Acceptability of endoscopic procedures and patients' willingness to repeat them: a single-centre nursing study of influential factors

2019 ◽  
Vol 17 (9) ◽  
pp. 22-28 ◽  
Author(s):  
Rocco Spagnuolo ◽  
Aida Bianco ◽  
Francesca Licata ◽  
Silvia Mazzea ◽  
Elena Manduci ◽  
...  
Keyword(s):  
Regression Models ◽  
Univariate Analysis ◽  
Influential Factors ◽  
Important Indicator ◽  
Endoscopic Procedures ◽  
Logistic Regression Models ◽  
Independent Variables ◽  
Experienced Pain ◽  
Before And After

Background: Patient satisfaction and factors that influence it have become an important indicator of the quality of digestive endoscopy. Aims: This study aimed to define variables that make endoscopic procedures acceptable and those that predispose patients to repeat them under the same conditions. Methods: Consecutive outpatients undergoing endoscopic examinations completed questionnaires, administered by the nursing staff, before and after the procedure. Univariate analysis and multivariate logistic regression models were designed to investigate independent variables associated with the following outcomes of interest. Findings: Most patients experienced pain and anxiety before and during the procedure, considered the procedure unacceptable and felt unwilling to repeat it. Conclusion: Symptoms strictly related to the patient, specifically anxiety and pain and type of sedation received, were the main factors related to satisfaction and willingness to repeat the procedure under the same conditions.

scholarly journals Sonographic Cervical Shortening after Labor Induction is a Predictor of Vaginal Delivery

2016 ◽  
Vol 38 (12) ◽  
pp. 585-588 ◽  
Author(s):  
Ugo Indraccolo ◽  
Gennaro Scutiero ◽  
Pantaleo Greco
Keyword(s):  
Logistic Regression ◽  
Vaginal Delivery ◽  
Regression Models ◽  
Operating Characteristic ◽  
Roc Curves ◽  
Cervical Length ◽  
Labor Induction ◽  
Logistic Regression Models ◽  
Independent Variables ◽  
Sonographic Evaluation

Objective Analyzing if the sonographic evaluation of the cervix (cervical shortening) is a prognostic marker for vaginal delivery. Methods Women who underwent labor induction by using dinoprostone were enrolled. Before the induction and three hours after it, the cervical length was measured by ultrasonography to obtain the cervical shortening. The cervical shortening was introduced in logistic regression models among independent variables and for calculating receiver operating characteristic (ROC) curves. Results Each centimeter in the cervical shortening increases the odds of vaginal delivery in 24.4% within 6 hours; in 16.1% within 24 hours; and in 10.5% within 48 hours. The best predictions for vaginal delivery are achieved for births within 6 and 24 hours, while the cervical shortening poorly predicts vaginal delivery within 48 hours. Conclusion The greater the cervical shortening 3 hours after labor induction, the higher the likelihood of vaginal delivery within 6, 24 and 48 hours.

Physician Perceptions on Quality of Life and Resuscitation Preferences for Extremely Early Newborns

2021 ◽  
Author(s):  
Danielle LoRe ◽  
Christopher Mattson ◽  
Dalia M. Feltman ◽  
Jessica T. Fry ◽  
Kathleen G. Brennan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Logistic Regression ◽  
Regression Models ◽  
Mixed Effects ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Comfort Care ◽  
Logistic Regression Models ◽  
Extremely Preterm

Objective The study aimed to explore physician views on whether extremely early newborns will have an acceptable quality of life (QOL), and if these views are associated with physician resuscitation preferences. Study Design We performed a cross-sectional survey of neonatologists and maternal fetal medicine (MFM) attendings, fellows, and residents at four U.S. medical centers exploring physician views on future QOL of extremely early newborns and physician resuscitation preferences. Mixed-effects logistic regression models examined association of perceived QOL and resuscitation preferences when adjusting for specialty, level of training, gender, and experience with ex-premature infants. Results A total of 254 of 544 (47%) physicians were responded. A minority of physicians had interacted with surviving extremely early newborns when they were ≥3 years old (23% of physicians in pediatrics/neonatology and 6% in obstetrics/MFM). The majority of physicians did not believe an extremely early newborn would have an acceptable QOL at the earliest gestational ages (11% at 22 and 23% at 23 weeks). The majority of physicians (73%) believed that having an extremely preterm infant would have negative effects on the family's QOL. Mixed-effects logistic regression models (odds ratio [OR], 95% confidence interval [CI]) revealed that physicians who believed infants would have an acceptable QOL were less likely to offer comfort care only at 22 (OR: 0.19, 95% CI: 0.05–0.65, p < 0.01) and 23 weeks (OR: 0.24, 95% CI: 0.07–0.78, p < 0.02). They were also more likely to offer active treatment only at 24 weeks (OR: 9.66, 95% CI: 2.56–38.87, p < 0.01) and 25 weeks (OR: 19.51, 95% CI: 3.33–126.72, p < 0.01). Conclusion Physician views of extremely early newborns' future QOL correlated with self-reported resuscitation preferences. Residents and obstetric physicians reported more pessimistic views on QOL. Key Points

scholarly journals Can Cut-Off-Values for Tumor Size or Patient Age in Breast Ultrasound Reduce Unnecessary Biopsies or is it all About Bi-rads?– A Retrospective Analysis of 763 Biopsied T1-Sized Lesions

2017 ◽  
Vol 03 (03) ◽  
pp. E94-E98 ◽  
Author(s):  
Laura Holzer-Fruehwald ◽  
Matthias Meissnitzer ◽  
Michael Weber ◽  
Stephan Holzer ◽  
Klaus Hergan ◽  
...  
Keyword(s):  
Regression Models ◽  
Breast Lesion ◽  
Binary Logistic Regression ◽  
Lesion Size ◽  
Breast Lesions ◽  
Predictive Values ◽  
Logistic Regression Models ◽  
Independent Variables ◽  
Oval Shape ◽  
Histological Result

Abstract Aims and Objectives To assess whether it is possible to establish a size cut-off-value for sonographically visible breast lesions in a screening situation, under which it is justifiable to obviate a biopsy and to evaluate the grayscale characteristics of the identified lesions. Materials and Methods Images of sonographically visible and biopsied breast lesions of 684 patients were retrospectively reviewed and assessed for the following parameters: size, shape, margin, lesion boundary, vascularity, patient’s age, side of breast, histological result, and initial BI-RADS category. Statistical analyses (t-test for independent variables, ROC analyses, binary logistic regression models, cross-tabulations, positive/negative predictive values) were performed using IBM SPSS (Version 21.0). Results Of all 763 biopsied lesions, 223 (29.2%) showed a malignant histologic result, while 540 (70.8%) were benign. Although we did find a statistically significant correlation of malignancy and lesion size (p=0.031), it was not possible to define a cut-off value, under which it would be justifiable to obviate a biopsy in terms of sensitivity and specificity (AUC: 0.558) at any age. Lesions showing the characteristics of a round or oval shape, a sharp delineation and no echogenic rim (n=112) were benign with an NPV of 99.1%. Conclusion It is not possible to define a cut-off value for size or age, under which a biopsy of a sonographically visible breast lesion can be obviated in the screening situation. The combination of the 3 grayscale characteristics, shape (round or oval), margin (circumscribed) and no echogenic-rim sign, showed an NPV of 99.1%. Therefore, it seems appropriate to classify such lesions as BI-RADS 2.

scholarly journals Satisfaction of patients received in emergencies in the department of obstetrics and gynecology at the Yalgado Ouedraogo teaching hospital: comparative study before and after the introduction of free care

2019 ◽  
Vol 8 (8) ◽  
pp. 3259
Author(s):  
Hyacinthe Zamané ◽  
Sibraogo Kiemtoré ◽  
Paul Dantola Kain ◽  
Lydie Zounogo Ouédraogo ◽  
Blandine Bonané Thiéba
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Teaching Hospital ◽  
Health Care Services ◽  
Care Process ◽  
Important Indicator ◽  
Care Services ◽  
Before And After ◽  
Free Care

Background: The quality of care perceived by the users of health care services is an important indicator of the quality of care. The aim of this study was to assess the satisfaction of patients received in obstetric and gynecological emergencies department of Yalgado Ouedraogo Teaching Hospital before and after the introduction of free care.Methods: This was a cross-sectional investigation. Data collection was carried out from February to July 2016, covering the last three months before the start of free care and the first three months of implementation of this free policy in Burkina Faso.Results: A total of 620 patients formed the sample. The reception (p=0.0001), the waiting period (p=0.0001), respect for treatment schedules (p=0.0001), respect for intimacy (p=0.0001), communication between providers and patients (p=0.007), the comfort of the delivery room (p=0.003) and the comfort of the ward room (p=0.002) were more favorably appreciated by patients before the free treatment than during that period. Overall patient satisfaction was better before the effectiveness of free care (p=0.003).Conclusions: The realization of free care process was followed by a lower patient’s satisfaction reflecting an alteration in the quality of health care services. A situational analysis of this free health care process is necessary in order to make corrective measures. Also adequate preventive measures should be adopted before any implementation to a larger scale of this free policy.

scholarly journals Trends in Peritoneal Dialysis Use in the United States after Medicare Payment Reform

2019 ◽  
Vol 14 (12) ◽  
pp. 1763-1772 ◽  
Author(s):  
Caroline E. Sloan ◽  
Cynthia J. Coffman ◽  
Linda L. Sanders ◽  
Matthew L. Maciejewski ◽  
Shoou-Yih D. Lee ◽  
...  
Keyword(s):  
United States ◽  
Peritoneal Dialysis ◽  
Regression Models ◽  
Prospective Payment System ◽  
The United States ◽  
Payment Reform ◽  
Logistic Regression Models ◽  
Medicare Data ◽  
Dialysis Facility

Background and objectivesPeritoneal dialysis (PD) for ESKD is associated with similar mortality, higher quality of life, and lower costs compared with hemodialysis (HD), but has historically been underused. We assessed the effect of the 2011 Medicare prospective payment system (PPS) for dialysis on PD initiation, modality switches, and stable PD use.Design, setting, participants, & measurementsUsing US Renal Data System and Medicare data, we identified all United States patients with ESKD initiating dialysis before (2006–2010) and after (2011–2013) PPS implementation, and observed their modality for up to 2 years after dialysis initiation. Using logistic regression models, we examined the associations between PPS and early PD experience (any PD 1–90 days after initiation), late PD use (any PD 91–730 days after initiation), and modality switches (PD-to-HD or HD-to-PD 91–730 days after initiation). We adjusted for patient, dialysis facility, and regional characteristics.ResultsOverall, 619,126 patients with incident ESKD received dialysis at Medicare-certified facilities, 2006–2013. Observed early PD experience increased from 9.4% before PPS to 12.6% after PPS. Observed late PD use increased from 12.1% to 16.1%. In adjusted analyses, PPS was associated with increased early PD experience (odds ratio [OR], 1.51; 95% confidence interval [95% CI], 1.47 to 1.55; P<0.001) and late PD use (OR, 1.47; 95% CI, 1.45 to 1.50; P<0.001). In subgroup analyses, late PD use increased in part due to an increase in HD-to-PD switches among those without early PD experience (OR, 1.59; 95% CI, 1.52 to 1.66; P<0.001) and a decrease in PD-to-HD switches among those with early PD experience (OR, 0.92; 95% CI, 0.87 to 0.98; P=0.004).ConclusionsMore patients started, stayed on, and switched to PD after dialysis payment reform. This occurred without a substantial increase in transfers to HD.

Body mass index (BMI), health behaviors, and perceptions in cancer survivors.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 97-97
Author(s):  
Lawson Eng ◽  
Sophia Yijia Liu ◽  
Jie Su ◽  
Dan Pringle ◽  
Mary Mahler ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Cancer Survivors ◽  
Current Smoker ◽  
Multiple Cancer ◽  
Logistic Regression Models ◽  
Quit Smoking ◽  
Before And After ◽  
Cancer Types ◽  
Behaviour Changes

97 Background: Obesity is associated with poorer outcomes across multiple cancer types. Health behaviour change (smoking cessation, physical activity (PA) and alcohol moderation) can improve both obesity and outcomes among cancer survivors. Methods: Cancer patients (pts) were cross-sectionally surveyed on their smoking, PA and alcohol use before and after diagnosis and their perceptions of these behaviours on quality of life (QoL), fatigue, survival (OS) and safety. Multivariable logistic regression models evaluated the association of BMI 1 year prior to diagnosis with behaviour changes and perceptions. Results: Of 1269 pts, 204 smoked at diagnosis and 58% quit afterwards; 350 met PA guidelines at diagnosis and 238 at follow-up; 661 drank alcohol at diagnosis and 50% reduced consumption afterwards. Median BMI was 25.8 (22% obese). Most pts perceived PA ( > 75%) as improving outcomes, smoking ( > 70%) as worsening outcomes and half (41-49%) felt alcohol worsened outcomes. At diagnosis, increased BMI was associated with being an ex-smoker (vs current smoker; P= 0.003), never using alcohol (vs former use; P= 0.05) and not meeting PA guidelines ( P= 0.01). Among smokers at diagnosis, increased BMI was associated with smoking cessation (aOR 1.08 per 1 unit BMI increase, P= 0.03) and perceiving that smoking worsens OS (aOR 1.10, P= 0.04) and fatigue (aOR 1.08, P= 0.08). Among pts not meeting PA guidelines at diagnosis, increased BMI was associated with perceiving that PA worsens fatigue (OR 1.02, P= 0.06) and is unsafe (OR 1.04, P= 0.06). Among drinkers at diagnosis, increasing BMI was associated with perceiving alcohol to be less harmful (aOR 0.93, P= 0.002), less likely to worsen OS (aOR 0.96, P= 0.04) and fatigue (aOR 0.97, P= 0.09). BMI was not associated with changes in alcohol or PA after diagnosis. BMI was not associated with counselling rates; however, 66% of current smokers received cessation counselling while only 14% of current drinkers and 13% of pts not meeting PA guidelines received counselling on their respective behaviours. Conclusions: Obese pts were more likely to quit smoking and perceive it to be harmful but less likely to perceive alcohol as harmful. Survivorship programs should consider focusing on PA and alcohol counselling in obese pts.

Omitting chemotherapy in more patients with early breast cancer in the post-TAILORx era.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e12534-e12534
Author(s):  
Christos Markopoulos ◽  
Zoi Andromahi Sariyanni ◽  
Dimitrios C. Ziogas ◽  
Zoh Antonopoulou ◽  
Nikolaos Tsoulos
Keyword(s):  
Breast Cancer ◽  
Early Breast Cancer ◽  
Regression Models ◽  
Recurrence Score ◽  
Treatment Decisions ◽  
Oncotype Dx ◽  
Logistic Regression Models ◽  
Previously Treated ◽  
High Clinical Risk

e12534 Background: The purpose of this analysis is to evaluate how many patients previously treated according to OncotypeDX Recurrence Score (RS) could have been spared of Chemotherapy if the TAILORx RS data had been taken into account in the clinical treatment decisions. Methods: A series of 182 patients, 34-74 years of age with early breast cancer, treated in our Breast Unit during the last 10 years, for whom treatment decisions were based on OncotypeDX RS. The Recurrence Scores of all these patients were obtained and the actual treatment decisions that were made based on the pre-TAILORx cut-offs of RS 18 and 31 were recorded. These decisions were then re-evaluated based on the after TAILORx cut-off scores, by taking also into consideration the patients’ age. Descriptive statistics were used as well as logistic regression models to estimate the potential change in treatment decisions based on the new Oncotype Dx cut-offs. Results: In the cohort of patients we analyzed that underwent Oncotype Dx testing, 34.1% (62/182) received Chemotherapy, based on the initial pre-TAILORX cut-offs of the RS. When utilizing the new cut-offs (after TAILORx results) in combination with age, we have estimated that, for the patients > 50 years of age, a 12.7% was potentially over-treated and for those ≤50 years old, 9.1% was potentially over-treated since they have received chemotherapy with a RS below 16; additionally, 30.8% of the patients of that age that have RS between 16 and 20 have received chemotherapy even though the average chemotherapy benefit for this group is 1.6% and can go up to 6.7% if they have a high clinical risk as it was defined by the investigators of the TAILORx trial. Finally, 84,6% of patients ≤50 years old with RS between 21-25 received chemotherapy with a 6.5% potential benefit demonstrated in the TAILORx trial. Conclusions: Our analysis suggests that, by using the cut-offs of TAILORx trial, adjuvant chemotherapy could had been omitted in at least a further 11.5% of patients with early breast cancer, reassuring their quality of life without declining their prognosis.

Logistic regression models for predicting physical and mental health-related quality of life in rheumatoid arthritis patients

2008 ◽  
Vol 18 (6) ◽  
pp. 601-608 ◽  
Author(s):  
Gholam Hossein Alishiri ◽  
Noushin Bayat ◽  
Ali Fathi Ashtiani ◽  
Seyed Abbas Tavallaii ◽  
Shervin Assari ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Mental Health ◽  
Regression Models ◽  
Health Related Quality ◽  
Physical And Mental Health ◽  
Logistic Regression Models ◽  
Related Quality ◽  
Health Related

scholarly journals Association of Fatigue With Sarcopenia and its Elements: A Secondary Analysis of SABE-Bogotá

2017 ◽  
Vol 3 ◽  
pp. 233372141770373 ◽  
Author(s):  
Daniela Patino-Hernandez ◽  
David Gabriel David-Pardo ◽  
Miguel Germán Borda ◽  
Mario Ulises Pérez-Zepeda ◽  
Carlos Cano-Gutiérrez
Keyword(s):  
Regression Models ◽  
Handgrip Strength ◽  
Secondary Analysis ◽  
Adverse Outcomes ◽  
Multiple Logistic Regression ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Independent Variables ◽  
Confounding Variables ◽  
Aging Adults

Objective: Sarcopenia, fatigue, and depression are associated with higher mortality rates and adverse outcomes in the aging population. Understanding the association among clinical variables, mainly symptoms, is important for screening and appropriately managing these conditions. The aim of this article is to evaluate the association among sarcopenia and its elements with depression and fatigue. Method: We used cross-sectional data from 2012 SABE ( Salud, Bienestar y Envejecimiento)-Bogotá study, which included 2,000 participants of ages ≥60 years. Sarcopenia and its elements were taken as the dependent variable, while fatigue and depression were the main independent variables. We tested the association among these through multiple logistic regression models, which were fitted for each dependent variable and adjusted for confounding variables. Results: Our findings showed that gait speed was associated with fatigue (adjusted odds ratio [OR] = 1.41, 95% confidence interval [CI] = [1.05, 1.90], p = .02) as well as abnormal handgrip strength (adjusted OR = 1.40, 95% CI = [1.02, 1.93], p = .04). No other associations were significant. Conclusion: While sarcopenia and fatigue are not associated, two of the sarcopenia-defining variables are associated with fatigue; this suggests that lack of sarcopenia does not exclude undesirable outcomes related to fatigue in aging adults. Also, the lack of association between sarcopenia-defining elements and depression demonstrates that depression and fatigue are different concepts.

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