scholarly journals The changing nature of the population of intensive-care patients

2018 ◽  
Vol 7 (2) ◽  
pp. 1 ◽  
Author(s):  
Fakhri Athari ◽  
Ken M. Hillman ◽  
Steven A. Frost
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
Elderly Patients ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Hospital Death ◽  
Very Elderly ◽  
Chronic Health ◽  
The Impact ◽  
Over Time

Background: The increase in the number of Australia’s frail, very elderly ( 80 years of age) population will have an impact on admissions to intensive care. As the number of very elderly patients increase, it will be important to have information about what the impact of increasing age will have on aspects such as: the impact of age and chronic health conditions on intensive care treatment, and the impact on prognosis in the short and longer-term as well as how we should be involving the very elderly in determining their own goals of care.Objective: To evaluate the long-term trend in the rates of the very elderly ( 80 years of age) admitted to intensive care, as well as describe their chronic health conditions, length of stay, and mortality rates.Methods: This study was a retrospective review that used a database from a 40-bed, multidisciplinary, adult intensive care unit (ICU), located in South-Western Sydney, Australia. The setting is an 877-bed tertiary hospital that has medical and surgical specialties; including a referral trauma unit, with approximately 80,000 admissions a year. Data were acquired over 15-years, from January 1st, 2000 to December 31st, 2015.Results: Data were available for 32,796 patients, and of these, 4,137 (12.5%) were aged ≥ 80 years. The percentage of the very elderly admitted to ICU progressively increased from 8.6% in 2000 to (14.5% in 2015, p < .001). Overall, the median length of stay (LOS) in the ICU was 2-days (interquartile range: 1.2-4.1), and increased from 2.0 to 2.3 (p < .001). Similarly, the median hospital LOS increased over time from 9 to 11 days (p < .001). Intensive care and hospital death rates decreased over time from 19.9% to 9.8% (p < .001), and 31.8% to 19.9% (p < .001), respectively. The majority of the very elderly were admitted from the emergency department (ED) (38.1%), other sources of admission being from the operating theatres (OT) (33.5%), and the general ward (18.1%).Conclusions: The number and percentage of very elderly patients being managed in ICU is increasing, representing a different population from the one that much of our practice has been previously based. For example, we may need to review the way we estimate severity of illness on admission to the ICU with more weight given to the chronic health component of the very elderly. The acute indications for admission to ICU such as falls and infections are relatively straightforward to manage and usually have a good outcome. However, because age and the chronic health status of the very elderly are largely progressive and irreversible, we as health care professionals working in intensive care may have to consider longer-term post hospital outcomes as a basis for evaluating the effectiveness of the interventions in ICU.

The Impact of Chronic Health Conditions on Length of Stay and Mortality in a General PICU*

2017 ◽  
Vol 18 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Scott O’Brien ◽  
Simon Nadel ◽  
Ofran Almossawi ◽  
David P. Inwald
Keyword(s):  
Length Of Stay ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Chronic Health ◽  
The Impact

The impact of concealable chronic health conditions on college students’ academic outcomes: A two-wave study

2022 ◽  
pp. 135910532110681
Author(s):  
M Rosie Shrout ◽  
Daniel J Weigel
Keyword(s):  
College Students ◽  
Academic Outcomes ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Online Surveys ◽  
Academic Anxiety ◽  
Chronic Health ◽  
The Impact ◽  
Stigma Experiences ◽  
Over Time

College students ( N = 125) with concealable chronic health conditions (CCHCs) completed online surveys at the beginning and end of the semester assessing stigma experiences and academic outcomes. Correlations showed stigma, alienation, and lack of campus fit were associated with greater illness-related academic interference ( ps < 0.001), negative academic self-comparison ( ps < 0.001), academic anxiety ( ps < 0.001), academic dissatisfaction ( ps < 0.001), and lower expected grades (except alienation; ps < 0.001–0.03) over time. Hierarchical multiple regressions identified a lack of campus fit as an important predictor across academic outcomes ( ps < 0.001–0.019). Students with CCHCs face health- and stigma-related challenges that can interfere with academic performance.

Nosocomial Influenza at a Canadian Pediatric Hospital From 1995 to 1999: Opportunities for Prevention

2002 ◽  
Vol 23 (10) ◽  
pp. 627-629 ◽  
Author(s):  
Robert Slinger ◽  
Peggy Dennis
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Influenza Infection ◽  
Chronic Health Conditions ◽  
Infect Control Hosp ◽  
Health Conditions ◽  
Pediatric Hospital ◽  
Chronic Health

AbstractNineteen cases of nosocomial influenza occurred at a pediatric hospital during a 5-year period. Only one of the nine children with chronic health conditions had been immunized. Length of stay was prolonged for seven children, with three intensive care unit admissions. We have now implemented strategies to decrease nosocomial influenza infection. (Infect Control Hosp Epidemiol 2002;23:627-629).

Psychosocial Risks of Chronic Health Conditions in Childhood and Adolescence

PEDIATRICS ◽  
1993 ◽  
Vol 92 (6) ◽  
pp. 876-878 ◽  
Author(s):  
Keyword(s):  
Children And Adolescents ◽  
Health Condition ◽  
Work And Family ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Medical Attention ◽  
Childhood And Adolescence ◽  
Chronic Health ◽  
Persistent Symptoms ◽  
The Impact

Chronic health conditions affect many children and adolescents. These conditions are illnesses or impairments that are expected to last for an extended period of time and require medical attention and care that is above and beyond what would normally be expected for a child or adolescent of the same age, extensive hospitalization, or in-home health services.1 These conditions include, among others, juvenile rheumatoid arthritis, asthma, cystic fibrosis, diabetes, spina bifida, hemophilia, seizure disorders, neuromuscular disease, acquired immunodeficiency syndrome, and congenital heart diseases. Although each specific condition may be relatively or extremely rare, when they are considered together, many children and adolescents are affected. Health conditions may be characterized by their duration and their severity. Although these terms are often linked, they refer to different aspects of a health condition. A chronic condition is generally one that has lasted or is expected to last more than a defined period of time, usually 3 months or longer. Conditions vary widely in their onset, course, and duration.2 Severity refers to the impact a condition has on a child's physical, intellectual, psychological, or social functioning.3 This impact may occur as a result of persistent symptoms, required treatments, limitations of activity or mobility, or interference with school, recreation, work, and family activities. Current estimates are that between 10 and 20 million American children and adolescents have some type of chronic health condition or impairment. Most of these conditions are relatively mild and interfere little with the children's ability to participate in usual childhood activities.4 However.

Children and Adolescents with Chronic Health Conditions

2017 ◽  
pp. 145-155
Author(s):  
Alina Morawska
Keyword(s):  
Well Being ◽  
Health Condition ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Triple P ◽  
Childhood Health ◽  
Chronic Health ◽  
Parenting Support ◽  
The Family ◽  
The Impact

Chronic childhood health conditions are common and significantly affect the child and family. This chapter begins by describing the central role parents play in children’s health outcomes and illness management and the impact the child’s health condition has on parents and the family. Few parenting interventions have been evaluated, and most focus on medical aspects rather than psychosocial factors related to child and family well-being. Existing approaches to parenting support are described, followed by an exploration of the evidence for Triple P interventions. Recent research using Positive Parenting for Healthy Living, a brief parenting intervention for parents with children with chronic health conditions, is showing promising outcomes. Policy and service implications of recent research are summarized.

The Impact of Chronic Health Conditions as an Underlying Challenge on Couple’s Wellbeing

2018 ◽  
Vol 40 (4) ◽  
pp. 318-325
Author(s):  
Megan R. Story ◽  
Benjamin Finlayson ◽  
Lauren Creger ◽  
Elise Bunce
Keyword(s):  
Chronic Health Conditions ◽  
Health Conditions ◽  
Chronic Health ◽  
The Impact

scholarly journals Housing Insecurity and the Emotional and Physical Health of African Americans

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 335-336
Author(s):  
Aarti Bhat ◽  
August Jenkins ◽  
David Almeida
Keyword(s):  
African American ◽  
African Americans ◽  
Negative Affect ◽  
Physical Health ◽  
The United States ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Chronic Health ◽  
African American Adults ◽  
The Impact

Abstract Housing insecurity—or limited and/or unreliable access to quality housing— is a potent on-going stressor that can adversely impact individual well-being. This study extends previous research by investigating the impact of housing insecurity on both the emotional and physical health of aging African American adults using the Midlife in the United States (MIDUS) Refresher oversample of African Americans collected from 2012-2013 (N = 508; M age = 43.02; 57% women). Participants reported on their negative affect, number of chronic health conditions experienced in the last year, and experiences of housing insecurity since the 2008 recession (e.g., homelessness, threatened with foreclosure or eviction, lost home). Negative affect and chronic conditions, respectively, were regressed on housing insecurity, and the potential moderating effect of age was tested. Results showed that housing insecurity was associated with more negative affect (B = 0.05, SE = 0.03, p = .002) and chronic health conditions (B = 0.26, SE = 0.03, p &lt; .001). Additionally, the association between housing insecurity and negative affect was moderated by age (B = -0.11, SE = 0.00, p = .019), such that the effect of housing insecurity on negative affect was stronger for younger adults than for older adults. These results suggest that experiences of insecure housing leave African American adults vulnerable to compromised emotional and physical health, however, the negative effects of housing insecurity may attenuate with age.

Effects of Patient- and Family-Centered Care for Young Adults With Chronic Health Conditions and Their Family Members: A Systematic Review

2019 ◽  
pp. 216769681988345
Author(s):  
David Allen ◽  
Nerina Scarinci ◽  
Louise Hickson
Keyword(s):  
Systematic Review ◽  
Young Adults ◽  
Meta Analysis ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Family Centered Care ◽  
Chronic Health ◽  
Centered Care ◽  
The Impact ◽  
Family Centered

Patient- and family-centered care has been shown to improve outcomes across a range of health conditions. The purpose of this study was to determine the impact of interventions to improve the patient- and family-centeredness of care (PFCIs) on the effectiveness of care of young adults (16–25) with chronic health conditions. A segregated design mixed-methods systematic review with meta-analysis and meta-synthesis of the literature was conducted. Thirteen quantitative papers and three qualitative papers were identified for inclusion. Random-effects meta-analysis was performed on quantitative findings, and a meta-synthesis was performed on qualitative findings. Preliminary evidence suggests that PFCIs were associated with improvements in the self-efficacy of young people with chronic health conditions. However, there were very few identified studies, and those that were identified were primarily in the field of mental health, requiring ongoing further research.

scholarly journals Detection and follow-up of chronic health conditions in Rio de Janeiro – the impact of residency training in family medicine

2021 ◽  
Author(s):  
Adelson Jantsch ◽  
Bo Burström ◽  
Gunnar Nilsson ◽  
Antônio de Leon
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Residency Training ◽  
Rio De Janeiro ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Chronic Health ◽  
Medical Consultations ◽  
The Impact

Abstract There is a need for evidence that residency training in family medicine (RTFM) can benefit the care of patients in primary care in low- and middle-income countries. We tested the hypothesis that two years of RTFM enables doctors to better detect chronic health conditions (CHC) while requesting fewer laboratory exams and providing more follow-up visits. We performed a retrospective longitudinal observational analysis of medical consultations from 2013 to 2018 in primary care in Rio de Janeiro, comparing doctors without RTFM (Generalists) versus family physicians (FPs). Multivariate multilevel binomial regression models estimated the risks of patients being diagnosed for a list of 31 CHCs, having a follow-up visit for these CHCs, and having laboratory tests ordered from a list of 30 exams. 569.289 patients had 2.908.864 medical consultations performed by 734 generalists and 231 FPs. Patients seen by FPs were at a higher risk of being detected for most of the CHCs, at a lower risk of having any of the 30 LTs requested, and at higher risk of having a follow-up visit in primary care. RTFM can make physicians more skilled to work in primary care. Policymakers must prioritize investments in RTFM to make primary care truly comprehensive.

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