Hospital Inpatients Research Articles

A comparison of patient ratings and staff ratings of disability using the World Health Organisation Disability Assessment Schedule in individuals with psychotic spectrum disorders who are forensic psychiatric inpatients.

Psychosocial rehabilitation in forensic psychiatric services requires sound measurement of patient and staff perceptions of psychosocial function. The recommended World Health Organisation Disability Assessment Schedule 2.0 (WHODAS), designed for this, has not been examined with offender patients. To examine patient and staff WHODAS ratings of secure hospital inpatients with psychosis, any differences between them and explore associations with other clinical factors. Seventy-three patients self-rated on the WHODAS after 3months as inpatients. An occupational therapist interviewed the patient's primary nurse and care team at about the same time (staff ratings). Scores were calculated according to the WHODAS manual. WHODAS scores and interview-rated symptom severity, cognitive measures, daily antipsychotic dose and duration of care were compared. Patient ratings indicated less disability than staff ratings for total score and for the domains of understanding and communicating, getting along and life activities. Self-care and participation ratings were similar. Patients were more likely to rate themselves as disabled in getting around (mobility). Only one-fifth of patient- and staff- ratings (16, 22%) were similar, while for nearly a third of the patients (23, 32%) self-ratings were higher than staff ratings. More severe positive symptoms were associated with higher self-rated WHODAS disability after accounting for treatment duration, negative symptoms, cognitive score and antipsychotic dose. No variable accounted for the staff/patient differences in ratings. Our mean WHODAS score findings echoed those in other patient samples-of patient underestimation of disability, linked to severity of symptoms. In this study using the WHODAS for the first time in a forensic mental health secure inpatient service, however, we found that, by comparing individuals, half of the patients reported equivalent or greater disability than did staff. Future research should focus on elucidating from patients what contributes to their self-ratings. Understanding their thought processes in rating may enhance rehabilitation planning.

요양병원 입원환자 환자안전사고 위해정도에 영향을 미치는 요인

Purpose: This study aimed to identify the characteristics of patient safety incidents among patients admitted to long-term care hospitals and the factors affecting the severity of these incidents, and provide essential data for developing strategies to prevent and manage patient safety incidents in long-term care hospitals. Method: The study utilized 7,594 patient safety report data collected from 2017 to 2022, based on Patient Safety Reporting and Learning System. Descriptive statistics and cross-analysis were conducted to identify the characteristics of patient safety incidents among inpatients of long-term care hospitals. Multinomial logistic regression analysis was performed to analyze the related factors. All statistical analyses were carried out using the SPSS statistical program. Results: Factors identified as affecting the severity of patient safety incidents in long-term care hospital inpatients included gender, age, primary diagnosis, the impact of COVID-19, the number of beds, the location of the incident, and the type of incident. Conclusion: As the aging population leads to an increase in patient safety incidents in long-term care hospitals, it is crucial to prevent these incidents and ensure their severity does not escalate. This requires systematic safety education for all healthcare workers and efforts such as implementing patient safety incident prevention programs and monitoring systems within long-term care hospitals.

The Burden of Inpatient Hospitalizations with Cardiac and Cerebrovascular Diseases in Patients with Type 1 Diabetes: Insights from the National Inpatient Sample in the US.

This study aimed to evaluate the burden and impact of cardiac and cerebrovascular disease (CCD) on hospital inpatients with type 1 diabetes mellitus (T1DM). This is a retrospective nationwide cohort study of people with T1DM with or without CCD in the US National Inpatient Sample between 2016 and 2019. The in-hospital mortality rates, length of stay (LoS), and healthcare costs were determined. A total of 59,860 T1DM patients had a primary diagnosis of CCD and 1,382,934 did not. The median LoS was longer for patients with CCD compared to no CCD (4.6 vs. 3 days). Patients with T1DM and CCD had greater in-hospital mortality compared to those without CCD (4.1% vs. 1.1%, p < 0.001). The estimated total care cost for all patients with T1DM with CCD was approximately USD 326 million. The adjusted odds of mortality compared to patients with non-CCD admission was greatest for intracranial hemorrhage (OR 17.37, 95%CI 12.68-23.79), pulmonary embolism (OR 4.39, 95%CI 2.70-7.13), endocarditis (OR 3.46, 95%CI 1.22-9.84), acute myocardial infarction (OR 2.31, 95%CI 1.92-2.77), and stroke (OR 1.47, 95%CI 1.04-2.09). The burden of CCD in patients with T1DM is substantial and significantly associated with increased hospital mortality and high healthcare expenditures.

Implementation of an Evidence-Based Treatment Protocol and Order Set for Alcohol Withdrawal Syndrome.

Alcohol withdrawal syndrome (AWS) is highly prevalent in hospital inpatients. Recent evidence supports use of phenobarbital and gabapentin in certain patients, and screening tools for severe withdrawal risk can be used to guide care. Inpatients with AWS should also be considered for evidence-based treatment for alcohol use disorder (AUD). The purpose of this quality improvement study was to monitor clinical outcomes and prescribing habits after updating an electronic order set for inpatient AWS management at a large, academic hospital. Protocol updates included use of the Prediction of Alcohol Withdrawal Severity Scale, phenobarbital and gabapentin protocols, and linkage to treatment resources. Data were collected for 10 months before and 14 months after implementation. Intensive care unit (ICU) transfer rate decreased by 2.3%, whereas length of stay and readmissions were not significantly different. In patients treated with the order set, ICU transfer and length of stay outcomes were superior. Patients treated through the order set were more likely to receive evidence-based treatment for AWS and AUD. Electronic order sets can promote evidence-based practice for AWS. The updated protocol will remain in place at the study institution, with future efforts focused on education and ease of use to increase order set utilization.

Stress perception and associated factors among patients with Parkinson’s disease: a cross-sectional study after the COVID-19 pandemic

BackgroundParkinson’s disease (PD) is a serious neurodegenerative disease that brings great stress to the physical and mental health of patients. At the same time, long-term treatment will also bring great economic losses and social burden to the family and society, especially after COVID-19 pandemic. The aim of this study is to analyze the current status of stress perception and anxiety in patients with PD and explore the influencing factors after the COVID-19 pandemic.MethodsThis study used the convenient sampling method to select the research objects of patients with PD who were outpatients or inpatients in a general public hospital in Hangzhou, Zhejiang Province, and the survey time was from February 2023 to March 2023. The measurements included the General information questionnaire, The Perceived Stress Scale (PSS) and The Self Rating Anxiety Scale (SAS). SPSS 21.0 software was used for data statistical analysis.Result394 out of 420 patients with PD completed the questionnaire. The stress perception score of PD was (16.41 ± 6.435) and the anxiety score was (54.77 ± 10.477). The stress perception scores of patients with PD were significantly different in gender, age, educational, occupation, nature of costs, time of sleep, quality of sleep, duration of disease, way of medical treatment and anxiety level (p < 0.05). Among them, age, duration of disease, public expenses, online remote therapy and anxiety level were the main influencing factors of stress perception in patients with PD (p < 0.05). Besides, there were significant differences in gender, educational, nature of costs, time of sleep, quality of sleep and duration of disease in anxiety among patients with PD (p < 0.05).ConclusionAfter the COVID-19 pandemic, the level of stress perception and anxiety in patients with PD is high, and the influencing factors are complex.

COVID-19 Inpatient Caseloads in General Hospitals Did Not Affect Quality Indicator Compliance Rates in Israel.

Early in the global COVID-19 pandemic, a concern was raised that potentially high volumes of COVID-19 inpatients in general hospitals might compromise the hospitals' capabilities to maintain high-quality care for routine patients and, thereby, to comply with indicators specifying quality of care. The objective of this study is to evaluate the impact of the surges of COVID-19 inpatients into general hospitals in Israel on the compliance rates for selected quality indicators reported by these hospitals within the Israeli National Program for Quality Indicators (NPQI). Compliance rate data were collected from the quality indicators reports made to the NPQI by participating hospitals. COVID-19 inpatient volume data were obtained from the Ministry of Health Digital Technologies and Data Division. Both datasets were analyzed on a week-by-week basis and plotted one alongside the other on a time scale. Association of each quality indicator's compliance rate with the number of COVID-19 inpatients was tested by Pearson's correlation analysis. The study included data from July 1, 2019 through June 30, 2022, spanning the duration of the COVID-19 pandemic in Israel. Five quality indicators included in the study were: Surgical repair of femoral neck fracture within 48h of admission; Assessment of cerebral ischemic event risk for patients with atrial fibrillation; Duplex carotid ultrasound within 72h of emergency department admission for patients with suspected transient ischemic attack; Antibiotic prophylaxis for caesarean sections; and Percutaneous coronary intervention within 90min for patients presenting with ST-elevation myocardial infarction. Compliance rates for five quality indicators, representing different aspects of routine health care, remained steady - even at times with high volumes of COVID-19 inpatients in general hospitals. This lack of effect was prominent throughout the analyzed period, i.e., general hospitals maintained similar compliance rates for all quality indicators both during the surges of COVID-19 patients and between these periods. Statistical analysis showed no correlation between the quality indicators' compliance rates and the number of COVID-19 inpatients. Our findings indicate that high volumes of COVID-19 inpatients in general hospitals did not affect the hospitals' capability to comply with routine health care quality indicators. The results of our study imply that general hospitals in Israel were able to withstand the challenges associated with the care of COVID-19 inpatients while preserving high quality of care for routine patients.

A comprehensive investigation of comorbidities of prolonged grief disorder in a bereaved inpatient psychiatric sample

Prolonged Grief Disorder (PGD) was recently added to ICD-11 and DSM-5-TR. Depression and Posttraumatic Stress Disorder (PTSD) are frequent comorbidities, but findings regarding comorbid somatoform disorder and personality disorders remain mixed and studies with severely impaired patients are scarce. It was therefore the objective of the present study to examine comorbidities of PGD in a bereaved inpatient psychiatric sample. We assessed N = 101 bereaved inpatients in a psychiatric hospital with clinical interviews and self-report questionnaires. We calculated differences between patients with and without a PGD-diagnosis in number and type of comorbid disorders as well as associations between the severity of PGD and comorbid disorders. On average, patients had 2.53 comorbid psychiatric diagnoses. Patients with and without a PGD-diagnosis did not differ in their number of comorbid diagnoses, and there was no association between number of comorbid diagnoses and PGD-severity. However, patients with PGD, had significantly more comorbid diagnoses belonging to neurotic-, stress-related and somatoform disorders of the ICD-10. Patients with PGDICD-11 also had significantly higher scores in self-reported depressive, PTSD-, and somatoform symptoms, as well as the negative affectivity personality domain than those without a PGD diagnosis. To the best of our knowledge, this is the first study to provide insights into comorbidities of PGD in a bereaved inpatient psychiatric sample. It highlights the importance of considering PGD symptoms as part of the complaints of bereaved patients to achieve a tailored treatment approach. Future longitudinal studies are needed to unveil relationships between pre-existing mental disorders and PGD.

Comparison of Diagnosis-Related Group Rehabilitation Reimbursement Payments With Those of a Novel Patient Classification-Based Payment System

ObjectiveTo compare the difference of reimbursement payments between diagnosis-related group (DRG) and a novel patient classification-based payment system, diagnosis-intervention packet (DIP), among rehabilitation inpatients in tertiary hospitals. DesignRetrospective cohort study. SettingTTertiary hospitals in Shenzhen, China. ParticipantsWe assessed the records of 268,362 individuals who visited tertiary hospitals providing rehabilitation services. InterventionsNot applicable. Main Outcome MeasuresThe outcome variable was the patients’ rehabilitation hospitalization cost of in our study. A quantile regression analysis was conducted to estimate the effects of DIP payment on the rehabilitation hospitalization cost. ResultsThe results showed that the predicted marginal hospitalization cost with DRG payment were 9%, 7%, 14%, and 10% higher than that with DIP payments in 2019, 2020, 2021, and 2022. The total difference in predicted marginal hospitalization cost between DRG and DIP was −1269 RMB (−193 USD). This difference in 2019, 2020, 2021, and 2022 was −1419 RMB (−228 USD), −1088 RMB (−158 USD), −1585 RMB (−246 USD), and −1034 RMB (−154 USD), respectively. All differences in predicted marginal hospitalization cost between DRG and DIP was significant (P<.001), after controlling for patients’ age, sex, public or private hospital, the type of disease, and the length of stay of hospitalization. ConclusionsThe findings of DIP payment reduced the rehabilitation hospitalization cost would be helpful in developing more effectively and efficiently tailored interventions for rehabilitation health care in China. Furthermore, the results of this study could provide advice on building more effective strategies and intervention options for other countries that struggle with controlling rehabilitation hospitalization costs.

Penerapan Hydrogel dan Antimicrobial Dressing terhadap Penyembuhan Luka dan Sensasi Perifer pada Pasien Gangrene Pedis

Gangrene is one of Diabetes Mellitus (DM) complication causing tissue death in wound and decreased peripheral sensation. Priority management of gangrene is through tissue reperfusion and wound care with modern dressing to enhance healing and increase periphery circulation. This research aimed to report wound healing progress and peripheral sensation gangrene in a patient who was given hydrogel and antimicrobial dressing. Research design used a descriptive case study approach. Sample involved one inpatient in West Java regional public hospital who was diagnosed with gangrene, had necrotic wounds, and poor peripheral perfusion, currently treated with modern dressing hydrogel and antimicrobial dressing. The instrument used is Bates Jensen Wound Assessment Tools (BJWAT), lowest score shows significant wound healing progress. Decreasing wound healing score using BJWAT questionnaire from 41 to 29, peripheral sensation (+), and monofilament score from 0/9 to 5/9 after the intervention. Modern dressing improved wound healing and peripheral sensation in gangrene pedis patient. Thus, it is expected to examine effectiveness of hydrogel and antimicrobial dressings on healing scores and peripheral sensation in gangrene pedis patients more extensively.

Appraisal of Nursing Care Received and it’s Satisfaction: A Case Study of Admitted Patients in Afe Babalola Multisystem Hospital, Ado Ekiti, Ekiti State

Background Patients are the best recruiter of patients if given prompt treatment and comprehensive care. Patient satisfaction with nursing care has been strongly advocated to be an important indicator of the quality of nursing care delivery which raises concerns in many areas, including information communication, privacy, physical and psychological care, availability and accessibility of nurses, and emotional care. The aim of this study centred on identifying the domain of nursing care received by in-patients of Afe Babalola Multisystem Hospital (AMSH) and determining the level of patient satisfaction towards nursing care in AMSH.  Methods A hospital-based cross-sectional, descriptive design was employed. A convenience sampling technique was used to select 102 patients admitted to surgical wards (male and female), Medical wards (male and female), renal wards, accident and emergencies and maternity wards. The Qualipak nursing quality questionnaire (QUALPAC) was used to collect the required data. Data were analysed using SPSS software version 27. Pearson chi-square test and logistic regression analysis was used.  Results Patients received overall moderate nursing care (64.7%) in the framework of physical, communication and psychosocial care. Overall satisfaction with nursing care received was found to be 76.5%. Among the domains of nursing satisfaction, satisfaction towards communication care (89.2%) and physical care (80.4%) showed a high level and satisfaction towards psychosocial care (58.8%) care was lower compared to other dimensions. Respondents’ between the ages of 18-25 years (P&lt; 0.05, Odd ratio- 14.569, CI: 679.461– 0.312), male patients (P&lt; 0.05, Odd ratio- 8.850, CI: 7.477– 0.097), single patients (P&lt; 0.05, Odd ratio- 5.130, CI: 7.569- 0.035), primary education (P&lt; 0.05, Odd ratio- 40.123, CI: 2021.829– 0.076), patients admitted to male renal ward (P&lt; 0.05, Odd ratio- 2.328, CI: 196.160– 0.028) and patients who chose expert doctors as a reason (P&lt; 0.05, Odd ratio- 4.900, CI: 25.509– 0.009) were associated with patient satisfaction. Nursing care received was high among admitted patients in male medical wards, female medical ward and male renal ward.  Conclusion Patientsin this study received moderate nursing care in the three domains of nursing care. A high nursing satisfaction was received. To increase satisfaction with nursing care, greater emphasis should be given to the psychosocial care of patients.

Better understanding of c-reactive protein and leukocytes in psychiatric inpatients with affective disorders: A biopsychosocial approach.

Affective disorders (AD) have been linked to inflammatory processes, although the underlying mechanisms of this relationship are still not fully elucidated. It is hypothesized that demographic, somatic, lifestyle, and personality variables predict inflammatory parameters in AD. To identify biopsychosocial factors contributing to inflammation in AD measured with two parameters, C-reactive protein (CRP) and leukocytes. This observational study investigated 186 hospital inpatients diagnosed with AD using demographic parameters, serum inflammatory markers, somatic variables, psychological questionnaires, and lifestyle parameters. Hierarchical regression analyses were used to predict inflammatory markers from demographic, somatic, lifestyle, and personality variables. Analyses showed that 33.8% of the variance of CRP was explained by body mass index and other somatic medication (e.g. anti-diabetics), age and education, and age of affective disorder diagnosis. For leukocytes, 20.1% of the variance was explained by smoking, diet, metabolic syndrome (MetS), and anti-inflammatory medication (e.g. non-steroidal anti-inflammatory drugs). Other psychiatric or behavioural variables did not reach significance. Metabolic components seem important, with mounting evidence for a metabolic affective disorder subtype. Lifestyle modifications and psychoeducation should be employed to prevent or treat MetS in AD.

A Survey of the Prevalence of Infections Present among Inpatients in a Tertiary Care Hospital in 2023

Objective: To explore the current infection rate among inpatients in a tertiary hospital in 2023, to understand the infection situation in the hospital, and to provide a reliable basis for carrying out further hospital infection prevention and control and other work. Methods: Inpatients of a tertiary hospital on a certain date in 2023 were selected, and the survey data were extracted with the Apricot Grove real-time monitoring system using a combination of questionnaires and medical record data. Results: The infection rate was 12.63%, of which the hospital infection rate was 2.25% and the community infection rate was 10.38%. Lower respiratory tract infections accounted for 77.28% of the community infections, and lower respiratory tract infections accounted for 73.44% of the cases of hospital infections, with a total of 44 strains of pathogens isolated from hospital infections, and a total of 218 strains of pathogens isolated from community infections. The total application rate of antimicrobial drugs was 31.67%, the proportion of prophylactic drugs in the whole hospital was 9.66%, the proportion of therapeutic drugs was 90.33%, and the rate of bacterial culture delivery was 39.18%. Conclusion: The infection rate survey truly reflects the dynamics of infection in this hospital, makes clearer the key departments and key links of hospital infection prevention and control, further provides the basis for targeted infection control, and improves the knowledge and execution of hospital infection prevention and control by medical staff.

Antimicrobial Susceptibility and Molecular Epidemiology of Multidrug-resistant Pseudomonas aeruginosa in Northeast of Brazil

Introduction: This study aimed to investigate the antimicrobial susceptibility profile of nosocomial strains of Pseudomonas aeruginosa isolated from inpatients of a teaching hospital in the City of Sobral, Ceará, in Northeast of Brazil (Santa Casa de Misericórdia de Sobral - SCMS) from March/2019 to March/2020, as well as to assess the occurrence of resistance genes bla-TEM, bla-SHV, bla-CTX-M 1/2, bla-IMP-1, bla-KPC, bla-GES, bla-SPM-1, bla- NDM-1, bla-VIM. Methodology: Bacterial identification and antimicrobial susceptibility tests (AST) were performed using the automated system Vitek®2. Conventional polymerase chain reaction (PCR) was used to amplify genes of interest. Results: Thirty-eight specimens of P. aeruginosa were collected. More than half of the isolates were resistant to imipenem (55.2%), and showed different rates of resistance to the other antimicrobials tested. In addition, intermediate susceptibility was also observed to gentamicin (7.8% of the isolates) and meropenem (10.52% of the isolates). The gene bla-CTX-M 1/2 was the most prevalent (41.9%), while bla-GES was highly identified among the carbapenemase-producing strains (12.9%). Conclusion: The results demonstrated considerable resistance rates to β-lactam antibiotics, which could be attributable to the indiscriminate use of these antibiotics in the analyzed hospital, whose control relies on the improvement of antimicrobial prescription policies.

Optimizing anticoagulation therapy for in-hospital patients on direct oral anticoagulants: a single-centre modified Delphi study.

The management of patients treated with direct oral anticoagulants (DOACs) during hospitalization is a common challenge in clinical practice. Although bridging is generally not recommended, too often DOACs are switched to parenteral therapy with low molecular weight heparins. Our objectives were to update a local guideline for perioperative DOAC management and to develop a guideline for the anticoagulation management in non-surgical patients regarding temporary DOAC discontinuation. We executed a two-step modified Delphi study in a 1000-bed university hospital in Belgium. The Delphi questionnaires were developed based on a literature review and a telephone survey of prescribers. Two expert panels were established: one dedicated to perioperative DOAC management and the other to DOAC management in non-surgical patients. Both panels completed two rounds, commencing with an individual and online round, followed by a face-to-face group session. After the two-round Delphi process, the updated perioperative guideline on DOAC management included reasons for delaying the resumption of DOACs following surgery, such as oral intake not possible, the probability of re-intervention within 3 days, and insufficient haemostasis (e.g. active clinically significant haematoma, haemorrhagic drains or wounds). Furthermore, a guideline for non-surgical hospitalized patients was developed, outlining possible reasons for interrupting DOAC therapy. Both guidelines offer clear anticoagulation therapy strategies corresponding to the identified scenarios. We have updated and developed guidelines for DOAC management in surgical and non-surgical patients during hospitalization, which aim to support prescribers and to enhance targeted prescription review by hospital pharmacists.

Global and regional seroprevalence, incidence, mortality of, and risk factors for scrub typhus: A systematic review and meta-analysis

ObjectivesScrub typhus is underdiagnosed and underreported but emerging as a global public health problem. We aimed to provide the first comprehensive review on the seroprevalence, incidence, mortality of and risk factors for scrub typhus. MethodsWe searched PubMed, Scopus, Web of Science, China National Knowledge Infrastructure and other databases. Trended incidence and median mortality were calculated and pooled seroprevalence and risk factors for scrub typhus were evaluated using the random-effects meta-analysis. ResultsWe included 663 articles from 29 countries/regions. The pooled seroprevalence was 10.73% (95%CI 9.47-12.13%) among healthy individuals and 22.58% (95%CI: 20.55%-24.76%) among febrile patients. Mainland China reported the highest number of cases and South Korea and Thailand had the highest incidence rates. Median mortalities were 5.00% (range: 0.00-56.00%) among hospital inpatients, 6.70% (range: 0.00-33.33%) among patients without specified admission status and 2.17% (range: 0.00-22.22%) among outpatients. The significant risk factors included agricultural work, specific vegetation exposure, other outdoor activities, risky personal health habits, and proximity to rodents, livestock, or poultry. ConclusionsOur comprehensive review elucidates the significant yet variable burden of scrub typhus across different regions, underscoring its emergence as a critical public health concern globally.

Patient reported experience measures: an assessment of the in-patients in a tertiary care teaching hospital

Patient reported experience measures: an assessment of the in-patients in a tertiary care teaching hospital

An Analysis of Inpatient Satisfaction with Trust-related Factors of Public Secondary and Tertiary Hospitals in China.

Patient satisfaction surveys are implemented as an essential quality improvement tool in healthcare markets. This study investigates patient satisfaction in public secondary and tertiary hospitals and identifies factors contributing to inpatient satisfaction, particularly trust-related factors, to eventually improve the quality of care in the healthcare system. A population-based cross-sectional survey was conducted between February and April 2021 in 31 Chinese provinces. Telephone interviews with computer assistance were used to gather data. Spearman Rank Correlation was used to analyze satisfaction with hospitalization services between secondary and tertiary hospitals. Multiple Linear Regression was used to determine the influencing factors of overall patient satisfaction. Inpatients reported more satisfaction with inpatient care when doctors treated them respectfully (p<0.01). Inpatients with higher self-identified social class reported higher satisfaction (p<0.01). Inpatients who trust in most people in society (p<0.01) and trust in the Chinese healthcare system (p<0.01) reported higher satisfaction. Female inpatients reported higher overall satisfaction (p<0.01). The study of Chinese inpatients in secondary and tertiary hospitals highlighted the importance of respect from doctors, their self-identified social class, and their trust in influencing satisfaction during their hospital stay and called for additional research into policy measures.

Oral discomfort and health behavior of patients with typical vs. atypical antipsychotic drugs.

Psychiatric patients suffer from oral diseases and side effects of antipsychotic medication. In particular, the typical antipsychotic drugs may cause severe hyposalivation with subsequent oral symptoms. We therefore aimed to compare oral health behavior and oral side effects of in-hospital patients taking typical vs. atypical antipsychotic drugs with the hypothesis that the former drugs cause more oral pain than the newer drugs. This cross-sectional questionnaire and interview study investigated subjective oral symptoms and their health behavior in 170 hospitalized psychiatric patients, comparing those taking typical vs. atypical antipsychotic drugs. Cross-tabulations and chi-square tests were used for analyses. Persistent oral pain lasting throughout the day was reported by 46% in the typical, and 5% in the atypical antipsychotic group patients, respectively. In both groups, the pain was mainly in the tongue and buccal mucosa and was described as a burning sensation. A significantly higher prevalence of xerostomia was reported in the typical antipsychotic medication group (66%) compared with the atypical antipsychotic medication group (53%, p<0.01). Self-assessed dental health was assessed as poor by two-thirds of the patients of whom 69% reported toothbrushing once daily. Approximately half of them reported having had a visit to a dentist within the previous year. Of the women 28%, and of the men 17%, respectively, had received professional consultations for oral symptoms. The current results on psychiatrically hospitalized patients emphasize the need for awareness of oral discomfort and its subsequent effects on the quality of life in this challenging patient group. Focus should also be placed on a wide range of support encouraging the patients to maintain good daily oral hygiene and seek professional dental help when needed.

Factors Related to Hospital Inpatients among the Poor in Indonesia

Background: The poor are vulnerable when they fall seriously ill and require hospitalization. The study aimed to analyze the factors related to hospital inpatients among the poor in Indonesia. Methods: We analysed the 2018 Indonesian Basic Health Survey data. This cross-sectional study examined 233778 respondents through stratification and multistage random sampling. We used seven independent variables age, gender, marital status, education, employment, and health insurance, in addition to the hospital inpatient, as a dependent variable. We employed binary logistic regression to evaluate the data. Results: The poor in urban areas were 1.315 times more likely to be hospital inpatients than those in rural areas (95%CI 1.249-1.385). Age, gender, and marital status were related to the hospital inpatients. The better the education level, the higher the hospital inpatient proportion. Meanwhile, the employed were 40% less likely than the unemployed to be hospital inpatients (95%CI 0.565-0.634). Furthermore, the insured were 3.513 times more likely than the uninsured to be hospital inpatients (95%CI 3.264-3.780). Conclusion: Seven variables were related to hospital inpatients among the poor in Indonesia: residence, age, gender, marital status, education, employment, and health insurance. Health insurance was the main factor associated with hospital inpatients among low-income people. The government must increase the subsidy quota for the poor's participation in National Health Insurance.

Effects of Early Gait Training on Inpatient Frailty After Transcatheter Aortic Valve Implantation.

This study aimed to clarify the relationship between the number of days of early gait training and frailty in in-hospital patients undergoing transcatheter aortic valve implantation (TAVI) for aortic stenosis, focusing on the Clinical Frailty Scale (CFS) and clinical laboratory data. Sixty-nine patients admitted to the Ichinomiya West Hospital from November 1, 2019 to November 30, 2023 were included in the study. Of the 69 patients, those who started gait training on postoperative day 0 or 1 were defined as the early gait training group and those who started gait training later than postoperative day 1 were defined as the delayed gait training group. There was a significant difference in the number of days to gait training initiation, which was 3.9 days in the delayed gait training group and 0.9 days in the early gait training group. The early gait training group started early mobilization and had a significantly shorter postoperative hospital stay than the delayed gait training group. Clinical laboratory data showed that walking speed was significantly faster and grip strength was significantly higher in the early group. The number of days to gait training initiation was an independent predictor of changes in CFS scores. Early gait training in patients after TAVI may predict early improvements in physical function and movement, shorter hospital stay, and frailty at discharge.