scholarly journals GAMBARAN TINGKAT KECEMASAN PASIEN DI INSTALASI GAWAT DARURAT

2019 ◽  
Vol 7 (2) ◽  
Author(s):  
Serenity Prayer Amiman ◽  
Mario Katuuk ◽  
Reginus Malara
Keyword(s):  
Emergency Department ◽  
Emergency Treatment ◽  
Rating Scale ◽  
To Receive ◽  
Hamilton Rating Scale

might be dangerous is called anxious. Fear and anxious is an emotion that appears in healthfacility. Anxiety appears with a dim without a clear cause that made an indiviual feltuncomfotable with the environment around. Anxiety can also became a signal to prepare anindividual to cope with a problem that might came. People with anxiety seems to be tense,worried and affraid, also there are change in physiological. Emergency treatment can makepatient to feel fear dan anxious to receive a treatment. An intervention to save lives can be thecause of anxiety since the treatment might cause change on a persons integrity. Anxious is aform of unspesific objek that cause uncomfortable and or might cause death. The purpose ofthis study is to see the levels of anxiety that might appears on patients at EmergencyDepartment in Bhayangkara Hospital Manado. Design of descriptive to collect data from therespondent using HARS anxiety questionair to measure the levels of anxiety. Samples are 69respondents that are the patients in Emergency Department in Bhayangkara Hospital. Theresult indicate that from 69 responden there are 47 responden (68,1%) are having severeanxiety.Keyword : Anxiety, Emergency DepartmentAbstrak: Cemas merupakan suatu perasaan yang muncul saat seseorang berada dalamkeadaan yang dapat mengancam keadaan jiwa. Takut dan cemas sebagai emosi yangdirasakan oleh pasien di sarana kesehatan. Kecemasan muncul secara samar tanpa penyebabyang jelas dan dapat membuat seseorang merasa tidak nyaman terhadap keadaan lingkungansekitarnya. Kecemasan juga dapat menjadi sinyal kepada seseorang untuk mempersiapkandirinya dalam menghadapi suatu keadaan. Kecemasan ditandai dengan adannya perasaantegang, khawatir dan ketakutan, serta dapat terjadi perubahan fisiologis. Perawatan gawatdarurat membuat pasien takut dan cemas dalam menghadapi tindakan perawatan. Memberikantindakan penyelamatan jiwa dapat menyebabkan kecemasan karena dapat mengancamintegritas jiwa. Cemas merupakan bentuk reaksi yang tidak spesifik yang menimbulkan rasatidak nyaman dan mengancam jiwa. Tujuan penelitian ini untuk melihat tingkat kecemasanyang dapat muncul atau dirasakan oleh pasien yang mendapat perawatan di IGD RSBhayangkara. Metode penelitian ini menggunakan desain penelitian deskriptif denganmenggunakan kuisioner HARS (Hamilton Rating Scale for Anxiety) sebagai alat ukur untukmengetahui tingkat kecemasan. Tingkat kecemasan dibagi menjadi 5 tingkatan, yaitu tidakada kecemasan, kecemasan ringan, kecemasan sedang, kecemasan berat dan kecemasan beratsekali. Sampel yang digunakan yaitu pasien yang berkunjung di IGD RS BhayangkaraManado yakni berjumlah 69 responden. Kesimpulan hasil penelitian didapatkan bahwa dari69 responden yang diteliti, sebanyak 47 responden (68,1%) mengalami kecemasan berat.Kata kunci: Kecemasan, Instalasi Gawat Darurat

Child Life Reduces Distress and Pain and Improves Family Satisfaction in the Pediatric Emergency Department

2018 ◽  
Vol 57 (13) ◽  
pp. 1567-1575 ◽  
Author(s):  
Natasha Sanchez Cristal ◽  
Jennifer Staab ◽  
Rachel Chatham ◽  
Sarah Ryan ◽  
Brian Mcnair ◽  
...  
Keyword(s):  
Emergency Department ◽  
Rating Scale ◽  
Pediatric Trauma ◽  
Family Satisfaction ◽  
Pediatric Emergency ◽  
Child Life ◽  
Convenience Sample ◽  
Patient Cooperation ◽  
To Receive ◽  
Pain Rating Scale

This study evaluated the effects of Certified Child Life Specialist (CCLS) intervention on pediatric distress and pain and family satisfaction during routine peripheral intravenous (PIV) line placement in the emergency department (ED). A convenience sample of 78 children (3-13 years) requiring PIV placement for their treatment at a regional level 1 pediatric trauma center ED with 70 000 annual visits were selected to receive either standard nursing care or CCLS intervention for PIV placement. CCLS involvement was associated with fewer negative emotional behaviors as indicated by a lower score on the Children’s Emotional Manifestation Scale (−3.37 ± 1.49, P = .027), a reduction in self-reported pain on the Wong-Baker Faces pain rating scale (−1.107 ± 0.445, P = .017), an increase in parent-reported patient cooperation during PIV placement, and greater satisfaction with the ED visit. This study demonstrates that Child Life can have an impact on important outcomes in the pediatric ED such as distress, pain, and visit satisfaction.

Treatment of Depression Using Sleep Electroencephalogram Modulated Repetitive Transcranial Magnetic Stimulation

2011 ◽  
Vol 26 (S2) ◽  
pp. 1142-1142
Author(s):  
M. He ◽  
Z. Gu ◽  
X. Wang ◽  
H. Shi
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Rating Scale ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Animal Experiments ◽  
Treatment Of Depression ◽  
Psychoactive Medication ◽  
Before And After ◽  
To Receive ◽  
Hamilton Rating Scale

Background and purposeThe conventional repetitive transcranial magnetic stimulation (rTMS) has some inadequate of efficacy weak and inadequate for the treatment of depression, easy symptomatic recurrence when stop the treatment. Ours invented the device of sleep electroencephalogram-modulated rTMS (SEM-rTMS) were safe and effective by proved of the animal experiments and clinical pre-test for the treatment of depression. The purpose of this study was to examine the efficacy and safety of SEM-rTMS for the treatment of depression.MethodsAfter 7 days without psychoactive medication, 164 patients with clinically defined depression, were randomly assigned to receive SEM-rTMS (N = 57), conventional rTMS (C-rTMS (N = 55), or sham-rTMS (N = 52) for 30 minutes/time/day for 10 days. Before and after scores on the 24-item Hamilton rating scale for depression (HAMD-24) and the clinical outcome at the 10th-day of therapy for all subjects were analyzed.ResultsTwenty two cases in the SEM-rTMS group improved mood as compared to 6 in the C-rTMS group and 2 in the sham-rTMS group (c2 = 15.89, p = 0.0004). After completion of the rTMS phase of the protocol, a (51 ± 5) % reduction of HAMD-24 scores from the baseline in the SEM-rTMS group compared with a (34 ± 4)% in the C-rTMS group ((q = 26.09, p = 0.001) and a (14 ± 3)% in Sham-rTMS group (q = 57.53,p = 0.000). The 88% total efficacy ratio in the SEM-rTMS group was significant higher than 68% in the C-rTMS group and 20% in the sham-rTMS group (c2 = 12.01, p = 0.0025). No significant side effects were noted.ConclusionIt is efficient and safe to treat depression with repetitive transcranial magnetic stimulation. (The registration. No: ChiCTR-TRC-00000438).

An intervention for depressive symptoms using a commercial game in a mental health impatient setting. (Preprint)

2019 ◽  
Author(s):  
Pablo Rodrigo Guzman Cortez ◽  
Matias Marzocchi ◽  
Neus Freixa Fontanals ◽  
Mercedes Balcells-Olivero
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Health Outcomes ◽  
Serious Games ◽  
Rating Scale ◽  
Depressive Symptomatology ◽  
Pilot Test ◽  
Potential Health ◽  
Depressive Episodes ◽  
Hamilton Rating Scale

BACKGROUND Computerized mental health interventions have shown evidence of their potential benefit for mental health outcomes in young users. All of the studied interventions available in the review and scientific literature can be classified as "serious games". Serious games are computerized interventions designed from the start with the objective of improving specific desired health outcomes. Moreover, there are reports of users experiencing subjective benefits in mental health after playing specific commercial games. These were games not intentionally made with a therapeutic objective in the design process. An example is the videogame "Journey", first released for the Playstation 3 console in 2012 which won "Game of the Year" in the 2013 D.I.C.E awards. The creator of the game describes the game as a short, 2-3-hour narrative experience in which the player goes through the "Hero's Journey" following a classic 3-part structure. There were more than 100 testimonials from players describing how the game helped them cope with psychological or personal issues. Some of them explicitly described recovering from depressive episodes through playing the game. OBJECTIVE To conduct a pilot test of the efficacy of the videogame Journey in reducing depressive symptoms in an acute impatient setting METHODS Depressive symptomatology was measured before and after the intervention using the Hamilton Rating Scale for Depression (HRSD) The intervention was conducted in an isolated room using a Playstation 3 console with the videogame "Journey" developed by Thatgamecompany. No internet access was allowed. The game was played over the course of 4 30-45 min sessions in a two week period. RESULTS The initial score in the Hamilton Rating Scale for Depression (HRSD) was 30, indicating a very severe depression. After the intervention the HRSD score was 10, showing a mild depression. CONCLUSIONS The Videogame Journey, a commercial game first available for the Playstation 3 console in 2012, was not created as a serious game with potential health benefits. Our pilot test is the first case report of a commercial game showing a potential effect in reducing depressive symptoms, which is consistent with the previous informal reports of users online.

Facial expression differences indicate pain improvement at the emergency department

2020 ◽  
Keyword(s):  
Emergency Department ◽  
Aspect Ratio ◽  
Facial Expressions ◽  
Pain Measurement ◽  
Rating Scale ◽  
Head Rotation ◽  
Numeric Rating Scale ◽  
Nasolabial Fold ◽  
Measurement Strategy ◽  
Pain Improvement

Purpose: Pain is a major symptom for patients to seek medical services, but limited evidence supports the applicability and usage of facial expressions as a pain measurement strategy in the emergency department (ED). In this study, we explored possible differences in facial expressions before and after pain management and compared these differences with those in a self-reported pain scale. Methods: In this observational study, convenience sampling of patients admitted to the ED was conducted. Two video sessions of facial expressions were recorded for each participant, and participants rated their painon a self-reported numeric rating scale (NRS). A total of 25 facial parameters were extracted per frame. The main outcome measurements were the differences in facial parameters, and their correlation with changes in NRS scores was examined. Results: This study included 163 participants. A stronger reduction in NRS scores was associated with differences in systolic blood pressure (sBPr = 0.247, P = 0.011) and the following changes in facial features: eye opening (left: r = -0.210, P = 0.007; right: r = -0.206, P = 0.008), eye aspect ratio (left: r = -0.382, P < 0.001; right: r = -0.305, P < 0.001), and head rotation angle (r = 0.218, P = 0.005). Pain improvement (a difference of ≥ 4 in NRS scores) was associated with differences in BP (sBP, odds ratio [OR] = 0.973, 95%confidence interval [CI]: 0.949-0.998, P = 0.034; dBP, OR = 1.078, 95% CI: 1.026-1.113, P = 0.003), eye aspect ratio (Left: β = 5.613, 95% CI: 2.234-14.104, P < 0.001; Right: β = 2.743, 95% CI: 1.395-5.391, P = 0.003), and nasolabial fold variation (β = 0.548, 95% CI: 0.306-0.982, P = 0.043), after adjustment for variables Conclusions: Intraindividual changes in facial expressions can be used to track clinically relevant differences in pain. Facial expressions alone cannot be used as a pain measurement strategy in the ED.

scholarly journals Sociodemographic and Clinical Profile of Patients Presenting With Erectile Dysfunction: Experience From a Tertiary Care Centre of North India

2021 ◽  
pp. 263183182110311
Author(s):  
Adarsh Tripathi ◽  
Dhirendra Kumar ◽  
Sujita Kumar Kar ◽  
PK Dalal ◽  
Anil Nischal
Keyword(s):  
Erectile Dysfunction ◽  
Rating Scale ◽  
Nuclear Family ◽  
Sexual Experience ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Sexual Disorders ◽  
Care Hospital ◽  
Tertiary Center ◽  
Hamilton Rating Scale

Background: Erectile dysfunction (ED) is one of the most common psychosexual disorders in clinical practice, and it results in significant distress, interpersonal impairments, poor quality of life, and marital disharmony. However, there is limited research on ED in India. Therefore, this study aimed to assess the sociodemographic and clinical profile of patients presenting with ED. Method: Cross-sectional evaluation of patients with ED presenting to the psychosexual outpatient department (OPD) of psychiatry department in a tertiary care hospital was done on structured clinical pro forma, Mini-International Neuropsychiatric Interview, International Index of Erectile Function-5, Arizona Sexual Experience, Hamilton rating scale for depression, and Hamilton rating scale for anxiety. Results: The sample included 102 patients. The mean age was 33.38 years. The majority of the patients were married (81.4%), Hindu (82.4%), residing in a rural area (60.8%), and belonging to a nuclear family (62.7%). The majority of the patients had a moderate level of ED (50%) followed by mild-to-moderate ED (26.5%) and severe ED (23.5%). Premature ejaculation (46.1%) and depression (28.4%) were the most common sexual and psychiatric comorbidities. Obesity was common (62.7%), and only a minority had other metabolic dysfunction, namely dyslipidemia (7.8%), diabetes (5.9%), and hypertension (4.9%). Tobacco dependence and alcohol dependence were present in 37.3% and 6.9% cases, respectively. Conclusion: Young adults with moderate-to-severe ED were present for treatment at a tertiary center. Comorbidities of other sexual disorders, psychiatric disorders, and substance use are commonly encountered in such patients. Promotion of early help-seeking should be encouraged. Clinicians should thoroughly assess even the young patients for other sexual, psychiatric, and medical comorbidities.

A comparison of the ‘Hamilton Rating Scale for Depression’ and the ‘Montgomery-Asberg Depression rating Scale’

1999 ◽  
Vol 11 (1) ◽  
pp. 34-37 ◽  
Author(s):  
I.P.A.M. Huijbrechts ◽  
P.M.J. Haffmans ◽  
K. Jonker ◽  
A. van Dijke ◽  
E. Hoencamp
Keyword(s):  
Clinical Practice ◽  
Clinical Global Impression ◽  
Rating Scale ◽  
Reliability And Validity ◽  
Structured Interview ◽  
Clinical Impression ◽  
Clinical Relationship ◽  
Hamilton Rating Scale ◽  
Depressive States

SummaryAlthough the Hamilton Rating Scale for Depression (HRSD) is the most frequently used rating scale for quantifying depressive states, it has been criticized for its reliability and its usability in clinical practice. This criticism is less applying to the Montgomery-Asberg Depression Rating Scale (MADRS). Goal of the present study is to investigate the reliability and validity, and clinical relationship between the HRSD and the MADRS. For 60 out-patients with diagnosed depression (DSM IV296.2x, 296.3x, 300.40 and 311.00), the HRSD and MADRS were scored at baseline and 6 weeks later by an independent rater according to a structured interview. Also the Clinical Global Impression (CGI) was assessed by a psychiatrist. Satisfying agreement was found between the totalscores (r= .75, p>.000 en r=.92, p>.000 respectively, at baseline and 6 weeks later). Furthermore agreement was found between the items of both scales, and these agree with the clinical impression. The reliability of the MADRS is more stable than the reliability of the HRSD (α = .6367 and α =.8900 vs α = .2193 and α = .8362 at baseline and at endpoint respectively). Considering the ease of scoring both scales in one interview and the widely international use of the HRSD, scoring both the HRSD and the MADRS to measure the severity of a depression seems to be an acceptabel covenant.

Abstract 3097: Acute In-hospital Stroke: How Do We Do Compared To Strokes In The Emergency Department?

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Dolora Wisco ◽  
Christopher Newey ◽  
Pravin George ◽  
James Gebel
Keyword(s):  
Emergency Department ◽  
Time Window ◽  
Stroke Treatment ◽  
Intravenous Tissue Plasminogen Activator ◽  
Tertiary Center ◽  
Neuro Imaging ◽  
One Year ◽  
To Receive ◽  
Iv Tpa ◽  
Arterial Thrombolysis

Introduction: Intravenous tissue plasminogen activator (IV tPA) has been approved for treating strokes up to 3 hours after onset of symptoms and may be beneficial up to 4.5 hours in patients who qualify. Additionally, neuro-intervention, i.e., intra-arterial thrombolysis or thrombectomy, is also an approved treatment option. Population studies show that 6% receive IV tPA within 3 hours of stroke onset. However, in-hospital strokes present challenges to treating within an adequate time. We present here our experience with in-hospital strokes, treatments, and identifiable delays in treatments. Methods: Single, tertiary center retrospective study of 55 in-hospital strokes over a one-year period from January 2009 to January 2010, and strokes in the Emergency Department over 6 month period from January 2010 to June 2010. Results: Twenty-nine in-hospital strokes were evaluated within 3 hours of symptoms onset. Two (6.9%) received IV tPA, and four (13.8%) received neuro-intervention (either intra-arterial thrombolysis or thrombectomy). None of the patients who presented greater than 3 hours after symptom onset was treated with any treatment (n=28). When compared to patients who present to the ED within 3 hours, in-hospital strokes were less likely to get IV tPA (6.9% vs. 20.8%), and they were more likely to receive neuro-intervention (13.8% vs. 10.3%). Neuro-intervention was performed on 9.09% of all in-hospital strokes (1 of 5 presented beyond the 3 hour time window). For in-hospital strokes that receive any treatment within 3 hours, the average time to neurology evaluation, to CT, and to treatment are 35 min, 68 min, and 237 min, respectively. For strokes in the Ed, the average time to evaluation, to CT, and to treatment are 90 min, 28 min, and 66 min respectively. The delay for in-hospital strokes is in obtaining the CT and initiating the treatment. Discussion: In-hospital stroke patients wait longer than their ED counterparts to be taken to CT and to receive stroke treatment. They are also less likely to receive IV tPA, and more likely to receive neuro-intervention. The longer time to neuro-imaging and thrombolytic treatment may reflect the fact that patients suffering in-hospital strokes have more complex medical co-morbidities that must be taken account during the evaluation and administration of thrombolytic therapy.

Lidocaine Adrenaline Tetracaine Gel Versus Tetracaine Adrenaline Cocaine Gel for Topical Anesthesia in Linear Scalp and Facial Lacerations in Children Aged 5 to 17 Years

PEDIATRICS ◽  
1995 ◽  
Vol 95 (2) ◽  
pp. 255-258 ◽  
Author(s):  
Amy A Ernst ◽  
Eduardo Marvez ◽  
Todd G. Nick ◽  
Eric Chin ◽  
Edmond Wood ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Emergency Department ◽  
Inner City ◽  
Rating Scale ◽  
Topical Anesthesia ◽  
Random Numbers ◽  
Study Objective ◽  
The Face ◽  
Double Blinded

Study objective. The purpose of the present study is to compare LAT gel (4% lidocaine, 1:2000 adrenaline, 0.5% tetracaine) to TAC gel (0.5% tetracaine, 1:2000 adrenaline, 11.8% cocaine) for efficacy, side effects, and costs in children aged 5 to 17 years with facial or scalp lacerations. Design. Randomized, prospective, double-blinded clinical trial. Setting. Inner-city Emergency Department with an Emergency Medicine residency program. Patients or other participants. Children aged 5 to 17 years with linear lacerations of the face or scalp. Intervention. After informed consent was obtained patients had lacerations anesthetized with topical TAC or LAT gel according to a random numbers table. Measurements and main results. A total of 95 patients were included in the statistical analysis with 47 receiving TAC and 48 receiving LAT. Physicians and patients/parents separately rated the overall pain of suturing using a modified multidimensional scale for pain assessment specifically for children. Patients/parents also stated the number of sutures causing pain. The power of the study to determine a ranked sum difference of 15 was 0.8. Multidimensional rating scale results and number and percentage of sutures causing pain were compared using Wilcoxon's rank sum test. According to patients no difference could be detected in percent of sutures causing pain in the LAT versus TAC group (P = .51). Using the multidimensional scale, physicians and patients/parents found LAT statistically the same as TAC in effectiveness (P = .80 for physicians and P = .71 for patients). Cost per application was $3.00 for LAT compared to $35.00 for TAC. Follow-up was accomplished in 85 of 95 participants in the study with no reported complications for either medication. Conclusion. LAT gel worked as well as TAC gel for topical anesthesia in facial and scalp lacerations. Considering the advantages of a noncontrolled substance and less expense, LAT gel appears to be better suited than TAC gel for topical anesthesia in laceration repair in children.

Sign in / Sign up

Export Citation Format

Share Document