scholarly journals Prevalence and Documentation Rates of Obesity in Hospitalized Patients: Results of a Retrospective Cohort Study

2018 ◽  
Author(s):  
Mohammad A. Hossain ◽  
Ami Amin ◽  
Anju Paul ◽  
Huzaif Qaisar ◽  
Monika Akula ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Weight Status ◽  
Average Length ◽  
Medical Center ◽  
Normal Weight ◽  
Hospitalized Patients ◽  
Obese Patients ◽  
Discharge Diagnosis ◽  
Care Providers ◽  
Management Interventions

While obesity is a serious chronic condition, its prevalence and documentation as a diagnosis has not been extensively studied in hospitalized patients. We conducted a retrospective chart review to investigate the prevalence and documentation of obesity as a diagnosis among patients admitted to our medical center. IRB approval was obtained for this retrospective study. Body mass index as per CDC, admission and discharge diagnosis of obesity and common comorbidities including hypertension, diabetes, hyperlipidemia and others, were recorded. Length of hospital stay was calculated. We also investigated whether counselling for weight loss was provided to obese patients. A total of 540 consecutive patients with mean age of 66 ± 6 years, were investigated, of which 182(34%) had normal weight, 188(35%) patients were overweight and 170(31%) patients were obese. Obese group included 55% female and 45% male. 100 (59%) had class I obesity, 43(25%) had class II obesity and 27(16%) class III obesity. Of the obese patients 40/170(23.5%) patients had obesity documented on the admission problem list and only 21(12%) had obesity documented as a discharge diagnosis. Only 3(2%) patients received appropriate counseling and referral for obesity management during the hospitalization. Comorbidities included hypertension (68%), diabetes (35%), hyperlipidemia (36%), coronary artery disease (18%), chronic kidney disease (17%), congestive heart failure (18%) and COPD (24%). The average length of stay in normal weight, overweight and obese patients was similar (4.5 ± 0.5 days). An overwhelming percentage never had weight status documented despite significant prevalence of obesity. Hospitalization offers health care providers a window of opportunity to identify obesity, communicate risks and initiate weight management interventions.

scholarly journals Maternal perceptions of 5-year-old child weight status and factors influencing perceptions: Findings from the ROLO Kids Study

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Anna Gouldson ◽  
Aisling Geraghty ◽  
Eileen O'Brien ◽  
Mary Horan ◽  
Jean Donnelly ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Weight Status ◽  
Normal Weight ◽  
Care Providers ◽  
Maternal Perceptions ◽  
Kappa Score ◽  
Weight Category ◽  
Child Weight ◽  
Factors Influencing ◽  
Child’S Weight

AbstractIntroductionObesity is a global condition affecting both adults and children. Mothers play an important role in identifying problems with their child's weight. However, studies are limited on the accuracy of maternal perceptions of her child's weight status in early childhood. The aim of this study was to look at maternal perceptions of her child's weight status in 5-year-old children and to investigate factors influencing this.Materials and Methods339 mother and child pairs were followed up from the ROLO Kids study in the National Maternity Hospital, Dublin, Ireland. Height and weight of the mother and the child were measured, and BMI was calculated. Demographic details were collected and questionnaires asked mothers to assign their child to a weight category and to give the reason they put their child in this particular category. KAPPA analysis and student t tests were used to analyse the data.ResultsIn this cohort over 75% of the children were normal weight, 14.7% were in the overweight category, and 8.5% in the obese category. The KAPPA score for maternal-perceived category and actual weight status was 0.037 which is a low level of agreement. Mothers were more likely to underestimate their child's weight, with 28.5% underestimating the appropriate weight category for their child compared with 2.4% who overestimated. Maternal age, education, and child sex did not influence accurate weight assessments; however, mothers with a higher BMI were more likely to inaccurately assess their child's weight (P < 0.05).DiscussionMaternal perception of their child's weight status is not an accurate indication of child weight, particularly for mothers with a raised BMI. This research highlights the important role of health care providers in assessing child weight status, rather than relying on parental reports alone, in order to appropriately intervene to reduce the incidence of childhood obesity.

Self-Perceived End-of-Life Care Competencies of Health-Care Providers at a Large Academic Medical Center

2018 ◽  
Vol 35 (11) ◽  
pp. 1409-1416 ◽  
Author(s):  
Marcos Montagnini ◽  
Heather M. Smith ◽  
Deborah M. Price ◽  
Bidisha Ghosh ◽  
Linda Strodtman
Keyword(s):  
Health Care ◽  
End Of Life ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Medical Center ◽  
Academic Medical Center ◽  
Hospitalized Patients ◽  
Care Providers ◽  
Academic Medical ◽  
Eol Care

Background: In the United States, most deaths occur in hospitals, with approximately 25% of hospitalized patients having palliative care needs. Therefore, the provision of good end-of-life (EOL) care to these patients is a priority. However, research assessing staff preparedness for the provision of EOL care to hospitalized patients is lacking. Objective: To assess health-care professionals’ self-perceived competencies regarding the provision of EOL care in hospitalized patients. Methods: Descriptive study of self-perceived EOL care competencies among health-care professionals. The study instrument (End-of-Life Questionnaire) contains 28 questions assessing knowledge, attitudes, and behaviors related to the provision of EOL care. Health-care professionals (nursing, medicine, social work, psychology, physical, occupational and respiratory therapist, and spiritual care) at a large academic medical center participated in the study. Means were calculated for each item, and comparisons of mean scores were conducted via t tests. Analysis of variance was used to identify differences among groups. Results: A total of 1197 questionnaires was completed. The greatest self-perceived competency was in providing emotional support for patients/families, and the least self-perceived competency was in providing continuity of care. When compared to nurses, physicians had higher scores on EOL care attitudes, behaviors, and communication. Physicians and nurses had higher scores on most subscales than other health-care providers. Conclusions: Differences in self-perceived EOL care competencies were identified among disciplines, particularly between physicians and nurses. The results provide evidence for assessing health-care providers to identify their specific training needs before implementing educational programs on EOL care.

scholarly journals Recognizing Obesity in Adult Hospitalized Patients: A Retrospective Cohort Study Assessing Rates of Documentation and Prevalence of Obesity

2018 ◽  
Vol 7 (8) ◽  
pp. 203 ◽  
Author(s):  
Mohammad Hossain ◽  
Ami Amin ◽  
Anju Paul ◽  
Huzaif Qaisar ◽  
Monika Akula ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Chronic Kidney Disease ◽  
Coronary Artery ◽  
Kidney Disease ◽  
Length Of Stay ◽  
Normal Weight ◽  
Hospitalized Patients ◽  
Obese Patients ◽  
Discharge Diagnosis ◽  
Artery Disease

Background: While obesity is a chronic condition that predisposes patients to other more serious disorders, the prevalence and the documentation of obesity as diagnosis has not been extensively studied in hospitalized patients. We conducted a retrospective chart review to investigate the prevalence and documentation of obesity as a diagnosis among patients admitted to our medical center. Method: IRB approval was obtained for this retrospective study. Body mass index (BMI) as per CDC, admission and discharge diagnosis of obesity and common comorbidities (hypertension, diabetes, hyperlipidemia, coronary artery disease, congestive heart disease, chronic kidney disease and chronic obstructive pulmonary disease) were recorded. The length of stay in the hospital was also calculated. We also investigated whether counselling was provided to the obese patients for weight loss. Results: A total of 540 consecutive patients were reviewed with a mean age was 66 ± 6 years. Out of 540 patients only 182 (34%) had normal weight, 188 (35%) of the patients were overweight and 170 (31%) patients were obese. Of the obese group, 55% were female and 45% were male.100 (59%) had class I obesity, 43 (25%) had class II obesity and 27 (16%) class III obesity. Of the obese patients 40/170 (23.5%) patients had obesity documented on the admission problem list and only 21 (12%) had obesity documented as a discharge diagnosis. Only 3 (2%) patients were given appropriate counseling and referral for obesity management during the hospitalization. Comorbidities and their prevalence included, hypertension (68%), diabetes mellitus (35%), hyperlipidemia (36%), coronary artery disease (18%), chronic kidney disease (17%), congestive heart failure (18%) and COPD (24%). The average length of stay in normal weight, overweight and obese patients was similar for all three groups (4.5 ± 0.5 days). Conclusion: A significant number of hospitalized patients were overweight and obese. An overwhelming percentage never had weight status documented. Hospitalization offers health care providers a window of opportunity to identify obesity, communicate risks, and initiate weight management interventions.

scholarly journals Weight Matters—Factors Influencing Eating Behaviors of Vulnerable Women

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1809 ◽  
Author(s):  
Marcela Vizcarra ◽  
Ana María Palomino ◽  
Lorena Iglesias ◽  
Alejandra Valencia ◽  
Patricia Gálvez Espinoza ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Low Income ◽  
Weight Status ◽  
Eating Behaviors ◽  
Normal Weight ◽  
World Health ◽  
Photo Elicitation ◽  
Obese Women ◽  
Care Providers ◽  
Qualitative Approaches

Women from low socioeconomic backgrounds are more affected by obesity than men. The influence of weight as a determinant of women’s eating behaviors has seldom been studied, especially in Latin America. In this study, we analyzed the food choices of vulnerable women according to their weight status. We conducted photo-elicitation interviews with 31 women from low-income neighborhoods in Santiago, Chile. Weight and height were measured and participants were divided into normal weight (n = 9), overweight (n = 15), and obese groups (n = 7) according to World Health Organization (WHO) body mass index (BMI) categories (p < 0.001). Quantitative and qualitative approaches were used for the analysis. Women in overweight and obese groups described more about their families, temporality, financial issues, and food perception. When weight groups were analyzed separately, more factors explaining eating behaviors were found (mental and physical health, body dissatisfaction, gender role, and obstacles for eating healthy) in the obese group. Results suggest that women with obesity or overweight based their diets on more internal and external factors than did normal weight women. This study contributes to our understanding of why changing behaviors can be difficult in women with obesity. Health care providers should consider these factors in the implementation of programs to address the need for a healthy diet for overweight and obese women.

scholarly journals The Role of Obesity in Predicting the Clinical Outcomes of COVID-19

Obesity Facts ◽  
2021 ◽  
pp. 1-9
Author(s):  
Serdar Sahin ◽  
Havva Sezer ◽  
Ebru Cicek ◽  
Yeliz Yagız Ozogul ◽  
Murat Yildirim ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Health Care Providers ◽  
Study Groups ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Care Providers ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Group D

<b><i>Introduction:</i></b> The aim of this was to describe the predictors of mortality related to COVID-19 infection and to evaluate the association between overweight, obesity, and clinical outcomes of COVID-19. <b><i>Methods:</i></b> We included the patients &#x3e;18 years of age, with at least one positive SARS-CoV-2 reverse transcriptase-polymerase chain reaction. Patients were grouped according to body mass index values as normal weight &#x3c;25 kg/m<sup>2</sup> (Group A), overweight from 25 to &#x3c;30 kg/m<sup>2</sup> (Group B), Class I obesity 30 to &#x3c;35 kg/m<sup>2</sup> (Group C), and ≥35 kg/m<sup>2</sup> (Group D). Mortality, clinical outcomes, laboratory parameters, and comorbidities were compared among 4 groups. <b><i>Results:</i></b> There was no significant difference among study groups in terms of mortality. Noninvasive mechanical ventilation requirement was higher in group B and D than group A, while it was higher in Group D than Group C (Group B vs. Group A [<i>p</i> = 0.017], Group D vs. Group A [<i>p</i> = 0.001], and Group D vs. Group C [<i>p</i> = 0.016]). Lung involvement was less common in Group A, and presence of hypoxia was more common in Group D (Group B vs. Group A [<i>p</i> = 0.025], Group D vs. Group A [<i>p</i> &#x3c; 0.001], Group D vs. Group B [<i>p</i> = 0.006], and Group D vs. Group C [<i>p</i> = 0.014]). The hospitalization rate was lower in Group A than in the other groups; in addition, patients in Group D have the highest rate of hospitalization (Group B vs. Group A [<i>p</i> &#x3c; 0.001], Group C vs. Group A [<i>p</i> &#x3c; 0.001], Group D vs. Group A [<i>p</i> &#x3c; 0.001], Group D vs. Group B [<i>p</i> &#x3c; 0.001], and Group D vs. Group C [<i>p</i> = 0.010]). <b><i>Conclusion:</i></b> COVID-19 patients with overweight and obesity presented with more severe clinical findings. Health-care providers should take into account that people living with overweight and obesity are at higher risk for COVID-19 and its complications.

Abstract 2197: Telestroke: Optimizing Access to Emergency Interventions in Acute Stroke Care

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Rayetta Johnson
Keyword(s):  
Quality Improvement ◽  
Acute Stroke ◽  
Health Care Providers ◽  
Positive Impact ◽  
Medical Center ◽  
Stroke Care ◽  
Nurse Specialist ◽  
Care Providers ◽  
Acute Stroke Care ◽  
Evidenced Based

Background and Issues: The burden of stroke in North Carolina is one of the highest in the nation (approximately 28,000 stroke hospitalizations from 2003-2007). The number and high costs of stroke have made it incumbent to improve the numbers of patients receiving effective treatment. There are two major barriers for treatment of acute stroke: time and access. The utilization of telestroke in community hospitals aids in decreasing these barriers by providing immediate access to a stroke neurologist. In order for telestroke to be successful, awareness and education regarding acute stroke care must be provided for health care providers as well as the communities. Thus, the development of a telestroke system requires nursing and medical expertise. The Primary Stroke Center Team at Wake Forest Baptist Medical Center in Winston-Salem, N.C. implemented a telestroke network system (Intouch's Health's RP-7 Robotic system) in January of 2010 to provide 24/7 access to the medical center's acute stroke experts and the latest advancements in stroke interventions. There are eight hospitals in the network at the present time. Methods: Our team identified that many of the network hospital's staff are not experienced in taking care of a stroke patient and that a “roadmap” is useful to guide them in these steps.The stroke nurse specialist developed a quality improvement plan for the network hospitals which included: an evidence-based algorithm for patient care; stroke education, in particular, neurological assessment and tPA administration classes for the ED staff; quarterly meetings to provide outcome and feedback data with each network hospital; stroke awareness events for the community. Mock telestroke consults were also performed prior to “going live” with telestroke for each of the network hospitals. Of utmost importance is the early involvement and education of the EMS system in the respective county of the network hospital. The buy-in of EMS was found to be a key component in the success of the network. Finally, attention to customized quality improvement efforts for each of the facilities are required to accomplish integration into the telestroke network. Results: The data has been analyzed, and thus far, a 24% rate of tPA administration has been seen with our network hospitals (an increase from the 3.6% national average). Comparisons between each of the eight network hospitals' rates of administration of tPA prior to and after joining the network show a trend of increase (10%-40%). The effectiveness of the algorithm has also been explored by analysis of feedback and initial results have shown a positive impact. Conclusion: A combination of improving access to stroke neurologists in conjunction with a focus on improving the level of care via evidenced based stroke care teaching and implementation of algorithms at a network hospital is required for implementing and building a successful telestroke network.

scholarly journals Nurses’ knowledge and practices related to pain assessment in critically ill patients in a selected private hospital in Bangladesh

2018 ◽  
Vol 5 (10) ◽  
pp. 4219 ◽  
Author(s):  
Sipra Mondol ◽  
Faisal Muhammad ◽  
A. B. M. Alauddin Chowdhury
Keyword(s):  
Critically Ill ◽  
Health Care Providers ◽  
Pain Assessment ◽  
Subjective Experience ◽  
Sampling Technique ◽  
Care Providers ◽  
Cross Sectional ◽  
Management Interventions ◽  
The Mean ◽  
Nurses Knowledge

Background: Most of the time pain is difficult to assess and manage because of being inherently a subjective experience influenced by multiple factors. The perception and tolerance of pain may vary because of different psychological and social influences of the patient. Therefore it is important for health care providers to assess the pain so that individualized management interventions can be provided. This study was aimed to assess the nurses’ knowledge and practices related to pain assessment in critically ill patients.Methods: A descriptive cross-sectional study was carried out among 200 registered nurses working at different ICU in Square Hospital. The study was conducted within April to August 2017. A non-probability purposive sampling technique was used. The data was collected using pre-tested self-administered semi-structured questionnaire and it was analysed using SPSS 22.0 version.Results: About 81% of the respondents were in the age group 22-32 years and the mean age of the respondents was 27.74±12.06 years. About 79.0% of the respondents were female and 59.5% of the respondents had diploma in nursing. The mean monthly income of the respondents’ was 19450.5 taka. The majority (59.5%) of the respondents had less than 2 years’ service experience. About 85.5% of the respondents said it is important to assess the pain and need for analgesia before, during, and after wound care.Conclusions: Our findings reported that the nurses were reasonably knowledgeable about the principles of pain assessment. More than four-fifths of the respondents had adequate knowledge about pain assessment.

scholarly journals Knowledge of Surgical Informed Consent and Associated Factors among Patients Undergone Obstetric and Gynecologic Surgery at Jimma Medical Center, Jimma, Oromia Region, Ethiopia, 2020. An Institutional Based Cross-Sectional Study.

2021 ◽  
Author(s):  
Belete Fenta Kebede ◽  
Tsegaw Biazin Tesfaye ◽  
Aynalem Yetwale Hiwot
Keyword(s):  
Informed Consent ◽  
Health Care Providers ◽  
Associated Factors ◽  
Medical Center ◽  
Educational Status ◽  
Cross Sectional Study ◽  
Outcome Variable ◽  
Gynecologic Surgery ◽  
Care Providers ◽  
Cross Sectional

Abstract Introduction: The practice of informed consent before any surgical procedure should form the fundamental element that serves to protect both patient and surgeon from prosecution. Several factors can affect the process of surgical informed consent. Knowledge towards surgical informed consent is one important factor. It is worth mentioning that patients’ understanding of the information provided in the consent form is a prerequisite for obtaining valid informed consent, otherwise, it will be only symbolic. The study aimed to assess knowledge of surgical informed consent and associated factors among patients who undergone obstetric and gynecologic surgery at Jimma Medical Center, Jimma, Oromia Region, EthiopiaMethodology: Institutional based crossectional study was conducted among systematically selected women undergo obstetrics and gynecologic surgery in Jimmy medical center from April 1 to May 30, 2020. The collected data were coded, entered into Epi data version 3.1, and analyzed using SPSS version 25. Bivariate and multivariate regression was carried out to determine the association between an outcome variable and an independent variable. Tables, pie -charts, and texts were used to report the result.Results: This study revealed that the mean age of the respondents was 29.5 ±3.5 years and the majority of them (83.3%) were married. The respondents had significantly poor overall knowledge of surgical informed consent 77.2 %( 95%CI: 72.8-81.2).Patient educational status (AOR: 1.22 (95%CI: 1.1-2.47), satisfaction level (AOR: 1.823(95%CI: 1.061-3.134).and patient- provider relation-ship (AOR: 0.472(95%CI: 0.271-0.822) were associated with knowledge of surgical informed consent.Conclusion: in this study, the overall level of knowledge regarding surgical informed consent was significantly poor than the other national and international figures. Patient Education, satisfaction, and patient-provider relation-ship were associated with knowledge of surgical informed consent. Health care providers should provide adequate information before surgery to improve patients’ knowledge regarding surgical informed consent and provide adequate input on ways to improve the consent process to make it better suited to fit the needs of all patients.

The Perspectives of Women and Their Health-Care Providers Regarding Using an ECA to Support Mode of Birth Decisions

2021 ◽  
Vol 30 (3) ◽  
pp. 135-144
Author(s):  
Somphit Chinkam ◽  
Courtney Steer-Massaro ◽  
Ivan Herbey ◽  
Zhe Zhang ◽  
Timothy Bickmore ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Care Providers ◽  
Medical Center ◽  
Decision Aids ◽  
Tertiary Care ◽  
Easy Access ◽  
Care Providers ◽  
Embodied Conversational Agent ◽  
Tertiary Care Medical Center ◽  
Mode Of Birth

This study used focus groups to assess the feasibility and acceptability of adapting an Embodied Conversational Agent (ECA) to support decision-making about mode of birth after previous cesarean. Twelve women with previous cesareans, and eight prenatal providers at an academic, tertiary-care medical center, viewed a prototype ECA and were asked to share feedback on the potential role in helping women prepare for decision-making. Both groups felt that although it was somewhat “robot-like,” the ECA could provide easy access to information for patients and could augment the visit with providers. Future work is needed to improve ECA visual appeal and clarify the role and timing for utilization of decision aids using ECA technology to enhance the shared decision-making process.

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