identified: 1: Physical examination, BMI and blood pressure recorded within the past year2: FBC recorded within the past year3: U&Es recorded within past year4: LFTs recorded within the past year5: HbA1C / random glucose / fasting glucose recorded within the past year6: Random lipids / fasting lipids recorded within the past yearMethodInclusion Criteria: Patients admitted for longer than a year currently prescribed an antipsychotic.Data were collected cross-sectionally on 24/7/20 for all inpatients meeting the inclusion criteria. Medical notes and the blood results system were reviewed for results of any annual physical examinations and blood monitoring over the past year.Anonymized data were analysed using Excel.Result13 out of 17 inpatients fulfilled the inclusion criteria. Of these 13 inpatients, 9 (69.2%) were prescribed clozapine, 1 (7.7%) zuclopenthixol, 1 (7.7%) paliperidone and 1 (7.7%) amisulpride.All patients had BMI and blood pressures recorded within the preceding month. Only 1 patient (7.7%) had an annual physical health examination within the past year.Findings for bloods taken within the past year were as follows:12 patients (92.3%) had an FBC recorded9 patients (69.2%) had U + Es recorded9 patients (69.2%) had LFTs recorded11 patients (84.6%) had HBA1c recorded7 patients (53.8%) had lipids recordedConclusionThere is scope for improvement with both annual physical examinations and blood monitoring.All patients had regular BMIs and blood pressure recorded which is largely attributable to nursing staff protocols. Low compliance with full annual physical examination could be explained by there being no local system in place for annual physical health checks and also frequent changes in junior doctor ward cover.Blood monitoring showed variable compliance with established standards. FBC monitoring had the best compliance, likely because the vast majority of our patients are prescribed clozapine, which necessitates minimal monthly FBC monitoring.This audit was presented to the Forensic Team and thereafter it was agreed for a local system to be put in place for annual physical health checks in the summer each year. This will improve oportunities to optimise our patients health. We plan to re-audit at this time.

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Testing a computerised tool to improve physical health monitoring in a medium secure forensic setting

BJPsych Open ◽

10.1192/bjo.2021.593 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S222-S223

Author(s):

Mike Smith ◽

Mustafa Abbas

Keyword(s):

Physical Examination ◽

Physical Health ◽

Health Monitoring ◽

Mental Health Problems ◽

Relevant Information ◽

Substantial Improvement ◽

Due Date ◽

Blood Tests ◽

The Past ◽

Health Checks

AimsThis project aimed to improve adherence to regular monitoring of the physical health of inpatients within a medium secure forensic psychiatric unit. A computerised tool to remind doctors to do checks was created, which was proposed would improve adherence.BackgroundThe physical health of people with mental health problems is of some concern, with higher rates of physical comorbidity and mortality compared to the general population.The forensic inpatient population has a high burden of both severe mental illness and physical ill health, and a high medication burden with potential adverse effects on physical health.To support the health of patients in our medium secure unit, each should routinely have three physical health checks done at least every six months. These are 1) an electrocardiogram (ECG), 2) a set of blood tests and 3) a full physical examination.MethodPatient records for 26 patients across two medium secure psychiatric wards were checked for 1) an ECG, 2) a full set of blood tests and 3) a full general physical examination within the past 6 months.A tool was created that automatically calculated the next due date for each check and colour coded which were overdue (red) or within 30 days of the due date (yellow). This tool was given to the core trainees working on these wards to help them keep track of which checks needed to be done.The records for patients on the same two wards were rechecked four months later and the adherence rates compared.ResultOn both wards, for each of the three physical health checks, a substantial improvement was seen in the proportion completed within the past 6 months.ConclusionThe tool created was a useful means of presenting, in one place, relevant information needed by doctors working in medium secure forensic wards regarding physical health checks, and drawing their attention to tasks that needed to be done. This led to an improvement in the adherence to physical health monitoring in these wards. An area for future improvement was identified regarding the unit's capacity to perform ECGs in a timely manner.

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Are we meeting local and national guidelines for physical health assessment following admission to the meadows?

BJPsych Open ◽

10.1192/bjo.2021.805 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S304-S305

Author(s):

Yasmin Abbasi ◽

Ruairidh Morgan ◽

Alice O'Docherty

Keyword(s):

Physical Examination ◽

Physical Health ◽

Psychotropic Medication ◽

Health Assessment ◽

Health Examination ◽

Nice Guidelines ◽

Blood Tests ◽

Healthcare Needs ◽

Common Diagnosis ◽

Level Of Consciousness

AimsWe audited practice at the Meadows Inpatient Unit regarding physical health assessment, against standards set by Surrey and Borders Partnership and NICE.BackgroundSABP policy states that within 24 hours of admission to inpatient services, physical health assessment should be offered. It should be completed within 72 hours. Refusal should be documented.These guidelines state that within 2 weeks of admission blood tests should be completed, and for specific individuals an ECG should be performed.NICE guidelines state that “physical healthcare needs” should be discussed with newly admitted patients. NICE guidelines regarding physical health monitoring for individuals with psychosis or schizophrenia recommend that assessment includes “full physical examination to identify physical illness”.NICE suggests use of antipsychotics for individuals with dementia who have severe distress, or are at risk of harming themselves or others. Those with behavioural and psychological symptoms of dementia (BPSD) should therefore be physically assessed to ensure safe use of antipsychotics may be implemented.MethodAll admissions to The Meadows over seven months were audited retrospectively. The clinical notes were accessed from Systm1.Consensus medical opinion was reached that full examination should include: GCS/level of consciousness, cardiorespiratory, abdominal and neurological examinations.Age, gender, diagnosis and prescriptions of psychotropic medication at time of admission were recorded.The sample included 35 patients.Result55% of patients had a diagnosis of dementia.63.8% of patients were prescribed antipsychotics on admission, more than other psychotropic medication. This may reflect that the most common diagnosis was dementia, commonly with associated BPSD.97% of patients had a physical examination completed within 24 hours; most excluded neurological examination. 91% of patients had blood tests completed in two weeks, with the most commonly excluded tests being lipids and glucose. 86% of patients had an ECG in two weeks. In general, documentation of reason for not completing an examination was completed.ConclusionWe found good compliance with recommendations for physical health assessment. Areas for improvement include better assessment of neurology and more thorough blood tests.Recommended physical health examination for new admissions is not outlined in SABP policy. We recommend the following:GCS/level of consciousness, cardiovascular, respiratory, abdominal, and neurological examinations, and baseline observations.ECG should be a requirement of admission. In order to facilitate this, staff need to be trained to perform ECGs.NICE guidelines refer to HBA1c rather than glucose, which should be reflected in SABP policy.

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Study on the Distribution Characteristics and Influencing Factors of Homocysteine in the Physical Examination Population

10.21203/rs.3.rs-520296/v1 ◽

2021 ◽

Author(s):

Fang Bao ◽

Ming Cui ◽

Xiuying Shi ◽

Shaoqing Ju ◽

Hui Cong

Keyword(s):

Blood Pressure ◽

Physical Examination ◽

Large Scale ◽

Kidney Injury ◽

Scientific Basis ◽

Cerebrovascular Diseases ◽

Health Examination ◽

Significant Difference ◽

The Difference

Abstract Background: Homocysteine (Hcy) is considered to be an independent risk factor for cardiovascular and cerebrovascular diseases. No study has evaluated the distribution of Hcy on a large-scale health examination. Accordingly, this study aimed to investigate the level and distribution of Hcy in the healthy physical examination population and the correlation with other biomarkers, and analyzed for cardiovascular and other diseases. The prevention provides an important scientific basis.Methods: From February 2017 to April 2020, 8063 medical examination populations were selected for analysis. Determination of serum Hcy, TC, TG, LDL-c, HDL-c, ALT, ALP, γ-GT, TBIL, GLU, urea, Cr, UA and related metabolic risk factors. According to the multivariate regression model of age, gender, smoking, drinking, body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP), the relationship between Hcy and other biochemical indicators was evaluated. Results: Among 8063 cases, the age, BMI, SBP and DBP of the high-Hcy group were higher than those of the low-Hcy group, the difference was statistically significant (P<0.05), and the proportion of males, smoking and drinking were higher than the low In the Hcy group, the difference was statistically significant (P<0.05); the ALT, ALP, γ-GT, TBIL, Urea, Cr, UA, and TG in the high Hcy group were higher than those in the low Hcy group, and the difference was statistically significant (P<0.05 ); HDL-c in the high-Hcy group was lower than that in the low-Hcy group, and the difference was statistically significant (P<0.05). There was no statistically significant difference in TC, LDL-c, and GLU between the high- and low-Hcy groups (P>0.05). In multivariate analysis, lnHDL-C was negatively correlated with lnHcy (β=-0.038, SE=0.016, P<0.05), lnCr was positively correlated with lnHcy (β=0.055, SE=0.016, P<0.05), lnUA and lnHcy were positive correlation (β=0.043, SE=0.019, P<0.05). Conclusion: Hcy is closely related to HDL-c, Cr and UA, which indicates that Hcy may affect the metabolism of HDL-c and UA, and can also be used as an auxiliary diagnostic index for kidney injury.

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Validation and reliability of a simplified food frequency questionnaire:A cross sectional study among physical health examination adults in southwest region of China

10.21203/rs.2.23239/v2 ◽

2020 ◽

Author(s):

Zhengyan Cheng ◽

Ping Shuai ◽

Qichuan Qiao ◽

Tingxin Li

Keyword(s):

Physical Examination ◽

Physical Health ◽

Reliability And Validity ◽

Correlation Coefficients ◽

Cross Sectional Study ◽

Health Examination ◽

Sectional Study ◽

Cross Sectional ◽

Food Frequency ◽

Southwest Region

Abstract Background: In China, many people are apt to participate in regular physical examination as a prevention. Some simplified food frequency questionnaire have been designed and used. However, the accuracy of questionnaire is absent. This study was conducted to examine the reliability and validity of simplified food frequency questionnaire (SFFQ) used among physical examination adults in southwest region of China.Methods: This study was a cross sectional study among physical health examination adults in Southwest region of China. A total of 239 participants aged 20-65 were conducted during February to June in 2019. The performance of the SFFQ was evaluated by the mean of three-day 24-hour dietary record (3R24). The relative validity and agreement was assessed by the Pearson`s correlation and intra-class correlation coefficients(ICC) respectively. Results: The median energy-adjusted ICC of food groups between SFFQ2 and SFFQ1 was 0.59 (range: 0.49-0.73) and the ICC of nutrients was 0.47(range: 0.39-0.76). The Pearson correlation showed the validity between the SFFQ1 and 3R24, which ranged from -0.086 to 0.93 for food and and 0.21 to 0.71 for nutritions, respectively. Energy-adjustment slightly increased the correlation coefficients.Conclusions: The reliability and validity of the SFFQ was acceptable. It could be an appropriate dietary assessment tool for future epidemiological studies among physical health examination adults in southwest China.Trial registration:CHiCTR, ChiCTR1900020934, Registered 22 January 2019, http://www.chictr.org.cn/edit.aspx?pid=35414&htm=4.

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Physical health of patients in rehabilitation and recovery: a survey of case note records

Psychiatric Bulletin ◽

10.1192/pb.29.6.210 ◽

2005 ◽

Vol 29 (6) ◽

pp. 210-212 ◽

Cited By ~ 14

Author(s):

Jayne Greening

Keyword(s):

Blood Pressure ◽

Physical Health ◽

Clinical Excellence ◽

Case Note ◽

Clinical Implications ◽

Endocrine Disorders ◽

Further Training ◽

Health Indices ◽

The Past ◽

Erythrocyte Sedimentation

Aims and MethodThe aim of this survey was to determine details recorded about the physical health of patients in rehabilitation and recovery. All medical and nursing notes from January 1998 to March 2003 were reviewed. Case notes from 63 patients were studied.ResultsThere was mention in less than 13 of the patients' notes (18%) of smoking, diet, exercise or prolactin levels; weight, blood pressure, electrocardiogram, erythrocyte sedimentation rate or lipids were mentioned in less than 20 (30%). A blood sugar test was performed in only 16 patients (25%) in the past year and 38 patients (59%) had a record of a test in the past 5 years. These results suggest that there is inadequate recording of the physical health parameters in patients in rehabilitation and recovery.Clinical ImplicationsThe physical healthcare of patients with schizophrenia is prioritised in the National Institute for Clinical Excellence (NICE) clinical guidelines, which specifically mention the monitoring of endocrine disorders such as diabetes and hyperprolactinaemia, cardiovascular risk factors, such as blood pressure and lipids, and lifestyle factors such as smoking. Routine recording of physical health indices should be mandatory and staff may need further training to enable them to do this.

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Validity and reliability of a simplified food frequency questionnaire: A cross sectional study among physical health examination adults in southwest region of China

10.21203/rs.2.23239/v3 ◽

2020 ◽

Author(s):

Zhengyan Cheng ◽

Ping Shuai ◽

Qichuan Qiao ◽

Tingxin Li

Keyword(s):

Physical Examination ◽

Physical Health ◽

Reliability And Validity ◽

Correlation Coefficients ◽

Cross Sectional Study ◽

Health Examination ◽

Sectional Study ◽

Cross Sectional ◽

Food Frequency ◽

Southwest Region

Abstract Background: In China, many people are suitable for participating in regular physical examination for prevention. Some simplified food frequency questionnaires have been designed and used. However, the accuracy of questionnaire is absent. This study aimed to examine the reliability and validity of simplified food frequency questionnaire (SFFQ) used among physical examination adults in southwest region of China.Methods: This was a cross-sectional study conducted among physical health examination adults in Southwest region of China. A total of 239 participants aged 20-65 were included from February 2019 to June 2019. The performance of SFFQ was evaluated by means of a three-day 24-hour dietary record (3R24). The relative validity and agreement was assessed by Pearson`s correlation and intra-class correlation coefficients (ICC), respectively. Results: The median energy-adjusted ICC of food groups between SFFQ2 and SFFQ1 was 0.59 (range: 0.49-0.73) and the ICC of nutrients was 0.47(range: 0.39-0.76). The Pearson correlation showed a validity between SFFQ1 and 3R24, which ranged from -0.086 to 0.93 for food and 0.21 to 0.71 for nutrition, respectively. The energy-adjustment slightly increased the correlation coefficients.Conclusions: The reliability and validity of SFFQ was acceptable. It could be an appropriate dietary assessment tool for future epidemiological studies among physical health examination adults in southwest China.Trial registration:CHiCTR, ChiCTR1900020934, Registered 22 January 2019, http://www.chictr.org.cn/edit.aspx?pid=35414&htm=4.

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UPAYA PENINGKATAN KUALITAS HIDUP LANSIA DI PANTI WERDHA SINTA RANGKANG

PengabdianMu Jurnal Ilmiah Pengabdian kepada Masyarakat ◽

10.33084/pengabdianmu.v3i1.22 ◽

2018 ◽

Vol 3 (1) ◽

pp. 15-19

Author(s):

Fitriani Ningsih

Keyword(s):

Quality Of Life ◽

Blood Pressure ◽

The Elderly ◽

Health Examination ◽

Height Measurement ◽

Activity Schedules ◽

Health Checks ◽

Health Related ◽

Elderly Health

Panti werdha / Jompo is a home or shelter for elderly (elderly). A means by which the elderly are provided with facilities, 24-hour services, activity schedules, and entertainment required as per the elderly. Certainly in the management of nursing homes cannot be separated from the obstacles and difficulties in managing the werdha home. One is the lack of fulfillment of eating and drinking for the elderly, in addition to facing the elderly who are experiencing a decline in health, or psychological disorders such as irritability, difficulty sleeping, depressed, nervous, lonely, impatient, tense, anxious and depressed. This activity aims to improve the quality of life of the elderly through promotive and preventive approaches, namely by conducting elderly health checks such as height measurement, weight, blood pressure, supplementary feeding, and elderly gymnastics and health-related counseling of the elderly. The method used in this activity is the method of counseling, where the counseling is done in Room Hall Panti Werdha Sinta Rangkang. The number of elderly people in Panti werdha Sinta Rangkang that is as much as 80 elderly, but who follow this activity only amounted to 62 people only. Because some elderly there is a sick so it takes a total bedrest. The results achieved from this activity is the implementation of this activity well, collecting data results of health examination of elderly as well as the increasing knowledge of elderly related to the health of elderly.

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Physical Examination of the Spine Using Telemedicine: A Systematic Review

Global Spine Journal ◽

10.1177/2192568220960423 ◽

2020 ◽

pp. 219256822096042

Author(s):

Joshua Piche ◽

Bilal B. Butt ◽

Arya Ahmady ◽

Rakesh Patel ◽

Ilyas Aleem

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Patient Satisfaction ◽

Physical Examination ◽

Primary Outcome ◽

Low Back ◽

Inclusion Criteria ◽

Physical Examinations ◽

Secondary Outcomes ◽

Acceptable Reliability

Study Design: This is a systematic review. Objective: To systematically review (1) the reliability of the physical examination of the spine using telehealth as it pertains to spinal pathology and (2) patient satisfaction with the virtual spine physical examination. Methods: We searched EMBASE, PubMed, Medline Ovid, and SCOPUS databases from inception until April 2020. Eligible studies included those that reported on performing a virtual spine physical examination. Two reviewers independently assessed all potential studies for eligibility and extracted data. The primary outcome of interest was the reliability of the virtual spine physical exam. Secondary outcomes of interest were patient satisfaction with the virtual encounter. Results: A total of 2321 studies were initially screened. After inclusion criteria were applied, 3 studies (88 patients) were included that compared virtual with in-person spine physical examinations. These studies showed acceptable reliability for portions of the low back virtual exam. Patient satisfaction surveys were conducted in 2 of the studies and showed general satisfaction (>80% would recommend). Conclusions: These results suggest that the virtual spine examination may be comparable to the in-person physical examination for low back pain, though there is a significant void in the literature regarding the reliability of the physical examination as it pertains to specific surgical pathology of the spine. Because patients are overall satisfied with virtual spine assessments, validating a virtual physical examination of the spine is an important area that requires further research.

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Physical health of patients under EIP - a service evaluation

BJPsych Open ◽

10.1192/bjo.2021.897 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S342-S342

Author(s):

Anu Priya ◽

Keerthan Dhanasekar ◽

James Hill-Cousins ◽

Mudasar Aziz ◽

Osama Suleiman ◽

...

Keyword(s):

Physical Health ◽

Reporting System ◽

Service Evaluation ◽

Test Results ◽

Antipsychotic Medications ◽

Blood Tests ◽

The Past ◽

Health Checks ◽

Number Of Patients ◽

Early Intervention In Psychosis

AimsThe aim of the project was to get a baseline of the number of patients who have had blood tests, ECG and physical health observations completed in the past 12 months.MethodThere are 30 patients under Early Intervention in Psychosis team at Bassetlaw Hospital , Nottinghamshire. The elctronic notes and blood reporting system were checked for each of the patients, to get the data on blood test results , ECG reports and Physical health (Blood pressure, heart rate and weight) .ResultIt was noted that 19/30 patients had Blood tests completed, 14/30 had ECG completed and 19/30 had physical health checks completed. All these patients except one were on antipsychotic medications.ConclusionFurther work is still required in getting 100% results for all these different variables. This may include the need to review the process of how we engage the patients for physical healthcare checks. With the inclusion of a physical healthcare worker now, we might be able to improve results. Hence this evaluation would be redone in a years' time.

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Validity and reliability of a simplified food frequency questionnaire: a cross sectional study among physical health examination adults in southwest region of China

Nutrition Journal ◽

10.1186/s12937-020-00630-z ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Zhengyan Cheng ◽

Ping Shuai ◽

Qichuan Qiao ◽

Tingxin Li

Keyword(s):

Physical Examination ◽

Physical Health ◽

Reliability And Validity ◽

Correlation Coefficients ◽

Cross Sectional Study ◽

Health Examination ◽

Sectional Study ◽

Cross Sectional ◽

Food Frequency ◽

Southwest Region

Abstract Background In China, many people are regarded suitable for participating in regular physical examination for diagnosis and prevention of diseases. Some simplified food frequency questionnaires have been designed and used; however, the accuracy of the questionnaire is absent. This study aimed to examine the reliability and validity of simplified food frequency questionnaire (SFFQ) used among adults undergoing physical examination in southwest region of China. Methods This was a cross-sectional study conducted among physical health examination adults in the Southwest region of China. A total of 239 participants aged 20–65 were included from February 2019 to June 2019. The performance of SFFQ was evaluated by means of a three-day 24-h dietary record (3R24). The relative validity and agreement was assessed by Pearson’s correlation and intra-class correlation coefficients (ICC), respectively. Results The median energy-adjusted ICC of food groups between SFFQ2 and SFFQ1 was 0.59 (range: 0.49–0.73) and the ICC of nutrients was 0.47(range: 0.39–0.76). The Pearson correlation showed a valid comparisons between SFFQ1 and 3R24, ranging from -0.086 to 0.93 for food and 0.21 to 0.71 for nutrition, respectively. The energy-adjustment slightly increased the correlation coefficients. Conclusions The reliability and validity of SFFQ was acceptable, and it could be an appropriate dietary assessment tool for the future epidemiological studies conducted among physical health examination adults of southwest China. Trial registration CHiCTR, ChiCTR1900020934, Registered 22 January 2019, https://www.chictr.org.cn/edit.aspx?pid=35414&htm=4.

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