scholarly journals How does Multimorbidity affect Middle-Aged Adults? A Cross-Sectional Survey in the Singapore Primary Healthcare Setting.

2020 ◽  
Author(s):  
Sai Zhen - Sim ◽  
Hui Li Koh ◽  
Sabrina Poay Sian Lee ◽  
Doris Yee Ling Young ◽  
Eng Sing Lee
Keyword(s):  
Primary Care ◽  
Chronic Conditions ◽  
Healthcare Setting ◽  
The Elderly ◽  
Sociodemographic Factors ◽  
Health State ◽  
Middle Aged ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Impact

Abstract Background: Multimorbidity is of increasing prevalence and importance. It has been negatively associated with health-related quality of life (HrQoL) especially in the elderly population. Despite substantial multimorbidity for the middle-aged population, defined as those between 40-64 years old, there is a paucity of research investigating the impact of multimorbidity in this population. This study aimed to investigate the association between multimorbidity and HrQoL in the middle-aged primary care population in Singapore.Methods: A cross-sectional study was conducted at a primary care centre in Singapore. Interviewer-administered questionnaires were used to collect data regarding the participants’ sociodemographic characteristics, chronic conditions, and HrQoL, as measured by the EuroQol five dimensions 3-levels questionnaire (EQ5D). We defined multimorbidity as the presence of three or more conditions, out of a list of 14 chronic conditions. The associations between multimorbidity and the components of the EQ5D were assessed using multivariable regression analyses.Results: The study included 297 participants, aged 40-64 years, of which 124 (41.7%) had multimorbidity. After adjusting for sociodemographic factors, participants with multimorbidity had significantly lower EQ5D UI, (β-coefficient -0.064 (C.I -0.125, -0.003), p = 0.04), but not significantly lower EQ5D VAS, (β-coefficient -0.045 (C.I 0.102, 0.012), p = 0.12). Additionally, participants with multimorbidity had higher odds (OR = 2.41, p = 0.01) of reporting problems due to pain/discomfort.Conclusion: Multimorbidity was not significantly associated with the overall health state, as measured by the EQ5D VAS, in middle-aged primary care patients. However, it was associated with the EQ5D UI which is a composite measure of five specific domains of HrQoL. Specifically, there was a statistically significant association between multimorbidity and the pain domain. Further studies are required to understand the relationship between multimorbidity and pain to enable physicians to better manage pain and HrQoL in this population.

scholarly journals How does Multimorbidity affect Middle-Aged Adults? A Cross-Sectional Survey in the Singapore Primary Healthcare Setting.

2020 ◽  
Author(s):  
Sai Zhen - Sim ◽  
Hui Li Koh ◽  
Sabrina Poay Sian Lee ◽  
Doris Yee Ling Young ◽  
Eng Sing Lee
Keyword(s):  
Primary Care ◽  
Chronic Conditions ◽  
Healthcare Setting ◽  
The Elderly ◽  
Sociodemographic Factors ◽  
Health State ◽  
Middle Aged ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Impact

Abstract Background Multimorbidity is of increasing prevalence and importance. It has been negatively associated with health-related quality of life (HrQoL) especially in the elderly population. Despite substantial multimorbidity for the middle-aged population, defined as those between 40-64 years old, there is a paucity of research investigating the impact of multimorbidity in this population. This study aimed to investigate the association between multimorbidity and HrQoL in the middle-aged primary care population in Singapore. Methods A cross-sectional study was conducted at a primary care centre in Singapore. Interviewer-administered questionnaires were used to collect data regarding the participants’ sociodemographic characteristics, chronic conditions, and HrQoL, as measured by the EuroQol five dimensions 3-levels questionnaire (EQ5D). We defined multimorbidity as the presence of three or more conditions, out of a list of 14 chronic conditions. The associations between multimorbidity and the components of the EQ5D were assessed using multivariable regression analyses. Results The study included 297 participants, aged 40-64 years, of which 124 (41.7%) had multimorbidity. After adjusting for sociodemographic factors, participants with multimorbidity had significantly lower EQ5D UI, (β-coefficient -0.064 (C.I -0.125, -0.003), p = 0.04), but not significantly lower EQ5D VAS, (β-coefficient -0.045 (C.I 0.102, 0.012), p = 0.12). Additionally, participants with multimorbidity had higher odds (OR = 2.41, p = 0.01) of reporting problems due to pain/discomfort. Conclusion Multimorbidity was not significantly associated with the overall health state, as measured by the EQ5D VAS, in middle-aged primary care patients. However, it was associated with the EQ5D UI which is a composite measure of five specific domains of HrQoL. Specifically, there was a statistically significant association between multimorbidity and the pain domain. Further studies are required to understand the relationship between multimorbidity and pain to enable physicians to better manage pain and HrQoL in this population

scholarly journals How does multimorbidity affect middle-aged adults? A cross-sectional survey in the Singapore primary healthcare setting

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Sai Zhen Sim ◽  
Hui Li Koh ◽  
Sabrina Poay Sian Lee ◽  
Doris Yee Ling Young ◽  
Eng Sing Lee
Keyword(s):  
Primary Care ◽  
Chronic Conditions ◽  
Healthcare Setting ◽  
The Elderly ◽  
Sociodemographic Factors ◽  
Health State ◽  
Middle Aged ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Impact

Abstract Background Multimorbidity is of increasing prevalence and importance. It has been associated with poorer health-related quality of life (HrQoL) especially in the elderly population. Despite substantial multimorbidity in the middle-aged population, defined as those aged between 40-64 years old, there is a paucity of research investigating the impact of multimorbidity in this population. This study aimed to investigate the association between multimorbidity and HrQoL in the middle-aged primary care population in Singapore. Methods A cross-sectional study was conducted at a primary care centre in Singapore. Interviewer-administered questionnaires were used to collect data regarding the participants’ sociodemographic characteristics, chronic conditions, and HrQoL, as measured by the EuroQol five dimensions 3-levels questionnaire (EQ5D). We defined multimorbidity as the presence of three or more conditions, out of a list of 14 chronic conditions. The associations between multimorbidity and the components of the EQ5D were assessed using multivariable regression analyses. Results The study included 297 participants, aged 40–64 years, of which 124 (41.7%) had multimorbidity. After adjusting for sociodemographic factors, participants with multimorbidity had significantly lower EQ5D UI, (β-coefficient − 0.064 (C.I -0.125, − 0.003), p = 0.04), but not significantly lower EQ5D VAS, (β-coefficient − 0.045 (C.I 0.102, 0.012), p = 0.12). Additionally, participants with multimorbidity had higher odds (OR = 2.41, p = 0.01) of reporting problems due to pain/discomfort. Conclusion Multimorbidity was not significantly associated with the overall health state, as measured by the EQ5D VAS, in middle-aged primary care patients. However, it was associated with the EQ5D UI which is a composite measure of five specific domains of HrQoL. Specifically, there was a statistically significant association between multimorbidity and the pain domain. Further studies are required to understand the relationship between multimorbidity and pain to enable physicians to better manage pain and HrQoL in this population.

scholarly journals How does Multimorbidity affect Middle-Aged Adults? A Cross-Sectional Survey in the Singapore Primary Healthcare Setting.

2020 ◽  
Author(s):  
Sai Zhen - Sim ◽  
Hui Li Koh ◽  
Sabrina Poay Sian Lee ◽  
Doris Yee Ling Young ◽  
Eng Sing Lee
Keyword(s):  
Primary Care ◽  
Healthcare Setting ◽  
The Elderly ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Health State ◽  
Middle Aged ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Impact

Abstract Background Multimorbidity is of increasing prevalence and importance. It has been associated with poorer health-related quality of life (HrQoL) especially in the elderly population. Despite substantial multimorbidity at midlife, defined as those between 40-64 years old, there is a paucity of research investigating the impact of multimorbidity in this population. This study aimed to investigate the association between multimorbidity and HrQoL in the middle-aged primary care population in Singapore. Methods A cross-sectional study involving 40-64 year old participants was conducted at a primary care centre in Singapore. Interviewer-administered questionnaires were used to collect data regarding the participants’ sociodemographic characteristics, chronic conditions, and HrQoL, as measured by the EuroQol 5 dimensions 3-levels questionnaire (EQ5D-3L). The associations between multimorbidity and the components of the EQ5D were assessed using multivariable regression analyses. Results The study included 297 participants, aged 40-64 years, of which 124 (42.7%) had multimorbidity. Participants with multimorbidity had lower mean EQ5D Utilities Index (UI) and mean Visual Analogue Scale (VAS) scores (UI = 0.804 ±0.251, VAS = 64.9 ±16.8) compared to those without multimorbidity (UI = 0.871 ±0.198, VAS = 68.5 ±16.0). After adjusting for sociodemographic factors, those with multimorbidity had significantly lower EQ5D UI, (β-coefficient = -0.064 (C.I -0.125, -0.003), p = 0.04), but not significantly lower EQ5D VAS, (β-coefficient = -0.045 (C.I 0.102, 0.012), p = 0.12). Additionally, participants with multimorbidity had higher odds (OR = 2.41, p = 0.01) of reporting problems due to pain/discomfort. Conclusion Multimorbidity was not significantly associated with the overall health state, as measured by the EQ5D VAS, in middle-aged primary care patients. However, it was associated with the EQ5D UI which is a composite measure of five specific domains of HrQoL. Specifically, there was a significant association between multimorbidity and the pain domain. Further studies are required to understand the relationship between multimorbidity and pain to enable physicians to better manage pain and HrQoL in this population.

scholarly journals Impact of postgraduate study on healthcare professionals' academic and clinical practice

2020 ◽  
Vol 26 (7) ◽  
pp. 171-178
Author(s):  
Samantha Holloway ◽  
Ann Taylor ◽  
Michal Tombs
Keyword(s):  
Clinical Practice ◽  
Personal Growth ◽  
Healthcare Professionals ◽  
Healthcare Setting ◽  
Subject Area ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Postgraduate Study ◽  
The Impact

Aims/Background Existing literature in the healthcare setting indicates that individuals enter higher education, particularly postgraduate programmes, to gain in-depth knowledge of a subject area, with a view to improving their career opportunities. Evidence also suggests that, in addition to perceived career enhancement, individuals also report benefits such as personal growth and broadening of perspectives, which have helped their clinical practice. The aim of this study was to examine the impact of postgraduate study on healthcare professionals' academic practice and discuss the potential links to improvements in clinical practice. Method This was a descriptive cross-sectional survey of a convenience sample of graduates from a range of postgraduate healthcare programmes at one UK university. A survey comprising 18 questions was designed to explore perceptions of impact and was distributed to 962 graduates with a response rate of 9.81% (n=98). Results The majority of respondents were doctors (n=54, 55.1%), women (n=59, 60.2%), based within the UK (n=36, 36.7%) and had completed their programme between 2014 and 2016 (n=72, 73.4%). With regards to achievements in professional practice, participants felt more confident in relation to research and evaluating evidence. In relation to impact on clinical practice, improvements in multidisciplinary team working as well as increased confidence emerged as main themes. Conclusions Findings support existing evidence in relation to the importance of postgraduate study, which is able to instil an increased sense of confidence in graduates' ability. This was particularly related to having a better understanding of speciality-related evidence and its application in clinical practice. This is something that previous studies do not seem to have reported and may reflect the multiprofessional nature of many of the postgraduate programmes provided.

scholarly journals The Subjective Wellbeing of Healthcare Staff and their Patients

2020 ◽  
Author(s):  
Ivo Vlaev ◽  
Henry A Lee ◽  
Paul Dolan ◽  
Ara Darzi
Keyword(s):  
Health Policy ◽  
Subjective Wellbeing ◽  
Empirical Work ◽  
Healthcare Setting ◽  
Data Sets ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
New Perspective ◽  
The Impact ◽  
The Way

Abstract Subjective wellbeing (SWB) is a broad category of phenomena that includes people’s emotional responses, domain satisfactions (e.g., health or work), and global judgements of life satisfaction. Measures of SWB offer a means to gauge the impact of events in the lives of individuals. This article examines for the first time the ways in which measures of SWB can be used within a healthcare setting, which brings a new perspective to the way that SWB is considered and applied in determining health policy. The research uses methods for SWB data collection developed through innovative empirical work. The study is a cross sectional survey of the adult inpatient population of an NHS hospital and the nurses caring for the patients, which was undertaken at two time points: summer and winter. This work on the SWB of the staff and inpatients of an acute NHS hospital generated new data sets in clinical populations. The SWB of patients was shown to be significantly affected by severe levels of EQ5D states. When considering the data on a ward-by-ward basis, it was shown that nurses health and job satisfaction were important determinants of patient SWB. We discuss the implications of this research and explain how, when and where SWB measures, when used in healthcare, can be used in health policy. We offer a novel perspective that ensures a greater focus is placed on the way that patients experience health interventions when developing health policy.

scholarly journals Perceived Value of Electronic Medical Records in Community Health Services: A National Cross-Sectional Survey of Primary Care Workers in Mainland China

2020 ◽  
Vol 17 (22) ◽  
pp. 8510
Author(s):  
Zining Xia ◽  
WenJuan Gao ◽  
Xuejuan Wei ◽  
Yingchun Peng ◽  
Hongjun Ran ◽  
...  
Keyword(s):  
Primary Care ◽  
Community Health ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Chronic Conditions ◽  
Mainland China ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Community Health Centres ◽  
Care Workers

Objective: To evaluate the degree to which electronic medical records (EMRs) were used in primary care and the value of EMRs as perceived by primary care workers in China. Methods: A cross-sectional survey was conducted on 2719 physicians (n = 2213) and nurses (n = 506) selected from 462 community health centres across all regions of mainland China except for Tibet. Regional differences in the responses regarding the functionality of existing EMR systems and the perceived value of EMRs were examined using Chi-square tests and ordinal regression analyses. Results: Less than 59% of the community health centres had adopted EMRs. More than 89% of the respondents believed that it was necessary to adopt EMRs in primary care. Of the existing EMR systems, 50% had access to telehealth support for laboratory, imaging or patient consultation services. Only 38.4% captured data that met all task needs and 35.4% supported referral arrangements. “Management of chronic conditions” was voted (66%) as the top preferred feature of EMRs. Higher levels of recognition of the value of EMRs were found in the relatively more developed eastern region compared with their counterparts in other regions. Conclusions: Rapid EMR adoption in primary care is evident in mainland China. The low level of functionality in data acquisition and referral arrangements runs counter to the requirements for “management of chronic conditions”, the most preferred feature of EMRs in primary care. Regional disparities in the realised value of EMRs in primary care deserve policy attention.

scholarly journals The subjective wellbeing of healthcare staff and their patients

2020 ◽  
Author(s):  
Henry Lee ◽  
Paul Dolan ◽  
Ara Darzi ◽  
Ivo Vlaev
Keyword(s):  
Health Policy ◽  
Subjective Wellbeing ◽  
Empirical Work ◽  
Healthcare Setting ◽  
Data Sets ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
New Perspective ◽  
The Impact ◽  
The Way

Abstract Subjective wellbeing (SWB) is a broad category of phenomena that includes people’s emotional responses, domain satisfactions (e.g., health or work), and global judgements of life satisfaction. Measures of SWB offer a means to gauge the impact of events in the lives of individuals. This article examines for the first time the ways in which measures of SWB can be used within a healthcare setting, which brings a new perspective to the way that SWB is considered and applied in determining health policy. The research uses methods for SWB data collection developed through innovative empirical work. The study is a cross sectional survey of the adult inpatient population of an NHS hospital and the nurses caring for the patients, which was undertaken at two time points: summer and winter. This work on the SWB of the staff and inpatients of an acute NHS hospital generated new data sets in clinical populations. The SWB of patients was shown to be significantly affected by severe levels of EQ5D states. When considering the data on a ward-by-ward basis, it was shown that nurses health and job satisfaction were important determinants of patient SWB. We discuss the implications of this research and explain how, when and where SWB measures, when used in healthcare, can be used in health policy. We offer a novel perspective that ensures a greater focus is placed on the way that patients experience health interventions when developing health policy.

scholarly journals The impact of personalized clinical decision support on primary care patients’ views of cancer prevention and screening: a cross-sectional survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel M. Saman ◽  
Ella A. Chrenka ◽  
Melissa L. Harry ◽  
Clayton I. Allen ◽  
Laura A. Freitag ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Support ◽  
Cancer Screening ◽  
Cancer Prevention ◽  
Weight Management ◽  
Clinical Decision Support ◽  
Clinical Decision ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Impact

Abstract Background Few studies have assessed the impact of clinical decision support (CDS), with or without shared decision-making tools (SDMTs), on patients’ perceptions of cancer screening or prevention in primary care settings. This cross-sectional survey was conducted to understand primary care patient’s perceptions on cancer screening or prevention. Methods We mailed surveys (10/2018–1/2019) to 749 patients aged 18 to 75 years within 15 days after an index clinical encounter at 36 primary care clinics participating in a clinic-randomized control trial of a CDS system for cancer prevention. All patients were overdue for cancer screening or human papillomavirus vaccination. The survey compared respondents’ answers by study arm: usual care; CDS; or CDS + SDMT. Results Of 387 respondents (52% response rate), 73% reported having enough time to discuss cancer prevention options with their primary care provider (PCP), 64% reported their PCP explained the benefits of the cancer screening choice very well, and 32% of obese patients reported discussing weight management, with two-thirds reporting selecting a weight management intervention. Usual care respondents were significantly more likely to decide on colorectal cancer screening than CDS respondents (p < 0.01), and on tobacco cessation than CDS + SDMT respondents (p = 0.02) and both CDS and CDS + SDMT respondents (p < 0.001). Conclusions Most patients reported discussing cancer prevention needs with PCPs, with few significant differences between the three study arms in patient-reported cancer prevention care. Upcoming research will assess differences in screening and vaccination rates between study arms during the post-intervention follow-up period. Trial registration clinicaltrials.gov, NCT02986230, December 6, 2016.

scholarly journals A Research on Functional Status, Environmental Conditions, and Risk of Falls in Dementia

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Sima Ataollahi Eshkoor ◽  
Tengku Aizan Hamid ◽  
Siti Sa’adiah Hassan Nudin ◽  
Chan Yoke Mun
Keyword(s):  
Physical Activity ◽  
Functional Status ◽  
Environmental Quality ◽  
Environmental Conditions ◽  
Functional Decline ◽  
The Elderly ◽  
Sociodemographic Factors ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Risk Of Falls

This study aimed to determine the effects of disability, physical activity, and functional status as well as environmental conditions on the risk of falls among the elderly with dementia after adjusting for sociodemographic factors. Data were derived from a group including 1210 Malaysian elderly who were demented and noninstitutionalized. The study was a national cross-sectional survey that was entitled “Determinants of Health Status among Older Malaysians.” Approximately 17% of subjects experienced falls. The results showed that ethnic non-Malay(OR=1.73)and functional decline(OR=1.67)significantly increased the risk of falls in samples (P<0.05). The findings indicated that increased environmental quality(OR=0.64)significantly decreased the risk of falls (P<0.05). Disability, age, marital status, educational level, sex differences, and physical activity were found irrelevant to the likelihood of falls in subjects (P>0.05). It was concluded that functional decline and ethnic non-Malay increased the risk of falls but the increased environmental quality reduced falls.

scholarly journals Period prevalence, risk factors and consequent injuries of falling among the Saudi elderly living in Riyadh, Saudi Arabia: a cross-sectional study

BMJ Open ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. e019063 ◽  
Author(s):  
Faisal Yousef Almegbel ◽  
Ibrahim Muthyib Alotaibi ◽  
Faisal Ahmed Alhusain ◽  
Emad M Masuadi ◽  
Salma Lafyan Al Sulami ◽  
...  
Keyword(s):  
Risk Factors ◽  
Saudi Arabia ◽  
Public Health Problem ◽  
The Elderly ◽  
Major Public Health Problem ◽  
Old People ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Period Prevalence ◽  
The Impact

ObjectivesApproximately 28% to 35% of people aged 65 and over fall each year. The consequent injuries of falls are considered a major public health problem. Falls account for more than half of injury-related hospitalisations among old people. The aim of this study was to measure a 1-year period prevalence of falling among old people in Riyadh, Saudi Arabia. In addition, this study described the most common risk factors and consequent injuries of falls.Setting and participantsA cross-sectional survey was carried out in Riyadh, using a convenient sampling. The targeted population were Saudi citizens who were 60 years or above. Over a 6-month period, 1182 individuals were sampled (545 men and 637 women).ResultsThe 1-year prevalence of falling among old Saudis (>=60 years) was 49.9%. Our results show that 74% of the participants who experienced falls had postfall injuries. Old participants who were uneducated and those with middle school certification were associated with falls (adjusted OR (aOR) 1.72; 95% CI 1.15 to 2.56, aOR 1.81; 95% CI 1.15 to 2.85, respectively). Those who live in rented houses had a higher risk of falls. Interestingly, having a caregiver was significantly associated with more falls (aOR 1.39; 95% CI 1.08 to 1.79). However, not using any medications was significantly related to fewer falls. In addition, old individuals using walking aids were more likely to fall than those who did not. Participants who mentioned ‘not having stressors were associated with less frequent falls (aOR 0.62; 95% CI 0.39 to 0.97). Cerebrovascular accidents were strongly associated with falls with an estimated OR of 2.75 (95% CI 1.18 to 6.43). Moreover, osteoporosis, poor vision and back pain were found to be predictors for falls among the elderly.Conclusion49.9% of elderly Saudis had experienced one or more falls during a 12-month period. Several preventable risk factors could be addressed by routine geriatric assessment. Research on the impact of these risk factors is needed.

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