Disaster preparedness among Thai elderly emergency department patients: A survey of patients’ perspective

Abstract Background: In disaster situations, the elderly are considered to be a particularly vulnerable population. Preparedness is the key to reduce post-disaster damage. There is limited research in middle income countries on how well elderly emergency department (ED) patients are prepared for disaster situations. The objective of this study was to determine the attitudes and behavior of elderly ED patients toward disaster preparedness. Methods: This study was a cross-sectional face-to-face survey at one urban teaching hospital in Bangkok, Thailand between August 1st and September 30th, 2016. Patients aged 60 and older who presented to the ED were included to this study. We excluded patients who had severe dementia [defined as Short Portable Mental State Questionnaire’s (SPMSQ) > 8], were unable to speak Thai, had severe trauma and/or needed immediate resuscitation. The survey instruction was adapted from previous disaster surveys. This study was approved by the Thai Institutional Review Board (IRB). Results: A total of 243 patients were enrolled. Most of them were female [154 patients (63.4%)]. The median age was 72 [Interquartile range (IQR) 66-81] years and the most common underlying diseases were hypertension [148 patients(60.9%)] and diabetes [108 patients (44.4%)]. The majority of patients [172 patients(72.4%)] reported that they had had some teaching about disaster knowledge from a healthcare provider and had experienced a disaster [138 patients(56.8%)]. While 175/197 (81.8%) of patients who have underlying diseases reported that they had a medication supply for disaster situations, only 61 (25.1%) patients had an emergency tool-box for disasters. Most 159 (65.4%) patients did not know the emergency telephone number, and 133 (54.7%) patients reported transportation limitations. Conclusions: While most Thai elderly ED patients reported having a medication supply for disaster situations, many lacked comprehensive plans for a disaster situation. Work needs to be done to improve the quality of preparedness in disaster situations among elderly patients. Future research should focus on preparedness knowledge regarding evacuation, and shelter/residence for older patients.

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Disaster preparedness among Thai elderly emergency department patients: a survey of patients’ perspective

BMC Emergency Medicine ◽

10.1186/s12873-019-0269-7 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Jiraporn Sri-on ◽

Alissara Vanichkulbodee ◽

Natchapon Sinsuwan ◽

Rapeeporn Rojsaengroeng ◽

Anucha Kamsom ◽

...

Keyword(s):

Emergency Department ◽

Disaster Preparedness ◽

The Elderly ◽

Severe Trauma ◽

Future Research ◽

Cross Sectional ◽

Middle Income ◽

Institutional Review ◽

Comprehensive Plans ◽

Underlying Diseases

Abstract Background In disaster situations, the elderly are considered to be a particularly vulnerable population. Preparedness is the key to reduce post-disaster damage. There is limited research in middle-income countries on how well elderly emergency department (ED) patients are prepared for disaster situations. The objective of this study was to determine the attitudes and behavior of elderly ED patients toward disaster preparedness. Methods This study was a cross-sectional face-to-face survey at one urban teaching hospital in Bangkok, Thailand between August 1st and September 30th, 2016. Patients aged 60 and older who presented to the ED were included to this study. We excluded patients who had severe dementia [defined as Short Portable Mental State Questionnaires (SPMSQ) > 8], were unable to speak Thai, had severe trauma and/or needed immediate resuscitation. The survey instruction was adapted from previous disaster surveys. This study was approved by the Vajira Institutional Review Board (IRB). Results A total of 243 patients were enrolled. Most of them were female [154 patients (63.4%)]. The median age was 72 [Interquartile range (IQR) 66–81] years and the most common underlying diseases were hypertension [148 patients (60.9%)] and diabetes [108 patients (44.4%)]. The majority of patients [172 patients (72.4%)] reported that they had had some teaching about disaster knowledge from a healthcare provider and had experienced a disaster [138 patients (56.8%)]. While 175/197 (81.8%) patients who had underlying diseases reported that they had a medication supply for disaster situations, only 61 (25.1%) patients had an emergency toolbox for disasters. Most patients (159, 65.4%) did not know the emergency telephone number, and 133 (54.7%) patients reported transportation limitations. Conclusions While most Thai elderly ED patients reported having a medication supply for disaster situations, many lacked comprehensive plans for a disaster situation. Work needs to be done to improve the quality of preparedness in disaster situations among elderly patients. Future research should focus on preparedness knowledge regarding evacuation, and shelter/residence for older patients.

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Disaster preparedness among Thai elderly emergency department patients: A survey of patients’ perspective

10.21203/rs.2.10829/v3 ◽

2019 ◽

Author(s):

Jiraporn Sri ◽

Alissara Vanichkulbodee ◽

Natchapon Sinsuwan ◽

Rapeeporn Rojsaengroeng ◽

Anucha Kamsom ◽

...

Keyword(s):

Emergency Department ◽

Disaster Preparedness ◽

The Elderly ◽

Severe Trauma ◽

Future Research ◽

Cross Sectional ◽

Middle Income ◽

Institutional Review ◽

Comprehensive Plans ◽

Underlying Diseases

Abstract Background: In disaster situations, the elderly are considered to be a particularly vulnerable population. Preparedness is the key to reduce post-disaster damage. There is limited research in middle-income countries on how well elderly emergency department (ED) patients are prepared for disaster situations. The objective of this study was to determine the attitudes and behavior of elderly ED patients toward disaster preparedness. Methods: This study was a cross-sectional face-to-face survey at one urban teaching hospital in Bangkok, Thailand between August 1st and September 30th, 2016. Patients aged 60 and older who presented to the ED were included to this study. We excluded patients who had severe dementia [defined as Short Portable Mental State Questionnaires (SPMSQ) > 8], were unable to speak Thai, had severe trauma and/or needed immediate resuscitation. The survey instruction was adapted from previous disaster surveys. This study was approved by the Vajira Institutional Review Board (IRB). Results: A total of 243 patients were enrolled. Most of them were female [154 patients (63.4%)]. The median age was 72 [Interquartile range (IQR) 66-81] years and the most common underlying diseases were hypertension [148 patients (60.9%)] and diabetes [108 patients (44.4%)]. The majority of patients [172 patients (72.4%)] reported that they had had some teaching about disaster knowledge from a healthcare provider and had experienced a disaster [138 patients (56.8%)]. While 175/197 (81.8%) patients who had underlying diseases reported that they had a medication supply for disaster situations, only 61 (25.1%) patients had an emergency toolbox for disasters. Most patients (159, 65.4%) did not know the emergency telephone number, and 133 (54.7%) patients reported transportation limitations. Conclusions: While most Thai elderly ED patients reported having a medication supply for disaster situations, many lacked comprehensive plans for a disaster situation. Work needs to be done to improve the quality of preparedness in disaster situations among elderly patients. Future research should focus on preparedness knowledge regarding evacuation, and shelter/residence for older patients.

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Disaster preparedness among Thai elderly emergency department patients: A survey of patients’ perspective

10.21203/rs.2.10829/v2 ◽

2019 ◽

Author(s):

Jiraporn Sri ◽

Alissara Vanichkulbodee ◽

Natchapon Sinsuwan ◽

Rapeeporn Rojsaengroeng ◽

Anucha Kamsom ◽

...

Keyword(s):

Emergency Department ◽

Disaster Preparedness ◽

The Elderly ◽

Severe Trauma ◽

Future Research ◽

Cross Sectional ◽

Middle Income ◽

Institutional Review ◽

Comprehensive Plans ◽

Underlying Diseases

Abstract Background: In disaster situations, the elderly are considered to be a particularly vulnerable population. Preparedness is the key to reduce post-disaster damage. There is limited research in middle-income countries on how well elderly emergency department (ED) patients are prepared for disaster situations. The objective of this study was to determine the attitudes and behavior of elderly ED patients toward disaster preparedness. Methods: This study was a cross-sectional face-to-face survey at one urban teaching hospital in Bangkok, Thailand between August 1st and September 30th, 2016. Patients aged 60 and older who presented to the ED were included to this study. We excluded patients who had severe dementia [defined as Short Portable Mental State Questionnaires (SPMSQ) > 8], were unable to speak Thai, had severe trauma and/or needed immediate resuscitation. The survey instruction was adapted from previous disaster surveys. This study was approved by the Vajira Institutional Review Board (IRB). Results: A total of 243 patients were enrolled. Most of them were female [154 patients (63.4%)]. The median age was 72 [Interquartile range (IQR) 66-81] years and the most common underlying diseases were hypertension [148 patients (60.9%)] and diabetes [108 patients (44.4%)]. The majority of patients [172 patients (72.4%)] reported that they had had some teaching about disaster knowledge from a healthcare provider and had experienced a disaster [138 patients (56.8%)]. While 175/197 (81.8%) patients who had underlying diseases reported that they had a medication supply for disaster situations, only 61 (25.1%) patients had an emergency toolbox for disasters. Most patients (159, 65.4%) did not know the emergency telephone number, and 133 (54.7%) patients reported transportation limitations. Conclusions: While most Thai elderly ED patients reported having a medication supply for disaster situations, many lacked comprehensive plans for a disaster situation. Work needs to be done to improve the quality of preparedness in disaster situations among elderly patients. Future research should focus on preparedness knowledge regarding evacuation, and shelter/residence for older patients.

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Level of Disaster Preparedness in Patients Visiting the Emergency Department: Results of the Civilian Assessment of Readiness for Disaster (CARD) Survey

Prehospital and Disaster Medicine ◽

10.1017/s1049023x12001811 ◽

2013 ◽

Vol 28 (2) ◽

pp. 127-131 ◽

Cited By ~ 7

Author(s):

Nicholas A. True ◽

Juliana D. Adedoyin ◽

Frances S. Shofer ◽

Eddie K. Hasty ◽

Jane H. Brice

Keyword(s):

Emergency Department ◽

Vulnerable Populations ◽

Disaster Preparedness ◽

Single Parents ◽

Public Hospitals ◽

University Hospital ◽

Future Research ◽

Cross Sectional Survey ◽

Publication Type ◽

Cross Sectional

AbstractBackgroundPatients seeking care in public hospitals are often resource-limited populations who have in past disasters become the most vulnerable. The objective of this study was to determine the personal disaster preparedness of emergency department (ED) patients and to identify predictors of low levels of preparedness. It was hypothesized that vulnerable populations would be better prepared for disasters.MethodsA prospective cross-sectional survey was conducted over a one-year period of patients seeking care in a public university hospital ED (census 65,000). Exclusion criteria were mentally impaired, institutionalized, or non-English speaking subjects. Subjects completed an anonymous survey detailing the 15 personal preparedness items from the Federal Emergency Management Agency's disaster preparedness checklist as well as demographic characteristics. Summary statistics were used to describe general preparedness. Chi-square tests were used to compare preparedness by demographics.ResultsDuring the study period, 857/1000 subjects completed the survey. Participants were predominantly male (57%), Caucasian (65%), middle-aged (mean 45 years), and high school graduates (83%). Seventeen percent (n = 146) reported having special needs and 8% were single parents. Most participants were not prepared: 451 (53%) had >75% of checklist items, 393 (46%) had food and water for 3 days, and 318 (37%) had food, water, and >75% of items. Level of preparedness was associated with age and parenting. Those aged 44 and older were more likely to be prepared for a disaster compared to younger respondents. (43.3% vs 31.1%, P = .0002). Similarly, single parents were more likely to be prepared than dual parenting households (47.1 vs 32.9%, P = .03).ConclusionsThis study and others have found that only the minority of any group is actually prepared for disaster. Future research should focus on ways to implement disaster preparedness education, specifically targeting vulnerable populations, then measuring the effects of educational programs to demonstrate that preparedness has increased as a result.TrueNA, AdedoyinJD, ShoferFS, HastyEK, BriceJH. Level of disaster preparedness in patients visiting the emergency department: results of the Civilian Assessment of Readiness for Disaster (CARD) survey. Prehosp Disaster Med.2013;28(2):1-5.

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Subjective Memory Complaints and Mild Cognitive Impairment

European Psychiatry ◽

10.1016/s0924-9338(09)71326-4 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1 ◽

Cited By ~ 2

Author(s):

M. Simoes ◽

L.C. Castro ◽

O. Ribeiro ◽

T. Salgado ◽

C. Paz

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

The Elderly ◽

Future Research ◽

Older Individuals ◽

Subjective Memory Complaints ◽

Subjective Memory ◽

Cross Sectional ◽

Memory Complaints ◽

Increased Risk

Background:Subjective Memory Complaints (SMC) are common in clinical practice. the clinical significance of these subjective complaints among older individuals is not well understood.Aim:To study and discuss the association between SMC and MCI, underlining the importance of an adequate clinical assessment of SMC in the elderly.Methods:Review of the literature.Results:There is no consistent definition of SMC in the literature. Some prospective studies showed an association with objective memory impairments, conceptualizing SMC as a Pre-Mild Cognitive Impairment. SMC are also currently considered to be a core feature of Mild Cognitive Impairment (MCI). Cross-sectional studies and longitudinal studies showed conflicting results concerning the association between SMC and MCI.Discussion:The understanding of the predictive value of SMC in cognitive decline is still poorly understood. It is important to define criteria aimed to increase specificity of memory complaints, allowing an earlier identification of populations with higher risk of MCI. Future research on this complex association is important to identify SMC individuals at increased risk of conversion to MCI and dementia.

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Usability and Effectiveness of a Smartphone Application for Tracking Oncology Patients in Gaborone, Botswana

Journal of Global Oncology ◽

10.1200/jgo.19.20000 ◽

2019 ◽

Vol 5 (Supplement_1) ◽

pp. 11-11

Author(s):

Sidrah Shah ◽

Barati Monare ◽

Sandra Urusaro ◽

Rohini Bhatia ◽

Sherman Preet Singh ◽

...

Keyword(s):

Gynecologic Oncology ◽

Smartphone Application ◽

Cross Sectional Study ◽

Text Messages ◽

University Of Pennsylvania ◽

Survey Period ◽

Cross Sectional ◽

Middle Income ◽

Median Response ◽

Institutional Review

PURPOSE Most cancer diagnoses are expected to be in low- and middle-income countries (LMICs) by 2025, and 65% of cancer deaths occur in LMICs. Treatment adherence and patient monitoring are essential to cancer care but are often not possible in LMICs. OP Care, a smartphone application developed to fill this gap, stores medical records virtually and texts appointment reminders to patients. This study assessed its usability and effectiveness. METHODS OP Care was piloted at Princess Marina Hospital in Gaborone, Botswana. The study was a cross-sectional study using surveys. All providers using the application were surveyed, along with all patients who were previously enrolled in the application and attended the gynecologic oncology clinic during the 3-week survey period. Staff demographics, reaction, opinions on usability, and patients’ reactions to appointment reminders were collected. Answers were recorded on a 1 (not at all) to 7 (extremely so) scale. Primary outcomes were the application’s usability and the effectiveness of the text reminders. The University of Pennsylvania Institutional Review Board and the Ministry of Health and Wellness in Botswana gave approval for the study. Patients provided written consent before enrollment. RESULTS Nine staff and 15 patients were surveyed. Staff included three doctors and six nurses, all of whom own a smartphone and use a computer at home. Most staff (78%) did not feel OP Care would increase their work burden and were willing to use the application if implemented permanently (median response, 6; interquartile range [IQR], 1). Most usability questions (17 of 19), such as “I feel comfortable using this system,” scored a median of 6. Most patients believed that the reminder text messages were helpful (median, 6; IQR, 1) but wanted the text reminders to be in the Setswana language (median, 7; IQR, 1). CONCLUSION High usability scores indicate the application is adaptable to other clinics. Although patients appreciate OP Care, the option for call and text reminders in Setswana is indicated. A potential limitation is that patients for whom the appointment reminders were not helpful were not necessarily included, because only patients in the clinic were surveyed. Strengths were inclusion of all involved staff, uniformity in survey administration, and inclusion of numerical analysis.

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Prevalence of Malnutrition among Elderly People Living in a Rural Area of Nepal

Journal of Nepal Medical Association ◽

10.31729/jnma.6013 ◽

2021 ◽

Vol 59 (234) ◽

Author(s):

Jagdish Chataut ◽

Shristi Jonche ◽

Manish Ghimire ◽

Dipesh Tamrakar ◽

Mukta Singh Bhandari

Keyword(s):

Nutritional Status ◽

Elderly People ◽

Rural Area ◽

The Elderly ◽

Cross Sectional Study ◽

Elderly Persons ◽

Cross Sectional ◽

Institutional Review ◽

Swallowing Difficulties ◽

Loss Of Appetite

Introduction: Elderly population is more likely to suffer from malnutrition due to aging-associated factors that influence nutritional status like loss of appetite, swallowing difficulties, digestive problems, and chronic illness. There is insufficient information related to the nutritional status of the elderly in Nepal. Hence, this study aims to determine the prevalence of malnutrition among elderly people living in the rural area of the Kavrepalanchok district. Methods: A descriptive cross-sectional study was conducted among 320 elderly people aged ≥60 years in a rural area of Kavre district from August to October 2019. Ethical approval was taken from the Institutional Review Committee (IRC-KUSMS: 68/19). Convenient sampling was done. Data analysis was performed using the Statistical Program for Social Sciences version 23. Results: The prevalence of malnutrition and risk of malnutrition was 37 (11.6%) and 159 (49.7%), respectively. Of 320 elderly persons, 193 (60.3%) males and 127 (39.7%) females, with a mean age of 68.23±7.38 years, participated in this study. The mean BMI was 22.54±3.25 kg/m2 (Mean±SD). The prevalence of malnutrition was higher among females 19 (15%) compared to males 18 (9.3%). Conclusions: The prevalence of malnutrition and risk of malnutrition is high in the study population. Interventions to improve the nutritional status of the elderly should focus primarily on older people, females, and those who have co-morbidities.

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Changing use of the emergency department by the elderly in the United Arab Emirates,1989 and 1999

Eastern Mediterranean Health Journal ◽

10.26719/2002.8.2-3.409 ◽

2002 ◽

Vol 8 (2-3) ◽

pp. 409-415

Author(s):

S. A. Margolis ◽

R. L. Reed

Keyword(s):

Emergency Department ◽

Emergency Room ◽

United Arab Emirates ◽

The Elderly ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Male Ratio ◽

Al Ain ◽

The Mean ◽

Over Time

Changes in use by the elderly of the emergency department of a major hospital in Al-Ain in the years 1989 and 1999 were examined. All patients aged 65 years or older who attended the emergency room were included in this cross-sectional survey. Patient numbers rose from 321 in 1989 to 1347 in 1999 with no significant change in the female to male ratio of 0.78 or the mean age of the elderly attendees 72.9 +/- 7.4 years. Attendance rose 5.4 fold while non-urgent attendance rose 14.7 fold, demonstrating rising use but falling illness severity over time.

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A Comparative Study of Clinical and Paraclinical Findings of Elderly and Non-Elderly Patients With Acute Pneumonia and Pneumosepsis

ACTA MEDICA IRANICA ◽

10.18502/acta.v57i8.2427 ◽

2020 ◽

Author(s):

Mohammad Mahdi Majzoobi ◽

Zahra Jalalvand ◽

Elham Khanlarzadeh ◽

Abbas Moradi

Keyword(s):

Elderly Patients ◽

Clinical Laboratory ◽

Average Length ◽

Length Of Hospital Stay ◽

The Elderly ◽

Elderly Group ◽

Radiological Findings ◽

Cross Sectional ◽

Electrolyte Disturbances ◽

Underlying Diseases

Accurate diagnosis and timely treatment of pneumonia, as one of the most common infectious diseases in elderly patients, require careful attention to the clinical and paraclinical findings, which may be different between the elderly and non-elderly patients. The aim of the present study was to compare the clinical, laboratory, and radiological findings of elderly and non-elderly patients with pneumonia and pneumosepsis. This cross-sectional study was performed on 97 elderly and 93 non-elderly patients with pneumonia, admitted to Sina hospital in Hamadan, west of Iran, in 2017. Patients in both groups were also compared in terms of the underlying diseases, sepsis rate, electrolyte disturbances and CURB-65 criteria. All underlying diseases, except for HIV infection, in addition to clinical findings such as tachypnea, lethargy, decreased consciousness, hypotension, and respiratory alkalosis were significantly more common in the elderly, compared to the non-elderly group. In the elderly group, the average length of hospital stay, sepsis rate, and mortality rate were 9.4 days, 74.2%, and 21.7%, respectively versus 6.2 days, 46.3%, and 3.2%, respectively in the non-elderly group. Patients in the two groups were significantly different in terms of CkkURB-65 criteria and radiological findings. For the timely diagnosis of pneumonia and pneumosepsis in the elderly, it is necessary to consider any alteration in respiratory rate and consciousness status. Also, for proper treatment, the clinicians should pay attention to the existence of any comorbidities and electrolyte disturbances. © 2019 Tehran University of Medical Sciences. All rights reserved. Acta Med Iran 2019;57(8):503-509.

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The Importance of Knowing the Basic First Aid Measures During Social Isolation of the Elderly

10.21203/rs.3.rs-840698/v1 ◽

2021 ◽

Author(s):

Eva Dolenc ◽

Damjan Slabe ◽

Ivan Eržen ◽

Uroš Kovačič

Keyword(s):

Social Isolation ◽

Emergency Preparedness ◽

Disaster Preparedness ◽

Pearson Correlation ◽

Age Groups ◽

The Elderly ◽

First Aid ◽

Population Based ◽

Cross Sectional ◽

Post Hoc

Abstract Background: The vulnerability of the elderly population increases with natural and other disasters. Consequent social isolation affects their health. Health problems, which can lead to emergencies, can be an even greater burden during times of social isolation. Early identification and action in terms of first aid for the most common emergencies that threaten an individual’s health or life affect these conditions. We aimed to examine the knowledge of first aid in the most common emergencies that threaten elderly people’s health and life among a Slovenian population, focusing on the elderly people’s knowledge. Methods: A cross-sectional population-based survey was conducted on 1079 respondents. Data were collected with a structured questionnaire. Statistically significant differences in average ratings among different age groups were determined with one-way ANOVA followed by a post hoc test. Significant differences between the categories of age groups were determined using the χ2 square test followed by appropriate post hoc testing for multiple comparisons. By regression analysis (Spearman’s rho and Pearson Correlation), we determined the correlations. Results: Our survey results indicated that Slovenes are aware of the importance of first aid knowledge and feel personally responsible for acquiring and developing this knowledge. The most surprising finding of our research is the high level of knowledge of recognising some of the most common conditions that occur in old age and taking action in response to them. Simultaneously, most of the knowledge tested does not depend on the person’s age or the time since that person was last educated in first aid. Nevertheless, out of all age groups, those older than 80 stand out. The respondents’ general opinion is that the elderly over 80 years of age need less first aid knowledge. Furthermore, their first aid knowledge is also somewhat worse, especially when recognising sudden illness. Conclusions: Older than 80 are the most vulnerable psycho physically and socially, especially in natural and other disasters such as a pandemic. In the same time, their disaster preparedness from a first aid perspective is poor. There is a need to raise awareness and provide guidance on emergency preparedness to older people.

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