Physical Health Status Of Patients Research Articles

Senior Nursing Students’ Assessment of the Physical Health Status of Patients Diagnosed with Mental Disorders

Senior Nursing Students’ Assessment of the Physical Health Status of Patients Diagnosed with Mental Disorders

COVID-19 infection at a psychiatric hospital in KwaZulu-Natal, South Africa: Clinical service planning and challenges.

South Africa had over 4 million cases of coronavirus disease 2019 (COVID-19) infections and more than 1 million COVID-19-related deaths. Despite the devastating psychological impact of the COVID-19 pandemic, there is little qualitative, critical evaluation of government mental health services in this resource-limited setting. The authors describe the clinical service plan and response to the COVID-19 pandemic at a government psychiatric hospital. KwaZulu-Natal, South Africa. A descriptive narrative overview of the specialised psychiatric hospital's clinical response (April 2020 - March 2021) to the COVID-19 pandemic was undertaken in the following domains: screening policy; testing and swabbing policy; staff training and monitoring; and restructuring the wards to accommodate mental health care users (MHCUs) with suspected cases of COVID-19. The in-depth narrative reviews led to the introduction of staff training, routine COVID-19 reverse transcription polymerase chain reaction (RT-PCR) testing of all MHCUs, the creation of designated quarantine and isolation facilities and screening of physical health status of patients with COVID-19 prior to transfer being implemented to prevent an outbreak or increased morbidity or mortality. Implementing a service plan early which included staff training, screening and routine COVID-19 testing services for psychiatric admissions in a rapidly evolving environment with few additional resources was challenging. The absence of guidelines early in the pandemic that addressed the unique needs of a clinical psychiatric inpatient population is a noteworthy learning point. The article highlights that the inpatient infrastructural requirements and clinical management protocols of acutely psychiatrically ill inpatients, in the context of infectious outbreaks, require dedicated task teams and bespoke policies.

Prognostic impact of self-reported health on clinical outcomes in patients with heart failure.

An in-depth understanding of the prognostic value of patient-reported outcomes (PRO) is essential to facilitate person-centred care in heart failure (HF). This study aimed to clarify the prognostic role of subjective mental and physical health status in patients with HF. Patients with HF were identified from the DenHeart Survey (n = 1499) and PRO data were obtained at hospital discharge, including the EuroQol five-dimensional questionnaire (EQ-5D), the HeartQoL, and the Hospital Anxiety and Depression Scale (HADS). Clinical baseline data were obtained from medical records and linked to nationwide registries with patient-level data on sociodemographics and healthcare contacts. Outcomes were all-cause and cardiovascular (CV) mortality, CV events, and HF hospitalization with 1- and 3-year follow-up. Analysing the PRO data on a continuous scale, a worse score in the following were associated with risk of all-cause and CV mortality after 1 year: the HeartQoL (adjusted hazard ratios (HRs) 1.91, 95% confidence interval (CI) 1.42-2.57 and 2.17, 95% CI 1.50-3.15, respectively), the EQ-5D (adjusted HRs 1.26, 95% CI 1.15-1.38 and 1.27, 95% CI 1.13-1.42, respectively), the HADS depression subscale (adjusted HRs 1.12, 95% CI 1.07-1.17 and 1.11, 95% CI 1.05-1.17, respectively), and the HADS anxiety subscale (adjusted HRs 1.08, 95% CI 1.03-1.13 and 1.09, 95% CI 1.04-1.15, respectively). Three-year results were overall in concordance with the 1-year results. A similar pattern was also observed for non-fatal outcomes. Health-related quality of life and symptoms of anxiety and depression at discharge were associated with all-cause and CV mortality at 1- and 3-year follow-up.

Decreased Occupational Functioning and Increased Physical Health Complaints in Treatment Seekers with Internet-Related Disorders: Compared to Patients with Gambling Disorder

Background: Internet-related disorders (IRDs) as a growing mental health issue will probably be included in the upcoming ICD-11. While research on psychological aspects has progressed, less data are available regarding the physical health status of patients. Thus, we provide new data on physical health complaints, prediagnosed illness, level of functioning, and work ability in a clinical sample. Methods: From consecutive treatment seekers, we included n = 286 patients with IRD, n = 95 subjects with excessive yet not disordered Internet use, and n = 106 patients with gambling disorder (GD). All 3 groups were compared regarding lifestyle habits, medical history, somatic complaints, sleep disturbances, level of functioning and work ability using standardized self-reports, and clinical ratings. Results: Patients with IRD differed from nonclinical controls by higher somatic complaints, a lower level of functioning, and a higher degree of impairment in social and occupational contexts. Only few differences were found between patients with IRD and GD. Conclusions: Compared to individuals with excessive, not addictive online behaviors, patients diagnosed with IRD displayed higher somatic symptoms, and more sleep problems. This implies that psychotherapeutic interventions should also consider physical and psychosomatic problems when treating patients. Among patients with IRD, significant social and occupational deficits were comparable to patients with GD. This emphasizes that IRD are causing severe impairment in relevant aspects of the patients’ lives.

Self-Management Counseling and Physical Health Status among Patients with Pulmonary TB in Bogor, Indonesia

Background: Patients with pulmonary TB experience physical, psychological, social, and spiritual changes, affecting their physical health status. Self-management counseling is an intervention which enhances the physical health status of patients with pulmonary TB.Purpose: This study aimed to identify the effects of self-management counseling on physical health status in patients with pulmonary TB.Methods: This study used a pre and post-test quasi-experimental design with a control group and took place in a hospital in Bogor. The total respondents were 60 patients who were assigned into two groups and recruited using purposive sampling. The counseling was given for four sessions in two weeks for about 60-90 minutes each session. The data were collected using the functional assessment of chronic illness therapy-tuberculosis (FACIT-TB) and analyzed using paired t-test and independent t-test.Results: The result showed that the physical health status in the intervention group increased significantly (MD=8.0, p=0.000) compared to the control group. However, there was no influence of self-management counseling on the improvement of physical health status (MD=3.24, p=0.314).Conclusion: Self-management counseling did not significantly increase the physical health status of pulmonary TB patients. More rigorous studies are needed to investigate the effect of self-management counseling delivered at early treatment on the improvement of physical health status. It is expected that patients can manage their TB symptoms and able to improve their physical health status.

Comorbidity burden is associated with poor psychological well-being and physical health status in patients with an implantable cardioverter-defibrillator

Comorbidity burden has been linked to survival in patients with an implantable cardioverter-defibrillator (ICD), but no study has examined the influence on psychological well-being and health status. We examined the relationship between comorbidity burden and anxiety, depression, and health status in patients with an ICD during the first 12 months post-implantation using a prospective study design. Consecutively, implanted ICD patients (N = 401; 78% men) completed the Hospital Anxiety and Depression Scale and the Short Form Health Survey 36 (SF-36) at baseline, 3, 6, and 12 months post-implantation. Data were analysed using general linear mixed modelling repeated measures multivariable analysis of variance. The mean Charlson comorbidity index score was 3.5 (± 2.4). In adjusted analyses, comorbidity burden was significantly associated with depression (P = 0.003) and the physical health status domains of the SF-36 (Physical Functioning: P < 0.001; Role Limitations-Physical: P = 0.023; Bodily Pain: P = 0.004; and General Health: P = 0.025) but not with anxiety (P = 0.62) and the mental health status domains of the SF-36 (all P's > 0.05). Chronic heart failure, chronic obstructive pulmonary disease, cerebrovascular disease, and renal failure were the comorbidities with the most impact on depression and physical health status. Comorbidity burden was a significant predictor of poorer psychological well-being and physical health status in ICD patients during the first 12 months post-implantation. In the care and management of ICD patients, it is important to recognize the impact of comorbidity burden on patients' mood and health status, and that adjunctive intervention may be warranted to enhance well-being.

Clinical Correlates of Self-reported Physical Health Status in Systemic Sclerosis

Systemic sclerosis (SSc) is a multisystem disease associated with impaired health-related quality of life (HRQOL). Our objective was to identify the clinical characteristics that correlate with the physical health status of patients with SSc, as assessed by the Medical Outcomes Trust Short Form-36 (SF-36). Cross-sectional, multicenter study of 416 patients from the Canadian Scleroderma Research Group Registry. Patients were assessed with detailed clinical histories, medical examinations, and self-administered SF-36. Multiple linear regression was used to assess the relationship between selected demographic and clinical variables and the SF-36 Physical Component Summary (PCS) score. The greatest impairments in the SF-36 were in the domains measuring physical health, and the mean SF-36 PCS score was 37.5 (+/-11.2). In multivariate analysis, significant clinical predictors of the SF-36 PCS were shortness of breath, number of gastrointestinal problems, skin score, swollen joint count, and age. The final model explained 47% of the variance in the SF-36 PCS. Clinical characteristics identified as significant correlates of the self-reported physical health status in SSc should each be targets of intervention in order to improve the HRQOL of patients with this disease.

P02-136 Completed audit of physical health status of patients with severe mental illness in a medium secure forensic psychiatric rehab ward

Aim:An audit was conducted in September 2006 to determine whether the Physical health monitoring of patients on anti-psychotic medication was concurrent with the national guidelines.This audit done in Dec 07 aimed to ascertain to what extent the recommendations were implemented and followed, thereby completing the audit cycle.Methods:The Audit was conducted in a 15 bedded medium secure forensic rehab ward.As there was a lack of recording of the physical health status a monitoring sheet was introduced in the notes after the first audit. Age, Weight, Height, Smoking status, Blood Pressure, Diabetic Status, Blood Lipid Profile, ECG and the Medication regimen were noted for each of the patient.Results:Conclusion:100% physical health monitoring was achieved and improvements in weight, CV risk, Total/HDL cholesterol ratio was noted 4 cases of significant QT prolongation and another 3 cases of prolactin elevation were detected because of the introduction of monitoring.

Measuring the Health Status of Patients with Vascular Leg Ulcers and the Burden for their Caregivers

To assess the health status of patients with leg ulcers and the impact and consequences of such chronic disease on the life of their caregivers. Observational study in a "day care" setting. Administration of the Short Form-12 questionnaire and of Visual Analogue Scales for pain to patients; of the Family Strain Questionnaire to caregivers. Eighty consecutive patients with leg ulcers and their principal caregivers were observed in the period January-August 2006. The emotional burden and problem in social involvement were statistically significantly higher in caregivers for patients with worse SF-12 scores on the physical scale. Values of emotional burden were lower than those observed for cancer patients and for patients in a persistent vegetative state; however, they were higher than those observed for patients with neurological, respiratory, or renal conditions. The score for social involvement was significantly higher for caregivers of patient with vascular leg ulcers compared to other diseases, with the single exception of the persistent vegetative state. Leg ulcers alter the relationship between family members, and the physical impairment causes significant strain on the caregiver. The improvement of physical health status in patients with leg ulcers may induce a reduction in the emotional burden and an improvement in the social involvement for caregivers.

Effects of cognitive behavioral treatment on physical health status in patients with panic disorder

The relationship between panic disorder and nonpsychiatric medical illness is complex, but some evidence suggests that panic disorder increases risk for a variety of nonpsychiatric medical conditions. Given the demonstrated efficacy of cognitive behavioral therapy (CBT) for panic disorder, we were interested in evaluating the effects of CBT for panic disorder on nonpsychiatric medical symptoms among these patients. Patients were randomized to a 12-week group-administered CBT protocol (n = 22) or a delayed-treatment control (n = 24). Treated patients showed marked improvement in both anxiety symptoms and physical health symptom ratings that were evident at midtreatment and were maintained through a 6-month follow-up period. Despite comparable rates of change, changes in anxiety symptoms did not appear to mediate the relationship between treatment and improved physical health ratings. These findings indicate that CBT appears to have an immediate and long-term beneficial impact on physical health and that this effect is independent from its impact on anxiety symptoms.

The ALS Health Profile Study: quality of life of amyotrophic lateral sclerosis patients and carers in Europe.

The measurement of functioning and well-being from the perspective of the patient has in recent years become central to the assessment of health and the evaluation of treatment regimes. The past decade has seen an enormous growth in the application of measures designed to assess quality of life in a vast array of medical specialties. However, the use of such measures in neurology has been relatively limited, and this has certainly been the case in amyotrophic lateral sclerosis (ALS). The European ALS Health Profile Study is a longitudinal survey of patients diagnosed with ALS or other motor neurone diseases in which patients are asked to complete questionnaires concerning their subjective health status. Data from clinical assessments are also collected. It is intended that the information collected will provide more systematic and detailed evidence of the impact of the disease from the perspective of the patient. This contribution documents results from baseline assessment obtained from data supplied by clinicians, carers and patients themselves. Three outcome measures are assessed in this paper: the SF-36, a generic measure of well being and functioning, the ALS Functional Rating Scale and the Carer Strain Index. The evidence presented here suggests that these measures provide a meaningful and valid picture of the impact of the disease. The data indicate that ALS has substantial adverse effects both upon the functioning and well being of patients and carers, as well as an association between the emotional health status of patients and carers, and between the physical health status of patients and carers.