Objective:To evaluate the practical application effect of nursing risk management in preventing falls among inpatients,and to provide a reference for optimizing clinical safety management strategies for inpatients.Met...Objective:To evaluate the practical application effect of nursing risk management in preventing falls among inpatients,and to provide a reference for optimizing clinical safety management strategies for inpatients.Methods:A total of 428 inpatients in our hospital from January 2021 to December 2023 were selected as the research objects.They were divided into a control group(218 cases)and a study group(210 cases)according to the nursing management method.The control group received routine fall prevention nursing,while the study group implemented systematic nursing risk management.The fall rate and post-fall injury rate during hospitalization were compared between the two groups.Results:The fall rate of the study group was significantly lower than that of the control group,and the difference was statistically significant(p<0.05).Conclusion:Nursing risk management can effectively reduce the fall rate and post-fall injury rate of inpatients through systematic risk identification,targeted intervention and continuous quality improvement.It also improves patients’awareness of fall prevention and nursing satisfaction,and promotes the improvement of nurses’risk management ability,which has important clinical promotion value.展开更多
Studies have shown that the implementation of targeted nursing countermeasures can significantly reduce the incidence of hypoglycemia in inpatients with diabetes mellitus,improve patients’quality of life,and promote ...Studies have shown that the implementation of targeted nursing countermeasures can significantly reduce the incidence of hypoglycemia in inpatients with diabetes mellitus,improve patients’quality of life,and promote the stable control of their condition.This paper conducts an in-depth analysis on the influencing factors of hypoglycemia in inpatients with diabetes mellitus and the corresponding nursing countermeasures.It expounds the main factors affecting hypoglycemia in inpatients with diabetes mellitus,and then puts forward effective nursing countermeasures.The purpose is to provide valuable references for promoting the innovative development of clinical nursing work.展开更多
Objective:To analyze the application effect of the Behavior Change Wheel(BCW)theory in fall prevention management for elderly inpatients.Methods:One hundred elderly inpatients admitted to Kunshan Fourth People’s Hosp...Objective:To analyze the application effect of the Behavior Change Wheel(BCW)theory in fall prevention management for elderly inpatients.Methods:One hundred elderly inpatients admitted to Kunshan Fourth People’s Hospital from January 2019 to April 2024 were selected and divided into an experimental group(fall prevention management intervention based on BCW theory)and a control group(routine fall prevention management intervention)using random sampling,with 50 patients in each group.The differences in knowledge,attitude,and behavior levels of fall prevention,prevention efficacy,and the incidence of falls and fall-related injuries during hospitalization,6 months after discharge,and 1 year after discharge were compared between the two groups.Results:Compared with before the intervention,the scores of the fall prevention knowledge,attitude,and behavior scale(knowledge dimension,attitude dimension,behavior dimension,and total score)for elderly inpatients in both groups increased,and the improvement in the experimental group was greater than that in the control group(P<0.05).After the intervention,the revised fall efficacy scale score was higher in the experimental group compared to the control group(P<0.05).The incidence of falls during hospitalization,6 months after discharge,and 1 year after discharge,as well as the rate of fall-related injuries 6 months and 1 year after discharge,were lower in the experimental group than in the control group(P<0.05).There was no statistically significant difference in the rate of fall-related injuries during hospitalization between the two groups(P>0.05).Conclusion:The fall prevention management intervention based on BCW theory has good application value in elderly inpatients.It effectively improves patients’knowledge,attitudes,and behavior levels regarding fall prevention,significantly enhances their self-prevention efficacy,and demonstrates good results in reducing the incidence of falls during hospitalization and after discharge.展开更多
BACKGROUND For children and adolescents,deliberate self-harm(DSH)is becoming a mental health problem of concern.Despite several studies on the prevalence and factors of DSH in the world,there is little information on ...BACKGROUND For children and adolescents,deliberate self-harm(DSH)is becoming a mental health problem of concern.Despite several studies on the prevalence and factors of DSH in the world,there is little information on DSH among children and adolescents in China.This study explores the prevalence,types,associated risk factors and tendency of DSH in pediatric psychiatric inpatients in China.AIM To understand the situation of DSH among hospitalized children and adolescents and its related factors.METHODS In this study,we retrospectively studied 1414 hospitalized children and adolescents with mental illness at Xiamen Mental Health Center from 2014 to 2019,extracted the demographic and clinical data of all patients,and analyzed clinical risk factors of DSH.RESULTS A total of 239(16.90%)patients engaged in at least one type of DSH in our study.Cutting(n=115,48.12%)was the most common type of DSH.Females(n=171,71.55%)were more likely to engage in DSH than males(n=68,28.45%).DSH was positively associated with depressive disorders[OR=3.845(2.196-6.732);P<0.01],female[OR=2.536(1.815-3.542);P<0.01],parental marital status[OR=5.387(2.254-12.875);P<0.01]and negative family history of psychiatric illness[OR=7.767(2.952-20.433);P<0.01],but not with occupation,substance use and history of physical abuse.CONCLUSION Our findings suggest that for patients with depression,females,an abnormal marriage of parents,and no history of mental illness,attention should be paid to the occurrence of DSH.展开更多
Our institution, Sultan Qaboos University Hospital, has set a protocol for vaccinating elderly > 65 years and eligible adult groups of patients against seasonal influenza and Streptococcus pneumoniae when admitted ...Our institution, Sultan Qaboos University Hospital, has set a protocol for vaccinating elderly > 65 years and eligible adult groups of patients against seasonal influenza and Streptococcus pneumoniae when admitted as inpatients or seen at outpatient clinics. Here, I assess the compliance of various medical teams with this policy. Background: Methods: electronic records of admitted patients in adult general medical words were reviewed for vaccination from 28 January 2024 until 28 February 2024. Results: Among 203 patients at presentation, 45 patients were new with unknown immunization status. At presentation, only seven and eleven of 158 patients (4.4% and 7%) had been vaccinated in the previous admission for influenza and Pneumococcus respectively. Upon discharge only four and six patients (2.12% and 3.24%) were given seasonal influenza and pneumococcal vaccines respectively. Discharge summaries and referral letters mentioned vaccination status of patients in two cases only. Conclusion: Rates of vaccination against influenza and S pneumoniae are very low in the elderly and adult patients with chronic medical conditions. A surveillance system needs to be set in place to monitor this.展开更多
Objective To investigate the status of vitamin B 12 deficiency in elderly inpatients in the department of neurology. Methods A total number of 827 patients in the department of neurology of Shanghai Punan hospital, fr...Objective To investigate the status of vitamin B 12 deficiency in elderly inpatients in the department of neurology. Methods A total number of 827 patients in the department of neurology of Shanghai Punan hospital, from March 2007 to July 2008, were employed in the present study. They were 60 years or older, and the average age was 77.1±7.5 years old. All the patients were diagnosed with no severe hepatic or renal dysfunction, without any usage of vitamin B 12 during the previous 3 months before the detection. The levels of serum vitamin B 12, folate and homocysteine （Hcy） were evaluated. The patients with vitamin B 12 deficiency were screened. The resulting symptoms, positive signs of neurological examination, and the neuroelectricphysiological results were compared between patients with or without vitamin B 12 deficiency. Results Vitamin B 12 deficiency was found in 163 patients （19.71% of the total patients）, and was more prevalent in female than in male patients, also with increased incidences with aging. Patients with low levels of serum vitamin B 12 exhibited higher rate of gastrointestinal diseases, while only 9.82% of the vitamin B 12 deficient patients had megaloblastic anemia. Symptoms of vitamin B 12 deficiency included unsteadily walking in the darkness and hypopallesthesia, and some chronic diseases such as cerebral ischemia, hypertension, Parkinson＇s disease （Parkinsonism）, diabetes mellitus and coronary heart disease. Most of the vitamin B 12 deficient patients had neuroelectricphysiological abnormalities. Conclusion Vitamin B 12 deficiency is remarkably common in elderly patients in neurology department, with various and atypical clinical manifestations, and the neurological symptoms are more common than megaloblastic anemia symptoms.展开更多
Objective To assess nutritional status and define gender-and age-specific handgrip strength（HGS） cut-point values for malnutrition or nutritional risk in elderly inpatients. Methods A cross-sectional study of 1,343 ...Objective To assess nutritional status and define gender-and age-specific handgrip strength（HGS） cut-point values for malnutrition or nutritional risk in elderly inpatients. Methods A cross-sectional study of 1,343 elderly inpatients was conducted in the Chinese PLA General Hospital. Nutrition Risk Screening（NRS 2002） and Subjective Global Assessment（SGA） were administered. Anthropometric measurements and blood biochemical indicators were obtained using standard techniques. The gender-and age-specific receiver operating characteristic（ROC） curves were constructed to evaluate the HGS for nutritional status by SGA and NRS 2002. Sensitivity, specificity, and areas under the curves（AUCs） were calculated. Results According to NRS 2002 and SGA, 63.81% of elderly inpatients were at nutritional risk and 28.22% were malnourished. Patients with higher HGS had an independently decreased risk of malnutrition and nutritional risk. The AUCs varied between 0.670 and 0.761. According to NRS 2002, the optimal HGS cut-points were 27.5 kg（65-74 years） and 21.0 kg（75-90 years） for men and 17.0 kg（65-74 years） and 14.6 kg（75-90 years） for women. According to SGA, the optimal HGS cut-points were 24.9 kg（65-74 years） and 20.8 kg（75-90 years） for men and 15.2 kg（65-74 years） and 13.5 kg（75-90 years） for women. Conclusion Elderly inpatients had increased incidence of malnutrition or nutritional risk. HGS cut-points can be used for assessing nutritional status in elderly inpatients at hospital admission in China.展开更多
<strong>Objective</strong>: This paper aims to explore clinical status and related influence factors of pressure injury (PI) in the elderly inpatients with kidney disease, so as to provide reference for th...<strong>Objective</strong>: This paper aims to explore clinical status and related influence factors of pressure injury (PI) in the elderly inpatients with kidney disease, so as to provide reference for the prevention and treatment of PI in the elderly inpatients with kidney disease. <strong>Methods</strong>: Retrospective collection method is adopted to collect 158 clinical cases of the elderly inpatients with kidney disease aged ≥ 60 in the Nephrology Department, the First Affiliated Hospital of Jinan University from January 2017 to December 2019, and then least absolute shrinkage and selection Operator (LASSO) regression analysis is used to analyze 17 possible influence factors;finally Logistic regression model is established to analyze and screen influence factors of risk. <strong>Results</strong>: 1) Among 158 elderly inpatients with medium and high risk of PI, the incidence of PI is 20.25%;the most common stage of injury is stage I (42.5%);sacrococcygeal (60%) is the high-risk site of pressure injury. 2) LASSO regression analysis shows that history of present respiratory infection/respiratory failure (<em>β </em>= 1.2714. <em>P</em> < 0.05) and hospitalization time (<em>β</em> = 0.4177. <em>P </em>< 0.05) are independent factors influencing PI risk in the elderly inpatients with kidney disease. <strong>Concl</strong><strong>usio</strong><strong>n</strong>: The elderly patients with kidney disease and PI risk are the high incidence population of hospital acquired PI;for the elderly inpatients with kidney disease and having respiratory infection history or respiratory failure, prolonged hospitalization will significantly increase the risk of PI. Therefore, targeted preventive and control measures should be taken to reduce the incidence of PI.展开更多
In Europe, there are an increasing number of persons suffering from depression, which also affects many relatives. The burden and health when being the relative of an inpatient suffering from severe depression has bee...In Europe, there are an increasing number of persons suffering from depression, which also affects many relatives. The burden and health when being the relative of an inpatient suffering from severe depression has been less examined. The aim of the study was to describe burden, health and sense of coherence among relatives of inpatients with severe depression. Furthermore, the aim was to investigate relatives’ burden in relation to their health and sense of coherence. A cross-sectional design was performed, with a questionnaire consisting of background questions and three instruments;Burden Assessment Scale, General Health Questionnaire and Sense of Coherence scale. The participants consisted of 68 relatives recruited from a sample of inpatients diagnosed with depression in the psychiatric specialist health services in one hospital trust in Norway. The Regional Committee for Medical and Health Research Ethics, Norway South East, gave approval to the study. The relatives reported burden to a various degree, with some reporting a significantly greater burden, poorer health and a weaker sense of coherence than others. With regard to subjective burden eight out of ten relatives reported “Worry about future”, and almost six out of ten were “Upset by change in patient”. Regarding objective burden, more than half the relatives reported having “Less time for friends” and “Reduced leisure time”. In conclusion the relatives with a high level of burden reported more mental distress, poorer health and weaker sense of coherence than those with lower level of burden. Further research should focus on identification of factors predicting burden and health of relatives of inpatients with severe depression.展开更多
Objective This study aimed to assess anxiety,depression,and stress among inpatients with cancer.Methods Two hundred thirty-five hospitalized patients with cancer were surveyed with the Depression Anxiety Stress Scales...Objective This study aimed to assess anxiety,depression,and stress among inpatients with cancer.Methods Two hundred thirty-five hospitalized patients with cancer were surveyed with the Depression Anxiety Stress Scales(simplified Chinese Version).The software program SPSS 25.0 was used for statistical analysis of the survey data.Results The average scores of depression,anxiety,and stress of inpatients with cancer were 12.17,11.84,and 13.98 respectively,which were higher than the normal range.The scores of anxiety and stress of inpatients with different caregivers were statistically different(P=0.024/0.036).The anxiety and stress scores of inpatients with spouses as caregivers were higher than those of inpatients with children as caregivers.There was a statistically significant difference in the incidence of stress between inpatients with cancer with religious beliefs and inpatients with cancer without religious beliefs(P=0.026),and those with religious beliefs had greater incidence of stress.The score of anxiety was significantly higher for inpatients with children than for inpatients without children(P=0.040).Conclusion The anxiety,depression,and stress levels of inpatients with cancer are relatively high.It is necessary to pay special attention to the psychological status of these patients during clinical diagnosis and treatment to improve their quality of life.展开更多
Objectives:To construct a comprehensive evaluation indicator system for inpatients'nursing service needs in tertiary general hospital and to provide evidence for identifying and meeting the needs of inpatients'...Objectives:To construct a comprehensive evaluation indicator system for inpatients'nursing service needs in tertiary general hospital and to provide evidence for identifying and meeting the needs of inpatients'nursing services.Method:We used the Delphi method to conduct two rounds of expert consultations with 41 experts.Result:The indicator system consisting of 5 first-level indicators and 48 second-level indicators was preliminarily constructed.Conclusions:We formed an evaluation indicator system for inpatients'nursing service needs in tertiary general hospital and classified it into five categories:hospital environment,nursing attitude,nursing skills,information exchange,and emotional support.The indicator system is scientific and reliable.It can provide a basis for nursing staffs to identify and meet the needs of inpatients'care services.展开更多
Objective The aim of the study was to analyze hospital costs for cancer inpatients availing different methods of payment and the influencing factors, to provide inputs to improve the medical insurance payment policy. ...Objective The aim of the study was to analyze hospital costs for cancer inpatients availing different methods of payment and the influencing factors, to provide inputs to improve the medical insurance payment policy. Methods We analyzed the information related to length of hospital stay, hospitalization cost, and self-pay cost, collected from one large-scale, Grade A, Class Three hospital in Shenyang, China, during 2004–2013.Results The number of cancer inpatients with different payment types(medical insurance group and non-medical insurance group) presented a rising trend. Further, the ratio of medical insurance inpatients increased rapidly(from 22.2% to 48.7%); however, this group was still a minority. The length of hospital stay became shorter(21 d vs. 17 d; P = 0.000) while the gap got narrower; the hospitalized expense showed an upward trend and the difference was remarkable($24048.6 ± $4376.28 vs. $20544.36 ± $4057.01; P = 0.000). Conclusion Along with normalization of cancer therapy, the influence of payment on treatment has been getting weak, the policy has impact on controlling hospitalization cost, lightening burden of cancer patient, as well as allocating medical resources in a reasonable way, becoming an important defray pattern of hospitalization cost.展开更多
Objective: To understand the prevalence of anxiety and depression in medical patients in general hospitals and find out main influencing factors. Methods: According to the inclusion criteria, a total of 564 inpatients...Objective: To understand the prevalence of anxiety and depression in medical patients in general hospitals and find out main influencing factors. Methods: According to the inclusion criteria, a total of 564 inpatients from the Third Affiliated Hospital of Inner Mongolia Medical University were selected during January to June of 2015. Patients were assessed for anxiety and/or depression by use of Hospital Anxiety and Depression Scale (HADS), Hamilton Anxiety Scale (HAMAS) and Hamilton Depression Scale (HAMDS). Meanwhile, final diagnosis was made on the basis of diagnostic criteria listed in Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV). Results: In different departments, the positive rate (HADS ≥ 8) was the highest in Department of Oncology (45.42%), and the lowest in Department of Gastroenterology (16.05%). After assessment with the help of HAMD and HAMA, the prevalence of anxiety/depression was the highest in Department of Oncology (46.43%), and the lowest in Department of Gastroenterology (16.05%). There was no statistical significance in diagnostic results acquired from HAMD and HAMA (p = .071). Two types of diagnostic methods were highly consistent (κ = 0.852, p = .000). Inpatients aged from 40 to 59 years, with junior high school education or below, very tiring work, poor marital status (separated, divorced, widowed), unharmonious family, low personal income, completely self-paying and family history of anxiety and depression, currently unable to take care of themselves were more prone to anxiety and depression (p < .05). Conclusions: The prevalence of anxiety and depression in medical patients in general hospitals is high due to many influencing factors. It is necessary to establish an effective diagnosis and treatment system for anxiety and depression, in order to make patients easy to receive an early and comprehensive treatment and improve their life quality.展开更多
Objective： The aim of this study was to explore the characteristics of and preventive management strategies for suicidal inpatients in a general hospital.Methods： A total of 54 suicide victims were drawn from a p...Objective： The aim of this study was to explore the characteristics of and preventive management strategies for suicidal inpatients in a general hospital.Methods： A total of 54 suicide victims were drawn from a patient safety adverse event network reporting system during hospitalization in a general hospital from November 2008 to January 2017.Results： Subjects who committed suicide in the general hospital were women and those who suffered from malignant neoplasms during general hospital treatment. Furthermore, most of the patients who committed suicide used more violent suicide methods. The most common and lethal means was jumping from heights at the windowsill.Conclusions： It is concluded that management straties for suicide prevention can be provided from the aspects of patients, medical staff and the hospital environment. It is not only urgent but also feasible to reduce the suicide rate of inpatients and further improve hospital safety management.展开更多
AIM To identify factors associated with depressive symptoms among inpatients with cardiovascular disease(CVD). METHODS This is a cross-sectional study performed in a subsample of a large cross-sectional research that ...AIM To identify factors associated with depressive symptoms among inpatients with cardiovascular disease(CVD). METHODS This is a cross-sectional study performed in a subsample of a large cross-sectional research that investigated affective disorders and suicide behaviour among inpatients hospitalized in non-surgical wards of the University Hospital of the Federal University of Minas Gerais from November 2013 to October 2015. Sociodemographic and clinical data were obtained through a structured interview and medical record review. Depression was assessed by the depression subscale of the Hospital Anxiety and Depression Scale, with scores ≥ 8 considered as positive screening for depression. We used the Fagestr?m Test for Nicotine Dependence to characterize nicotine dependence. For assessing resilience and early-life trauma, we used the raw scores of the Wagnild and Young Resilience Scale and Childhood Trauma Questionnaire, respectively.RESULTS At endpoint, we included 137 subjects. Thirty-eight(27.7%) subjects presented depressive symptoms and nine(23.7%) of those were receiving antidepressant treatment during hospitalization. The female sex; a lower mean educational level; a greater prevalence of previous suicide attempts; a higher level of pain; a higher prevalence of family antecedents of mental disorders; a lower resilience score; and higher childhood trauma score were the factors significantly associated with screening positive for major depression(P < 0.05). Multivariate analysis demonstrated that the factors independently associated with the depressive symptoms were a higher childhood trauma severity(OR = 1.06; P = 0.004); moderate to severe nicotine dependence(OR = 8.58; P = 0.008); and the number of previous hospital admissions(OR = 1.11; P = 0.034). The obtained logistic model was considered valid, indicating that the three factors together distinguished between having or not depressive symptoms, and correctly classified 74.6% of individuals in the sample.CONCLUSION Our results demonstrate that inpatients presenting both CVD and a positive screening for depression are more prone to have antecedents of childhood trauma, nicotine dependence and a higher number of previous hospitalizations.展开更多
BACKGROUND In children and adolescents compared to adults,clinical high-risk of psychosis(CHR)criteria and symptoms are more prevalent but less psychosis-predictive and less clinically relevant.Based on high rates of ...BACKGROUND In children and adolescents compared to adults,clinical high-risk of psychosis(CHR)criteria and symptoms are more prevalent but less psychosis-predictive and less clinically relevant.Based on high rates of non-converters to psychosis,especially in children and adolescents,it was suggested that CHR criteria were:(1)Pluripotential;(2)A transdiagnostic risk factor;and(3)Simply a severity marker of mental disorders rather than specifically psychosis-predictive.If any of these three alternative explanatory models were true,their prevalence should differ between persons with and without mental disorders,and their severity should be associated with functional impairment as a measure of severity.AIM To compare the prevalence and severity of CHR criteria/symptoms in children and adolescents of the community and inpatients.METHODS In the mainly cross-sectional examinations,8–17-year-old community subjects(n=233)randomly chosen from the population register of the Swiss Canton Bern,and inpatients(n=306)with primary diagnosis of attention-deficit/hyperactivity disorder(n=86),eating disorder(n=97),anxiety including obsessive–compulsive disorder(n=94),or autism spectrum disorder(n=29),not clinically suspected to develop psychosis,were examined for CHR symptoms/criteria.Positive items of the Structured Interview for Psychosis-Risk Syndromes(SIPS)were used to assess the symptomatic ultra-high-risk criteria,and the Schizophrenia Proneness Instrument,Child and Youth version(SPI-CY)was used to assess the 14 basic symptoms relevant to basic symptom criteria.We examined group differences in frequency and severity of CHR symptoms/criteria usingχ^(2) tests and nonparametric tests with Cramer’s V and Rosenthal’s r as effect sizes,and their association with functioning using correlation analyses.RESULTS The 7.3%prevalence rate of CHR criteria in community subjects did not differ significantly from the 9.5%rate in inpatients.Frequency and severity of CHR criteria never differed between the community and the four inpatient groups,while the frequency and severity of CHR symptoms differed only minimally.Group differences were found in only four CHR symptoms:suspiciousness/persecutory ideas of the SIPS[χ2(4)=9.425;P=0.051,Cramer’s V=0.132;and Z=-4.281,P<0.001;Rosenthal’s r=0.184],and thought pressure[χ^(2)(4)=11.019;P=0.026,Cramer’s V=0.143;and Z=-2.639,P=0.008;Rosenthal’s r=0.114],derealization[χ2(4)=32.380;P<0.001,Cramer’s V=0.245;and Z=-3.924,P<0.001;Rosenthal’s r=0.169]and visual perception disturbances[χ^(2)(4)=10.652;P=0.031,Cramer’s V=0.141;and Z=-2.822,P=0.005;Rosenthal’s r=0.122]of the SPI-CY.These were consistent with a transdiagnostic risk factor or dimension,i.e.,displayed higher frequency and severity in inpatients,in particular in those with eating,anxiety/obsessive–compulsive and autism spectrum disorders.Low functioning,however,was at most weakly related to the severity of CHR criteria/symptoms,with the highest correlation yielded for suspiciousness/persecutory ideas(Kendall’s tau=-0.172,P<0.001).CONCLUSION The lack of systematic differences between inpatients and community subjects does not support suggestions that CHR criteria/symptoms are pluripotential or transdiagnostic syndromes,or merely markers of symptom severity.展开更多
Background: After the March 2011 “triple” disaster in Japan, the residents of Fukushima Prefecture suffered from serious psychological stress. Aims: This study aimed to elucidate the influence of stressful condition...Background: After the March 2011 “triple” disaster in Japan, the residents of Fukushima Prefecture suffered from serious psychological stress. Aims: This study aimed to elucidate the influence of stressful conditions on psychiatric disorders, as reflected in new psychiatric admissions. Methods: Diagnoses and background conditions among new psychiatric admissions during the 3 months immediately after the disaster in 2011 and the corresponding time periods of 2010 and 2012 were surveyed. Results: In 2011, more patients were admitted in confusional, manic, neurasthenic, and delirious states, whereas there were fewer admissions for depression. In 2012, more admissions pertained to depression. Twenty-four percent of the new admissions in 2011 were associated with concerns about radiation contamination and hospitalization, which declined to 4% in 2012. Conclusions: The diagnoses and background conditions among new psychiatric admissions were affected by the disaster;with the influence differing according to the time elapsed after the disaster.展开更多
Delirium is a complex neuropsychiatric syndrome that is often associated with adverse outcomes including prolonged hospitalization. This study aims to determine the length of hospital stay among medically-ill patients...Delirium is a complex neuropsychiatric syndrome that is often associated with adverse outcomes including prolonged hospitalization. This study aims to determine the length of hospital stay among medically-ill patients with and without delirium who were admitted through the Accident and Emergency unit of the Jos University Teaching Hospital, in North-Central Nigeria. It was a cross-sectional study that employed a consecutive sampling technique to select 290 eligible subjects in a face-to-face interview, using a confusion assessment method to assess for delirium within 24 hours of admission. All the respondents were followed-up from the Accident and Emergency unit until discharge or death. The results showed that respondents with delirium rather than those without, were significantly more likely to stay longer in the hospital (P < 0.001). The significant factors associated with prolonged hospitalization among those with delirium include, current medications use, duration of illness before presentation and type of medical diagnosis (P < 0.001), (P < 0.001) and (P < 0.001) respectively. The results point to the importance of screening for delirium in medically-ill patients, with particular attention to patients with infectious and cerebrovascular diseases.展开更多
Background: Delirium is one of the most common medical emergencies and is associated with poor outcomes including: mortality, prolonged length of stay and poor functional outcome. The more severe delirium is the worst...Background: Delirium is one of the most common medical emergencies and is associated with poor outcomes including: mortality, prolonged length of stay and poor functional outcome. The more severe delirium is the worst the clinical outcomes of medical illness. Despite the obvious, not much has been documented on delirium severity and its associated factors among medical inpatients in low income countries including Nigeria. Objectives: This study was conducted to examine the severity of delirium among medical inpatients admitted through the Accident and Emergency unit of Jos University Teaching Hospital as well as to assess its associated Sociodemographic and Clinical characteristics. Method: This was a cross-sectional study that employed a consecutive sampling technique to select 290 eligible subjects from medical inpatients that presented to Accident and Emergency unit of Jos University Teaching Hospital. On admission, patients were assessed for delirium using Confusion Assessment Method and severity of delirium was evaluated using Delirium Rating Scale-Revised-98. Results: Of the 105 delirious medical inpatients, 48 (45.7%) had severe delirium, 41 (39.1%) developed less severe delirium while 16 (15.2) presented with no severe delirium. Sociodemographic characteristics found to be significantly associated with less to more severe delirium include male gender (P = 0.001), nonprofessionals (P = 0.003), income range of N20,000 - N49,000 (P Conclusion: This study demonstrates that delirium is often associated with higher severity in Accident and Emergency unit admission and there are strongly associated clinical characteristics to watch out for in high risk medical inpatients.展开更多
<strong>Background:</strong> Frailty is a geriatric syndrome, and a common negative consequence of aging, which shares some obvious characteristics as cognitive impairment. Preventing and relieving frailty...<strong>Background:</strong> Frailty is a geriatric syndrome, and a common negative consequence of aging, which shares some obvious characteristics as cognitive impairment. Preventing and relieving frailty may reduce the possibility of developing cognitive impairment. <strong>Objective: </strong>This study aimed to investigate frailty prevalence and its correlation with cognitive function in elderly surgical inpatients. <strong>Methods: </strong>We enrolled a random sample of elderly surgical inpatients from Jingzhou from June 2020 to August 2020. We used a self-made registration sheet to collect their demographic data (gender, age, nationality, educational level and monthly income), and used the FRAIL Scale to assess the prevalence of frailty, and used the Mini-Mental State Examination (MMSE) to assess cognitive function. We used multiple linear regression analysis to explore the correlation between frailty level and demographic data, then Pearson correlation analysis was performed to analyze the correlation between frailty and cognitive function. <strong>Results: </strong>In the 143 elderly surgical inpatients, prevalence of frail was seen in 29 (20.3%), and pre-frail state was found in 64 (44.8%). Only 50 (34.9%) were in healthy state. Cognitive impairment was seen in 28 (19.5%). Pearson correlation analysis showed that the frail scoring was correlated with cognitive function in elderly surgical inpatients (r = -0.378, P < 0.05). <strong>Conclusion:</strong> The prevalence of frailty is high in elderly surgical inpatients, which is closely related to age and gender. Elderly surgical inpatients have high cognitive impairment, and frailty appears strongly associated with cognitive status. The findings suggest that attention should be paid to the frailty and cognitive function in the elderly surgical inpatients by pro-vision of effective interventions.展开更多
文摘Objective:To evaluate the practical application effect of nursing risk management in preventing falls among inpatients,and to provide a reference for optimizing clinical safety management strategies for inpatients.Methods:A total of 428 inpatients in our hospital from January 2021 to December 2023 were selected as the research objects.They were divided into a control group(218 cases)and a study group(210 cases)according to the nursing management method.The control group received routine fall prevention nursing,while the study group implemented systematic nursing risk management.The fall rate and post-fall injury rate during hospitalization were compared between the two groups.Results:The fall rate of the study group was significantly lower than that of the control group,and the difference was statistically significant(p<0.05).Conclusion:Nursing risk management can effectively reduce the fall rate and post-fall injury rate of inpatients through systematic risk identification,targeted intervention and continuous quality improvement.It also improves patients’awareness of fall prevention and nursing satisfaction,and promotes the improvement of nurses’risk management ability,which has important clinical promotion value.
文摘Studies have shown that the implementation of targeted nursing countermeasures can significantly reduce the incidence of hypoglycemia in inpatients with diabetes mellitus,improve patients’quality of life,and promote the stable control of their condition.This paper conducts an in-depth analysis on the influencing factors of hypoglycemia in inpatients with diabetes mellitus and the corresponding nursing countermeasures.It expounds the main factors affecting hypoglycemia in inpatients with diabetes mellitus,and then puts forward effective nursing countermeasures.The purpose is to provide valuable references for promoting the innovative development of clinical nursing work.
基金Application of Behavior Change Wheel(BCW)Theory in Fall Prevention Management for Elderly Hospitalized Patients(Key Research and Development Program of Kunshan City,Jiangsu Province(KS2372))。
文摘Objective:To analyze the application effect of the Behavior Change Wheel(BCW)theory in fall prevention management for elderly inpatients.Methods:One hundred elderly inpatients admitted to Kunshan Fourth People’s Hospital from January 2019 to April 2024 were selected and divided into an experimental group(fall prevention management intervention based on BCW theory)and a control group(routine fall prevention management intervention)using random sampling,with 50 patients in each group.The differences in knowledge,attitude,and behavior levels of fall prevention,prevention efficacy,and the incidence of falls and fall-related injuries during hospitalization,6 months after discharge,and 1 year after discharge were compared between the two groups.Results:Compared with before the intervention,the scores of the fall prevention knowledge,attitude,and behavior scale(knowledge dimension,attitude dimension,behavior dimension,and total score)for elderly inpatients in both groups increased,and the improvement in the experimental group was greater than that in the control group(P<0.05).After the intervention,the revised fall efficacy scale score was higher in the experimental group compared to the control group(P<0.05).The incidence of falls during hospitalization,6 months after discharge,and 1 year after discharge,as well as the rate of fall-related injuries 6 months and 1 year after discharge,were lower in the experimental group than in the control group(P<0.05).There was no statistically significant difference in the rate of fall-related injuries during hospitalization between the two groups(P>0.05).Conclusion:The fall prevention management intervention based on BCW theory has good application value in elderly inpatients.It effectively improves patients’knowledge,attitudes,and behavior levels regarding fall prevention,significantly enhances their self-prevention efficacy,and demonstrates good results in reducing the incidence of falls during hospitalization and after discharge.
基金Supported by Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties,No.SZGSP013Shenzhen Key Medical Discipline Construction Fund,No.SZXK042+2 种基金Sanming Project of Medicine in Shenzhen,No.SZSM202311025Natural Science Fund of Fujian Province,No.2023J011622Natural Science Fund of Xiamen City,No.3502Z20224ZD1259.
文摘BACKGROUND For children and adolescents,deliberate self-harm(DSH)is becoming a mental health problem of concern.Despite several studies on the prevalence and factors of DSH in the world,there is little information on DSH among children and adolescents in China.This study explores the prevalence,types,associated risk factors and tendency of DSH in pediatric psychiatric inpatients in China.AIM To understand the situation of DSH among hospitalized children and adolescents and its related factors.METHODS In this study,we retrospectively studied 1414 hospitalized children and adolescents with mental illness at Xiamen Mental Health Center from 2014 to 2019,extracted the demographic and clinical data of all patients,and analyzed clinical risk factors of DSH.RESULTS A total of 239(16.90%)patients engaged in at least one type of DSH in our study.Cutting(n=115,48.12%)was the most common type of DSH.Females(n=171,71.55%)were more likely to engage in DSH than males(n=68,28.45%).DSH was positively associated with depressive disorders[OR=3.845(2.196-6.732);P<0.01],female[OR=2.536(1.815-3.542);P<0.01],parental marital status[OR=5.387(2.254-12.875);P<0.01]and negative family history of psychiatric illness[OR=7.767(2.952-20.433);P<0.01],but not with occupation,substance use and history of physical abuse.CONCLUSION Our findings suggest that for patients with depression,females,an abnormal marriage of parents,and no history of mental illness,attention should be paid to the occurrence of DSH.
文摘Our institution, Sultan Qaboos University Hospital, has set a protocol for vaccinating elderly > 65 years and eligible adult groups of patients against seasonal influenza and Streptococcus pneumoniae when admitted as inpatients or seen at outpatient clinics. Here, I assess the compliance of various medical teams with this policy. Background: Methods: electronic records of admitted patients in adult general medical words were reviewed for vaccination from 28 January 2024 until 28 February 2024. Results: Among 203 patients at presentation, 45 patients were new with unknown immunization status. At presentation, only seven and eleven of 158 patients (4.4% and 7%) had been vaccinated in the previous admission for influenza and Pneumococcus respectively. Upon discharge only four and six patients (2.12% and 3.24%) were given seasonal influenza and pneumococcal vaccines respectively. Discharge summaries and referral letters mentioned vaccination status of patients in two cases only. Conclusion: Rates of vaccination against influenza and S pneumoniae are very low in the elderly and adult patients with chronic medical conditions. A surveillance system needs to be set in place to monitor this.
基金supported by the grant from Shanghai Pudong New District Science and Technology Committee (No. PKJ2008-Y09)Shanghai Pudong New District Social Development Bureau (No. PDRd2006-09)
文摘Objective To investigate the status of vitamin B 12 deficiency in elderly inpatients in the department of neurology. Methods A total number of 827 patients in the department of neurology of Shanghai Punan hospital, from March 2007 to July 2008, were employed in the present study. They were 60 years or older, and the average age was 77.1±7.5 years old. All the patients were diagnosed with no severe hepatic or renal dysfunction, without any usage of vitamin B 12 during the previous 3 months before the detection. The levels of serum vitamin B 12, folate and homocysteine （Hcy） were evaluated. The patients with vitamin B 12 deficiency were screened. The resulting symptoms, positive signs of neurological examination, and the neuroelectricphysiological results were compared between patients with or without vitamin B 12 deficiency. Results Vitamin B 12 deficiency was found in 163 patients （19.71% of the total patients）, and was more prevalent in female than in male patients, also with increased incidences with aging. Patients with low levels of serum vitamin B 12 exhibited higher rate of gastrointestinal diseases, while only 9.82% of the vitamin B 12 deficient patients had megaloblastic anemia. Symptoms of vitamin B 12 deficiency included unsteadily walking in the darkness and hypopallesthesia, and some chronic diseases such as cerebral ischemia, hypertension, Parkinson＇s disease （Parkinsonism）, diabetes mellitus and coronary heart disease. Most of the vitamin B 12 deficient patients had neuroelectricphysiological abnormalities. Conclusion Vitamin B 12 deficiency is remarkably common in elderly patients in neurology department, with various and atypical clinical manifestations, and the neurological symptoms are more common than megaloblastic anemia symptoms.
文摘Objective To assess nutritional status and define gender-and age-specific handgrip strength（HGS） cut-point values for malnutrition or nutritional risk in elderly inpatients. Methods A cross-sectional study of 1,343 elderly inpatients was conducted in the Chinese PLA General Hospital. Nutrition Risk Screening（NRS 2002） and Subjective Global Assessment（SGA） were administered. Anthropometric measurements and blood biochemical indicators were obtained using standard techniques. The gender-and age-specific receiver operating characteristic（ROC） curves were constructed to evaluate the HGS for nutritional status by SGA and NRS 2002. Sensitivity, specificity, and areas under the curves（AUCs） were calculated. Results According to NRS 2002 and SGA, 63.81% of elderly inpatients were at nutritional risk and 28.22% were malnourished. Patients with higher HGS had an independently decreased risk of malnutrition and nutritional risk. The AUCs varied between 0.670 and 0.761. According to NRS 2002, the optimal HGS cut-points were 27.5 kg（65-74 years） and 21.0 kg（75-90 years） for men and 17.0 kg（65-74 years） and 14.6 kg（75-90 years） for women. According to SGA, the optimal HGS cut-points were 24.9 kg（65-74 years） and 20.8 kg（75-90 years） for men and 15.2 kg（65-74 years） and 13.5 kg（75-90 years） for women. Conclusion Elderly inpatients had increased incidence of malnutrition or nutritional risk. HGS cut-points can be used for assessing nutritional status in elderly inpatients at hospital admission in China.
文摘<strong>Objective</strong>: This paper aims to explore clinical status and related influence factors of pressure injury (PI) in the elderly inpatients with kidney disease, so as to provide reference for the prevention and treatment of PI in the elderly inpatients with kidney disease. <strong>Methods</strong>: Retrospective collection method is adopted to collect 158 clinical cases of the elderly inpatients with kidney disease aged ≥ 60 in the Nephrology Department, the First Affiliated Hospital of Jinan University from January 2017 to December 2019, and then least absolute shrinkage and selection Operator (LASSO) regression analysis is used to analyze 17 possible influence factors;finally Logistic regression model is established to analyze and screen influence factors of risk. <strong>Results</strong>: 1) Among 158 elderly inpatients with medium and high risk of PI, the incidence of PI is 20.25%;the most common stage of injury is stage I (42.5%);sacrococcygeal (60%) is the high-risk site of pressure injury. 2) LASSO regression analysis shows that history of present respiratory infection/respiratory failure (<em>β </em>= 1.2714. <em>P</em> < 0.05) and hospitalization time (<em>β</em> = 0.4177. <em>P </em>< 0.05) are independent factors influencing PI risk in the elderly inpatients with kidney disease. <strong>Concl</strong><strong>usio</strong><strong>n</strong>: The elderly patients with kidney disease and PI risk are the high incidence population of hospital acquired PI;for the elderly inpatients with kidney disease and having respiratory infection history or respiratory failure, prolonged hospitalization will significantly increase the risk of PI. Therefore, targeted preventive and control measures should be taken to reduce the incidence of PI.
文摘In Europe, there are an increasing number of persons suffering from depression, which also affects many relatives. The burden and health when being the relative of an inpatient suffering from severe depression has been less examined. The aim of the study was to describe burden, health and sense of coherence among relatives of inpatients with severe depression. Furthermore, the aim was to investigate relatives’ burden in relation to their health and sense of coherence. A cross-sectional design was performed, with a questionnaire consisting of background questions and three instruments;Burden Assessment Scale, General Health Questionnaire and Sense of Coherence scale. The participants consisted of 68 relatives recruited from a sample of inpatients diagnosed with depression in the psychiatric specialist health services in one hospital trust in Norway. The Regional Committee for Medical and Health Research Ethics, Norway South East, gave approval to the study. The relatives reported burden to a various degree, with some reporting a significantly greater burden, poorer health and a weaker sense of coherence than others. With regard to subjective burden eight out of ten relatives reported “Worry about future”, and almost six out of ten were “Upset by change in patient”. Regarding objective burden, more than half the relatives reported having “Less time for friends” and “Reduced leisure time”. In conclusion the relatives with a high level of burden reported more mental distress, poorer health and weaker sense of coherence than those with lower level of burden. Further research should focus on identification of factors predicting burden and health of relatives of inpatients with severe depression.
基金a grant from the National Key Research and Development Program:the Key Technology of Palliative Care and Nursing for Cancer Patients(No.2017YFC1309200).
文摘Objective This study aimed to assess anxiety,depression,and stress among inpatients with cancer.Methods Two hundred thirty-five hospitalized patients with cancer were surveyed with the Depression Anxiety Stress Scales(simplified Chinese Version).The software program SPSS 25.0 was used for statistical analysis of the survey data.Results The average scores of depression,anxiety,and stress of inpatients with cancer were 12.17,11.84,and 13.98 respectively,which were higher than the normal range.The scores of anxiety and stress of inpatients with different caregivers were statistically different(P=0.024/0.036).The anxiety and stress scores of inpatients with spouses as caregivers were higher than those of inpatients with children as caregivers.There was a statistically significant difference in the incidence of stress between inpatients with cancer with religious beliefs and inpatients with cancer without religious beliefs(P=0.026),and those with religious beliefs had greater incidence of stress.The score of anxiety was significantly higher for inpatients with children than for inpatients without children(P=0.040).Conclusion The anxiety,depression,and stress levels of inpatients with cancer are relatively high.It is necessary to pay special attention to the psychological status of these patients during clinical diagnosis and treatment to improve their quality of life.
文摘Objectives:To construct a comprehensive evaluation indicator system for inpatients'nursing service needs in tertiary general hospital and to provide evidence for identifying and meeting the needs of inpatients'nursing services.Method:We used the Delphi method to conduct two rounds of expert consultations with 41 experts.Result:The indicator system consisting of 5 first-level indicators and 48 second-level indicators was preliminarily constructed.Conclusions:We formed an evaluation indicator system for inpatients'nursing service needs in tertiary general hospital and classified it into five categories:hospital environment,nursing attitude,nursing skills,information exchange,and emotional support.The indicator system is scientific and reliable.It can provide a basis for nursing staffs to identify and meet the needs of inpatients'care services.
基金Supported by a grant from the Science and Technology Key Programs of Liaoning Province(No.2013225220)
文摘Objective The aim of the study was to analyze hospital costs for cancer inpatients availing different methods of payment and the influencing factors, to provide inputs to improve the medical insurance payment policy. Methods We analyzed the information related to length of hospital stay, hospitalization cost, and self-pay cost, collected from one large-scale, Grade A, Class Three hospital in Shenyang, China, during 2004–2013.Results The number of cancer inpatients with different payment types(medical insurance group and non-medical insurance group) presented a rising trend. Further, the ratio of medical insurance inpatients increased rapidly(from 22.2% to 48.7%); however, this group was still a minority. The length of hospital stay became shorter(21 d vs. 17 d; P = 0.000) while the gap got narrower; the hospitalized expense showed an upward trend and the difference was remarkable($24048.6 ± $4376.28 vs. $20544.36 ± $4057.01; P = 0.000). Conclusion Along with normalization of cancer therapy, the influence of payment on treatment has been getting weak, the policy has impact on controlling hospitalization cost, lightening burden of cancer patient, as well as allocating medical resources in a reasonable way, becoming an important defray pattern of hospitalization cost.
文摘Objective: To understand the prevalence of anxiety and depression in medical patients in general hospitals and find out main influencing factors. Methods: According to the inclusion criteria, a total of 564 inpatients from the Third Affiliated Hospital of Inner Mongolia Medical University were selected during January to June of 2015. Patients were assessed for anxiety and/or depression by use of Hospital Anxiety and Depression Scale (HADS), Hamilton Anxiety Scale (HAMAS) and Hamilton Depression Scale (HAMDS). Meanwhile, final diagnosis was made on the basis of diagnostic criteria listed in Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV). Results: In different departments, the positive rate (HADS ≥ 8) was the highest in Department of Oncology (45.42%), and the lowest in Department of Gastroenterology (16.05%). After assessment with the help of HAMD and HAMA, the prevalence of anxiety/depression was the highest in Department of Oncology (46.43%), and the lowest in Department of Gastroenterology (16.05%). There was no statistical significance in diagnostic results acquired from HAMD and HAMA (p = .071). Two types of diagnostic methods were highly consistent (κ = 0.852, p = .000). Inpatients aged from 40 to 59 years, with junior high school education or below, very tiring work, poor marital status (separated, divorced, widowed), unharmonious family, low personal income, completely self-paying and family history of anxiety and depression, currently unable to take care of themselves were more prone to anxiety and depression (p < .05). Conclusions: The prevalence of anxiety and depression in medical patients in general hospitals is high due to many influencing factors. It is necessary to establish an effective diagnosis and treatment system for anxiety and depression, in order to make patients easy to receive an early and comprehensive treatment and improve their life quality.
基金supported by the National Natural Science Foundation of China(No.71673100)
文摘Objective： The aim of this study was to explore the characteristics of and preventive management strategies for suicidal inpatients in a general hospital.Methods： A total of 54 suicide victims were drawn from a patient safety adverse event network reporting system during hospitalization in a general hospital from November 2008 to January 2017.Results： Subjects who committed suicide in the general hospital were women and those who suffered from malignant neoplasms during general hospital treatment. Furthermore, most of the patients who committed suicide used more violent suicide methods. The most common and lethal means was jumping from heights at the windowsill.Conclusions： It is concluded that management straties for suicide prevention can be provided from the aspects of patients, medical staff and the hospital environment. It is not only urgent but also feasible to reduce the suicide rate of inpatients and further improve hospital safety management.
基金Supported by the program of Young Researchers of the Federal University of Minas Gerais,No.01/2013FAPEMIG(Fundacao de Amparo a Pesquisa do Estado de Minas Gerais,Brazil),No.APQ-01714-13.
文摘AIM To identify factors associated with depressive symptoms among inpatients with cardiovascular disease(CVD). METHODS This is a cross-sectional study performed in a subsample of a large cross-sectional research that investigated affective disorders and suicide behaviour among inpatients hospitalized in non-surgical wards of the University Hospital of the Federal University of Minas Gerais from November 2013 to October 2015. Sociodemographic and clinical data were obtained through a structured interview and medical record review. Depression was assessed by the depression subscale of the Hospital Anxiety and Depression Scale, with scores ≥ 8 considered as positive screening for depression. We used the Fagestr?m Test for Nicotine Dependence to characterize nicotine dependence. For assessing resilience and early-life trauma, we used the raw scores of the Wagnild and Young Resilience Scale and Childhood Trauma Questionnaire, respectively.RESULTS At endpoint, we included 137 subjects. Thirty-eight(27.7%) subjects presented depressive symptoms and nine(23.7%) of those were receiving antidepressant treatment during hospitalization. The female sex; a lower mean educational level; a greater prevalence of previous suicide attempts; a higher level of pain; a higher prevalence of family antecedents of mental disorders; a lower resilience score; and higher childhood trauma score were the factors significantly associated with screening positive for major depression(P < 0.05). Multivariate analysis demonstrated that the factors independently associated with the depressive symptoms were a higher childhood trauma severity(OR = 1.06; P = 0.004); moderate to severe nicotine dependence(OR = 8.58; P = 0.008); and the number of previous hospital admissions(OR = 1.11; P = 0.034). The obtained logistic model was considered valid, indicating that the three factors together distinguished between having or not depressive symptoms, and correctly classified 74.6% of individuals in the sample.CONCLUSION Our results demonstrate that inpatients presenting both CVD and a positive screening for depression are more prone to have antecedents of childhood trauma, nicotine dependence and a higher number of previous hospitalizations.
基金Supported by the conjoint research grant of the Swiss National Science Foundation,SNSF,No. 144100the German Research Foundation,DFG,No. 231563730, within the Lead Agency Process (SNSF as exclusive evaluating and approving lead agency)
文摘BACKGROUND In children and adolescents compared to adults,clinical high-risk of psychosis(CHR)criteria and symptoms are more prevalent but less psychosis-predictive and less clinically relevant.Based on high rates of non-converters to psychosis,especially in children and adolescents,it was suggested that CHR criteria were:(1)Pluripotential;(2)A transdiagnostic risk factor;and(3)Simply a severity marker of mental disorders rather than specifically psychosis-predictive.If any of these three alternative explanatory models were true,their prevalence should differ between persons with and without mental disorders,and their severity should be associated with functional impairment as a measure of severity.AIM To compare the prevalence and severity of CHR criteria/symptoms in children and adolescents of the community and inpatients.METHODS In the mainly cross-sectional examinations,8–17-year-old community subjects(n=233)randomly chosen from the population register of the Swiss Canton Bern,and inpatients(n=306)with primary diagnosis of attention-deficit/hyperactivity disorder(n=86),eating disorder(n=97),anxiety including obsessive–compulsive disorder(n=94),or autism spectrum disorder(n=29),not clinically suspected to develop psychosis,were examined for CHR symptoms/criteria.Positive items of the Structured Interview for Psychosis-Risk Syndromes(SIPS)were used to assess the symptomatic ultra-high-risk criteria,and the Schizophrenia Proneness Instrument,Child and Youth version(SPI-CY)was used to assess the 14 basic symptoms relevant to basic symptom criteria.We examined group differences in frequency and severity of CHR symptoms/criteria usingχ^(2) tests and nonparametric tests with Cramer’s V and Rosenthal’s r as effect sizes,and their association with functioning using correlation analyses.RESULTS The 7.3%prevalence rate of CHR criteria in community subjects did not differ significantly from the 9.5%rate in inpatients.Frequency and severity of CHR criteria never differed between the community and the four inpatient groups,while the frequency and severity of CHR symptoms differed only minimally.Group differences were found in only four CHR symptoms:suspiciousness/persecutory ideas of the SIPS[χ2(4)=9.425;P=0.051,Cramer’s V=0.132;and Z=-4.281,P<0.001;Rosenthal’s r=0.184],and thought pressure[χ^(2)(4)=11.019;P=0.026,Cramer’s V=0.143;and Z=-2.639,P=0.008;Rosenthal’s r=0.114],derealization[χ2(4)=32.380;P<0.001,Cramer’s V=0.245;and Z=-3.924,P<0.001;Rosenthal’s r=0.169]and visual perception disturbances[χ^(2)(4)=10.652;P=0.031,Cramer’s V=0.141;and Z=-2.822,P=0.005;Rosenthal’s r=0.122]of the SPI-CY.These were consistent with a transdiagnostic risk factor or dimension,i.e.,displayed higher frequency and severity in inpatients,in particular in those with eating,anxiety/obsessive–compulsive and autism spectrum disorders.Low functioning,however,was at most weakly related to the severity of CHR criteria/symptoms,with the highest correlation yielded for suspiciousness/persecutory ideas(Kendall’s tau=-0.172,P<0.001).CONCLUSION The lack of systematic differences between inpatients and community subjects does not support suggestions that CHR criteria/symptoms are pluripotential or transdiagnostic syndromes,or merely markers of symptom severity.
文摘Background: After the March 2011 “triple” disaster in Japan, the residents of Fukushima Prefecture suffered from serious psychological stress. Aims: This study aimed to elucidate the influence of stressful conditions on psychiatric disorders, as reflected in new psychiatric admissions. Methods: Diagnoses and background conditions among new psychiatric admissions during the 3 months immediately after the disaster in 2011 and the corresponding time periods of 2010 and 2012 were surveyed. Results: In 2011, more patients were admitted in confusional, manic, neurasthenic, and delirious states, whereas there were fewer admissions for depression. In 2012, more admissions pertained to depression. Twenty-four percent of the new admissions in 2011 were associated with concerns about radiation contamination and hospitalization, which declined to 4% in 2012. Conclusions: The diagnoses and background conditions among new psychiatric admissions were affected by the disaster;with the influence differing according to the time elapsed after the disaster.
文摘Delirium is a complex neuropsychiatric syndrome that is often associated with adverse outcomes including prolonged hospitalization. This study aims to determine the length of hospital stay among medically-ill patients with and without delirium who were admitted through the Accident and Emergency unit of the Jos University Teaching Hospital, in North-Central Nigeria. It was a cross-sectional study that employed a consecutive sampling technique to select 290 eligible subjects in a face-to-face interview, using a confusion assessment method to assess for delirium within 24 hours of admission. All the respondents were followed-up from the Accident and Emergency unit until discharge or death. The results showed that respondents with delirium rather than those without, were significantly more likely to stay longer in the hospital (P < 0.001). The significant factors associated with prolonged hospitalization among those with delirium include, current medications use, duration of illness before presentation and type of medical diagnosis (P < 0.001), (P < 0.001) and (P < 0.001) respectively. The results point to the importance of screening for delirium in medically-ill patients, with particular attention to patients with infectious and cerebrovascular diseases.
文摘Background: Delirium is one of the most common medical emergencies and is associated with poor outcomes including: mortality, prolonged length of stay and poor functional outcome. The more severe delirium is the worst the clinical outcomes of medical illness. Despite the obvious, not much has been documented on delirium severity and its associated factors among medical inpatients in low income countries including Nigeria. Objectives: This study was conducted to examine the severity of delirium among medical inpatients admitted through the Accident and Emergency unit of Jos University Teaching Hospital as well as to assess its associated Sociodemographic and Clinical characteristics. Method: This was a cross-sectional study that employed a consecutive sampling technique to select 290 eligible subjects from medical inpatients that presented to Accident and Emergency unit of Jos University Teaching Hospital. On admission, patients were assessed for delirium using Confusion Assessment Method and severity of delirium was evaluated using Delirium Rating Scale-Revised-98. Results: Of the 105 delirious medical inpatients, 48 (45.7%) had severe delirium, 41 (39.1%) developed less severe delirium while 16 (15.2) presented with no severe delirium. Sociodemographic characteristics found to be significantly associated with less to more severe delirium include male gender (P = 0.001), nonprofessionals (P = 0.003), income range of N20,000 - N49,000 (P Conclusion: This study demonstrates that delirium is often associated with higher severity in Accident and Emergency unit admission and there are strongly associated clinical characteristics to watch out for in high risk medical inpatients.
文摘<strong>Background:</strong> Frailty is a geriatric syndrome, and a common negative consequence of aging, which shares some obvious characteristics as cognitive impairment. Preventing and relieving frailty may reduce the possibility of developing cognitive impairment. <strong>Objective: </strong>This study aimed to investigate frailty prevalence and its correlation with cognitive function in elderly surgical inpatients. <strong>Methods: </strong>We enrolled a random sample of elderly surgical inpatients from Jingzhou from June 2020 to August 2020. We used a self-made registration sheet to collect their demographic data (gender, age, nationality, educational level and monthly income), and used the FRAIL Scale to assess the prevalence of frailty, and used the Mini-Mental State Examination (MMSE) to assess cognitive function. We used multiple linear regression analysis to explore the correlation between frailty level and demographic data, then Pearson correlation analysis was performed to analyze the correlation between frailty and cognitive function. <strong>Results: </strong>In the 143 elderly surgical inpatients, prevalence of frail was seen in 29 (20.3%), and pre-frail state was found in 64 (44.8%). Only 50 (34.9%) were in healthy state. Cognitive impairment was seen in 28 (19.5%). Pearson correlation analysis showed that the frail scoring was correlated with cognitive function in elderly surgical inpatients (r = -0.378, P < 0.05). <strong>Conclusion:</strong> The prevalence of frailty is high in elderly surgical inpatients, which is closely related to age and gender. Elderly surgical inpatients have high cognitive impairment, and frailty appears strongly associated with cognitive status. The findings suggest that attention should be paid to the frailty and cognitive function in the elderly surgical inpatients by pro-vision of effective interventions.
