scholarly journals The perception of behaviour associated with dementia in the acute hospital

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S260-S260
Author(s):  
Zumer Jawaid ◽  
George Crowther ◽  
Syeda Ashar
Keyword(s):  
Health Care Professionals ◽  
Qualitative Methodology ◽  
Hospital Setting ◽  
Photo Elicitation ◽  
Experience Levels ◽  
Hospitalised Patients ◽  
High Prevalence ◽  
Case Vignettes ◽  
Medical Specialities

AimsGeneral hospital based Health Care Professionals (HCPs) use very varied language to describe behaviour in dementia. Lessons from medicine and other professions tell us that non-uniform communication is a source of error and subsequent poor decision making. Knowing how HCPs communicate behaviour in dementia in a hospital setting may help better understand these potential sources of communication error and identify training needs.BackgroundAround 25% of hospital beds occupied with people living with dementia. Hospitalised patients with dementia have a high prevalence of distressing symptoms (pain 70%, delirium 66%, depression 35%, anxiety 34%, hallucinations 14% delusions 11%). These symptoms often displayed as behaviour can be challenging for HCPs to interpret. Variations in communicating behaviour may lead to inconsistent understanding of the need, with the potential for missing treatable conditions that drive the behaviour. Standardizing communication and documentation have the potential to improve the quality of information handed over between HCPs which may improve the quality of care and patient outcomes.MethodQualitative methodology including photo elicitation was used. A purposive sample of 59 HCPs was selected. This was identified from a range of professional backgrounds, experience levels and medical specialities. They were presented with a photograph and case vignettes depicting 4 behaviours associated with distress (aggression, depression, delirium and psychosis). HCPs were asked to respond to the scenarios as if they were handing over to colleagues or documenting in the medical record. Data were analysed by thematic analysis.Result59 HCPs were interviewed with photo-elicitation. Participants recorded their responses in limited time to reflect time constraints in a busy ward environment. 2 HCPs declined to participate in research.When describing behaviour associated with aggression and depression HCPs were consistent with the language used (49/57). When presented with a delirium less consistency was observed (31/47). While describing psychosis each HCP chose either paranoia or suspiciousness among other descriptions.ConclusionOverall there has been consistency in describing the distress experienced by the patient even though HCPs came from very different roles and specialities. Doctors, Nurses, CSWs and dieticians all described the behaviour alike. Newer staff were more accurate which could be due to dementia training within National Dementia Action Alliance.

Restless legs syndrome: the most prevalent “unknown” disorder

2011 ◽  
Vol 152 (7) ◽  
pp. 259-266 ◽  
Author(s):  
Anett Lindner ◽  
Márta Novák ◽  
Miklós Zsolt Molnár
Keyword(s):  
Restless Legs Syndrome ◽  
Health Care Professionals ◽  
Clinical Presentation ◽  
Social Consequences ◽  
Sleep Disruption ◽  
Daytime Functioning ◽  
Restless Legs ◽  
High Prevalence ◽  
Consequences Of Disease

Sleep disorders are also considered as significant chronic disorders, as their physiological and psycho-social consequences are well documented. Restless legs syndrome has high prevalence, as it occurs in 5–10 % of the general population. Since clinical presentation is not well appreciated by many of the health care professionals, only a small proportion of the patients with restless legs syndrome is diagnosed and treated. The consequences of disease, however, are not negligible. The majority of the patients suffer from insomnia, impaired daytime functioning and quality of life. Although, restless legs syndrome is frequently characterized as a sleep disorder, it does not only influence sleep but also the daytime functioning of the patients. Additionally, restless legs syndrome causes not only subjective complaints and sleep disruption, but it is also associated with cardiovascular disorders. Orv. Hetil., 2011, 152, 259–266.

Experience and Views of Oncology and Palliative Care Professionals on a Corounding Model of Care for Inpatients With Advanced Cancer

2018 ◽  
Vol 35 (11) ◽  
pp. 1433-1438
Author(s):  
Grace Meijuan Yang ◽  
Sungwon Yoon ◽  
Yung Ying Tan ◽  
Karen Liaw
Keyword(s):  
Palliative Care ◽  
Patient Care ◽  
Advanced Cancer ◽  
Health Care Professionals ◽  
Care Delivery ◽  
Hospital Setting ◽  
Model Of Care ◽  
Consult Service ◽  
Quality Of Patient Care

Background: Palliative care is associated with better outcomes in advanced cancer, but there is limited research comparing different models of palliative care delivery alongside oncology care. For inpatients with cancer, palliative care is mostly delivered through a consult service, primarily relying on oncologist-initiated referrals to a separate specialist palliative care team. In our hospital setting, we piloted a palliative care and oncology corounding model of care. Aim: To explore the views and experience of oncology and palliative care professionals on the corounding model compared to an inpatient consult service. Design: A qualitative study nested within a pre–post study of the corounding model of care, with semistructured interviews using thematic analysis. Setting/Participants: Eleven doctors and nurses involved in the pilot corounding model were interviewed. Results: Two main themes emerged: (1) the efficiency of care delivery and (2) quality of patient care. The theme on the efficiency of care delivery was related to access to palliative care input, team communications, and parallel workflow. The quality of patient care was described in terms of holistic approach to cancer care and rapport building with patients and their families. Most participants acknowledged positive aspects of the corounding model, yet some minor concerns were reported, such as disagreements between oncology and palliative care professionals. Conclusions: This study provides insights into the benefits and drawbacks of a corounding model of care for inpatients. The views of health-care professionals can be incorporated into the development of integrated oncology and palliative care models to improve care for patients with advanced cancer.

scholarly journals Why Early Psychological Attention for Type 2 Diabetics Could Contribute to Metabolic Control

2018 ◽  
Vol 25 (3) ◽  
pp. 329-334
Author(s):  
Alfredo Briones-Aranda ◽  
Manuela Castellanos-Pérez ◽  
Raquel Gómez-Pliego
Keyword(s):  
Metabolic Control ◽  
Health Care Professionals ◽  
Economic Resources ◽  
Diabetic Patients ◽  
Type 2 Diabetics ◽  
High Prevalence ◽  
Patient Families ◽  
Health Institutions

Abstract Background and aims: Type 2 Diabetes Mellitus (T2DM) is currently a public health emergency that requires inter- and multidisciplinary medical services. The principal aim of the present work was to review the basic factors related to the possible advantages of providing early psychological attention to T2DM patients as a coadjuvant for achieving adequate metabolic control. Material and methods: A literature review was conducted to explore the interaction between stress and depression and the relation of both to the ability of T2DM patients to effectively manage their disease. Results: It was found that stress is one of the factors linked to the etiology of depression, which is a disorder with high prevalence in diabetic patients. Consequently, an inter- and multidisciplinary approach to treating diabetic patients was developed. One of the main focuses of this approach is early psychological attention, starting shortly after the initial diagnosis. Conclusions: The ability to create consciousness among health care professionals about the importance of early psychological attention for T2DM patients under an inter- and multidisciplinary strategy could possibly improve pharmacological adherence, metabolic control, the quality of life and the life expectancy of patients, as well as save economic resources for patient families and health institutions.

scholarly journals Creating Significant Life Rituals in Neuro-Palliative Care

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Lana Kim McGeary
Keyword(s):  
Palliative Care ◽  
Health Care Professionals ◽  
Meaning Making ◽  
Hospital Setting ◽  
Whole Person ◽  
Life Issues ◽  
Significant Life ◽  
Care Health ◽  
Team Setting

Ritual can be described as an act which helps make sense of life, “there is what many people recognize as a spiritual quality to life, which in suffering, confronts people with questions and possibilities that reach beyond the immediate dilemmas of physical insult.” (Cobb and Robshaw, 1998); in this vein, ritual serves as a vehicle to navigate the inherent moments of sorrow and suffering in our lives. Fred Bird describes ritual as something which allows for communication, representation, meaning making, validation and relationing. (Bird, 1995)This presentation explores the ways in which creating accessible and significant contemporary rituals, within a hospital setting, may serve as a means to crystallize our deepest sensitivities for life, and living. It looks at some of the ways rituals can serve as a bridge to wholing and healing, within the patient, with family members and with health care professionals interacting with patient. Through examples from spiritual care counseling, within a multidisciplinary team setting, in neuro-palliative care, a path is set for some simple ways to ritually nurture quality of life issues, as part of a whole person care health protocol.

Systematic Review for the Quality of End-of-Life Care for Patients With Dementia in the Hospital Setting

2018 ◽  
Vol 35 (12) ◽  
pp. 1572-1583 ◽  
Author(s):  
Felicity Moon ◽  
Fiona McDermott ◽  
David Kissane
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Health Care Professionals ◽  
End Of Life Care ◽  
Hospital Setting ◽  
Psychosocial Care ◽  
Life Care ◽  
Hospital Patients ◽  
To Receive

Background: Patients with dementia may receive suboptimal end-of-life care in hospital settings reflecting broader debate around the palliative status of dementia syndromes. Objectives: To synthesize literature describing the quality of end-of-life care for patients with dementia dying in hospital. Methods: An integrative review assessed the quality of 26 articles concerning medical, nursing, and psychosocial care of patients with dementia dying in hospital settings. Results: Literature reflects a growing awareness of the need to consider a palliative approach to end-of-life care for patients with dementia in hospital. Patients with dementia are less likely to receive aggressive care at the end of life, but provision of palliative care interventions is inconsistent. Health-care professionals highlighted the need for greater education around identification and management of problematic symptoms at the end of life. Engagement of family caregivers is essential in optimizing end-of-life care, and further research is required to ascertain their experiences around decision-making. Conclusion: Although patients with dementia appear to receive less aggressive treatment at the end of life, the provision of palliative care and symptom management may be inadequate.

Musical Anhedonia

2020 ◽  
Vol 31 (2) ◽  
pp. 62-68
Author(s):  
Sara E. Holm ◽  
Alexander Schmidt ◽  
Christoph J. Ploner
Keyword(s):  
Quality Of Life ◽  
Nucleus Accumbens ◽  
Brain Damage ◽  
Parietal Cortex ◽  
Neurological Disorders ◽  
Brain Regions ◽  
Precise Information ◽  
Exact Localization ◽  
High Prevalence

Abstract. Some people, although they are perfectly healthy and happy, cannot enjoy music. These individuals have musical anhedonia, a condition which can be congenital or may occur after focal brain damage. To date, only a few cases of acquired musical anhedonia have been reported in the literature with lesions of the temporo-parietal cortex being particularly important. Even less literature exists on congenital musical anhedonia, in which impaired connectivity of temporal brain regions with the Nucleus accumbens is implicated. Nonetheless, there is no precise information on the prevalence, causes or exact localization of both congenital and acquired musical anhedonia. However, the frequent involvement of temporo-parietal brain regions in neurological disorders such as stroke suggest the possibility of a high prevalence of this disorder, which leads to a considerable reduction in the quality of life.

The experience of using a diode laser in the herpes labial treatment

2020 ◽  
Vol 25 (1) ◽  
pp. 43-46
Author(s):  
S. L. Blashkova ◽  
E. V. Krikun ◽  
Yu. V. Fazylova ◽  
Yu. V. Blashkova
Keyword(s):  
Oral Cavity ◽  
Diode Laser ◽  
Comparison Group ◽  
Treatment Time ◽  
Local Treatment ◽  
Allergic Reactions ◽  
High Prevalence ◽  
Dental Diseases ◽  
Simplex Virus

Relevance. The relevance of the problem is in the high prevalence of the herpes simplex virus. According to WHO, nearly 90% of the population are carriers. Relapses can occur several times a year, which leads to disability and impairs the quality of life. Currently, there are a large number of drugs for general and local treatment. However, they are toxic and can cause allergic reactions. In recent years, a large number of studies have been devoted to the use of lasers in the treatment of dental diseases. Therefore, the question of the use of a laser in the treatment of herpetic lesions of the oral cavity remains relevant.Purpose. The research purpose was to determine the effectiveness of the use of a diode laser in the treatment of herpetic lesions of the lips.Materials and methods. We conducted a comparative assessment of the effectiveness of the use of a diode laser in monotherapy of herpetic lip lesions in 18 patients. The comparison group consisted of 18 patients, in the local treatment of which antiviral ointments were used.Results. The results of the study showed that the use of a diode laser can reduce treatment time, accelerate the epithelization of foci.Conclusion. The results of our study allow us to recommend the use of a diode laser in the complex treatment of herpetic lesions of the oral cavity.

Problems in the Health Care of Dying Old Men: Complaints by their Widows

1995 ◽  
Vol 31 (2) ◽  
pp. 121-141 ◽  
Author(s):  
Maria M. Talbott
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Medical Care ◽  
Health Care Professionals ◽  
Lack Of Control ◽  
Old Men

Complaints of older widows regarding their husbands' health care are investigated in this study. Sixty-four older widows were interviewed several years after their husbands' deaths. The deaths occurred in the early 1980s. Forty-six percent reported problems in the health care their husbands had received. Widows whose husbands had not known in advance that they were going to die were more likely to complain about their husbands' medical care than widows whose husbands had known in advance. Complaints were also related to the frequency of several symptoms of grief. The widows' complaints about their husbands' care focus on quality of care, perceived insensitivity on the part of health care professionals, lack of control over the death, and the organization of services.

scholarly journals Neglected femoral neck fractures in cerebral palsy: a narrative review

2020 ◽  
Vol 5 (1) ◽  
pp. 58-64
Author(s):  
Giuseppe Toro ◽  
Antimo Moretti ◽  
Marco Paoletta ◽  
Annalisa De Cicco ◽  
Adriano Braile ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Femoral Neck ◽  
Motor Function ◽  
Treatment Options ◽  
High Morbidity ◽  
Fibular Graft ◽  
Motor Impairments ◽  
High Prevalence ◽  
Neck Fracture

Hip fractures are severe conditions with a high morbidity and mortality, especially when the diagnosis is delayed, and if formulated over 30 days after the injury, is termed a ‘neglected femoral neck fracture’ (NFNF). Cerebral palsy (CP) is probably one of the major risk factors for NFNF in Western countries, mainly because of both cognitive and motor impairments. However, considering the high prevalence of fractures in these patients, the incidence of NFNF in this population is probably underestimated, and this condition might result in persistent hip or abdominal pain. Several techniques are available for the treatment of NFNF (i.e. muscle pedicle bone graft, fixation with fibular graft, valgisation osteotomy), but most of them could affect motor function. Motor function must be preserved for as long as possible, in order to enhance the quality of life of CP patients. After discussing published NFNF cases in CP patients and available treatment options, a practical approach is proposed to facilitate the orthopaedic surgeon to both early identify and appropriately manage these challenging fractures. Cite this article: EFORT Open Rev 2020;5:58-64. DOI: 10.1302/2058-5241.5.190019

scholarly journals Exploring patient safety outcomes for people with learning disabilities in acute hospital settings: a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e047102
Author(s):  
Gemma Louch ◽  
Abigail Albutt ◽  
Joanna Harlow-Trigg ◽  
Sally Moore ◽  
Kate Smyth ◽  
...  
Keyword(s):  
Learning Disabilities ◽  
Patient Safety ◽  
Adverse Events ◽  
Grey Literature ◽  
Good Practice ◽  
Hospital Setting ◽  
Eligibility Criteria ◽  
Infant Outcomes ◽  
Safety Outcomes

ObjectivesTo produce a narrative synthesis of published academic and grey literature focusing on patient safety outcomes for people with learning disabilities in an acute hospital setting.DesignScoping review with narrative synthesis.MethodsThe review followed the six stages of the Arksey and O’Malley framework. We searched four research databases from January 2000 to March 2021, in addition to handsearching and backwards searching using terms relating to our eligibility criteria—patient safety and adverse events, learning disability and hospital setting. Following stakeholder input, we searched grey literature databases and specific websites of known organisations until March 2020. Potentially relevant articles and grey literature materials were screened against the eligibility criteria. Findings were extracted and collated in data charting forms.Results45 academic articles and 33 grey literature materials were included, and we organised the findings around six concepts: (1) adverse events, patient safety and quality of care; (2) maternal and infant outcomes; (3) postoperative outcomes; (4) role of family and carers; (5) understanding needs in hospital and (6) supporting initiatives, recommendations and good practice examples. The findings suggest inequalities and inequities for a range of specific patient safety outcomes including adverse events, quality of care, maternal and infant outcomes and postoperative outcomes, in addition to potential protective factors, such as the roles of family and carers and the extent to which health professionals are able to understand the needs of people with learning disabilities.ConclusionPeople with learning disabilities appear to experience poorer patient safety outcomes in hospital. The involvement of family and carers, and understanding and effectively meeting the needs of people with learning disabilities may play a protective role. Promising interventions and examples of good practice exist, however many of these have not been implemented consistently and warrant further robust evaluation.

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