Can compliment and complaint data inform the care of individuals with chronic subdural haematoma (cSDH)?

ObjectivesTo explore the frequency and nature of complaints and compliments reported to Patient Advice and Liaison (PALS) in individuals undergoing surgery for a chronic subdural haematoma (cSDH).DesignA retrospective study of PALS user interactions.SubjectsIndividuals undergoing treatment for cSDH between 2014 and 2019.MethodsPALS referrals from patients with cSDH between 2014 and 2019 were identified. Case records were reviewed and data on the frequency, nature and factors leading up to the complaint were extracted and coded according to Healthcare Complaints Analysis Tool (HCAT).ResultsOut of 531 patients identified, 25 (5%) had a PALS interaction, of which 15 (3%) were complaints and 10 (2%) were compliments. HCAT coding showed 8/15 (53%) of complaints were relationship problems, 6/15 (33%) a management problem and 1/15 (7%) other. Of the relationship problems, 6 (75%) were classed as problems with communication and 2 (25%) as a problem with listening. Of the compliments, 9/10 (90%) related to good clinical quality and 1/10 (10%) to staff–patient relationship. Patients were more likely to register a compliment than family members, who in turn were more likely to register a complaint (p<0.005). Complaints coded as a relationship problem had 2/8 (25%) submitted by a patient and 6/8 (75%) submitted by a relative.ConclusionsUsing the HCAT, routinely collected PALS data can easily be coded to quantify and provide unique perspective on tertiary care, such as communication. It is readily suited to quality improvement and audit initiatives.

Gender and Age Moderate the Effects of Partner Substance Use on Problem Drinking in Adulthood

The current study examined whether partner substance use problems predict problem drinking and how gender and age moderate this relationship. Problem drinking refers to alcohol use resulting in alcohol dependence or health and social consequences. Participants were adults (n=2142, 53% female, mean age=54, range= 33-83) from Wave 2 of the Midlife Development in the United States (MIDUS) Study. Participants reported on both past 12-month problem drinking (e.g., emotional problems from drinking, urges to drink, month or “much time” drinking, drinking more to get effects, drinking more than intended, and alcohol-related role interference) and partner substance use problems. Results indicated that 22.2% of the sample reported at least one problem drinking behavior in the past year. Multiple linear regression analysis revealed a significant interaction between gender and partner substance use problems (b=0.05, p=0.01) such that for males having a partner with substance use problems was a risk factor for their own problem drinking. However, a three-way interaction with gender, age, and partner substance use problems (b=-0.41, p&lt;0.01) indicated that partner substance use problems might have both gender and age-specific effects on problem drinking. Exploratory analyses of this interaction indicated that with age partner substance use problems might no longer promote risk for male problem drinking. Older adults are especially sensitive to the effects of alcohol for reasons such as lower tolerance, medication interaction, and health conditions. There is thus a need for identifying age-relevant factors associated with these drinking behaviors for intervention and prevention efforts.

Characterization and analysis of the basic elements of health payment mechanisms and their most frequent types

Introduction Healthcare systems are developed in imperfect scenarios, in which there are constant failures (uncertainty, information asymmetry, agency relationship problem, and supply-induced demand). These failures, based on the imperfection of the sector, determine the relationships and incentives between the actors. It is within this context that payment mechanisms regulate aspects of the system behavior and incentives, acting as instruments for the purchasing of health care from providers, mediated by health insurance on behalf of users. Objective To characterize the basic elements of most frequent payment mechanisms to help providers in their relationship with payers. Methods A review of the evidence was conducted in PubMed, Google, Google Scholar, and strategic snowball selection. Payment mechanisms consist of three classical microeconomics variables, fixed or variable: price, quantity, and expense. Time dimensions are used to analyze their attributes and effects. Different mechanisms emerge from the combination of these variables. Results Among the most used are: Fee-For-Service, Global Budget, Bundled Payments, Diagnosis-Related Groups, Per-capita, Performance Pay, and Risk-Sharing Agreements. A fourth has also gained importance: Financial Risk. Conclusions Payment mechanisms are essential to link health efforts with clinical practice. They make it possible to regulate relationships between insurers, providers, and users, which, depending on the architecture of the mechanism, can become beneficial or hinder the fulfillment of the objectives of the health system.

Review of Parasuicide Cases in a South African District Hospital from 2013-20181

ABSTRACT Parasuicide is referred to as an apparent attempt at suicide without the actual intention of killing oneself. Its prevalence continues to increase at Brits District Hospital. The current study aimed to review the parasuicide cases presented at this hospital from 2013 to 2018. The hospital is located in Madibeng district, in the North-West Province of South Africa. The study results have painted a clear picture of parasuicide cases at Brits district hospital where the phenomenon was more often observed among young African females, who were single, unemployed, and with a secondary level of education. For most of them, it was the first attempt and mainly occurred in the months of January and February. Overdose of medication was the most common method used and a relationship problem remained the main reason that motivated the attempt.

Profile of parasuicide cases attending Brits Hospital, North West Province, South Africa: a 5-year chart review

Background Parasuicide is referred to as an apparent attempt at suicide without the actual intention of killing oneself. Its prevalence continues to increase in the Brits/Madibeng community. The current study aimed to determine the profile of parasuicide cases attending Brits Hospital, North West Province of South Africa, from 2013 to 2018. Methods The basis of this article is a 5-year retrospective chart review of parasuicide cases attending Brits Hospital from 01 January 2013 to 01 January 2018. Brits Hospital is a 200-bed hospital serving people in the Brits/Madibeng community. Results Of the 477 parasuicide cases, the mean age was 26.6, the median 24 years with minimum and maximum ages respectively of 12 and 64 years. The majority (257; 53.88%) were between 16 and 25 years of age and comprised females (297; 62.26%), African (391; 82.84%), single people (352; 73.79%), unemployed (304; 63.7%) and those who had completed the secondary level of education, 300 (62.9%). The highest number of cases (85, 86 and 87) were registered during the odd years (2013, 2015 and 2017), while the lowest number (68, 75 and 76) during even years, i.e. 2014, 2016 and 2017. The summer months of January and February registered more cases, respectively 65 (13.63%) and 64 (13.42%). The majority of cases (430; 90.15%) represented a first attempt at suicide. Overdose of medication (300; 62.82%) was the most common method used and a relationship problem the main reason that led to the attempt. Most cases (409; 85.74%) did not have any medical or psychiatric symptoms prior to the parasuicide crisis. Conclusion This study painted a clear picture of parasuicidal cases attended at Brits Hospital, being younger between 16-25, mainly female, single, unemployed, the method used for parasuicide mostly overdose of medication and done mainly in Januaries and Februaries. Furthermore, reason for the parasuicidal attempt were relationship problem as well as unemployment. In most of the cases, it was the first attempt.

Formation of conflict-free interaction of elderly people under conditions of a general type board

The article discusses the problem of the relationship of older people living in KRSESS "Boarding House for the Elderly and Disabled" (hereinafter referred to as Kirov Boarding House for the elderly and disabled) with different social status, including those with canceled criminal records. Attention is payed to the personal attitudes of citizens living in Kirov Boarding House for the elderly and disabled (hereinafter Living), their age characteristics, and services to society and the state. An overview is given of the well-established strategies for the work of a boarding psychologist. Briefly describes a program to reduce anxiety and the formation of conflict-free interaction of older people. The following methods were used in the study: the method of expert assessment of the situation according to E.V. Bityutskaya, monitoring suicidal risk, including the following methods: Hospital scale of anxiety and depression; Spielberg-Khanin methodology that determines situational and reactive anxiety; Suicidal risk 45; Prognostic criteria for suicidal risk, additional questionnaire. The study showed that the integration of those who served their sentences in boarding schools requires special training of personnel who are currently not ready to regulate relations between people living with a lack of necessary knowledge. During the diagnosis, it was found that Residents drew attention to the existing relationship problem, which they could not solve on their own. The main reason for helplessness and hopelessness was physical ailments such as: blindness, lack of mobility.

The Relationship Problem Solving (RePS) Model: How Partners Influence One Another to Resolve Relationship Problems

In this article, we synthesize existing literatures across numerous domains to introduce a novel model—the Relationship Problem Solving (RePS) model—for understanding the process through which romantic partners influence one another to resolve relationship problems. The first section briefly describes the key constructs and stages of the model. The second section details the interpersonal behaviors that influence various intrapersonal factors (e.g., affect, self-efficacy) that ultimately influence partners’ motivation and ability to progress through the stages of the model. The third section uses the model to generate novel predictions that suggest that the effectiveness of these interpersonal behaviors often depends on contextual factors. Finally, the fourth section discusses the implications of this model for understanding relationship problem solving, highlights the need to consider the role of context in the problem-solving process, and offers numerous specific predictions to be addressed by future research.