Latent vestibular dysfunction and its effect on quality of life in elderly individuals, the need of active screening and intervention

Background: Dizziness is a commonly reported complaint among elderly.. Among the elderly in particular, factors such as Ageing, presbycusis, diabetes, chronic kidney disease, osteopenia, and osteoporosis increase the risk. Dizziness handicap inventory is used to assess the quality of life among the individuals with vestibular dysfunction. This is also used to assess the impact of interventions for vestibular dysfunction. This study aims to estimate the prevalence of latent vestibular dysfunction among the Indian population, and the impact of interventions among the same.Methods: A prospective observational study was conducted at a tertiary care hospital. As per sample size estimates, 200 participants aged >60 years without previous diagnosis of vestibular dysfunction were screened using appropriate tests. The quality of life of the affected individuals were assessed using Dizziness Handicap Inventory Score (DHIS) before and after intervention. Results: The prevalence of latent vestibular dysfunction was found to be 23.5%. Most of them reported having moderate handicap due to the condition. Following intervention, those with moderate handicap either became normal (47.8%) or had residual mild handicap (52.2%). The mean DHIS score significantly decreased from 40.91 points during pre-intervention to 16.12 points post-intervention.Conclusions: Around one-fourth of the Indian elderly is found to have latent vestibular dysfunction. It has a major impact on the individual’s quality of life. Yet, screening and intervention is found to make a considerable improvement among the affected individuals.

Download Full-text

600. Decreased Hospital Readmission After Programmatic Strengthening of an Outpatient Parenteral Antimicrobial Therapy (OPAT) Program

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.794 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S362-S363

Author(s):

Gaurav Agnihotri ◽

Alan E Gross ◽

Minji Seok ◽

Cheng Yu Yen ◽

Farah Khan ◽

...

Keyword(s):

Hospital Readmission ◽

Multinomial Logistic Regression ◽

Univariate Analysis ◽

Tertiary Care ◽

Intervention Group ◽

Care Hospital ◽

Full Time ◽

Post Intervention ◽

Before And After ◽

The Impact

Abstract Background Although it is recommended that an OPAT program should be managed by a formal OPAT team that supports the treating physician, many OPAT programs face challenges in obtaining necessary program staff (i.e nurses or pharmacists) due to limited data examining the impact of a dedicated OPAT team on patient outcomes. Our objective was to compare OPAT-related readmission rates among patients receiving OPAT before and after the implementation of a strengthened OPAT program. Methods This retrospective quasi-experiment compared adult patients discharged on intravenous (IV) antibiotics from the University of Illinois Hospital before and after implementation of programmatic changes to strengthen the OPAT program. Data from our previous study were used as the pre-intervention group (1/1/2012 to 8/1/2013), where only individual infectious disease (ID) physicians coordinated OPAT. Post-intervention (10/1/2017 to 1/1/2019), a dedicated OPAT nurse provided full time support to the treating ID physicians through care coordination, utilization of protocols for lab monitoring and management, and enhanced documentation. Factors associated with readmission for OPAT-related problems at a significance level of p< 0.1 in univariate analysis were eligible for testing in a forward stepwise multinomial logistic regression to identify independent predictors of readmission. Results Demographics, antimicrobial indications, and OPAT administration location of the 428 patients pre- and post-intervention are listed in Table 1. After implementation of the strengthened OPAT program, the readmission rate due to OPAT-related complications decreased from 17.8% (13/73) to 6.5% (23/355) (p=0.001). OPAT-related readmission reasons included: infection recurrence/progression (56%), adverse drug reaction (28%), or line-associated issues (17%). Independent predictors of hospital readmission due to OPAT-related problems are listed in Table 2. Table 1. OPAT Patient Demographics and Factors Pre- and Post-intervention Table 2. Factors independently associated with hospital readmission in OPAT patients Conclusion An OPAT program with dedicated staff at a large academic tertiary care hospital was independently associated with decreased risk for readmission, which provides critical evidence to substantiate additional resources being dedicated to OPAT by health systems in the future. Disclosures All Authors: No reported disclosures

Download Full-text

Quality of life in epilepsy

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20170024 ◽

2017 ◽

Vol 5 (2) ◽

pp. 452 ◽

Cited By ~ 1

Author(s):

Prem Singh ◽

Achyut Kumar Pandey

Keyword(s):

Quality Of Life ◽

Pearson Correlation ◽

Tertiary Care ◽

P Value ◽

Care Hospital ◽

Lower Education Level ◽

One Year ◽

Patients With Epilepsy ◽

The Impact

Background: The quality of life (QOL) evaluation is a relatively new measure to evaluate the outcome of epilepsy. Many factors influence the quality of life of people with epilepsy, including seizure severity, stigma, fear, and the presence of cognitive or psychiatric problems. QOL is influenced by biological factors as well as cultural, social and religious beliefs and values. This study was planned to find out the impact of epilepsy on quality of life of epileptic patients.Methods: The study was conducted in the epilepsy clinic of department of neurology at a tertiary care hospital over a period of one year.101 patients were included after fulfilling the inclusion criteria. All the patients seeking treatment in the OPD were screened, assessed and then all procedures were fully explained to them. History regarding name, age sex, socio-demographic profile and detailed history regarding seizure disorder was taken from both the patient and the reliable informant. Bengali version of QOLIE-9 was used to assess the quality of life.Results: One hundred and one patients with epilepsy consisting of 70 men (69.3%) and 31 women (30.7%) were included. Their ages ranged from 15 to 52, the mean age being 26.17 (SD = 7.84). Out of the 101 patients, 65 patients (64.4%) were suffering from partial epilepsies and 36 patients (35.6%) were suffering from generalized epilepsies. Mean QOLIE-9 total scores were 16.66, 19.74, 20.13 and 24.00 in married, widows, unmarried and separated individuals respectively. The differences in the means were statistically significant on ANOVA (p value 0.002). Mean QOLIE-9 total scores were 27.75, 19.64, 19.65, 18.14 and 18.00 in primary, secondary, higher secondary, graduate and postgraduate individuals respectively. The differences were highly significant statistically on ANOVA (p value<0.001). Frequency of seizures per month was positively correlated with QOLIE-9 total scores (Pearson Correlation 0.622) and was highly statistically significant (p value<0.001).Conclusions: Frequent seizures, lower education level and single status are associated with lower quality of life in persons with epilepsy.

Download Full-text

Quality of Life and Stigma among Women with Epilepsy during Their Reproductive Years

Journal of Epilepsy Research ◽

10.14581/jer.21009 ◽

2021 ◽

Vol 11 (1) ◽

pp. 63-71

Author(s):

Pallerla Srikanth ◽

Mysore Narasimha Vranda ◽

Priya Treesa Thomas ◽

Kenchaiah Raghvendra

Keyword(s):

Quality Of Life ◽

Tertiary Care ◽

Reproductive Age ◽

Care Hospital ◽

Age Group ◽

Stigma Scale ◽

The Impact ◽

The Relationship ◽

Reproductive Age Group

Background and Purpose: The purpose of this study was to understand the relationship between quality of life and stigma among reproductive age group women with epilepsy.Methods: A cross-sectional descriptive study was conducted to assess the data from the 49 women with epilepsy from a tertiary care hospital in India. Quality of life was evaluated with the quality of life in epilepsy-31 questionnaire and stigma was evaluated with the stigma scale of epilepsy. Data also included socio-demographic and clinical characteristics.Results: The mean age of the participants was 24.67±3.72 years. Quality of life total score (r=-0.485**) and seizure worry domain (r=-0.427**) were significantly negatively correlated with stigma total score at p<0.01 level. Being uneducated, married, unemployed, having children, having generalized tonic-clonic seizures, duration of illness (˃10 years), and consuming levetiracetam, anti-epileptic drug (AED), were the significant contributing factors for low quality of life among women with epilepsy during the reproductive age group. Belonging to lower socio-economic status and taking more than two AEDs were also associated with lower quality of life among women with epilepsy, which are trending towards significance.Conclusions: The study assessed the relationship between the quality of life and the Stigma scale of epilepsy and demonstrated the impact of stigma and quality of life on socio-demographic and clinical variables of women with epilepsy under the reproductive age group. To enhance the quality of life and reduce the stigma levels among women with epilepsy, some of the modifiable parameters can be considered by the multidisciplinary health care professionals from the findings of the current research.

Download Full-text

The Impact of Hospital Accreditation on the Patients Satisfaction of Haemodialysis Department Services

International Journal of Emerging Research in Management and Technology ◽

10.23956/ijermt.v6i8.170 ◽

2018 ◽

Vol 6 (8) ◽

pp. 384

Author(s):

Zuber Mujeeb Shaikh

Keyword(s):

Patient Satisfaction ◽

Health Care Quality ◽

Tertiary Care ◽

Care Quality ◽

Care Hospital ◽

Significant Difference ◽

Before And After ◽

The Impact ◽

Survey Questionnaires

The quality of hospital Haemodialysis Department Service is one of the most relevant items of health care quality perceived by patients and by their families. Patient satisfaction is considered a way of measuring the quality of services provided. Objectives: To study the impact of National Accreditation Board for Hospitals & Healthcare Providers (NABH) Accreditation, India on Haemodialysis Department Service patient satisfaction. Methods: It is a quantitative, descriptive and inferential research based case study in which sample of a population was studied by structured satisfaction survey questionnaires (before and after the accreditation) in a private tertiary care hospital at Secunderabad, Telangana State, India to determine its characteristics, and it is then inferred that the population has the same or different characteristics. Significance of Research: It was observed initially before the accreditation that there was a lower patient satisfaction rate of the hospital Haemodialysis Department Services, which was affecting the study hospitals’ business. Hypothesis: Null Hypothesis (Ho) and Alternative Hypothesis (H1) were used and tested to compare the before and after impact of accreditation by applying to each question in the questionnaire. Study Design: The closed ended questionnaire was developed considering the Haemodialysis Department Services and incorporated the six dimensions of quality Safe, Timely, Effective, Efficient, Equitable, and Patient-centred (STEEP) and tested prior to implementing. Questionnaires were given to the patients' families for completion upon using the Haemodialysis Department Services two months before and two months after the accreditation. The data were collected in order to cover all three shifts of the Haemodialysis Department Services. Study Population: Simple random sampling method was selected, the researcher had involved all conscious patients (clinical conditions) from all age groups. Data Collections: Primary data were collected from the survey questionnaires. Secondary data were collected from relevant published journals, articles, research papers, academic literature and web portals. Conclusion: At the 5 % level of significance, the t-test results indicate that there is a significant difference in the responses between before (M=51.11, SD=21.89) and after accreditation (M=58.56, SD=17.28) with p-value <0.001. The mean satisfaction score has improved from before accreditation compared to after accreditation.

Download Full-text

A descriptive study on quality of life, depression and anxiety in chronic urticaria patients attending a tertiary care hospital in Bengaluru, South India

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20192861 ◽

2019 ◽

Vol 6 (7) ◽

pp. 3118

Author(s):

Giriyanna Gowda ◽

Sweta Balappa Athani

Keyword(s):

Quality Of Life ◽

Chronic Urticaria ◽

Tertiary Care ◽

Mental Illnesses ◽

Care Hospital ◽

Depression And Anxiety ◽

General Anxiety Disorder ◽

General Anxiety ◽

The Impact

Background: Chronic urticaria (CU) is a common skin disorder characterized by the recurrent appearance of wheals typically associated with pruritis and/or angioedema for more than 6 weeks. It has a significant impact on patient’s quality of life (QoL). Hence it is of utmost importance to identify the impact of CU on the patient’s life and psychiatric comorbidities associated with it. The objectives of the study were to assess the effect of chronic urticaria on the quality of life of the patient; to assess the depression in patients with chronic urticaria; to assess the anxiety in patients with urticaria.Methods: A total of 106 patients with chronic urticaria attending allergy clinic, KIMS Hospital during November-January 2019 (3 months) were included in the study. Informed consent was obtained. Each patient was interviewed using pretested questionnaire developed using chronic urticaria on quality of life: (CU-Q2oL), patient health questionnaire-9 (PHQ-9) and general anxiety disorder-7 (GAD-7). Data was entered in Epi-info7 and descriptive statistics were used.Results: There were 43 (40.6%) males and 63 (59.4%) females. The mean age of the patients was 36.5±11.7 years. Quality of life was affected A lot in 9.5% of the patients and is somewhat affected in 38.7% of the CU patients. As much as 42.5% of them suffered from some grade of depression and 34.9% of them suffered from anxiety.Conclusions: Chronic urticaria has a significant role in impairment of QOL and also leads to mental illnesses such as depression and anxiety.

Download Full-text

The impact of chronic pelvic pain and its associated symptoms on women’s quality of life in a tertiary care hospital in Brazil

Journal of Endometriosis ◽

10.5301/je.5000262 ◽

2016 ◽

Vol 8 (4) ◽

pp. 167-171 ◽

Cited By ~ 1

Author(s):

Kathiane L. Augusto ◽

Licia A. Araujo ◽

Thais F. Magalhaes ◽

Manuela C.P. Marinho ◽

Leonardo R.P.S. Bezerra

Keyword(s):

Quality Of Life ◽

Pelvic Pain ◽

Chronic Pelvic Pain ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Associated Symptoms ◽

The Impact

Download Full-text

Quality of Life in Patients with Stoma

Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University ◽

10.48036/apims.v17i3.388 ◽

2021 ◽

Vol 17 (3) ◽

pp. 255-259

Author(s):

Abeer Irshad ◽

Muhammad Fahim Ahsan ◽

Mumtaz Ahmed Khan ◽

Isbah Rasheed ◽

Muhammad Asif

Keyword(s):

Quality Of Life ◽

Social Life ◽

Demographic Data ◽

Tertiary Care ◽

Bed Rest ◽

Sexual Life ◽

Care Hospital ◽

Stoma Formation ◽

The Impact

Objective: To determine the quality of life of patients with stoma at tertiary care Hospital. Methodology: This prospective study has been conducted at the general surgery department, Pakistan Institute of Medical Sciences hospital Islamabad (PIMS). The study was conducted from September 2019 to February 2020. All the patients having age more than 12 years, underwent intestinal stoma formation and either gender were included for study. Patients were interviewed regarding their routine activities after stoma and the impact of it on their social life including working status, sexual activities and life satisfaction. All the information of patients including demographic data was documented via self-derived proforma. Analysis of data was done by SPSS version 20. Results: Total 46 patients were studied having a stoma and were interviewed regarding their quality of life. The patient's mean age was 44.93+6.78 years. Out of all 34.8% were working currently and rest of the patients were still on bed rest. 34.8% were satisfied with sexual life. 71.7% were depressed after stoma surgery and 52.2% were hopeful about their future. 63% were socialised with peoples as before, 58.7% replied that stoma has affected their recreational activities and 52.2% answered that they can’t travel in any way. However according to overall satisfaction, 32.6% of patients were disagreeing, 34.8% were agreeing and 30.4% were undecided. Conclusion: It was concluded that almost half of the patients were satisfied and they are performing social and daily life activities however almost half of the patients needed psychological, financial, and relative support. Key words: Stoma, Quality of life

Download Full-text

The impact of a computerized physician order entry system implementation on 20 different criteria of medication documentation—a before-and-after study

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-021-01607-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Viktoria Jungreithmayr ◽

Andreas D. Meid ◽

Janina Bittmann ◽

Markus Fabian ◽

Ulrike Klein ◽

...

Keyword(s):

Tertiary Care ◽

Multivariable Analysis ◽

Computerized Physician Order Entry ◽

Care Hospital ◽

Order Entry ◽

Significant Difference ◽

Before And After ◽

Physician Order Entry ◽

The Impact

Abstract Background The medication process is complex and error-prone. To avoid medication errors, a medication order should fulfil certain criteria, such as good readability and comprehensiveness. In this context, a computerized physician order entry (CPOE) system can be helpful. This study aims to investigate the distinct effects on the quality of prescription documentation of a CPOE system implemented on general wards in a large tertiary care hospital. Methods In a retrospective analysis, the prescriptions of two groups of 160 patients each were evaluated, with data collected before and after the introduction of a CPOE system. According to nationally available recommendations on prescription documentation, it was assessed whether each prescription fulfilled the established 20 criteria for a safe, complete, and actionable prescription. The resulting fulfilment scores (prescription-Fscores) were compared between the pre-implementation and the post-implementation group and a multivariable analysis was performed to identify the effects of further covariates, i.e., the prescription category, the ward, and the number of concurrently prescribed drugs. Additionally, the fulfilment of the 20 criteria was assessed at an individual criterion-level (denoted criteria-Fscores). Results The overall mean prescription-Fscore increased from 57.4% ± 12.0% (n = 1850 prescriptions) before to 89.8% ± 7.2% (n = 1592 prescriptions) after the implementation (p < 0.001). At the level of individual criteria, criteria-Fscores significantly improved in most criteria (n = 14), with 6 criteria reaching a total score of 100% after CPOE implementation. Four criteria showed no statistically significant difference and in two criteria, criteria-Fscores deteriorated significantly. A multivariable analysis confirmed the large impact of the CPOE implementation on prescription-Fscores which was consistent when adjusting for the confounding potential of further covariates. Conclusions While the quality of prescription documentation generally increases with implementation of a CPOE system, certain criteria are difficult to fulfil even with the help of a CPOE system. This highlights the need to accompany a CPOE implementation with a thorough evaluation that can provide important information on possible improvements of the software, training needs of prescribers, or the necessity of modifying the underlying clinical processes.

Download Full-text

Correlation of Depression, Anxiety and Stress with Quality of Life in COVID-19 Pandemic

Esculapio ◽

10.51273/esc21.2517218 ◽

2021 ◽

Vol 17 (2) ◽

pp. 195-199

Author(s):

Aysha Rashid ◽

◽

Umair Mudassar ◽

Ismail Tariq ◽

Adil Zaheer ◽

...

Keyword(s):

Quality Of Life ◽

Psychological Health ◽

Tertiary Care ◽

Depression Score ◽

Care Hospital ◽

Cross Sectional ◽

Quality Of Life Scale ◽

The Mean ◽

The Impact

Due to Covid-19 pandemic the psychological health of individuals is disturbed globally. There is a dire need of looking into details about the effects of mental health issues on quality of life (QOL). Objectives: To determine correlation between depression, anxiety, stress, and quality of life among adults in Covid-19 and evaluate the impact of demographics on quality of life. Methods: It was a cross-sectional study carried out at a tertiary care hospital. Patients presenting in the psychiatry outdoor of age 18 to 60 years, of both genders and scoring ≥21 on Depression, Anxiety, and Stress Scale (DASS) were enrolled in the study and depression, anxiety and stress severity was assessed and Quality of Life Scale (QOLS) was applied on all to assess their quality of life. All findings were then subjected to statistical analysis. Results: The mean age of the patients was 21.78±3.204, mean depression score on DASS was 8.58±4.510, mean anxiety score on DASS was 11.68±4.160 and the mean stress score on DASS was 14.84±3.192. There were 63.5% males and 36.5% females. Depression, anxiety and stress had a negative correlation with quality of life. Depression and stress were significantly correlated negatively with quality of life (p=0.000). No demographical factor was significantly associated with poor quality of life. Conclusion: Depression, anxiety and stress were negatively correlated with poorer QOL and depression and stress had significant association with poor QOL. Key words: Anxiety, Depression, Covid-19, Quality of life How to cite: Rashid A., Mudassar U., Tariq I., Zaheer A., Iftikhar M., Mazhar N. Correlation of Depression, Anxiety and Stress with Quality of Life in COVID-19 Pandemic. Esculapio 2021;17(02):195-199.

Download Full-text