Multinational Cross-sectional Survey Research Articles

Burden of Disease on Chronic Heart Failure Patients: A Multinational Cross-Sectional Survey in Real World Setting

Burden of Disease on Chronic Heart Failure Patients: A Multinational Cross-Sectional Survey in Real World Setting

Are Quality-Adjusted Life Years a Good Proxy Measure of Individual Capabilities?

BackgroundThere is a debate in the health economics literature concerning the most appropriate way of applying Amartya Sen’s capability approach in economic evaluation studies. Some suggest that quality-adjusted life years (QALYs) alone are adequate while others argue that this approach is too narrow and that direct measures of capability wellbeing provide a more extensive application of Sen’s paradigm.ObjectiveThis paper empirically explores whether QALYs provide a good proxy for individual capabilities.MethodsData is taken from a multinational cross-sectional survey of individuals with seven health conditions (asthma, arthritis, cancer, depression, diabetes, hearing loss, heart disease) and a healthy population. Each individual completed the ICECAP-A measure of capability wellbeing for adults and six health utility instruments that are used to generate QALYs, including EQ-5D and SF-6D. Primary analysis examines how well health utility instruments can explain variation in the ICECAP-A using ordinary least squares regression.ResultsThe findings show that all seven health conditions have a negative association on overall capability as measured by the ICECAP-A index. Inclusion of health utility instruments into separate regressions improves the predictive power of capability but on average, explains less than half of the variation in capability wellbeing. Individuals with arthritis appear to be less inhibited in terms of capability losses when accounting for health utility, yet those who have depression record significant reductions in capability relative to the healthy population even after accounting for the most commonly used health utility instruments.ConclusionThe study therefore casts doubt on the ability of QALYs to act as a reliable proxy measure of individuals’ capability.

Job Satisfaction and Subjective Well-Being Among Midwives: Analysis of a Multinational Cross-Sectional Survey.

There is a considerable amount of empirical evidence to indicate a positive association between an employee's subjective well-being and workplace performance and job satisfaction. Compared with nursing research, there is a relative lack of consistent scientific evidence concerning midwives' subjective well-being and its determinants related to domains of job satisfaction. The purpose of the study was to examine the association between the domains of job satisfaction and components of subjective well-being in hospital midwives. This cross-sectional descriptive study involved 1190 hospital midwives from 7 countries. Job satisfaction was measured by the McCloskey/Mueller Satisfaction Scale. Subjective well-being was conceptualized in the study by the 2 components (the affective and the cognitive component). The affective component of subjective well-being (ie, emotional well-being) was assessed by the Positive and the Negative Affect Scale. The cognitive component of subjective well-being (ie, life satisfaction) was measured by the Personal Well-Being Index. Pearson correlations and multiple regression analyses were used to determine associations between variables. Findings from correlation and regression analyses indicated an overall weak association between the domains of job satisfaction and components of subjective well-being. Satisfaction with extrinsic rewards, coworkers, and interaction opportunities accounted for only 13% of variance in the cognitive component (life satisfaction). The affective component (emotional well-being) was weakly associated with satisfaction with control and responsibility. The low amount of variance suggests that neither component of subjective well-being is influenced by the domains of job satisfaction. Further studies should focus on identifying other predictors of subjective well-being among midwives. A better understanding of how specific job facets are related to the subjective well-being of midwives might assist employers in the design of counseling and intervention programs for subjective well-being of midwives in the workplace and workplace performance.

PATIENTS WITH ALZHEIMER’S DISEASE SUFFERED REDUCED QUALITY OF LIFE RELATIVE TO THE GENERAL POPULATION: RESULTS FROM A RECENT MULTINATIONAL CROSS-SECTIONAL SURVEY

PATIENTS WITH ALZHEIMER’S DISEASE SUFFERED REDUCED QUALITY OF LIFE RELATIVE TO THE GENERAL POPULATION: RESULTS FROM A RECENT MULTINATIONAL CROSS-SECTIONAL SURVEY

A multinational cross-sectional survey of the management of patient medication adherence by European healthcare professionals

ObjectivesTo examine which interventions healthcare professionals use to support patients with taking medicines and their perceptions about the effectiveness of those actions.DesignCross-sectional multinational study.SettingOnline survey in Austria, Belgium, England, France,...

Assessing asthma in African American children using the Asthma Control Test and the Childhood Asthma Control Test

African Americans disproportionally experience uncontrolled asthma. [1] US Department of Health and Human Services, Office of Minority HealthAsthma and African Americans. US Dept of Health and Human Services, Washington, DCAugust 2012http://minorityhealth.hhs.gov/templates/content.aspx?ID=6170 Google Scholar Because asthma control is now the focus of asthma management, [2] US Department of Health and Human Resources, National Institutes of Health, The National Heart Lung and Blood Institute, and the National Asthma Education and Prevention ProgramExpert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. US Dept of Health and Human Resources, Washington, DC2007 Google Scholar publicly available questionnaires, such as the Asthma Control Test (ACT) [3] Asthma Control Test (ACT). Quality Metric 2014. http://www.qualitymetric.com/WhatWeDo/DiseasespecificHealthSurveys/AsthmaControlTestACT/tabid/190/Default.aspx. Accessed June 19, 2014. Google Scholar and the Childhood Asthma Control Test (C-ACT), [4] Childhood Asthma Control Test. GlaxoSmithKline 2005. http://www.michaelaye.com/actchild.pdf. Accessed June 19, 2014. Google Scholar represent the most accessible, standardized, nonphysician methods of assessing control and are typically considered cost-effective and easily implemented asthma care strategies for primary care offices. Both the ACT (for those 12 years or older) and the C-ACT (for those younger than 12 years) query asthma symptoms during the past 4 weeks and use a cut point of 19 or less for not well-controlled asthma. 3 Asthma Control Test (ACT). Quality Metric 2014. http://www.qualitymetric.com/WhatWeDo/DiseasespecificHealthSurveys/AsthmaControlTestACT/tabid/190/Default.aspx. Accessed June 19, 2014. Google Scholar , 4 Childhood Asthma Control Test. GlaxoSmithKline 2005. http://www.michaelaye.com/actchild.pdf. Accessed June 19, 2014. Google Scholar Because neither questionnaire has been validated in African American children, 5 Cloutier M.M. Schatz M. Castro M. et al. Asthma outcomes: composite scores of asthma control. J Allergy Clin Immunol. 2012; 129: S24-S33 Abstract Full Text Full Text PDF PubMed Scopus (161) Google Scholar , 6 Schatz M. Sorkness C.A. Li J.T. et al. Asthma Control Test: reliability, validity, and responsiveness in patients not previously followed by asthma specialists. J Allergy Clin Immunol. 2006; 117: 549-556 Abstract Full Text Full Text PDF PubMed Scopus (867) Google Scholar , 7 Thomas M. Kay S. Pike J. et al. The Asthma Control Test (ACT) as a predictor of GINA guideline-defined asthma control: analysis of a multinational cross-sectional survey. Prim Care Respir J. 2009; 18: 41-49 Crossref PubMed Scopus (215) Google Scholar , 8 Liu A.H. Zeiger R.S. Sorkness C.A. et al. Development and cross-sectional validation of the Childhood Asthma Control Test. J Allergy Clin Immunol. 2007; 119: 817-825 Abstract Full Text Full Text PDF PubMed Scopus (639) Google Scholar , 9 Liu A.H. Zeiger R.S. Sorkness C.A. et al. The Childhood Asthma Control Test: retrospective determination and clinical validation of a cut point to identify children with very poorly controlled asthma. J Allergy Clin Immunol. 2010; 126: 267-273 Abstract Full Text Full Text PDF PubMed Scopus (80) Google Scholar , 10 Nathan R.A. Sorkness C.A. Kosinski M. et al. Development of the asthma control test: a survey for assessing asthma control. J Allergy Clin Immunol. 2004; 113: 59-65 Abstract Full Text Full Text PDF PubMed Scopus (1969) Google Scholar we sought to determine whether the ACT and the C-ACT are appropriate screening tools for asthma control in this population.

Job satisfaction and leaving intentions of midwives: analysis of a multinational cross-sectional survey.

To investigate the relationship between turnover intentions and job satisfaction among hospital midwives from seven countries and to determine how the related variables differ between countries. Studies investigating professional turnover and job satisfaction among midwives are limited in scope. A cross-sectional descriptive survey was used to investigate the intended turnover and job satisfaction relationship among 1190 hospital midwives in European and Asian countries. Data were collected using a set of questionnaires that included questions regarding the leaving intentions of midwives and the McCloskey/Mueller satisfaction scale. Midwives were least satisfied with their extrinsic rewards and professional opportunities and with the balance between family and work. Significant differences were found in all domains of job satisfaction according to midwives' intentions to leave their current workplace in hospital or profession of midwife, and to work abroad. There are some general satisfying and dissatisfying elements for the profession of midwife across different countries. The results highlight the importance of understanding midwives' leaving intentions and related factors across different countries. To prevent midwife turnover, health-care managers should gain greater insight into the early stage of midwives' turnover intention.

Factors that affect readiness to change lifestyle: A 22-country survey from primary care

Background: The family physician's task in prevention is not only an assessment of patients’ health risks but also counselling individual patients.Aim: Aim of this primary care based study was to find how patients’ characteristics relate to their readiness to change.Methods: This multinational cross-sectional survey was conducted in primary care in 22 European countries, coordinated by EUROPREV. Consecutive attenders from randomly selected family practices answered a questionnaire about attitudes towards prevention and about lifestyle.Results: The questionnaire was answered by 7947 patients in 224 primary care practices in 22 European countries. Smoking was reported by 828 women (23.2%) versus 1238 (32.57%) men, unhealthy diet by 637 (11.6%) women versus 830 men (17.62%), risky alcohol consumption by 348 women (8.19%) versus 1009 men (23.07%) and the lack of physical activity by 617 women (12.68%) versus 614 men (16.45%). The need for change was declared by 432 (31.8%) of 1357 risky drinkers, 612 (29.6%) of 2066 smokers, 1210 (82.4%) of 1467 patients with unhealthy diet and by 2456 (30.9%) of all participants, 1231 of them were not physically active at all. Among patients with unhealthy dietary habits, 681 (56.3%) were confident of successfully changing their behaviour, among physically inactive it was 1561 (63.6 %), among smokers 284 (46.4%), and among risky drinkers 214 (49.5%).Conclusion: More likely to be ready to change unhealthy lifestyles are frequent attenders, European Union citizens, women and patients under 50 years of age.

PND56 - Clinical Practice Of Intrathecal Drugs For Management Of Pain And Spasticity: A Multinational Cross-Sectional Survey Of Health Care Providers

PND56 - Clinical Practice Of Intrathecal Drugs For Management Of Pain And Spasticity: A Multinational Cross-Sectional Survey Of Health Care Providers

Snapshots of Diabetes Care in Canada

Snapshots of Diabetes Care in Canada

PGI21 - Impact Of Opioid-Induced Constipation: A Multinational Cross-Sectional Survey Of Patients And Health Care Providers

PGI21 - Impact Of Opioid-Induced Constipation: A Multinational Cross-Sectional Survey Of Patients And Health Care Providers

Risque thromboembolique veineux et pratique de prévention hospitalière : résultats obtenus en France de l’étude internationale ENDORSE

Information about the variation in the risk for venous thromboembolism (VTE) and in prophylaxis practices in France and around the world is scarce. The Epidemiologic International Day for the Evaluation of Patients at Risk for Venous Thromboembolism in the Acute Hospital Care Setting (ENDORSE) study is a multinational cross-sectional survey designed to assess the prevalence of VTE risk in the acute hospital care setting, and to determine the proportion of at-risk patients who receive effective prophylaxis, in accordance with the 2004 American College of Chest Physicians (ACCP) guidelines. This paper gives the results of the ENDORSE study in the French centres in comparison with the global worldwide results of the ENDORSE study and with other Western Europe countries. In France, 18 randomized hospitals participated to the study between august 2006 and January 2007. 2844 patients were evaluated (917 from chirurgical wards and 1927 from medical wards). One thousand four hundred and nineteen patients (49.9%) were at VTE risk (78.3% in chirurgical wards and 36.4% in medical wards). Of the 1419 patients at VTE risk, 62.4% received ACCP-recommended VTE prophylaxis (71.2% in chirurgical wards and 53.5% in medical wards). VTE Prophylaxis in France (62.4%) is more frequent than worldwide in the international ENDORSE study (50.2%) and similar to the majority of the other western European countries and the USA. It is also more used in university hospitals (66.9%) than in other hospitals (58.9%). Prophylaxis in patients at risk for VTE was presented in 43% patients with acute heart failure, 53% with non-infectious acute respiratory failure, 57% in patients with pulmonary infection, 56% in patients with stroke, 55% in patients with active cancer and 48% in patients with non-pulmonary sepsis. The ENDORSE study has shown a high level of patients at risk for VTE in the population of hospitalized patients in France. The rate of prophylaxis for VTE remained low, in particular in Medicine wards. Our data reinforced the rationale for the use of hospital-wide strategies to assess patients' VTE risk and to implement measures that ensure that at-risk patients receive appropriate prophylaxis, in particularly in medical patients.

The AVAIL ME Extension: a multinational Middle Eastern survey of venous thromboembolism risk and prophylaxis

Venous thromboembolism (VTE) is a major worldwide problem. The primary objectives of this survey were to identify patients at risk for VTE, to define the rate of patients receiving appropriate VTE prophylaxis and to examine the frequency of the presence of guidelines and their application. Ten countries, 101 hospitals and a total of 4983 patients were included in this multinational cross-sectional survey. Standardized case report forms were filled out by trained individuals on one predefined day. Risks were categorized according to the Caprini Risk Assessment Model. Logistic regressions were carried out to assess factors that determined VTE prophylaxis. Of 4983 patients, 3368 (68%) and 1615 (32%) were surgical and medical, respectively. Seven hundred and seventy-two (15.5%) were considered to be at low risk, 1001 (20%) at moderate risk, 1289 (26%) at high risk and 1921 (38.5%) at very high risk for VTE. Of 3575 (72%) patients who were eligible to receive VTE prophylaxis, 2747 (77%) received any drug prophylaxis. Among these patients 720/1056 (68%) and 2027/2519 (80%) were medical and surgical patients, respectively. The overall compliance with ACCP guidelines was 38%, being 24% for medical patients and 44% for surgical patients. The results of this large multinational survey, although indicating overall improvement in VTE prophylaxis, identify a considerable number of patients who either did not receive any VTE prophylaxis or received it inappropriately. Although more medical patients were at risk for VTE, they were given prophylaxis less frequently than surgical patients. Concordance with VTE prophylaxis guidelines was higher in surgical patients, but overall application of these tools was unacceptably low.

Results of ENDORSE-2-HUNGARIA study. Repeated assessment of the prevalence of venous thromboembolism risk and prophylaxis in acute hospital care setting

ENDORSE (Epidemiologic International Day for the Evaluation of Patients at Risk for Venous Thromboembolism in the Acute Hospital Care Setting) study in 2006, was a multinational cross-sectional survey designed to assess the prevalence of venous thromboembolism (VTE) risk in the acute hospital care setting, and to determine the proportion of at-risk patients who receive appropriate prophylaxis. From the 358 randomly selected hospitals across 32 countries in the global registry, 9 Hungarian centers were included. According to the Hungarian results, the use of appropriate prophylaxis was more common in surgical patients but much less common in medical patients comparing to the worldwide average. ENDORSE 2-HUNGARY was a local survey to compare the prophylactic habits after two years and two months time period. In both surveys, the 2004 American College of Chest Physicians (ACCP) evidence-based consensus guidelines were used to assess venous thromboembolism risk and to determine whether patients were receiving recommended prophylaxis. The one day survey ENDORSE 2-HUNGARY was repeated beside seven already audited hospitals, and in two newly recruited hospitals. A total of 886 patients were assessed for thrombosis risk on the basis of hospital chart review. Of these patients 59.0% (N=523) were judged at risk for VTE, including 100% (N=327) surgical and 35.1% (N=196) medical patients. 67.9% (N=355) of the total at-risk patients received ACCP-recommended VTE prophylaxis. Among surgical patients, 84.4% (N=276) received recommended prophylaxis compared with 40.3% (N=79) of medical patients. Results of the ENDORSE in 2006 and 2009 were compared, as well. The rate of appropriate prophylaxis use in at-risk patients did not changed significantly in surgical patients, however, a significant, 43.9% increase was found in medical patients (p=0.002), that proves the success of lectures presenting the facts and focusing to increase medical prophylaxis during the time period between the two studies. 59.7% of at-risk medical patients and 15.6% of surgical patients were unprotected against thrombosis in 2009. We should further increase the rate of at-risk patients receiving appropriate prophylaxis. We should reinforce the rationale for the increase of awareness of VTE risk in hospitalized medical patients, and to enhance the prophylaxis practice among healthcare professionals.

Thromboembolierisiko und -prophylaxe internistischer und chirurgischer Patienten im Krankenhaus

Venous thromboembolism (VTE) leads to an increased morbidity in hospitalized patients. This multinational cross-sectional survey was designed to assess the prevalence of VTE risk factors and to determine the proportion of at-risk patients who receive effective VTE-prophylaxis. The results of the 16 participating German hospitals of the study are presented and compared with the international results. All hospital inpatients aged >or= 40 years admitted to a medical ward and all surgical inpatients aged >or= 18 years were enrolled. The American College of Chest Physicians (ACCP) guidelines (2004) were applied to assess VTE risk and to determine whether patients were receiving recommended VTE prophylaxis. Overall, 2,370 patients were enrolled: 1,210 (51 %) were categorised as surgical and 1,160 (49 %) as acute medically ill. 838 (69 %) of surgical and 479 (41 %) of medical patients were judged to be at risk for VTE. Of the surgical patients at risk, 772 (92 %) received ACCP-recommended VTE prophylaxis, compared with 337 (70 %) medical patients at risk of VTE. Low-molecular weight heparins were most frequently used. In total, in comparison to other countries, Germany has a leading position in the implementation of international guidelines with regard to VTE prophylaxis. Whereas in a surgical ward effective VTE prophylaxis is consistently standard care, in the medical indications there is still room for improvement in terms of stratification of VTE risk and corresponding VTE-prophylaxis.

Decreased food intake is a risk factor for mortality in hospitalised patients: The NutritionDay survey 2006

Malnutrition is a known risk factor for the development of complications in hospitalised patients. We determined whether eating only fractions of the meals served is an independent risk factor for mortality. The NutritionDay is a multinational one-day cross-sectional survey of nutritional factors and food intake in 16,290 adult hospitalised patients on January 19th 2006. The effect of food intake and nutritional factors on death in hospital within 30 days was assessed in a competing risk analysis. More than half of the patients did not eat their full meal provided by the hospital. Decreased food intake on NutritionDay or during the previous week was associated with an increased risk of dying, even after adjustment for various patient and disease related factors. Adjusted hazard ratio for dying when eating about a quarter of the meal on NutritionDay was 2.10 (1.53-2.89); when eating nothing 3.02 (2.11-4.32). More than half of the patients who ate less than a quarter of their meal did not receive artificial nutrition support. Only 25% patients eating nothing at lunch receive artificial nutrition support. Many hospitalised patients in European hospitals eat less food than provided as regular meal. This decreased food intake represents an independent risk factor for hospital mortality.

The Asthma Control TestTM (ACT) as a predictor of GINA guideline-defined asthma control: analysis of a multinational cross-sectional survey

To evaluate whether the Asthma Control Test (ACT) score is predictive of Global Initiative for Asthma (GINA) guideline-defined classification levels of asthma control. The ACT is a validated, 5-item, patient-completed measure of asthma control with a recall period of four weeks. Cross-sectional survey comparing ACT score and GINA classification of asthma control among 2949 patients attending primary care physicians and specialists in France, Germany, Italy, Spain, the UK, and the USA. The area under the receiver operating characteristics curve for ACT score predicting GINA control was 0.84 (95% CI 0.82-0.85). An ACT score of <19 (not well-controlled asthma) correctly predicted GINA-defined partly controlled/uncontrolled asthma 94% of the time, while an ACT score of >20 predicted GINA-defined controlled asthma 51% of the time, with kappa statistic of 0.42, representing moderate agreement. An ACT score <19 is useful for identifying patients with poorly controlled asthma as defined by GINA.

Results of ENDORSE study in Hungary. Multinational, cross-sectional study to assess the prevalence of venous thromboembolism risk and prophylaxis in acute hospital care setting

Information about the risk of venous thromboembolism and prophylactic practices around the world is limited. ENDORSE (Epidemiologic International Day for the Evaluation of Patients at Risk for Venous Thromboembolism in the Acute Hospital Care Setting) study is a multinational cross-sectional survey designed to assess the prevalence of venous thromboembolism (VTE) risk in the acute hospital care setting, and to determine the proportion of at-risk patients who receive appropriate prophylaxis. All hospital inpatients aged 40 years or above admitted to a medical ward, or those aged 18 years or above admitted to a surgical ward, in 358 randomly selected hospitals across 32 countries were assessed for risk of VTE on the basis of hospital chart review. The 2004 American College of Chest Physicians evidence-based consensus guidelines were used to assess venous thromboembolism risk and to determine whether patients were receiving recommended prophylaxis. Nine Hungarian centers were included in the international survey, and a total of 1300 patients were assessed for thrombosis risk in Hungary. Of these patients 39.9% (N=519) were judged at risk for VTE, including 58.2% (N=253) surgical and 30.8% (N=266) medical patients. 56.6% (N=294) of the total at-risk patients received ACCP-recommended VTE prophylaxis. Among major surgery patients 86.6% (N=219) received recommended prophylaxis compared with 28.2% (N=75) of medical patients. In Hungary more than two-thirds of at-risk hospitalized medical patients did not receive appropriate prophylaxis. ENDORSE results reinforced that a large proportion of hospitalized surgical and medical patients are at risk for VTE worldwide as well as in Hungary. The rate of at-risk patients receiving appropriate prophylaxis should be urgently increased.

Venous thromboembolism risk and prophylaxis in the acute hospital care setting (ENDORSE study): a multinational cross-sectional study

Information about the variation in the risk for venous thromboembolism (VTE) and in prophylaxis practices around the world is scarce. The ENDORSE (Epidemiologic International Day for the Evaluation of Patients at Risk for Venous Thromboembolism in the Acute Hospital Care Setting) study is a multinational cross-sectional survey designed to assess the prevalence of VTE risk in the acute hospital care setting, and to determine the proportion of at-risk patients who receive effective prophylaxis. All hospital inpatients aged 40 years or over admitted to a medical ward, or those aged 18 years or over admitted to a surgical ward, in 358 hospitals across 32 countries were assessed for risk of VTE on the basis of hospital chart review. The 2004 American College of Chest Physicians (ACCP) evidence-based consensus guidelines were used to assess VTE risk and to determine whether patients were receiving recommended prophylaxis. 68 183 patients were enrolled; 30 827 (45%) were categorised as surgical, and 37 356 (55%) as medical. On the basis of ACCP criteria, 35 329 (51.8%; 95% CI 51.4-52.2; between-country range 35.6-72.6) patients were judged to be at risk for VTE, including 19 842 (64.4%; 63.8-64.9; 44.1-80.2) surgical patients and 15 487 (41.5%; 41.0-42.0; 21.1-71.2) medical patients. Of the surgical patients at risk, 11 613 (58.5%; 57.8-59.2; 0.2-92.1) received ACCP-recommended VTE prophylaxis, compared with 6119 (39.5%; 38.7-40.3; 3.1-70.4) at-risk medical patients. A large proportion of hospitalised patients are at risk for VTE, but there is a low rate of appropriate prophylaxis. Our data reinforce the rationale for the use of hospital-wide strategies to assess patients' VTE risk and to implement measures that ensure that at-risk patients receive appropriate prophylaxis.