Extension to ‘combined SNA and LDA methods to understand adverse medical events’: Doctor and nurse perspectives

2020 ◽  
Vol 31 (4) ◽  
pp. 221-246
Author(s):  
Lin Zhu ◽  
Iris Reychav ◽  
Roger McHaney ◽  
Arik Broda ◽  
Yossi Tal ◽  
...  
Keyword(s):  
Adverse Events ◽  
Information Transfer ◽  
Latent Dirichlet Allocation ◽  
Well Being ◽  
Government Officials ◽  
Daily Lives ◽  
Significant Difference ◽  
Role Based ◽  
Adverse Medical Events ◽  
Events Data

BACKGROUND: Physicians and nurses are responsible for reporting medical adverse events. Each views these events through a different lens subject to their role-based perceptions and barriers. Physicians typically engage with diagnosis and treatment while nurses primarily care for patients’ daily lives and mental well-being. This results in reporting and describing medical adverse events differently. OBJECTIVE: We aimed to compare adverse medical event reports generated by physicians and nurses to better understand the differences and similarities in perspective as well as the nature of adverse medical events using social network analysis (SNA) and latent Dirichlet allocation (LDA). METHODS: The current study examined data from the Maccabi Healthcare Community. Approximately 17,868 records were collected from 2000 to 2017 regarding medical adverse events. Data analysis used SNA and LDA to perform descriptive text analytics and understand underlying phenomenon. RESULTS: A significant difference in harm levels reported by physicians and nurses was discovered. Shared topic keyword lists broken down by physicians and nurses were derived. Overall, communication, lack of attention, and information transfer issues were reported in medical adverse events data. Specialized keywords, more likely to be used by a physician were determined as: repeated prescriptions, diabetes complications, and x-ray examinations. For nurses, the most common special adverse event behavior keywords were vaccine problem, certificates of fitness, death and incapacity, and abnormal dosage. CONCLUSIONS: Communication and inattentiveness appeared most frequently in medical adverse events reports regardless of whether doctors or nurses did the reporting. Findings suggest feedback and information sharing processes could be implemented as a step toward alleviating many issues. Institutional management, healthcare managers and government officials should take actions to decrease medical adverse events, many of which may be preventable.

A Multicentre Open Comparison of Isosorbide-5-Mononitrate and Nifedipine Given Prophylactically to General Practice Patients with Chronic Stable Angina Pectoris

1989 ◽  
Vol 17 (2) ◽  
pp. 172-178 ◽  
Author(s):  
S. I. Ankier ◽  
L. Fay ◽  
S. J. Warrington ◽  
D. F. Woodings
Keyword(s):  
General Practice ◽  
Angina Pectoris ◽  
Adverse Events ◽  
Glyceryl Trinitrate ◽  
Stable Angina ◽  
Chronic Stable Angina ◽  
Well Being ◽  
Sublingual Administration ◽  
Stable Angina Pectoris ◽  
Significant Difference

A total of 126 patients from general practice with chronic stable angina pectoris entered the treatment phase of this open, randomized, crossover comparison of 20 mg isosorbide-5-mononitrate, and 20 mg nifedipine. Both treatments were given orally, three times daily, for 4 weeks and sublingual administration of glyceryl trinitrate was allowed throughout. Over the whole treatment period, there was no statistically significant difference between treatments for anginal attacks. However, significantly fewer glyceryl trinitrate tablets were required by patients receiving prophylaxis with nifedipine, although this difference was too small to be of clinical significance. No statistical difference existed between treatments in respect of scores for ‘overall intensity of pain’, ‘physical exercise ability’ and ‘general well-being’. Of those patients who expressed a preference, the majority preferred the second treatment with no statistically significant difference between isosorbide-5-mononitrate and nifedipine. Both treatments showed similar levels of adverse events, the major difference (not significant) being for flushing of the skin which occurred in five patients given nifedipine compared with one patient given isosorbide-5-mononitrate. It is concluded that, in clinical terms, the two treatments were similar. Headache and dizziness/giddiness were the most frequently recorded adverse events.

Measuring Impact of Stress in Sandwich Generation Caring for Demented Parents

GeroPsych ◽  
2014 ◽  
Vol 27 (4) ◽  
pp. 171-179 ◽  
Author(s):  
Laurence M. Solberg ◽  
Lauren B. Solberg ◽  
Emily N. Peterson
Keyword(s):  
Factor Analysis ◽  
Exploratory Factor Analysis ◽  
Social Worker ◽  
Resource Availability ◽  
Well Being ◽  
Sandwich Generation ◽  
Item Questionnaire ◽  
Significant Difference ◽  
Adult Caregivers ◽  
The Impact

Stress in caregivers may affect the healthcare recipients receive. We examined the impact of stress experienced by 45 adult caregivers of their elderly demented parents. The participants completed a 32-item questionnaire about the impact of experienced stress. The questionnaire also asked about interventions that might help to reduce the impact of stress. After exploratory factor analysis, we reduced the 32-item questionnaire to 13 items. Results indicated that caregivers experienced stress, anxiety, and sadness. Also, emotional, but not financial or professional, well-being was significantly impacted. There was no significant difference between the impact of caregiver stress on members from the sandwich generation and those from the nonsandwich generation. Meeting with a social worker for resource availability was identified most frequently as a potentially helpful intervention for coping with the impact of stress.

Finnish refugee children’s experiences of Swedish refugee camps during the Second World War

2015 ◽  
Vol 12 (1) ◽  
pp. 28-37
Author(s):  
Merja Paksuniemi
Keyword(s):  
Well Being ◽  
Second World War ◽  
Refugee Children ◽  
Refugee Camps ◽  
World War ◽  
Daily Routines ◽  
Decisive Importance ◽  
Significant Difference ◽  
Camp Life ◽  
Second World

This article seeks to demonstrate how Finnish refugee children experienced living in Swedish refugee camps during the Second World War (1939–1945). The study focuses on children’s opinions and experiences reflected through adulthood. The data were collected through retrospective interviews with six adults who experienced wartime as children in Finland and were evacuated to Sweden as refugees. Five of the interviewees were female and one of them was male. The study shows, it was of decisive importance to the refugee children’s well-being to have reliable adults around them during the evacuation and at the camps. The findings demonstrate that careful planning made a significant difference to the children´s adaptations to refugee camp life. The daily routines at the camp, such as regular meals, play time and camp school, reflected life at home and helped the children to continue their lives, even under challenging circumstances.

Efficacy and Safety of Non-Steroidal Anti-Androgens in Patients with Metastatic Prostate Cancer: Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 15 (1) ◽  
pp. 34-47 ◽  
Author(s):  
Muhammed Rashid ◽  
Madhan Ramesh ◽  
K. Shamshavali ◽  
Amit Dang ◽  
Himanshu Patel ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Adverse Events ◽  
Randomized Controlled Trials ◽  
Quality Assessment ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
Significant Difference

Background: Prostate cancer (PCa) is the sixth primary cause of cancer death. However, conflicts are present about the efficacy and safety of Non-steroidal anti-androgens (NSAA) for its treatment. The aim of this study was to assess the efficacy and safety of NSAAs versus any comparator for the treatment of advanced or metastatic PCa (mPCa). Methodology: MEDLINE and the Cochrane Library were searched. References of included studies and clinicaltrials.gov were also searched for relevant studies. Only English language studies after 1990 were considered for review. Randomized controlled trials (RCTs) examining the efficacy and safety of NSAAs as compared with any other comparator including surgery or chemotherapy in mPCa patients were included. The outcomes include efficacy, safety and the tolerability of the treatment. The Cochrane Risk of Bias Assessment Tool was used for quality assessment. Two authors were independently involved in the selection, extraction and quality assessment of included studies and disagreements were resolved by discussion or by consulting a third reviewer. Results: Fifty-eight out of 1307 non-duplicate RCTs with 29154 patients were considered for the review. NSAA showed significantly better progression-free survival [PFS] (Hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.46-0.78; P=0.0001), time to distant metastasis or death [TTD] (HR, 0.80; 95% CI 0.73-0.91; p<0.0001), objective response (Odds ratio [OR], 1.64; 95% CI 1.06-2.54; P=0.03) and clinical benefits (OR, 1.33; 95% CI 1.08-1.63; P=0.006) as compared to the control group. There was no significant difference observed between the groups in terms of overall survival (HR, 0.95; 95%CI, 0.87-1.03; P=0.18) and time to progression (HR, 0.93; 95% CI 0.77-1.11; P=0.43). Treatment-related adverse events were more with the NSAA group, but the discontinuation due to lack of efficacy reason was 43% significantly lesser than the control group in patients with mPCa. Rest of the outcomes were appeared to be non-significant. Conclusion: Treatment with NSAA was appeared to be better efficacious with respect to PFS, TTD, and response rate with considerable adverse events when compared to the control group in patients with metastatic PCa.

(Preprint)

2018 ◽  
Author(s):  
Natalia Banasik ◽  
Dariusz Jemielniak ◽  
Wojciech P?dzich
Keyword(s):  
Medical Condition ◽  
Extended Period ◽  
Well Being ◽  
Marginal Effect ◽  
Life Duration ◽  
Significant Difference ◽  
The Mean ◽  
Academic Teachers ◽  
Length Of Life ◽  
The Impact

BACKGROUND There have been mixed results of the studies checking whether prayers do actually extend the life duration of the people prayed for. Most studies on the topic included a small number of prayers and most of them focused on people already struggling with a medical condition. Intercessory prayer’s influence on health is of scholarly interest, yet it is unclear if its effect may be dependent on the number of prayers for a named individual received per annum. OBJECTIVE We sought to examine if there is a noticeable increased longevity effect of intercessory prayer for a named individual’s well-being, if he receives a very high number of prayers per annum for an extended period. METHODS We retrieved and conducted a statistical analysis of the data about the length of life for 857 Roman Catholic bishops, 500 Catholic priests, and 3038 male academics from the US, France, Italy, Poland, Brazil, and Mexico. We obtained information for these individuals who died between 1988 and 2018 from Wikidata, and conducted an observational cohort study. Bishops were chosen for the study, as they receive millions of individual prayers for well being, according to conservative estimates. RESULTS There was a main effect for occupation F(2, 4391) = 4.07, p = .017, ηp 2 = .002, with pairwise comparisons indicating significant differences between the mean life duration of bishops (M=30489) and of priests (M=29894), but none between the academic teachers (M=30147) and either of the other groups. A comparison analysis between bishops from the largest and the smallest dioceses showed no significant difference t(67.31)=1.61, p = .11. Our main outcome measure is covariance of the mean length of life in each of the categories: bishops, priests, academic teachers, controlled for nationality. CONCLUSIONS The first analysis proved that bishops live longer than priests, but due to a marginal effect size this result should be treated with caution. No difference was found between the mean length of life of bishops from the largest and the smallest dioceses. We found no difference between bishops and male academics. These results show that the impact of intercessory prayers on longevity is not observable.

scholarly journals Using the Life Story Book With Mentally Alert Residents of Nursing Homes

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 487-487
Author(s):  
Theresa Chrisman
Keyword(s):  
Depressive Symptoms ◽  
Nursing Homes ◽  
Meaning In Life ◽  
Life Story ◽  
Well Being ◽  
Post Intervention ◽  
Significant Difference ◽  
Wilks Lambda ◽  
Potential Benefits ◽  
Hispanic White

Abstract Depression and lack of meaning in life (MIL) are common among residents of nursing homes (NHs) and contribute to a reduction in overall health and well-being. Life Story Book (LSB), a reminiscence intervention, is designed to provide a person with the opportunity to review their past and capture their life stories and photographs into a book. LSB has demonstrated positive outcomes for residents of NHs with dementia, yet little is known for residents without dementia. A switching replication design was used to examine the effects of LSB among 21 mentally alert residents from two NHs (NH-A and NH-B) in Houston, Texas. Participants in NH-A received three weeks of the LSB intervention, while NH-B received three weeks of care-as-usual; the intervention was then switched. The GDS-12R and the MIL questionnaire (MLQ) were used to measure depressive symptoms and MIL respectively. Participants from NH-A (n =11) and NH-B (n = 10) had a mean age of 75 years (SD =11.34); 81% female; 52% non-Hispanic white and 33% African American. Results from a one-way MANCOVA found no statistically significant difference on the GDS-12R and MLQ (F(3, 14) = 2.50, p = .102; Wilks’ Lambda = .652; η2 = .35). Further analyses comparing the pre-intervention and post-intervention scores for the entire sample (N =21) found a significant reduction in depressive symptoms (M = 2.67; SD = 2.52) and (M =1.67, SD = 2.29); (t (20) = 2.21, p = 0.039). The potential benefits of LSB for mentally alert residents of NHs warrants further research.

scholarly journals Gender-wise Comparative Assessment of Lifestyle Patterns and Well-being Status among Healthcare Employees at a Tertiary Care Hospital

2021 ◽  
Author(s):  
Vanajakshamma Velam ◽  
Vyshnavi Kancherla ◽  
Latheef Kasala ◽  
Anusha Kancherla ◽  
Mounica Reddy Pillaram
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Well Being ◽  
Care Hospital ◽  
Cross Sectional ◽  
Significant Difference ◽  
Female Employees ◽  
The Mean ◽  
Lifestyle Patterns ◽  
Comprehensive Study

Abstract Background This study was an attempt to assess and compare the gender-wise lifestyle patterns and well-being status among the employees of a tertiary care teaching hospital. Material and Methods This is a cross-sectional, questionnaire-based study conducted at a tertiary care hospital between May and August 2019. A total of 777 employees belonging to both genders (male and female) and working at different professional levels were assessed. All the enrolled employees were subjected to a comprehensive study tool consisting of various dimensions of their health, which included physical, mental, social, spiritual and intellectual health dimensions. Results Among the participants, 327 (42.1%) were male and 450 (57.9%) were female. There was no significant difference in the mean age of male (37.91 ± 7.52) and female (36.85 ± 8.16) employees (p = 0.07). A significantly higher proportion of diabetes and hypertension were seen in male employees (9.8% and 14.4%, respectively) than in female (5.6% and 6.2% respectively). The overall well-being was better in male employees than in females and was statistically significant (p < 0.0001). We found that male employees had statistically significant better well-being in terms of physical, mental and social health whereas female employees had intellectual health. Conclusion The overall well-being in healthcare staff was good at our tertiary care hospital, and the outstanding/good well-being rate was higher in male employees than in female employees. Female employees experienced risks with regard to their physical health.

scholarly journals Self-reported morbidities, nutritional characteristics, and associated factors in institutionalized and non-institutionalized older adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abdelhafid Benksim ◽  
Rachid Ait Addi ◽  
Elhassania Khalloufi ◽  
Aziz Habibi ◽  
Mohamed Cherkaoui
Keyword(s):  
Older Adults ◽  
Health Insurance ◽  
Nutritional Status ◽  
Statistical Significance ◽  
Well Being ◽  
Public Institution ◽  
Subjective Well Being ◽  
Number Of Children ◽  
Significant Difference ◽  
Nutritional Characteristics

Abstract Background As the world’s population ages and people live longer, it seems important to ensure that older people have a good quality of life and positive subjective well-being. The objective of this study is to determine socio-economic, health and nutritional characteristics of institutionalized and non-institutionalized elders in the province of Marrakech. Methods This study was conducted among 368 older adults in the province of Marrakech between March 2017 and June 2019. Of all participants, 180 older adults reside in a public institution and 188 of them live in their own homes. Data on health conditions, nutritional status, functional and socio-economic characteristics were collected. Data was analyzed using SPSS Statistics for Windows, Version 16.0. Statistical significance was set at p < 0.05. Results Institutionalized elders were illiterate (80.0%), had low incomes (95.5%), and unmarried (73.3%), they reported also no children (56.1%) and no health insurance (98.9%). Institutional residents suffered from malnutrition (22.2%), hearing impairments (35.6%) and severe edentulism (43.3%). There was no significant difference between both groups on daily activities and depression. A multivariate analysis identified a model with three significant variables associated with non-institutionalized elders: health insurance (P = 0.001; OR = 107.49), number of children (P = 0.001; OR = 1.74) and nutritional status (p = 0.001; OR = 3.853). Conclusions This study shows that the institutionalization of older adults is considerably induced by various factors such as nutritional problems, lack of health insurance and family structure. To mitigate the effects of this phenomenon, home care strategies and preventive actions should be implemented to delay the institutionalization of older adults and therefore keep them socially active in their own homes.

How Czecho-Slovakia Bounces Back: Population-Based Validation of the Brief Resilience Scale in Two Central European Countries

2021 ◽  
pp. 003329412110296
Author(s):  
Jana Furstova ◽  
Natalia Kascakova ◽  
Iva Polackova Solcova ◽  
Jozef Hasto ◽  
Peter Tavel
Keyword(s):  
Convergent Validity ◽  
Factor Model ◽  
Age Groups ◽  
Reliability And Validity ◽  
Well Being ◽  
Population Based ◽  
Resilience Scale ◽  
Significant Difference ◽  
Mental Well Being ◽  
Best Fit

Objective In recent years, resilience has become a focus of research in the medical and behavioral sciences. The Brief Resilience Scale (BRS) was developed to assess the individual ability to recover from stress (“to bounce back”) after experiencing adversities. The aim of the study was to validate the Czech and Slovak versions of the BRS. Methods A representative sample of the Czech and Slovak populations (NCZ = 1800, mean age MCZ = 46.6, SDCZ = 17.4, 48.7% of men; NSK = 1018, mean age MSK = 46.2, SDSK = 16.6, 48.7% men) completed a survey assessing their health and well-being. Several confirmatory factor analysis (CFA) models of the BRS were compared to find the best fit. Cronbach’s alpha and McDonald’s omega coefficients of reliability were evaluated. Convergent validity was assessed by correlating resilience (BRS), physical and mental well-being (SF-8) and psychopathology symptoms (BSI-53). Differences in gender and age groups were appraised. Results A single-factor model with method effects on the reverse items was evaluated to best fit the data in both the Czech and Slovak samples (χ2CZ(6) = 39.0, p < 0.001, CFICZ = 0.998, TLICZ = 0.995, RMSEACZ = 0.055, SRMRCZ = 0.024; χ2SK(6) = 23.9, p < 0.001, CFISK = 0.998, TLISK = 0.995, RMSEASK = 0.054, SRMRSK = 0.009). The reliability was high in both samples (αCZ = 0.80, ωCZ = 0.85; αSK = 0.86, ωSK = 0.91). The BRS was positively associated with physical and mental well-being and negatively associated with somatization, depression and anxiety. In both countries, a lower BRS score was associated with higher age. Czech men reported significantly higher BRS scores than women. No significant difference was found in the mean BRS scores between the two countries. Conclusion This study provides evidence of good psychometric properties, reliability and validity of the Czech and Slovak adaptations of the BRS.

Current measures of distress may not account for what's most important in existential care interventions: Results of the outlook trial

2020 ◽  
Vol 18 (6) ◽  
pp. 648-657
Author(s):  
Karen E. Steinhauser ◽  
Karen M. Stechuchak ◽  
Katherine Ramos ◽  
Joseph Winger ◽  
James A. Tulsky ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Early Stage ◽  
Well Being ◽  
Primary Analysis ◽  
Significant Difference ◽  
Spiritual Well Being ◽  
Screening For Distress ◽  
Secondary Outcomes ◽  
Stage Renal Disease

AbstractObjectiveCompare the efficacy of two interventions addressing emotional and existential well-being in early life-limiting illness.MethodPrimary trial analysis (n = 135) included patients with advanced cancer, congestive heart failure, or end-stage renal disease; Arm 1 received the Outlook intervention, addressing issues of life completion and preparation, and Arm 2 received relaxation meditation (RM). Primary outcomes at five weeks (primary endpoint) and seven weeks (secondary): completion and preparation (QUAL-E); secondary outcomes: anxiety (POMS) quality of life (FACT-G) and spiritual well-being (FACIT-Sp) subscales of faith, meaning, and peace.ResultsAverage age was 62; 56% were post-high school-educated, 54% were married, 52% white, 44% female, and 70% had a cancer diagnosis. At baseline, participants demonstrated low levels of anxiety (<5 on POMS subscale) and depression (<10 on CESD) relative to population norms. Results of the primary analysis revealed no significant differences in mean Preparation by treatment arm at five weeks (14.4 Outlook vs. 14.8 RM; between-group difference −0.4 [95% CI, −1.6, 0.8], p = 0.49) or seven weeks (15.2 vs.15.4; between-group difference −0.2 [95% CI, −1.5, 1.0], p = 0.73). There were also no significant differences in mean Life Completion by treatment arm between five weeks (26.6 Outlook vs. 26.3 RM; between-group difference 0.2 [95% CI, −1.2, 1.7], p = 0.76) or seven weeks (26.5 vs. 27.5; between-group difference −1.0 [95% CI, −2.7, 0.7], p = 0.23). Compared to RM, Outlook participants did not have significant differences over time in the secondary outcomes of overall quality of life, anxiety, depression, FACT-G subscales, and FACIT-Sp subscales.DiscussionIn early-stage life-limiting illness, Outlook did not demonstrate a significant difference in primary or secondary outcomes relative to RM. Results underscore the importance of pre-screening for distress. Qualitatively, Outlook participants were able to express suppressed emotions, place illness context, reflect on adaptations, and strengthen identity. Screening for distress and identifying specified measures of distress, beyond anxiety and depression, is essential in our ability to adequately assess the multi-dimensional mechanisms that decrease existential suffering.

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