Emergency department use at the end of life in elderly patients with gastrointestinal malignancies and mental health comorbidities.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 811-811
Author(s):  
Mehr Kashyap ◽  
Jeremy Phillip Harris ◽  
Daniel Tandel Chang ◽  
Erqi L. Pollom
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Substance Abuse ◽  
Mental Disorders ◽  
Elderly Patients ◽  
End Of Life ◽  
Health Care Expenditures ◽  
Gastrointestinal Malignancies ◽  
The Impact

811 Background: Aggressive care at the end-of-life can contradict patients’ wishes, negatively impact patient quality of life, and contribute to overall health care expenditures. Patients with mental disorders (MD) often experience disparities in medical care and have poorer clinical outcomes. We investigated the impact of mental disorders on emergency department (ED) use at the end of life among elderly patients with gastrointestinal (GI) malignancies. Methods: We conducted a retrospective cohort study using the SEER-Medicare database. We identified patients aged 66 years and older with GI malignancies (colorectal, pancreatic, gastric, hepatic, biliary, esophageal, small bowel, and anal cancer) diagnosed between 2004 and 2013 who had recorded death. We assessed the association between MD (depression, bipolar disorder, psychotic disorder, anxiety, dementia, and substance abuse) and ED use within 30 days of death using logistic regression models. Results: Of the 160,367 decedents included, 54,461 (34.1%) had at least one MD diagnosis between one year prior to cancer diagnosis and death. Those with MD were more likely to use the ED more than once in the last 30 days of life (14.7% vs. 12.4% p < 0.01). ED use was highest among decedents with anxiety disorder (15.8%) and substance abuse (16.3%). Among decedents with mental disorders, risk factors associated with ED use at end of life include being male (adjusted odds ratio [aOR] 1.16, 95% confidence interval [CI] 1.10 – 1.22), younger (aOR 1.14, 95% CI 1.06 - 1.23), and black (aOR 1.33, 95% CI 1.23 – 1.45), living in a lower income zip code (1.21, 95% CI 1.13 – 1.30), and having a higher Charlson comorbidity score (aOR 1.71, 95% CI 1.56 – 1.87). ED use was also associated with pancreatic (aOR 1.16, 95% CI 1.08 - 1.25), hepatic (aOR 1.21, 95% CI 1.11 - 1.33), biliary (aOR 1.16, 95% CI 1.03 - 1.30) and esophageal (aOR 1.16, 95% CI 1.04 - 1.29) cancer compared to colorectal cancer. Conclusions: MD is associated with increased ED use at the end of life among elderly patients with GI cancer. Palliative and supportive care including mental health services early in the disease course may improve quality of end-of-life care in this vulnerable population.

scholarly journals Impact of clinical pharmacist’s interventions on pharmacotherapy management in elderly patients on polypharmacy with mental health problems including quality of life: A prospective non-randomized study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Matej Stuhec ◽  
Nika Bratović ◽  
Aleš Mrhar
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Elderly Patients ◽  
Mental Health Problems ◽  
Randomized Study ◽  
The Elderly ◽  
Health Problems ◽  
Potentially Inappropriate Medications ◽  
The Impact

AbstractMental health problems (MHPs) are very common in the elderly and can have an important influence on their quality of life (QoL). There is almost no data on the impact of clinical pharmacists’ (CPs) interventions on the QoL including elderly patients and MHPs. The main aim of this study was to determinate the impact of (CP’s) interventions on the QoL and quality of pharmacotherapy. A prospective non-randomized pre-post study was designed which included residents of a nursing home aged 65 age or more with at least one MHP. Each patient also filled out the EQ-5D questionnaire. The medical review MR included drug-related problems (DRPs) and potentially drug-drug interactions (pDDIs), as well as potentially inappropriate medications (PIMs). After 2 months, the participants were interviewed again. The mean number of medications before the intervention was 12,2 ± 3,1 per patient and decreased to 10,3 ± 3,0 medications per patient (p < 0,05) (n = 24). The total number of PIMs and pDDIs was also reduced and QoL was also significantly higher (p < 0,05). A collaborative care approach with a CP led to a decrease of DRPs, pDDIs, PIMs, the total number of medications and to an improvement in the patients’ QoL.

The Impact of Adolescent Substance Abuse on Family Quality of Life, Marital Satisfaction, and Mental Health in Qatar

2021 ◽  
pp. 106648072110007
Author(s):  
Eid G. Abo Hamza ◽  
Samuel Gladding ◽  
Ahmed A. Moustafa
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Substance Abuse ◽  
Marital Satisfaction ◽  
Family Quality Of Life ◽  
Adolescent Substance Abuse ◽  
Adolescent Substance ◽  
Substance Addiction ◽  
The Impact

This study investigated the impact of substance-addicted adolescents on family quality of life in the Arab country of Qatar. Two groups of families were compared: families with a teenager who had a substance addiction ( n = 50) and families without such a teen ( n = 53). Results showed families with a substance-addicted teenager had a lower family quality of life, that is, lower marital satisfaction, and higher couple scores on depression, anxiety, and stress. The study suggests that the relationship between family dynamics and adolescent substance addiction is bidirectional in Arab families, that is, family problems may lead to adolescent substance abuse, and substance addiction in adolescents may also impact marital health quality and the mental health of parents.

scholarly journals Air pollutants and daily number of admissions to psychiatric emergency services: evidence for detrimental mental health effects of ozone

2019 ◽  
Vol 29 ◽  
Author(s):  
F. Bernardini ◽  
L. Attademo ◽  
R. Trezzi ◽  
C. Gobbicchi ◽  
P.M. Balducci ◽  
...  
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Mental Disorders ◽  
Air Pollutants ◽  
Emergency Services ◽  
Psychiatric Emergency ◽  
Psychiatric Emergency Services ◽  
General Hospitals ◽  
Short Term Exposure ◽  
The Impact

Abstract Aims Aim of the current study is to investigate the associations between daily levels of air pollutants (particulate matter, ozone, carbon monoxide, nitrogen dioxide) and daily admissions for mental disorders to the emergency department of two general hospitals in Umbria region (Italy). Methods We collected data about daily admissions to psychiatric emergency services of two general hospitals, air pollutants' levels and meteorological data for the time period 1 January 2015 until 31 December 2016. We assessed the impact of an increase in air pollutants on the number of daily admissions using a time-series econometric framework. Results A total of 1860 emergency department admissions for mental disorders were identified. We observed a statistically significant impact of ozone levels on daily admissions. The estimated coefficient of O3 is statistically significant at the 1% level. All other pollutants were not significantly associated with the number of daily admissions. Conclusions Short-term exposure to ozone may be associated with increased psychiatric emergency services admissions. Findings add to previous literature on existing evidence for air pollution to have an impact on mental health. Ozone may be considered a potential environmental risk factor for impaired mental health.

A descriptive study of the prevalence of psychological distress and mental disorders in the Canadian population: comparison between low-income and non-low-income populations

2010 ◽  
Vol 30 (3) ◽  
pp. 148-149 ◽  
Author(s):  
J. Caron ◽  
A. Liu
Keyword(s):  
Mental Health ◽  
Substance Abuse ◽  
Psychological Distress ◽  
Mental Disorders ◽  
Low Income ◽  
Well Being ◽  
Descriptive Study ◽  
Canadian Community Health Survey ◽  
Vulnerable Groups ◽  
High Psychological Distress

Objective This descriptive study compares rates of high psychological distress and mental disorders between low-income and non-low-income populations in Canada. Methods Data were collected through the Canadian Community Health Survey – Mental Health and Well-being (CCHS 1.2), which surveyed 36 984 Canadians aged 15 or over; 17.9% (n = 6620) was classified within the low-income population using the Low Income Measure. The K-10 was used to measure psychological distress and the CIDI for assessing mental disorders. Results One out of 5 Canadians reported high psychological distress, and 1 out of 10 reported at least one of the five mental disorders surveyed or substance abuse. Women, single, separated or divorced respondents, non-immigrants and Aboriginal Canadians were more likely to report suffering from psychological distress or from mental disorders and substance abuse. Rates of reported psychological distress and of mental disorders and substance abuse were much higher in low-income populations, and these differences were statistically consistent in most of the sociodemographic strata. Conclusion This study helps determine the vulnerable groups in mental health for which prevention and promotion programs could be designed.

Quality of Life and Mental Health of Infertile Women Affected by Endometriosis: A Narrative Review

2019 ◽  
Vol 15 (4) ◽  
pp. 238-244
Author(s):  
Cristina Zarbo ◽  
Agostino Brugnera ◽  
Rita Secomandi ◽  
Ilario Candeloro ◽  
Chiara Malandrino ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Narrative Review ◽  
Stress Perception ◽  
Infertile Women ◽  
Assisted Reproductive Treatment ◽  
General Quality ◽  
The Impact ◽  
Test Outcomes

Objective: Infertility has a severe impact on quality of life and mental health. This condition could be exacerbated by the existence of comorbid medical disease, like endometriosis. The aim of this critical narrative review is the examination of the state of the art about the quality of life and mental health in infertile women with endometriosis. Methods: We performed a rigorous and systematic search for studies on multiple electronic databases. A total of 6 papers were included in the review and were subjected to interpretative and critical narrative synthesis. Results and Discussion: Major findings are resumed in the following points: (a) infertile women with endometriosis when compared to infertile ones without endometriosis show higher depression, stress perception, and anxiety, and lower general quality of life; (b) quality of life specifically related to infertility is similar among women with and without endometriosis and seems to be related to personality and beliefs factors; (c) giving birth to a child is related to better mental quality of life; (d) during assisted reproductive treatment (ART) stimulation, infertile women with endometriosis have a decrease of dysmenorrhea and dyspareunia; (e) satisfaction of ART is related to the number of attempts, treatment accomplishment and pregnancy test outcomes. Clinical implications of these findings and suggestions for future researches were discussed. Conclusion: Concluding, it is crucial to assess the psychological factors related to endometriosis and infertility to reduce the impact of these diseases on quality of life and mental health, provide adequate support to these patients, improve their satisfaction and increase the change to get pregnant.

scholarly journals Promoting the Quality of Life of Elderly during the COVID-19 Pandemic

2021 ◽  
Vol 18 (13) ◽  
pp. 6813
Author(s):  
Chia-Jung Lee ◽  
Yen Hsu
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Learning Experience ◽  
The Elderly ◽  
Learning Approach ◽  
Learning Center ◽  
Learning Centers ◽  
Technology Learning ◽  
The Impact

This study explored the technology learning model of the elderly in a senior learning center under the impact of the COVID-19 pandemic. Many senior learning centers were closed during the pandemic, and many of them adopted the mode of online education. However, problems such as decreased motivation and a lack of peer interaction still exist. To solve these problems, this study used the easy-to-implement calligraphy AR approach and E-book approach to conduct a quasi-experiment on the elderly of a calligraphy course offered by a senior learning center. The results show a higher learning motivation among the elderly who use calligraphy AR. The learning effectiveness and technology acceptance of the elderly in the E-book learning group were higher than those in the calligraphy AR group. The elderly mentioned that the E-book learning approach is more user-friendly. In general, in the face of the COVID-19 pandemic affecting the suspension of classes in senior centers, education through the development of technology has stimulated the growth of education in advanced learning centers. Through this kind of scientific and technological learning method, it will bring a whole new experience to the elderly. It can improve the stress relief methods, mental health, and quality of life of the elderly during the COVID-19 emergency shutdown, and provide a novel calligraphy technique learning experience for the elderly. Therefore, we believe that the calligraphy AR learning approach and the calligraphy E-book learning approach are practical and may promote quality of life and mental health of the elderly during the emergency closures due to COVID-19, providing elderly attendees with a novel calligraphy technology learning experience.

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