scholarly journals Is It Feasible to Conduct Post-Tuberculosis Assessments at the End of Tuberculosis Treatment under Routine Programmatic Conditions in China?

2021 ◽  
Vol 6 (3) ◽  
pp. 164
Author(s):  
Yan Lin ◽  
Yuqin Liu ◽  
Guanghui Zhang ◽  
Qinghe Cai ◽  
Weihua Hu ◽  
...  
Keyword(s):  
Health Workers ◽  
Tuberculosis Treatment ◽  
Significant Morbidity ◽  
Abnormal Chest ◽  
End Of Treatment ◽  
National Tuberculosis ◽  
Patients With Diabetes ◽  
Chest X Ray ◽  
Previously Treated

There is growing evidence that a substantial proportion of people who complete anti-tuberculosis treatment experience significant morbidity and mortality which can negatively affect their quality of life. It is suggested that national tuberculosis programs conduct end-of-treatment assessments, but whether this is feasible is currently not known. We therefore assessed whether tuberculosis program staff could assess functional and general health status of patients at the end of treatment in five TB clinics in four provinces in China. There were 115 patients, aged 14–82 years, who completed anti-tuberculosis treatment and a post-TB assessment. There were 54 (47%) patients who continued to have symptoms, the commonest being cough, dyspnea and fatigue. Symptom continuation was significantly more common in the 22 patients with diabetes (p = 0.027) and the 12 patients previously treated for TB (p = 0.008). There were 12 (10%) current smokers, an abnormal chest X-ray was found in 106 (92%) patients and distance walked in the 6-min walking test (6MWT) ranged from 30–750 m (mean 452 ± 120); 24 (21%) patients walked less than 400 m. Time taken to perform the post-TB assessment, including the 6MWT, ranged from 8–45 min (mean 21 ± 8 min). In 98% of the completed questionnaires, health workers stated that conducting post-TB assessments was feasible and useful. This study shows that post-TB assessments can be conducted under routine programmatic conditions and that there is significant morbidity that needs to be addressed.

Monitoring Shifts in Social Relations Among Chronically Ill Mexican Americans as a Culturally Sensitive Indicator of Depression

2013 ◽  
Vol 35 (3) ◽  
pp. 33-37 ◽  
Author(s):  
Kerstin Reinschmidt ◽  
Jenny Chong ◽  
Mark Nichter
Keyword(s):  
Social Relations ◽  
Mexican Americans ◽  
Mexican American ◽  
Health Workers ◽  
Chronically Ill ◽  
Female Community ◽  
Patients With Diabetes ◽  
Primary Care Patients ◽  
Chronically Ill Patients

Chronically ill patients commonly suffer from comorbid depression that negatively influences disease trajectories, reduces patients' quality of life, and renders them less able to cope with the challenges of daily living. Among Hispanic primary care patients, depression is often not detected until severe. According to promotoras (de salud), who are female community health workers working with Mexican American patients with diabetes in Southern Arizona, depression is commonly undiagnosed in their communities.

scholarly journals KAJIAN LITERATUR: PERANAN TEKNOLOGI INFORMASI KESEHATAN PADA PERAWATAN DIABETES MELLITUS [LITERATURE REVIEW: THE ROLE OF HEALTH INFORMATION TECHNOLOGY IN THE CARE OF DIABETES MELLITUS]

2020 ◽  
Vol 8 (1) ◽  
pp. 47
Author(s):  
Pina Pudiyanti ◽  
Tuti Afriani
Keyword(s):  
Diabetes Mellitus ◽  
Information Technology ◽  
Literature Review ◽  
Health Information Technology ◽  
Health Information ◽  
Health Workers ◽  
Research Articles ◽  
Prisma Statement ◽  
Patients With Diabetes

<p><em>People with diabetes mellitus must take responsibility for their own care to improve their quality of life. People with diabetes mellitus often need a set of services and support ranging from glucose monitoring, insulin and other treatment management, psychotherapy and social support, physical activity, nutritional counseling and others. Diabetes mellitus patients can play a more active role in treating their diabetes with health information technology. This literature review uses the PRISMA statement as a guide to search for research articles from two databases, Ebsco and Scopus. The results of the analysis of nine selected research articles indicate that information technology provides patient education and support for patients with diabetes mellitus. Information technology has been used to improve the quality of care for patients with diabetes mellitus, enable health workers to more effectively manage patients and to help patients manage their own illnesses so that research and related publications are needed to improve the care of patients with diabetes mellitus at home.</em></p><p><strong>BAHASA INDONESIA ABSTRAK: </strong>Penderita diabetes mellitus harus bertanggung jawab atas perawatan mereka sendiri untuk meningkatkan kualitas hidupnya. Penderita diabetes mellitus seringkali membutuhkan seperangkat layanan dan dukungan mulai dari pemantauan glukosa, insulin dan manajemen pengobatan lainnya, psikoterapi dan dukungan sosial, aktivitas fisik, konseling gizi dan lain-lain. Pasien diabetes mellitus bisa memainkan peran lebih aktif dalam perawatan diabetesnya dengan teknologi informasi kesehatan. Kajian pustaka ini menggunakan <em>PRISMA statement </em>sebagai panduan pencarian artikel penelitian dari dua database yaitu <em>Ebsco</em> dan <em>Scopus. </em>Hasil analisis sembilan artikel penelitian terpilih menunjukkan bahwa teknologi informasi memberikan pasien pendidikan dan dukungan pada pasien diabetes mellitus. Teknologi informasi telah digunakan untuk meningkatkan kualitas asuhan pasien diabetes mellitus,   memungkinkan tenaga kesehatan lebih efektif mengelola pasien dan untuk membantu pasien mengelola sendiri penyakitnya sehingga penelitian dan publikasi terkait diperlukan untuk meningkatkan perawatan pasien diabetes mellitus di rumah.</p>

scholarly journals Enhancing tuberculosis case finding in Tanzania: implementation of a quality improvement initiative

2020 ◽  
Vol 10 (2) ◽  
pp. 57-59
Author(s):  
E. Wandwalo ◽  
V. Kamara ◽  
M. A. Yassin ◽  
L. Morrison ◽  
N. B. Nwaneri ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Health Workers ◽  
National Level ◽  
Case Finding ◽  
Quality Improvement Initiative ◽  
Tuberculosis Case ◽  
National Tuberculosis ◽  
Tuberculosis Programme ◽  
Case Notification

Tuberculosis (TB) is one of the major causes of morbidity and mortality in Tanzania. A quality improvement (QI) initiative was implemented by the National Tuberculosis Programme with support from The Global Fund to enhance TB case finding. The initiative involved identifying gaps in the quality of services, introducing tools, building capacity of health workers, and strengthening laboratory and referral services. The initiative was piloted at sub-national level and subsequently scaled-up nationally. Overall, 1280 health workers were trained, leading to an 81% cumulative increase in notified TB cases in the pilot region and 4000 additional TB cases notified nationally. The QI initiative could serve as a model for the improvement of TB case notification in other settings.

scholarly journals GAMBARAN KUALITAS HIDUP PASIEN DENGAN DIABETES MELITUS DI PUSKESMAS WANARAJA

2020 ◽  
pp. 70-80
Author(s):  
Miftah Hudatul Umam ◽  
Tetti Solehati ◽  
Dadang Purnama
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Social Relations ◽  
Health Workers ◽  
Descriptive Analysis ◽  
Community Health Center ◽  
Sampling Technique ◽  
Patients With Diabetes ◽  
Quantitative Descriptive

Diabetes melittus merupakan salah satu penyakit kronis yang tidak dapat disembuhkan. Penderita diabetes melittus akan mengalami berbagai permasalahan dalam proses kehidupannya yang dapat mempengaruhi kualitas hidupnya. Tujuan penelitian ini adalah untuk mengetahui gambaran kualitas hidup pasien dengan diabetes mellitus di Puskesmas Wanaraja Kabupaten Garut. Metode penelitian yang digunakan adalah deskriptif kuantitatif. Sampeldidapatkandenganteknik total sampling berjumlah 91 orang. Instrumen yang digunakan dalam penelitian ini WHOQOL-BREF yang terdiri dari 26 pertanyaan yang sudah valid dan reliabel. Analisa data yang dilakukan menggunakan analisa deskriptif. Hasil penelitian menunjukan kualitas hidup pasien diabetes mellitus sebagian besar63,7% berada pada kategorisedang. Kualitashidupberdasarkan domain fisik sebagian besar memiliki kualitas hidup pada kategori sedang sebanyak 61,5%, domain psikologis sebagian besar memiliki kualitas hidup pada kategori sedang sebanyak  60,4%, domain hubungansosial sebagian besar memiliki kualitas hidup pada kategori sedang sebanyak 58,2%, dan domain lingkungan sebagian besar memiliki kualitas hidup pada kategori sedang sebanyak 53,8%.Berdasarkan data tersebutdapatdisimpulkan bahwa sebagian besar responden memiliki kualitas hidup yang sedang baik dari segi domain fisik, psikologis, hubungan sosial dan lingkungan. Oleh sebab itu pentingnya peran petugas kesehatan untuk melakukan promosi kesehatan untuk meningkatkan kualitas hidup pasien diabetes mellitus menjadilebihbaik.   Diabetes mellitus is a chronic disease that cannot be cured. Patients with diabetes mellitus will experience various problems in their life processes that can affect their quality of life. The purpose of this study was to determine the description of the quality of life of patients with diabetes mellitus in Community Health Center Wanaraja, Garut Regency. The research method used was quantitative descriptive. Samples were obtained by a total sampling technique as many as 91 people. The instrument used in this study was WHOQOL-BREF which consisted of 26 valid questions. Data analysis was performed using descriptive analysis. The results showed that the quality of life of patients with diabetes mellitus was mostly in the moderate category as many as 63.7%. Quality of life based on the physical domain mostly has a quality of life in the moderate category of 61.5%, the psychological domain mostly has a quality of life in the moderate category of 60.4%, the domain of social relations mostly has a quality of life in the medium category of 58.2 %, and most of the environmental domains have a quality of life in the medium category of 53.8%. Based on these data it can be concluded that the majority of respondents have a moderate quality of life in terms of physical, psychological, social and environmental relations. Therefore the important role of health workers to conduct health promotion to improve the quality of life of patients with diabetes mellitus be better.

Effects of wearable technology on patients with diabetes: A systematic review and meta-analysis (Preprint)

2020 ◽  
Author(s):  
Dongjun Wu ◽  
Nicholas Buys ◽  
Guandong Xu ◽  
Jing Sun
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Relapse Prevention ◽  
Diabetes Management ◽  
Meta Analysis ◽  
Intervention Group ◽  
Wearable Technologies ◽  
Patients With Diabetes ◽  
Hba1c Levels

UNSTRUCTURED Aims: This systematic review and meta-analysis aimed to evaluate the effects of wearable technologies on HbA1c, blood pressure, body mass index (BMI), and fastening blood glucose (FBG) in patients with diabetes. Methods: We searched PubMed, Scopus, Embase, the Cochrane database, and the Chinese CNKI database from last 15 years until August 2021. The quality of the 16 included studies was assessed using the PEDro scale, and random effect models were used to estimate outcomes, with I2 used for heterogeneity testing. Results: A significant reduction in HbA1c (-0.475% [95% CI -0.692 to -0.257, P<0.001]) was found following telemonitoring. However, the results of the meta-analysis did not show significant changes in blood pressure, BMI, and glucose, in the intervention group (P>0.05), although the effect size for systolic blood pressure (0.389) and diastolic blood pressure may indicate a significant effect. Subgroup analysis revealed statistically significant effects of wearable technologies on HbA1c when supported by dietetic interventions (P<0.001), medication monitoring (P<0.001), and relapse prevention (P<0.001). Online messages and telephone interventions significantly affected HbA1c levels (P<0.001). Trials with additional online face-to-face interventions showed greater reductions in HbA1c levels. Remote interventions including dietetic advice (P<0.001), medication (P<0.001), and relapse prevention (P<0.001) during telemonitoring showed a significant effect on HbA1c, particularly in patients attending ten or more intervention sessions (P<0.001). Conclusion: Wearable technologies can improve diabetes management by simplifying self-monitoring, allowing patients to upload their live measurement results frequently and thereby improving the quality of telemedicine. Wearable technologies also facilitate remote medication management, dietetic interventions, and relapse prevention.

scholarly journals Assessment of Liver Stiffness Regression and Hepatocellular Carcinoma Risk in Chronic Hepatitis C Patients after Treatment with Direct-Acting Antiviral Drugs

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 210
Author(s):  
Martynas Ridziauskas ◽  
Birutė Zablockienė ◽  
Ligita Jančorienė ◽  
Artūras Samuilis ◽  
Rolandas Zablockis ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Liver Stiffness ◽  
Direct Acting Antiviral ◽  
End Of Treatment ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Direct Acting

Background and Objectives: Chronic hepatitis C virus infection affects about 71 million people worldwide. It is one of the most common chronic liver conditions associated with an increased risk of developing liver cirrhosis and cancer. The aim of this study was to evaluate changes in liver fibrosis and the risk of developing hepatocellular carcinoma after direct-acting antiviral drug therapy, and to assess factors, linked with these outcomes. Materials and Methods: 70 chronic hepatitis C patients were evaluated for factors linked to increased risk of de novo liver cancer and ≥ 20% decrease of ultrasound transient elastography values 12 weeks after the end of treatment. Results: The primary outcome was an improvement of liver stiffness at the end of treatment (p = 0.004), except for patients with diabetes mellitus type 2 (p = 0.49). Logistic regression analysis revealed factors associated with ≥ 20% decrease of liver stiffness values: lower degree of steatosis in liver tissue biopsy (p = 0.053); no history of interferon-based therapy (p = 0.045); elevated liver enzymes (p = 0.023–0.036); higher baseline liver stiffness value (p = 0.045) and absence of splenomegaly (p = 0.035). Hepatocellular carcinoma developed in 4 (5.7%) patients, all with high alpha-fetoprotein values (p = 0.0043) and hypoechoic liver mass (p = 0.0001), three of these patients had diabetes mellitus type 2. Conclusions: Liver stiffness decrease was significant as early as 12 weeks after the end of treatment. Patients with diabetes and advanced liver disease are at higher risk of developing non-regressive fibrosis and hepatocellular carcinoma even after successful treatment.

scholarly journals “We’re on a Merry-Go-Round”: Reflections of Patients and Carers after Completing Treatment for Sarcoma

2021 ◽  
Vol 28 (4) ◽  
pp. 3003-3014
Author(s):  
Rhys Weaver ◽  
Moira O’Connor ◽  
Richard Carey Smith ◽  
Dianne Sheppard ◽  
Georgia K. B. Halkett
Keyword(s):  
Social Constructionist ◽  
Rare Cancer ◽  
Family Carers ◽  
Structured Interviews ◽  
Qualitative Research Design ◽  
Previously Treated ◽  
Sarcoma Treatment ◽  
Silver Lining

Sarcoma is a rare cancer that has a significant impact on patients’ and carers’ quality of life. Despite this, there has been a paucity of research exploring the diverse experiences of patients and carers following sarcoma treatment. The aim of this study was to explore patients’ and carers’ reflections on life after treatment for sarcoma. A qualitative research design with a social constructionist epistemology was used. Participants included patients previously treated for sarcoma (n = 21) and family carers of patients treated for sarcoma (n = 16). Participants completed semi-structured interviews which were analysed using thematic analysis. Three primary themes were identified: “This journey is never going to be over”, “But what happens when I am better?”, and finding a silver lining. Participants represented sarcoma as having a long-term, and sometimes indefinite, threat on their life that they had limited control over. Conclusions: This study highlight the heterogeneous and ongoing needs of sarcoma survivors and their families. Patients and carers strove to translate their experiences in a meaningful way, such as by improving outcomes for other people affected by sarcoma. Parental carers in particular attempted to protect the patient from the ongoing stress of managing the disease.

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