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Fleury MJ, Cao Z, Armoon B, Grenier G, Lesage A. Profiles of patients using emergency departments or hospitalized for suicidal behaviors. Suicide Life Threat Behav 2022; 52:943-962. [PMID: 35686920 DOI: 10.1111/sltb.12892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/07/2022] [Accepted: 05/26/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study identified profiles of patients with suicidal behaviors, their sociodemographic and clinical correlates, and assessed the risk of death within a 12-month follow-up period. METHODS Based on administrative databases, this 5-year study analyzed data on 5064 patients in Quebec who used emergency departments (ED) or were hospitalized for suicidal behaviors over a 2-year period. Latent class analysis was used for patient profiles, bivariate analysis for patient correlates over 2 years, and survival analysis for risk of death within a 12-month follow-up. RESULTS Four profiles were identified: high suicidal behaviors and high service use (Profile 1: 23%); low suicidal behaviors and moderate service use (Profile 2: 46%); low suicidal behaviors and low service use (Profile 3: 25%); and high suicidal behaviors and high acute care, but low outpatient care (Profile 4: 6%). Profiles 1 and 4 patients had more serious conditions, with a higher risk of death in Profile 1 versus Profiles 2 and 3. Profile 2 patients had relatively more common mental disorders, and Profile 3 patients had less severe conditions. Profiles 3 and 4 included more men and younger patients. CONCLUSION Programs better adapted to patient profiles should be deployed after ED use and hospitalization in coordination with outpatient services.
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Affiliation(s)
- Marie-Josée Fleury
- Douglas Hospital Research Centre, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Zhirong Cao
- Douglas Hospital Research Centre, Montreal, Quebec, Canada
| | - Bahram Armoon
- Douglas Hospital Research Centre, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Guy Grenier
- Douglas Hospital Research Centre, Montreal, Quebec, Canada
| | - Alain Lesage
- Centre de recherche de l'Institut Universitaire en santé mentale de Montréal, Montreal, Quebec, Canada.,Department of Psychiatry, Université de Montréal, Montreal, Quebec, Canada
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General Surgery Clinical Information Management System Based on Intelligent Data Management. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:8601164. [PMID: 35958777 PMCID: PMC9359822 DOI: 10.1155/2022/8601164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/04/2022] [Indexed: 11/28/2022]
Abstract
In order to improve the effect of surgical clinical information management, this paper combines the intelligent data management technology to construct the general surgery clinical information management system. Based on the design and development of general surgery clinical medical case information management system, this paper studies the mutual conversion between XML data and relational data, and designs a clinical medical case information management system based on the design idea of layered architecture. The clinical medical case information management system mainly adopts the modular design idea and adopts a digital microscopic image storage mode based on HDFS architecture. After building the system function structure, the system effect is verified by simulation test. From the experimental statistical results, it can be seen that the general surgery clinical information management system based on intelligent data management proposed in this paper has a good effect.
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Quemada-González C, Morales-Asencio JM, Hurtado MM, Martí-García C. Study protocol: a randomised, controlled trial of a nurse navigator program for the management of hepatitis C virus in patients with severe mental disorder. BMC Nurs 2022; 21:92. [PMID: 35443727 PMCID: PMC9020053 DOI: 10.1186/s12912-022-00870-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 04/10/2022] [Indexed: 01/18/2023] Open
Abstract
Background To evaluate the impact of a nurse navigation program on treatment adherence and resolution of hepatitis C infection in patients with severe mental disorder. Methods An open, randomized, controlled trial with blinded outcome assessment. The intervention group will engage in a nurse navigation program designed by mental health nurses. The program involves active screening for patients with severe mental disorder. The patients and caregivers included in the program will receive information, training, support and guidance throughout the treatment and recovery process, which involves different healthcare professionals and units. The control group will receive the standard of care, which includes follow-up by a family physician, referral to the hepatologist, serological testing, new referral to the hepatologist, onset of treatment, and follow-up. Multidisciplinary care will be provided along a coordinated and seamless clinical pathway led by a nurse navigator. The primary endpoints are total recovery (hepatitis C cure) and treatment adherence. Occurrence of symptoms of schizophrenia and health-related quality of life will be also recorded. Follow-up of patients will be performed three and six months after the administration of antiviral treatment. The study was authorised by the Ethics Committee of Malaga in December 2021. Funding was approved in March 2021. Discussion If this intervention is proven to be effective in improving treatment access and adherence, it will represent a step forward in addressing a chronic health issue that is 16 times more prevalent in the population with severe mental disease. Finally, this intervention may lead to the detection of undertreated HCV infection in this population of patients. Trial registration This protocol has been registered in ClinicalTrials.gov with identifier code NCT04891445 on May 18, 2021.
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Affiliation(s)
- Casta Quemada-González
- Mental Health Unit, Regional University Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA), 29009, Málaga, Spain.,Faculty of Health Sciences, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - José Miguel Morales-Asencio
- Faculty of Health Sciences, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - María M Hurtado
- Mental Health Unit, Regional University Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA), 29009, Málaga, Spain.
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Analysis of Risk Factors of Hospital Emergency Nursing Based on Comprehensive Nursing Methods. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2021; 2021:1077358. [PMID: 34950220 PMCID: PMC8691987 DOI: 10.1155/2021/1077358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 10/23/2021] [Accepted: 11/16/2021] [Indexed: 01/02/2023]
Abstract
In order to improve the comprehensive nursing effect of the hospital emergency treatment, this paper analyzes the process of the hospital emergency treatment. In addition, this paper combines the possible risks to analyze the risk factors of the comprehensive nursing in the hospital emergency treatment and builds an intelligent analysis model based on the actual situation of the hospital emergency treatment. At the same time, this paper conducts a systematic survey of emergency services and gives the composition and structure of the system. In addition, this paper divides the business required by the system into modules, including registration module, doctor workstation, nurse workstation, query statistics module, decision-making module, and maintenance module. Finally, this paper suggests that in the process of the clinical triage, more ideas for improving the existing evaluation model should be proposed, and experience should be transformed into advantages, so as to improve emergency triage skills; establish an objective, quantitative, and scientific concept of emergency classification and triage; and fully realize scientific triage and precise triage.
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5
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Evaluation of the Effect of Intensive Nursing Intervention Based on Process Analysis. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2021; 2021:8769780. [PMID: 34912473 PMCID: PMC8668331 DOI: 10.1155/2021/8769780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 10/23/2021] [Accepted: 11/16/2021] [Indexed: 11/17/2022]
Abstract
In order to achieve significant improvements in the evaluation of key indicators such as speed, quality, cost, and service, this paper fundamentally rethinks and completely redesigns the business process, and recreates a new business process. This study combines the particularity of AMI with emergency nursing to construct an in-hospital AMI emergency nursing process to further standardize the AMI rescue work. The implementation of the process helps to clarify the responsibilities and requirements of nurses in the AMI emergency process, reduce the delay time of AMI emergency, and improve the efficiency and effectiveness of emergency. In addition, after refactoring the business process, this paper builds an intelligent digital critical illness monitoring system. This system combines the original work flow of the ICU medical staff, optimizes the work flow of the medical staff through computer technology and information technology, and designs and completes the digital intensive nursing system software to run and use in the hospital and obtain significant results.
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Nuño L, Guilera G, Rojo E, Gómez-Benito J, Barrios M. An Integrated Account of Expert Perspectives on Functioning in Schizophrenia. J Clin Med 2021; 10:jcm10184223. [PMID: 34575332 PMCID: PMC8465628 DOI: 10.3390/jcm10184223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 09/09/2021] [Indexed: 11/28/2022] Open
Abstract
An integrated and interdisciplinary care system for individuals with schizophrenia is essential, which implies the need for a tool that assesses the difficulties and contextual factors of relevance to their functioning, and facilitates coordinated working across the different professions involved in their care. The International Classification of Functioning, Disability and Health Core Sets (ICF-CS) cover these requirements. This study aimed to evaluate the content validity of the ICF-CSs for schizophrenia from the perspective of experts. Six three-round Delphi studies were conducted with expert panels from different professional backgrounds which have played a significant role in the treatment of individuals with schizophrenia (psychiatry, psychology, nursing, occupational therapy, social work and physiotherapy). In total, 790 experts from 85 different countries participated in the first round. In total, 90 ICF categories and 28 Personal factors reached expert consensus (reached consensus from four or more professional perspectives). All the categories in the brief version of the ICF-CS for schizophrenia reached consensus from all the professional perspectives considered. As for the comprehensive version, 89.7% of its categories reached expert consensus. The results support the worldwide content validity of the ICF-CSs for schizophrenia from an expert perspective and underline the importance of assessing functioning by considering all the components implied.
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Affiliation(s)
- Laura Nuño
- Clinical Institute of Neuroscience (ICN), Hospital Clinic, 08036 Barcelona, Spain
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, 08007 Barcelona, Spain; (G.G.); (J.G.-B.); (M.B.)
- Correspondence:
| | - Georgina Guilera
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, 08007 Barcelona, Spain; (G.G.); (J.G.-B.); (M.B.)
- Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences, University of Barcelona, 08007 Barcelona, Spain
| | - Emilio Rojo
- Hospital Benito Menni CASM, Sisters Hospitallers, 08830 Sant Boi de Llobregat, Spain;
- Department of Psychiatry, International University of Catalonia, 08007 Barcelona, Spain
| | - Juana Gómez-Benito
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, 08007 Barcelona, Spain; (G.G.); (J.G.-B.); (M.B.)
- Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences, University of Barcelona, 08007 Barcelona, Spain
| | - Maite Barrios
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, 08007 Barcelona, Spain; (G.G.); (J.G.-B.); (M.B.)
- Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences, University of Barcelona, 08007 Barcelona, Spain
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De Baetselier E, Dilles T, Batalha LM, Dijkstra NE, Fernandes MI, Filov I, Friedrichs J, Grondahl VA, Heczkova J, Helgesen AK, Jordan S, Keeley S, Klatt T, Kolovos P, Kulirova V, Ličen S, Lillo-Crespo M, Malara A, Padysakova H, Prosen M, Pusztai D, Riquelme-Galindo J, Rottkova J, Sino CG, Talarico F, Tziaferi S, Van Rompaey B. Perspectives of nurses' role in interprofessional pharmaceutical care across 14 European countries: A qualitative study in pharmacists, physicians and nurses. PLoS One 2021; 16:e0251982. [PMID: 34043650 PMCID: PMC8158867 DOI: 10.1371/journal.pone.0251982] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 05/07/2021] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES To understand healthcare professionals' experiences and perceptions of nurses' potential or ideal roles in pharmaceutical care (PC). DESIGN Qualitative study conducted through semi-structured in-depth interviews. SETTING Between December 2018 and October 2019, interviews were conducted with healthcare professionals of 14 European countries in four healthcare settings: hospitals, community care, mental health and long-term residential care. PARTICIPANTS In each country, pharmacists, physicians and nurses in each of the four settings were interviewed. Participants were selected on the basis that they were key informants with broad knowledge and experience of PC. DATA COLLECTION AND ANALYSIS All interviews were conducted face to face. Each country conducted an initial thematic analysis. Consensus was reached through a face-to-face discussion of all 14 national leads. RESULTS 340 interviews were completed. Several tasks were described within four potential nursing responsibilities, that came up as the analysis themes, being: 1) monitoring therapeutic/adverse effects of medicines, 2) monitoring medicines adherence, 3) decision making on medicines, including prescribing 4) providing patient education/information. Nurses' autonomy varied across Europe, from none to limited to a few tasks and emergencies to a broad range of tasks and responsibilities. Intended level of autonomy depended on medicine types and level of education. Some changes are needed before nursing roles can be optimised and implemented in practice. Lack of time, shortage of nurses, absence of legal frameworks and limited education and knowledge are main threats to European nurses actualising their ideal role in PC. CONCLUSIONS European nurses have an active role in PC. Respondents reported positive impacts on care quality and patient outcomes when nurses assumed PC responsibilities. Healthcare professionals expect nurses to report observations and assessments. This key patient information should be shared and addressed by the interprofessional team. The study evidences the need of a unique and consensus-based PC framework across Europe.
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Affiliation(s)
- Elyne De Baetselier
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- * E-mail:
| | - Tinne Dilles
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Luis M. Batalha
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Nienke E. Dijkstra
- Research Group Care for the Chronically Ill, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Maria I. Fernandes
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Izabela Filov
- University "St. Kliment Ohridski" Bitola, Bitola, Republic of North-Macedonia
| | - Juliane Friedrichs
- Medical Faculty, Institute of Health and Nursing Science, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Vigdis A. Grondahl
- Faculty of Health and Welfare, Østfold University College, Halden, Norway
| | - Jana Heczkova
- Institute of Nursing Theory and Practice, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ann Karin Helgesen
- Faculty of Health and Welfare, Østfold University College, Halden, Norway
| | - Sue Jordan
- Department of Nursing, Swansea University, Swansea, Wales, United Kingdom
| | - Sarah Keeley
- Department of Nursing and Clinical Science, Bournemouth University, Bournemouth, England, United Kingdom
| | - Thomas Klatt
- Medical Faculty, Institute of Health and Nursing Science, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Petros Kolovos
- Department of Nursing, Laboratory of Integrated Health Care, University of Peloponnese, Sparti, Greece
| | - Veronika Kulirova
- Institute of Nursing Theory and Practice, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Sabina Ličen
- Faculty of Health Sciences, Department of Nursing, University of Primorska, Izola, Slovenia
| | - Manuel Lillo-Crespo
- Department of Nursing, Faculty of Health Sciences, University of Alicante, Alicante, Spain
| | | | - Hana Padysakova
- Faculty of Nursing and Professional Health Studies, Slovak Medical University in Bratislava, Bratislava, Slovak Republic
| | - Mirko Prosen
- Faculty of Health Sciences, Department of Nursing, University of Primorska, Izola, Slovenia
| | - Dorina Pusztai
- Institute of Nursing Sciences, Basic Health Sciences and Health Visiting, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - Jorge Riquelme-Galindo
- Department of Nursing, Faculty of Health Sciences, University of Alicante, Alicante, Spain
| | - Jana Rottkova
- Faculty of Nursing and Professional Health Studies, Slovak Medical University in Bratislava, Bratislava, Slovak Republic
| | - Carolien G. Sino
- Research Group Care for the Chronically Ill, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | | | - Styliani Tziaferi
- Department of Nursing, Laboratory of Integrated Health Care, University of Peloponnese, Sparti, Greece
| | - Bart Van Rompaey
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Ercis M, Seçkin M, Ayık B, Üçok A. Correlates of Patient Satisfaction in Psychiatric Inpatient Care: A Survey Study from a Tertiary Hospital in Turkey. J Psychosoc Nurs Ment Health Serv 2020; 59:38-47. [PMID: 33301044 DOI: 10.3928/02793695-20201203-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In the current study, a questionnaire to evaluate satisfaction levels and related factors upon discharge was completed by 100 patients receiving care for mental illness in a tertiary care hospital in Turkey. The relationships among sociodemographic variables, nonpharmacological interventions, and participants' views about the treatment course and quality of care they received were investigated. Overall satisfaction levels of participants were good. Older participants reported more positive opinions. Involuntary hospitalization, use of restraints/seclusion, or electroconvulsive therapy did not change overall satisfaction. Participants who were hospitalized for the first time were more afraid of other patients, which may imply that this population needs special care from the treatment team. Spending an adequate amount of time and providing necessary information about their treatment plan impact patients' treatment experience positively. [Journal of Psychosocial Nursing and Mental Health Services, 59(4), 38-47.].
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Færden A, Bølgen B, Løvhaug L, Thoresen C, Dieset I. Patient satisfaction and acute psychiatric inpatient treatment. Nord J Psychiatry 2020; 74:577-584. [PMID: 32427019 DOI: 10.1080/08039488.2020.1764620] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background: Patient satisfaction (PS) with treatment is one of different outcome- and quality measures used by health care providers worldwide to improve service. We report from a study of patients admitted to the Department of Acute Psychiatry at the Oslo University Hospital where we investigated PS and difference between genders, days of hospital stay, diagnostic groups, voluntary-and involuntary admitted patients according to hospital records and perceived voluntary-and involuntary admittance.Materials and methods: All admitted patients during a 9-month period in 2014 were asked to participate by written consent. We used The Psychiatric Inpatient Questionnaire (PIPEQ), a self-report survey validated for assessment post-discharge. Analyses were conducted for a general dimension of PS and individual questions. A user representative was a part of the study from the beginning.Results: A total of 357 patients were asked and 256 consented. Results show that 68% were over all satisfied and 14% dissatisfied. Highest PS was found for cooperation with relatives and lowest for influence on choice of treatment and medication. We found no significant difference in PS between men and women, but patients with a personality disorder and with short stay were less satisfied. PS was significantly less for those perceiving involuntary admission regardless of legal status.Conclusion: The PIPEQ gives important input of patient's experience with the delivery of care. Answers range from very much satisfied to not at all depending on what was asked for. Exploring PS provides valuable information for quality improvements for different patient groups.
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Affiliation(s)
- Ann Færden
- Division of Mental Health and Addiction, Department of Acute Psychiatry, Oslo University Hospital, Oslo, Norway
| | | | - Lars Løvhaug
- Division of Mental Health and Addiction, Department of Acute Psychiatry, Oslo University Hospital, Oslo, Norway
| | | | - Ingrid Dieset
- Division of Mental Health and Addiction, Department of Acute Psychiatry, Oslo University Hospital, Oslo, Norway
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Facchinetti G, Piredda M, Ausili D, Angaroni V, Albanesi B, Marchetti A, Di Mauro S, De Marinis MG. Information before discharge in geriatric patients in Italy: cultural adaptation and validation of the Patient Continuity of Care Questionnaire. Eur J Ageing 2020; 18:99-107. [PMID: 33746685 DOI: 10.1007/s10433-020-00576-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Our aim is to culturally adapt the first section of the Patient Continuity of Care Questionnaire (PCCQ) for use among older Italian patients with chronic diseases and to test its psychometric properties. The PCCQ was translated, adapted to the Italian context, and completed by 236 older inpatients with chronic diseases at the point of discharge through a cross-sectional multi-centre validation study. Face and content validity were assessed. Exploratory factor analysis (EFA) with Mplus MLr estimator was conducted. Internal consistency was analysed through Cronbach's alpha and factor score determinacy coefficients. The overall content validity index of the 15-item Italian version of the questionnaire was 0.9. The EFA revealed a four-factor model yielding adequate fit indices. The factor score determinacy coefficients ranged from 0.87 to 0.94. The Cronbach's alpha coefficients ranged from 0.71 to 0.86 showing good reliability. The study provides health professionals with an instrument with adequate psychometric properties to assess patients' perception of the information received before hospital discharge.
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Affiliation(s)
- Gabriella Facchinetti
- Department of Biomedicine and Prevention, School of Nursing, Faculty of Medicine, Tor Vergata University, Via Montpellier 1, 00133 Rome, Italy.,Research Unit Nursing Science, Campus Bio-Medico di Roma University, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Michela Piredda
- Research Unit Nursing Science, Campus Bio-Medico di Roma University, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Davide Ausili
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | | | - Beatrice Albanesi
- Department of Biomedicine and Prevention, School of Nursing, Faculty of Medicine, Tor Vergata University, Via Montpellier 1, 00133 Rome, Italy
| | - Anna Marchetti
- Department of Biomedicine and Prevention, School of Nursing, Faculty of Medicine, Tor Vergata University, Via Montpellier 1, 00133 Rome, Italy.,Research Unit Nursing Science, Campus Bio-Medico di Roma University, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Stefania Di Mauro
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Maria Grazia De Marinis
- Research Unit Nursing Science, Campus Bio-Medico di Roma University, Via Alvaro del Portillo 21, 00128 Rome, Italy
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Mirniam AA, Habibi Z, Khosravi A, Sadeghi M, Eghbali-Babadi M. A clinical trial on the effect of a multifaceted intervention on blood pressure control and medication adherence in patients with uncontrolled hypertension. ARYA ATHEROSCLEROSIS 2020; 15:267-274. [PMID: 32206070 PMCID: PMC7073804 DOI: 10.22122/arya.v15i6.1904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Hypertension (HTN) is the key risk factor for cardiovascular diseases (CVDs). The purpose of this study was to determine the effect of a multifaceted intervention on blood pressure (BP) control and medication adherence (MA) among patients with uncontrolled HTN. METHODS A randomized controlled clinical trial study was conducted on 72 patients in the emergency ward who were selected through convenience sampling method. They were randomly divided into intervention and control groups. The studied multifaceted intervention includes motivational interviews and 90 minutes of training sessions, use of a drug reminder box, family support, and 4 phone call follow-ups. The8-Item Morisky Medication Adherence Scale (MMAS-8) was used before and after the intervention. BP was measured in both groups before and after the intervention and compared between them. RESULTS No significant difference existed between the two groups in terms of MA and systolic and diastolic BP before the study. The differences between the mean changes in post-intervention systolic (-25.75 ± 19.39 vs. -2.88 ± 11.92 mmHG; P < 0.001) and diastolic (-6.18 ± 8.87 vs. -1.06 ± 8.70 mmHg; P = 0.010) BP in the intervention and control groups were statistically significant. The mean changes in post-intervention MA in the intervention and control group was 2.91 ± 1.64 and -0.36 ± 1.15, respectively; this difference was statistically significant (P < 0.001). CONCLUSION The studied multifaceted intervention promoted MA and reduced systolic and diastolic BP. Thus, the use of this method as a supplementary treatment is recommended after patient discharge.
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Affiliation(s)
- Azam-Alsadat Mirniam
- MSc Student, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Habibi
- MSc Student, Global Studies Institute, University of Geneva, Geneva, Switzerland
| | - Alireza Khosravi
- Professor, Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Sadeghi
- Professor, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Eghbali-Babadi
- Assistant Professor, Nursing and Midwifery Care Research Center AND Department of Intensive Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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12
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Tyler N, Wright N, Waring J. Interventions to improve discharge from acute adult mental health inpatient care to the community: systematic review and narrative synthesis. BMC Health Serv Res 2019; 19:883. [PMID: 31760955 PMCID: PMC6876082 DOI: 10.1186/s12913-019-4658-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 10/20/2019] [Indexed: 01/25/2023] Open
Abstract
Background The transition from acute mental health inpatient to community care is often a vulnerable period in the pathway, where people can experience additional risks and anxiety. Researchers globally have developed and tested a number of interventions that aim to improve continuity of care and safety in these transitions. However, there has been little attempt to compare and contrast the interventions and specify the variety of safety threats they attempt to resolve. Methods The study aimed to identify the evidence base for interventions to support continuity of care and safety in the transition from acute mental health inpatient to community services at the point of discharge. Electronic Databases including PsycINFO, MEDLINE, Embase, HMIC, CINAHL, IBSS, Cochrane Library Trials, ASSIA, Web of Science and Scopus, were searched between 2000 and May 2018. Peer reviewed papers were eligible for inclusion if they addressed adults admitted to an acute inpatient mental health ward and reported on health interventions relating to discharge from the acute ward to the community. The results were analysed using a narrative synthesis technique. Results The total number of papers from which data were extracted was 45. The review found various interventions implemented across continents, addressing problems related to different aspects of discharge. Some interventions followed a distinct named approach (i.e. Critical Time Intervention, Transitional Discharge Model), others were grouped based on key components (i.e. peer support, pharmacist involvement). The primary problems interventions looked to address were reducing readmission, improving wellbeing, reducing homelessness, improving treatment adherence, accelerating discharge, reducing suicide. The 69 outcomes reported across studies were heterogeneous, meaning it was difficult to conduct comparative quantitative meta-analysis or synthesis. Conclusions The interventions reviewed are spread across a spectrum ranging from addressing a single problem within a single agency with a single solution, to multiple solutions addressing multi-agency problems. We recommend that future research attempts to improve homogeneity in outcome reporting.
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Affiliation(s)
- Natasha Tyler
- NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK.
| | - Nicola Wright
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Justin Waring
- NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK.,Health Services Management Centre, School of Social Policy, University of Birmingham, Birmingham, UK
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Kang E, Gillespie BM, Tobiano G, Chaboyer W. General surgical patients' experience of hospital discharge education: A qualitative study. J Clin Nurs 2019; 29:e1-e10. [PMID: 31509311 DOI: 10.1111/jocn.15057] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/18/2019] [Accepted: 09/03/2019] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To explore adult general surgical patients' perceptions of, and satisfaction with, discharge education provided by healthcare providers. BACKGROUND Discharge education is essential for general surgical patients as it equips them with the required knowledge and skills to engage in their care after discharge. Insufficient knowledge to self-manage or assess their symptoms can result in postdischarge complications, unplanned hospital readmission and overall dissatisfaction with the hospital experience. DESIGN A constructivist-interpretivist paradigm using qualitative interviews. METHODS Telephone interviews were conducted with 13 patients between August 2018 and November 2018 and analysed using inductive content analysis. COREQ guidelines were adopted for the conduct and reporting of the study. RESULTS Four themes were uncovered: (a) The quality of discharge information influences patients' postdischarge experience; (b) The negative impact of contextual influences on delivery of discharge education; (c) Patients actively participating in their surgical journey; (d) Patients' preferences with the delivery of discharge education. CONCLUSION Inadequate discharge education leads to patients' inability to self-manage their recovery process. Information sharing with patients fosters shared understanding towards goals and expectations. RELEVANCE TO CLINICAL PRACTICE Understanding patients' view may inform the design of patient-centred discharge education interventions for patients to self-manage their recovery postdischarge.
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Affiliation(s)
- Evelyn Kang
- School of Nursing and Midwifery, Griffith University, Gold Coast, Qld, Australia
| | - Brigid M Gillespie
- School of Nursing and Midwifery, Griffith University, Gold Coast, Qld, Australia.,Nursing and Midwifery Education and Research Unit, Gold Coast University Hospital, Gold Coast Health, Gold Coast, Qld, Australia
| | - Georgia Tobiano
- Nursing and Midwifery Education and Research Unit, Gold Coast University Hospital, Gold Coast Health, Gold Coast, Qld, Australia
| | - Wendy Chaboyer
- School of Nursing and Midwifery, Griffith University, Gold Coast, Qld, Australia.,Healthcare Practice and Survivorship Program, Menzies Health Institute Queensland, Gold Coast, Qld, Australia
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Nuño L, Barrios M, Moller MD, Calderón C, Rojo E, Gómez-Benito J, Guilera G. An international survey of Psychiatric-Mental-Health Nurses on the content validity of the International Classification of Functioning, Disability and Health Core Sets for Schizophrenia. Int J Ment Health Nurs 2019; 28:867-878. [PMID: 30834663 DOI: 10.1111/inm.12586] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/07/2019] [Indexed: 12/12/2022]
Abstract
The International Classification of Functioning, Disability and Health (ICF) Core Sets for schizophrenia describe the key problems in functioning that are experienced by individuals with this disorder. This study examines the content validity of these Core Sets and aims to identify the most frequent problems faced by people with schizophrenia, considering for this analysis the perspective of Psychiatric-Mental-Health Nurses. The study complied with the COREQ checklist for qualitative studies. A total of 101 nurses from 30 countries covering all six World Health Organization regions participated in a Delphi study. Their responses in Round 1 were linked to ICF categories, retaining those reported by at least 5% of participants. In Round 2, they were asked to rate the relevance of each of these categories to the nursing care of patients with schizophrenia. This process was repeated in Round 3. A total of 2327 concepts were extracted in Round 1 and linked to ICF categories. Following the analysis, 125 categories and 31 personal factors were presented to the experts in rounds 2 and 3. Consensus (defined as agreement ≥75%) was reached for 97 of these categories and 29 personal factors. These categories corresponded to all those (N = 25) in the Brief Core Set and 87 of the 97 categories of the Comprehensive Core Set for schizophrenia. Ten new categories emerged. The Delphi process identified the problems in functioning that nurses encounter when treating individuals with schizophrenia, and the results supported the content validity of the Core Sets. We conclude that these Core Sets offer a comprehensive framework for structuring clinical information and guiding the treatment process.
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Affiliation(s)
- Laura Nuño
- Clinical Institute of Neuroscience (ICN), Hospital Clinic, Barcelona, Spain.,Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain
| | - Maite Barrios
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain.,Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Mary D Moller
- School of Nursing, Pacific Lutheran University, Tacoma, Washington, USA
| | - Caterina Calderón
- Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neuroscience, University of Barcelona, Barcelona, Spain.,Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Emilio Rojo
- Hospital Benito Menni CASM, Sisters Hospitallers, Sant Boi de Llobregat, Spain.,Department of Psychiatry, International University of Catalonia, Sant Cugat del Vallès, Spain
| | - Juana Gómez-Benito
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain.,Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Georgina Guilera
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain.,Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neuroscience, University of Barcelona, Barcelona, Spain
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15
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Abstract
PURPOSE OF STUDY Many hospitals established telephone follow-up (TFU) programs to improve care transitions and reduce hospital readmissions. However, there is a lack of knowledge on how to increase the outreach of TFU programs. This integrative review aims to answer the clinical practice question, "What is the best practice for increasing telephone follow-up reach rates post-hospital discharge?" PRIMARY PRACTICE SETTING The primary setting evaluated in this review was hospital-based phone call programs that are conducting post-hospital discharge TFU. METHODOLOGY In this integrative review, we searched studies published between January 2003 and November 2017. We searched 5 electronic databases including PubMed, EMBASE, CINAHL, Web of Science, and Cochrane. The Johns Hopkins Nursing Evidence-Based Practice model was used to critically analyze and synthesize the selected articles. RESULTS Nine articles were reviewed, and this study uncovered that pre-hospital face-to-face meeting might increase TFU reach rates. However, most studies calculated reach rates using only frequencies/percentages. This contributed to our low-quality rating on most of the reviewed studies. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE This review identified that TFU, as a component of a care coordination program, may reduce hospital readmissions and control health care utilization. However, few studies (n = 2) used TFU reach rates as a major study outcome to determine the impact of face-to-face meetings on phone outreach. Therefore, the evidence is limited to inform case management practice to increase phone outreach post-hospital discharge. It is recommended to conduct further research and test different methods that may increase phone outreach.
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