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Psychological Impact of Covid-19 among Healthcare Workers in Cameroon Covid-19对喀麦隆医护人员的心理影响
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2021-03-31 DOI: 10.36959/569/462
N. Tendongfor, Vanessa Amana Bokagne Therese, Destin Kouam Talla Gilchrist, Vanessa Lambou Fopa, Doreen Christie, Alice Ketchanji, Atiepoh Nganyewo Cynthia, Mandaah Forlemu Vanessa
Background: Since December 2019, the world has been experiencing the Covid-19 pandemic which has claimed several thousands of lives worldwide. The healthcare workers are among the population at high risk. Evaluating the psychological impact of the Covid-19 on the mental health of healthcare workers in Cameroon is very crucial to maintain their psychological well-being, and ensure good monitoring and follow up of patients. Methods: This study was an online survey in which electronic questionnaires were made available to healthcare workers through email and social media. The survey involved the risk perception towards Covid-19, psychological distressand the motivation of healthcare workers. The level of psychological distress was measured using the 12-item generalised health questionnaire. Data was analysed in SPSS version 25. Results: A majority of the healthcare workers (99.3%) perceived Covid-19 as a major public health problem with 74.9% feeling unsaved working during the pandemic and 21% feeling as abandoning their job. Psychological distress was moderate in 63% and high in 16% of the Healthcare workers and did not vary with sociodemographic characteristics. Healthcare workers directly involved in the Covid-19 unit had a significantly higher psychological distress score compare to those not directly involved (p = 0.009). The motivation to carry out their duty (74.2%), respect of the hypocrate oath (60.9%) and serving the nation (50.2%) were the main reasons motivating the healthcare workers to keep on performing their duty. Conclusion: Our study highlights that healthcare workers in Cameroon are experiencing moderate to high psychological distress as a result of the Covid-19 pandemic. Therefore there is a need for psychosocial support to mitigate the distress and to ensure their well-being.
背景:自2019年12月以来,世界一直在经历Covid-19大流行,在全球范围内夺去了数千人的生命。医护人员属于高危人群。评估Covid-19对喀麦隆医护人员心理健康的心理影响对于保持他们的心理健康以及确保对患者进行良好监测和随访至关重要。方法:本研究是一项在线调查,通过电子邮件和社交媒体向卫生保健工作者提供电子问卷。该调查涉及对Covid-19的风险认知、心理困扰和医护人员的动机。心理困扰水平采用12项综合健康问卷进行测量。数据采用SPSS 25进行分析。结果:绝大多数医护人员(99.3%)认为新冠肺炎是一个重大的公共卫生问题,74.9%的医护人员感到在疫情期间无法挽救工作,21%的医护人员感到放弃工作。63%的卫生保健工作者的心理困扰是中度的,16%的卫生保健工作者的心理困扰是重度的,并且不随社会人口学特征而变化。直接参与Covid-19单位的医护人员的心理困扰评分明显高于未直接参与的医护人员(p = 0.009)。履行职责的动机(74.2%)、履行伪善誓言的动机(60.9%)和为国家服务的动机(50.2%)是促使医务人员继续履行职责的主要原因。结论:我们的研究强调,由于Covid-19大流行,喀麦隆的卫生保健工作者正在经历中度至高度的心理困扰。因此,有必要提供社会心理支持,以减轻痛苦并确保他们的幸福。
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引用次数: 1
Cutaneous Granuloma Revealing Familial Mercury Intoxication 揭示家族汞中毒的皮肤肉芽肿
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2020-11-13 DOI: 10.36959/569/461
Rachdi Imène, Daoud Fatma, Jeridi Mayssam, S. Mehdi, Zoubeidi Hana, Dhaou Besma Ben, A. Zohra, H. Mohamed, B. Fatma
Human exposure to mercury is known to lead to major health problems. Mercury toxicity effects multiple organs especially the central nervous system and kidneys. Skin diseases resulting from mercury exposure are various and may reveal intoxications. We report the case of a 60-year-old male who had skin lesions that histologically showed foreign-body reaction with granuloma. The foreign body turned to be mercury. That unveiled paucal symptomatic family intoxication. Blood and urine analysis were run and found heavy metals including mercury surpassing normal range. The source of exposure remained unknown as the patient denied professional exposure or manipulation of inorganic mercury. The family was treated with chelation therapy over seas.
众所周知,人类接触汞会导致重大健康问题。汞中毒影响多个器官,特别是中枢神经系统和肾脏。接触汞引起的皮肤病多种多样,可能会出现中毒。我们报告的情况下,60岁的男性谁有皮肤病变,组织学上显示异物反应与肉芽肿。那异物原来是水银。这暴露了保罗有症状的家庭中毒。进行了血液和尿液分析,发现包括汞在内的重金属超出正常范围。由于患者否认专业接触或操纵无机汞,接触源仍然未知。这家人在海外接受了螯合治疗。
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引用次数: 0
The COVID-19 Pandemic and Face Shields: A Review COVID-19大流行与面罩:综述
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2020-11-12 DOI: 10.36959/569/459
F. HaJennifer
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引用次数: 0
Spontaneous Retinal Pigment Epithelium Rips under Fovea with Preserved Good Visual Acuity Outcome 自发性视网膜色素上皮在中央凹下撕裂,保留良好的视力结果
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2020-10-11 DOI: 10.36959/569/458
Au Sunny Chi Lik, Kostina Li
An 80-year-old lady was follow up in retina clinic for right only eye with Pigment Epithelium Detachment (PED). She had a history of left eye occult choroidal neovascularization, developed macula scar and legal blindness years ago despite repeated anti-Vascular Endothelial Growth Factor (anti-VEGF) injection. Upon regular follow-up, her right eye maculadeveloped serous PED centered at fovea, enlarging with time (Figure 1A, Figure 1B, Figure 1C and Figure 1D) throughout 2-years. There was no leakage, nor polyps/abnormal branch vascular network all along on serial Fundus Fluorescein Angiography (FFA) and Indocyanine Green Angiography respectively, thus anti-VEGF injection was never given to her right eye, or photodynamic therapy.
本文报告一位80岁高龄妇女因右眼色素上皮脱离(PED)在视网膜门诊随访。患者多年前多次注射抗血管内皮生长因子(anti-VEGF),但左眼隐匿性脉络膜新生血管,出现黄斑疤痕和法定失明。经定期随访,患者右眼黄斑发展为以中央凹为中心的浆液性PED,随着时间的推移而增大(图1A、图1B、图1C和图1D)。连续眼底荧光素血管造影(FFA)及吲酞菁绿血管造影(Indocyanine Green Angiography)均未见渗漏,未见息肉/分支血管网络异常,因此未给予右眼抗vegf注射及光动力治疗。
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引用次数: 1
Prevalence of Diabetic Keto Acidosis and Associated Factors among Newly Diagnosed Patients with Type One Diabetic Mellitus at Dilla University Referral Hospital, September 9th/2017 – May 30th/2019: South Ethiopia; Crossectional Study 2017年9月9日- 2019年5月30日:南埃塞俄比亚迪拉大学转诊医院新诊断1型糖尿病患者糖尿病酮症酸中毒患病率及相关因素Crossectional研究
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2020-08-31 DOI: 10.36959/569/457
E. Alem, Girma Zeleke, Mandefreo Baharu, H. Amare
Background: Diabetic Ketoacidosis (DKA) is one of the most serious acute complications of Diabetes Mellitus (DM) and the leading cause of morbidity and mortality in young adults with type 1 diabetes. The mortality rate for DKA ranges from 2 to 5% in developed countries and 6 to 24% in developing countries. Even though many DKA patients were seen in emergency unit of Ethiopian hospitals and health centers, little is known about precipitating factors and clinical-laboratory features of DKA among Ethiopian patients and information is scant to promote better health service to prevent mortality due to DKA. So the aim of this study is to assess the prevalence and associated risk factors of DKA in newly diagnosed Type 1 Diabetic patients in Dilla University Referral Hospital (DURH) from September 9th/2017-May 30th/2019. Method: Quantitative institutional based study was conducted among 421 newly diagnosed type one diabetic patients. Data was double entered from the paper-based abstraction sheet into Epi info version 7 and exported to SPSS version 20 for analysis. A descriptive analysis was performed. Bivariate and multivariate logistic analysis was done to identify factors associated with the magnitude of Keto acidosis. Variables with p-value less than 0.05 were declared as having significant association between factors and dependent variable. Result: The magnitude of Diabetic Keto Acidosis (DKA) in newly diagnosed patients with type one diabetic Mellitus (T1DM) was found to be 38%. The significant predictors of Diabetic Keto Acidosis (DKA) among newly diagnosed patients with type one diabetic Mellitus (T1DM) were young age of the adult, family history of diabetes and infection prior to onset of Diabetic Keto Acidosis (DKA). Conclusion: The overall magnitude of Diabetic Keto Acidosis (DKA) in adults with newly diagnosed type 1 diabetes is high. In particular, adults between 18-25 years of age have a high risk of Diabetic Keto Acidosis (DKA) at onset of diabetes mellitus. Young Age, first degree relatives with Diabetic Mellitus (DM) and infection prior to Diabetic Keto Acidosis (DKA) are found to be the significant explanatory variable of Diabetic Keto Acidosis (DKA) in primary onset of T1DM.
背景:糖尿病酮症酸中毒(DKA)是糖尿病(DM)最严重的急性并发症之一,也是年轻1型糖尿病患者发病和死亡的主要原因。DKA的死亡率在发达国家为2%至5%,在发展中国家为6%至24%。尽管在埃塞俄比亚医院和保健中心的急诊科看到了许多DKA患者,但对埃塞俄比亚患者中DKA的诱发因素和临床-实验室特征知之甚少,而且促进更好的卫生服务以预防DKA导致的死亡的信息也很少。因此,本研究的目的是评估2017年9月9日至2019年5月30日在迪拉大学转诊医院(DURH)新诊断的1型糖尿病患者DKA的患病率及其相关危险因素。方法:对421例新诊断的1型糖尿病患者进行定量制度研究。将数据从纸质摘要表中双重输入到Epi info version 7中,并导出到SPSS version 20中进行分析。进行描述性分析。进行了双变量和多变量逻辑分析,以确定与酮症酸中毒程度相关的因素。p值小于0.05的变量被认为因子与因变量之间具有显著相关性。结果:初诊1型糖尿病(T1DM)患者的糖尿病酮症酸中毒(DKA)发生率为38%。新诊断的1型糖尿病(T1DM)患者发生糖尿病酮症酸中毒(DKA)的重要预测因素为成人年龄、糖尿病家族史和发病前感染。结论:成人新诊断1型糖尿病患者糖尿病酮症酸中毒(DKA)总体程度较高。特别是18-25岁之间的成年人在糖尿病发病时发生糖尿病酮症酸中毒(DKA)的风险很高。研究发现,年轻、糖尿病一级亲属及糖尿病酮症酸中毒(DKA)前感染是T1DM发病中糖尿病酮症酸中毒(DKA)的重要解释变量。
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引用次数: 2
PRACTITIONER APPLICATION: Process Improvement in Patient Pathways: A Case Study Applying Accelerated Longitudinal Design With Decomposition Method. 从业者应用:病人路径的过程改进:应用分解方法加速纵向设计的案例研究。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2019-11-01 DOI: 10.1097/JHM-D-19-00194
R. Chandran
428 Volume 64, Number 6 • November/December 2019 (Eds.), Health operations management: Patient flow logistics in health care. New York, NY: Routledge. Wijeysundera, H. C., Wang, X., Tomlinson, G., Ko, D. T., & Krahn, M. D. (2012). Techniques for estimating health care costs with censored data: An overview for the health services researcher. ClinicoEconomics and Outcomes Research, 4, 145–155. Yabroff, K. R., Warren, J. L., Knopf, K., Davis, W. W., & Brown, M. L. (2005). Estimating patient time costs associated with colorectal cancer care. Medical Care, 43(7), 640–648. Young, T. A. (2005). Estimating mean total costs in the presence of censoring: A comparative assessment of methods. PharmacoEconomics, 23(12), 1229–1242. Zevalkink, J., & Berghout, C. C. (2006). Expanding the evidence base for the cost-effectiveness of long-term psychoanalytic treatment. Journal of the American Psychoanalytic Association, 54(4), 1313–1319. Zweifel, P., Breyer, F., & Kifmann, M. (2009). Health economics. Heidelberg, Germany: Springer Nature.
428第64卷,第6期•2019年11月/12月(编辑),健康运营管理:医疗保健中的患者流物流。纽约州纽约:劳特利奇。Wijeysunderra,H.C.,王,X.,Tomlinson,G.,Ko,D.T.和Krahn,M.D.(2012)。用审查数据估计医疗保健成本的技术:卫生服务研究人员综述。临床经济学和结果研究,4145-155。Yabroff,K.R.、Warren,J.L.、Knopf,K.、Davis,W.W.和Brown,M.L.(2005)。估计与结直肠癌癌症治疗相关的患者时间成本。医疗保健,43(7),640–648。Young,T.A.(2005)。在存在审查的情况下估计平均总成本:方法的比较评估。药物经济学,23(12),1229–1242。Zevalkink,J.和Berghout,C.C.(2006)。扩大长期精神分析治疗成本效益的证据基础。美国精神分析协会杂志,54(4),1313-1319。Zweifel,P.、Breyer,F.和Kifmann,M.(2009)。健康经济学。德国海德堡:施普林格自然。
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引用次数: 0
Lean Management and U.S. Public Hospital Performance: Results From a National Survey. 精益管理与美国公立医院绩效:全国调查结果。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2019-11-01 DOI: 10.1097/JHM-D-18-00163
Justine Po, T. Rundall, S. Shortell, J. Blodgett
EXECUTIVE SUMMARYMany public hospitals have adopted Lean management methodology, but little is known about the extent of Lean adoption or the relationship between Lean adoption and hospital performance. Using data from the 2017 National Survey of Lean/Transformational Performance Improvement in Hospitals, linked with data from the American Hospital Association 2015 Annual Hospital Survey and 2015 Centers for Medicare & Medicaid Services data on hospital performance, we compare public hospitals with nonprofit and for-profit hospitals on the rate of Lean adoption and the extent of Lean implementation. We also assess the associations between Lean adoption by the end of 2014 and measures of public hospital financial performance, patient outcomes, and patient satisfaction measured in 2015.Among the 288 public hospitals that responded to the survey, 54.2% reported that they had adopted Lean. The average length of time of Lean implementation was 4.58 years. The mean number of units in which Lean was implemented was 11.9 out of 29 possible hospital units, with the emergency department (ED) being the unit in which Lean was most frequently implemented. The most common Lean practices used were daily huddles, plan-do-study-act cycles, visual management, and use of standard work. Lean adoption by 2014 was significantly associated in the direction predicted with earnings before interest, taxes, depreciation, and amortization margin (b = .042, p < .020) and percentage of patients leaving the ED without being seen (b = -0.610, p < .068). No significant associations were found between Lean adoption and patient outcomes or patient satisfaction.
EXECUTIVE SUMMARYMany公立医院都采用了精益管理方法,但对精益采用的程度或精益采用与医院绩效之间的关系知之甚少。使用2017年全国医院精益/转型绩效改善调查的数据,结合美国医院协会2015年年度医院调查和2015年医疗保险和医疗补助服务中心的医院绩效数据,我们将公立医院与非营利和营利性医院在精益采用率和精益实施程度方面进行了比较。我们还评估了2014年底采用精益与2015年衡量公立医院财务绩效、患者结果和患者满意度之间的关系。在288家接受调查的公立医院中,54.2%的医院表示他们采用了精益。精益实施的平均时间为4.58年。在29个可能的医院单元中,实施精益的平均单元数为11.9个,急诊科是最常实施精益的单元。最常见的精益实践是日常会议、计划-实践-学习-行动周期、可视化管理和标准工作的使用。到2014年,精益采用与利息、税收、折旧和摊销前利润预测方向显著相关(b=.042,p<.020),与未就诊的患者离开急诊室的百分比(b=-0.610,p<.068)。精益采用与患者结果或患者满意度之间没有显着关联。
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引用次数: 21
ABSTRACTS FROM THE FORUM ON ADVANCES IN HEALTHCARE MANAGEMENT RESEARCH 医疗管理研究进展论坛摘要
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2019-11-01 DOI: 10.1097/jhm-d-19-00192
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引用次数: 0
PRACTITIONER APPLICATION: Patient Engagement Functionalities in U.S. Hospitals: Is Early Adoption Associated With Financial Performance? 从业者应用:美国医院的患者参与功能:早期采用与财务绩效有关吗?
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2019-11-01 DOI: 10.1097/JHM-D-19-00197
Peter V Huynh
396 Volume 64, Number 6 • November/December 2019 JHM-D-19-00197 Senge, P. (1990). The fifth discipline: The art & practice of the learning organization. New York, NY: Doubleday Currency. Teece, D., & Pisano, G. (1994). The dynamic capabilities of firms: An introduction. Industrial and Corporate Change, 3(3), 537–556. Teece, D. J., Pisano, G., & Shuen, A. (1997). Dynamic capabilities and strategic management. Strategic Management Journal, 18(7), 509–533. Toscos, T., Daley, C., Heral, L., Doshi, R., Chen, Y. C., Eckert, G. J., ... Mirro, M. J. (2016). Impact of electronic personal health record use on engagement and intermediate health outcomes among cardiac patients: A quasiexperimental study. Journal of the American Medical Informatics Association, 23(1), 119–128. doi: 10.1093/jamia/ocv164 Walker, D. M., Sieck, C. J., Menser, T., Huerta, T. R., & Scheck McAlearney, A. (2017). Information technology to support patient engagement: Where do we stand and where can we go? Journal of the American Medical Informatics Association, 24(6), 1088–1094. doi: 10.1093/jamia/ocx043 Weingart, S. N., Rind, D., Tofias, Z., & Sands, D. Z. (2006). Who uses the patient internet portal? The PatientSite experience. Journal of the American Medical Informatics Association, 13(1), 91–95. Wernerfelt, B. (1984). A resource-based view of the firm. Strategic Management Journal, 5(2), 171–180. Zeger, S. L., & Liang, K. Y. (1986). Longitudinal data analysis for discrete and continuous outcomes. Biometrics, 42(1), 121–130.
396第64卷第6期•2019年11月/12月JHM-D-19-00197 Senge,P.(1990)。第五个学科:学习型组织的艺术与实践。纽约:双日货币。Teece,D.和Pisano,G.(1994)。企业的动态能力:导论。工业和企业变革,3(3),537–556。Teece,D.J.、Pisano,G.和Shuen,A.(1997)。动态能力和战略管理。《战略管理杂志》,18(7),509-533。Toscos,T.,Daley,C.,Heral,L.,Doshi,R.,Chen,Y.C.,Eckert,G.J.,…Mirro,M.J.(2016)。电子个人健康记录的使用对心脏病患者参与度和中间健康结果的影响:一项准实验研究。美国医学信息学协会杂志,23(1),119–128。doi:10.1093/jamia/ocv164 Walker,D.M.、Sieck,C.J.、Menser,T.、Huerta,T.R.和Scheck McAlearney,A.(2017)。支持患者参与的信息技术:我们的立场和方向?《美国医学信息学协会杂志》,24(6),1088-1094。doi:10.1093/jamia/ocx043 Weingart,S.N.,Rind,D.,Tofias,Z.和Sands,D.Z.(2006)。谁使用患者互联网门户?PatientSite体验。美国医学信息学协会杂志,13(1),91-95。Wernerfelt,B.(1984)。基于资源的公司观。《战略管理杂志》,5(2),171-180。泽格尔,S.L.,梁,K.Y.(1986)。离散和连续结果的纵向数据分析。生物计量学,42(1),121-130。
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引用次数: 0
PRACTITIONER APPLICATION: Can Organizational Leaders Sustain Compassionate, Patient-Centered Care and Mitigate Burnout? 从业者应用:组织领导者能否维持富有同情心、以病人为中心的护理并减轻职业倦怠?
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2019-11-01 DOI: 10.1097/JHM-D-19-00196
John Campbell
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引用次数: 0
期刊
Journal of Healthcare Management
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