scholarly journals Improving the quality of GP referrals to the Croydon Assessment & Liaison Team

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S205-S205
Author(s):  
Gabriella Lewis ◽  
Lucia Chaplin ◽  
Gareth Knott ◽  
Alexandra Coull ◽  
Lamide Sobamowo
Keyword(s):  
Random Sample ◽  
Gold Standard ◽  
Relevant Information ◽  
Post Intervention ◽  
Significant Difference ◽  
Referral Form ◽  
Patient Assessments ◽  
New Form ◽  
Intervention Uptake

AimsTo increase the percentage of GP referrals to the Croydon Assessment & Liaison (A&L) Team deemed to be of ‘good quality’. The A&L Team receives a large number of referrals daily from GPs, and it was identified that many of these referrals did not include important and relevant information, leading to delays in patient assessments.MethodA questionnaire was distributed to A&L MDT members to collect information about what information they consider important in a GP referral. The project team reviewed the results of the questionnaire, along with current policies and guidelines, to create a set of criteria by which to assess the quality of GP referrals, as there was no pre-existing gold standard available. A random sample of 6 GP referrals per week stratified by locality was collected and assessed against these criteria.Using Plan-Do-Study-Act (PDSA) methodology change ideas were generated, and a GP referral form was identified as an important intervention to adopt. A previously-developed draft form was updated after a round of consultations with various stakeholders including Assessment & Liaison staff, GPs and the CCG. The new GP referral form was uploaded to the GP DSX electronic referrals platform and GP practices were also emailed directly to encourage them to use the new form.The proportion of GP referrals deemed to be of good quality was compared pre and post-intervention. Uptake of the new GP referral form was recorded as a process measure, and the length of time taken to discuss referrals at A&L daily referrals meetings as a counterbalance measure.ResultAt baseline 33% of GP referrals were deemed to be of good quality using the developed criteria. This improved to 58% after implementation of the new referral form in January 2021. There was poor overall uptake of the form, with only 32.5% of GP referrals utilising the new form so far, however of the referrals received on the new form 69% fulfilled the criteria for good quality. Comparison of length of discussion required for referrals with and without the new form showed no significant difference (7.7 and 7.6 minutes respectively).ConclusionImplementation of a standardised GP referral form was effective at increasing the proportion of referrals deemed to be of good quality. However, further PDSA cycles focused on improving uptake of the form will be required.

Evaluation of the Quality, Educational Value and Utility of the Videos on YouTube for Laparoscopic Low Anterior Resection

2021 ◽  
pp. 000313482110111
Author(s):  
Erol Piskin ◽  
Muhammet Kadri Çolakoğlu ◽  
Ali Bal ◽  
Volkan Oter ◽  
Erdal Birol Bostanci
Keyword(s):  
Anterior Resection ◽  
Low Anterior Resection ◽  
Video Quality ◽  
Relevant Information ◽  
Teaching Quality ◽  
Educational Value ◽  
Laparoscopic Low Anterior Resection ◽  
Significant Difference ◽  
October 17

Background Minimally invasive surgery is a rising trend in colorectal surgery and is on its way to becoming the gold standard due to the benefits it provides for patients. This study aims to test the efficacy for educational purposes by evaluating the videos published on YouTube ( www.youtube.com ) channel for low anterior resection procedure in rectum surgery. Methods We searched YouTube on October 17, 2020 to choose video clips that included relevant information about laparoscopic low anterior resection (LAR) for rectal cancer. Results We included 25 academics and 75 individual videos in this study. The teaching quality of the videos was evaluated according to academic and individual videos, and it was seen that the teaching quality scores of academic videos were higher and this result was statistically significant ( P = .03). The modified Laparoscopic Surgery Video Educational Guidelines (LAP-VEGaS) criteria were found that the score was higher in individual videos ( P = .014). The median Video Power Index (VPI) value was 1.50 (range .05-347) and the mean ratio was 7.01 ± 3.52. There was no statistically significant difference between the 2 groups ( P = .443). Discussion Video-based surgical learning is an effective method for surgical education. Our study showed that the video quality and educational content of most of the videos about the low anterior resection procedure on YouTube were low. The videos of academic origin seem more valuable than individual videos. As far as video popularity is concerned, YouTube viewers are not selective. For this reason, training videos to be used for educational purposes must be passed through a standardized evaluation filter.

Effectiveness of duloxetine on severity of pain and quality of life in chronic low back pain in patients who had posterior spinal fixation

2021 ◽  
pp. 221049172098333
Author(s):  
Arezoo Samadi ◽  
Razieh Salehian ◽  
Danial Kiani ◽  
Atefeh Ghanbari Jolfaei
Keyword(s):  
Quality Of Life ◽  
Back Pain ◽  
Rating Scale ◽  
Low Back ◽  
Spinal Fixation ◽  
Post Intervention ◽  
Significant Difference ◽  
Hamilton Anxiety Rating Scale ◽  
Hamilton Anxiety

Background: In this study, we want to search the effectiveness of Duloxetine on the severity of pain and quality of life in patients with chronic low back pain who had posterior spinal fixation. Methods: In this randomized, placebo-controlled trial done in 6 months 50 patients who had CLBP and were candidates for PSF surgery selected and divided into two groups (drug and placebo). They filled the VAS, SF-36, and Hamilton questionnaires before surgery and after 6 weeks from using 30 mg of duloxetine or placebo. Results: Significant differences were evidenced among groups for the Visual Analogue Scale (P = 0.005) and Verbal Analogue Scale (p = 0.003). Patients in the Duloxetine group have more visual and verbal pain scores than the placebo group. In the quality of life, there was a significant difference between the two groups before the intervention. Also, significant differences were evidenced among groups for the Hamilton Anxiety Rating Scale (p = 0.17). After the intervention, only the Hamilton Anxiety Rating Scale (p = 0.001) and ‘bodily pain’ and ‘general health’ subscales of quality of life (p = 0.008, 0.004, respectively) have a significant difference between the two groups. There was a significant difference between pre and post-intervention in the Hamilton Anxiety Rating Scale only in the duloxetine group. Also, in terms of quality of life, the subscales of ‘physical role’, ‘emotional role’, ‘physical pain’ and ‘total score of quality of life’ in the duloxetine and placebo groups were significantly different between pre and post-intervention. However, the subscales of ‘physical function’ and ‘general health’ were significantly different only in the duloxetine group between pre and post-intervention. Conclusion: The results suggest that the use of duloxetine in patients who had spinal surgery can help to better control back pain, on the other hand, it can cause a better psychological condition that affects the quality of life.

scholarly journals Effect of aerobic dance on pain, functional disability and quality of life on patients with chronic low back pain

2012 ◽  
Vol 68 (3) ◽  
Author(s):  
U.A.C. Okafor ◽  
T.A. Solanke ◽  
S.R.A. Akinbo ◽  
D.O. Odebiyi
Keyword(s):  
Quality Of Life ◽  
Low Back Pain ◽  
Back Pain ◽  
Functional Disability ◽  
Low Back ◽  
Post Intervention ◽  
Aerobic Dance ◽  
Significant Difference ◽  
Conventional Physiotherapy

Low back pain (LBP) is often an indication of pathologicalcondition of the intervertebral discs, vertebral bodies or supporting soft tissuesof the lower vertebral region. Chronic Low Back Pain (CLBP) presents withenormous consequence on the general performance of the sufferer, exerting ahuge cost on the individual, the family and the society. Dance therapy is arelatively new approach in the management of low back pain. This study wastherefore designed to investigate the effect of dance therapy on pain, functionaldisability and quality of life in patients with chronic low back pain.Thirty subjects diagnosed with non-specific CLBP particpated in the study.They were randomly divided into 2 groups, A and B, each comprising 15 subjects.In addition to conventional physiotherapy programme given to both groups,subjects in Group A also received aerobic dance, which comprised a four stage protocol. The entire treatment routinewas administered in a group session three times weekly consecutively for six weeks. Data as obtained in the copies ofcompleted questionnaires (Roland Morris Diability questionnaires and Nottingham Health Profile questionnaires) andother measurements were summarized using mean, standard deviation and frequency tables. Student T-test was used toanalyze the data at 95 % confidence interval.There was a statistically significant difference (p<0.05) between the pre- and post- intervention scores for painintensity, functional disability and quality of life within the groups. There was also a statistically significant difference(p<0.05) in the mean change (pre/post intervention) scores between Group A and Group B for pain intensity,functional disability and quality of life. Also the opinions and testimonies given by participants formed part of theevidence-based data.Whereas both conventional physiotherapy and aerobic dance showed significant effects in the pre/post-interventionscores, the aerobic dance group reported more significant effect in all studied parameters of pain intensity, functionaldisability and quality of life.

scholarly journals The use of mindfulness-based intervention to improve bracing compliance for AIS patients

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
X Li ◽  
C H Y Leung ◽  
T Gao ◽  
V C H Chung ◽  
Yu FWP ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Stress Reduction ◽  
Emotional Regulation ◽  
Control Group ◽  
Linear Mixed Effect Model ◽  
Primary Analysis ◽  
Post Intervention ◽  
Mixed Effect ◽  
Significant Difference

Abstract Introduction Despite good bracing compliance is crucial to prevent curve progression among braced AIS patients, only few interventions were suggested to improve bracing compliance. This study examined the effect of MBI on bracing compliance for AIS patients. Methods 116 eligible AIS patients were randomized and 86 participants were enrolled in intervention. Patients in the MBI group joint weekly sessions, which is an adapted version of mindfulness-based stress reduction (MBSR) program, for 8 weeks. Control group consisted of an 8-week PE intervention that is recommended according to the SOSORT 2011 guideline. The primary outcome is the 6-month post-intervention bracing compliance. The secondary outcomes include quality of life and psychosocial measurements. Primary analysis was ANCOVA with treatment as covariate. Trend analysis was conducted using Linear Mixed effect model. Results At the end of intervention, intention-to-treat analysis improved bracing compliance by1.24h/day and 0.08h/day for MBI and PE respectively. MBI group presented an increase in emotional regulation than baseline (ERQ-CCA) (1.92, p = 0.01), especially in Cognitive reappraisal sub-scale (1.00, p = 0.05). Bracing Specific Quality of Life (SRS-22) reduced significantly in both groups, but MBI group decreased less (MBI: -3.08, p = 0.00, PE -4.47, p = 0.00). Effect at six months for compliance progressed negatively but favoured MBI group (MBI: -1.16, p = 0.13, PE: -1.84, p = 0.06) although there was no significant difference between groups (p = 0.78). The Perception of stress (PSS) decreased significantly in PE group (-3,53, p = 0.01) rather than MBI (1.53, p = 0.22), however the between-group difference isn't significant (p = 0.62). Conclusions It is alarming that patients in both interventions group progressed with poorer compliance and worsen QoL. These progressions were less severe in the MBI group than in the PE group, but the differences did not reach statistical significant. Key messages Both groups decreased in compliance and QoL but MBI group reduced less. MBI wasn't more effective in improving participants’ compliance and other measurements.

scholarly journals Introduction of the identification, situation, background, assessment, recommendations tool to improve the quality of information transfer during medical handover in intensive care

2016 ◽  
Vol 18 (1) ◽  
pp. 17-23 ◽  
Author(s):  
Benjamin Ramasubbu ◽  
Emma Stewart ◽  
Rosalba Spiritoso
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Patient Information ◽  
Information Transfer ◽  
Relevant Information ◽  
Interquartile Range ◽  
Quality And Safety ◽  
Significant Difference ◽  
Handover Process

Objective To audit the quality and safety of the current doctor-to-doctor handover of patient information in our Cardiothoracic Intensive Care Unit. If deficient, to implement a validated handover tool to improve the quality of the handover process. Methods In Cycle 1 we observed the verbal handover and reviewed the written handover information transferred for 50 consecutive patients in St George’s Hospital Cardiothoracic Intensive Care Unit. For each patient’s handover, we assessed whether each section of the Identification, Situation, Background, Assessment, Recommendations tool was used on a scale of 0–2. Zero if no information in that category was transferred, one if the information was partially transferred and two if all relevant information was transferred. Each patient’s handover received a score from 0 to 10 and thus, each cycle a total score of 0–500. Following the implementation of the Identification, Situation, Background, Assessment, Recommendations handover tool in our Intensive Care Unit in Cycle 2, we re-observed the handover process for another 50 consecutive patients hence, completing the audit cycle. Results There was a significant difference between the total scores from Cycle 1 and 2 (263/500 versus 457/500, p < 0.001). The median handover score for Cycle 1 was 5/10 (interquartile range 4–6). The median handover score for Cycle 2 was 9/10 (interquartile range 9–10). Patient handover scores increased significantly between Cycle 1 and 2, U = 13.5, p < 0.001. Conclusions The introduction of a standardised handover template (Identification, Situation, Background, Assessment, Recommendations tool) has improved the quality and safety of the doctor-to-doctor handover of patient information in our Intensive Care Unit.

scholarly journals Effect of Educational Intervention Guideline on Quality of Life among Women with Polycystic Ovary Syndrome

2020 ◽  
Vol 1 (4) ◽  
pp. 14
Author(s):  
Aziza I. Mohamed ◽  
Shimaa A. Moustafa
Keyword(s):  
Quality Of Life ◽  
Polycystic Ovary Syndrome ◽  
Educational Intervention ◽  
Polycystic Ovary ◽  
University Hospital ◽  
Life Questionnaire ◽  
Post Intervention ◽  
Ovary Syndrome ◽  
Significant Difference

Contexts: Polycystic ovary syndrome is a common endocrine disorder among women at the childbearing period that diminished women’s quality of life. Aim: The current study evaluated the effect of educational intervention guidelines on quality of life among women with polycystic ovary syndrome. Methods: The current study conducted at the outpatient gynecological clinic at Benha University Hospital. A Quasi-experimental design used to collect data from a purposive sample of 98 women diagnosed with polycystic ovary syndrome. Three tools used for data collection.  A structured interviewing questionnaire, a healthy practice assessment scale, and health-related quality of life questionnaire for polycystic ovary syndrome. Results: The study findings revealed that women's knowledge mean score was increased from (8.84±5.72) pre-intervention to (33.56±3.91) at post-intervention. Besides, the healthy practice was satisfactory improved, as practice mean score was increased from (11.41±4.56) to (28.85±2.47) at the post-intervention phase, with a statistically significant difference between the two phases, that subsequently affect the improvement of studied women’s quality of life. Conclusion: An educational intervention guideline is effectively improving the quality of life of women with polycystic ovary syndrome. Educational intervention guideline is essentially recommended for women with polycystic ovary in order to improve different quality of life domains. Counseling and health education program must be provided to all women attended gynecological clinics to increases women knowledge regarding PCOS and its management, to enable early detection, and to improve their quality of life. A replication of the study on a larger probability sample in order to obtain generalizability is highly recommended.

scholarly journals The effect of group-based education on gastrointestinal symptoms and quality of life in patients with celiac disease: randomized controlled clinical trial

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Zahra Akbari Namvar ◽  
Reza Mahdavi ◽  
Masood Shirmohammadi ◽  
Zeinab Nikniaz
Keyword(s):  
Quality Of Life ◽  
Celiac Disease ◽  
Gastrointestinal Symptoms ◽  
Control Group ◽  
Post Intervention ◽  
Sf 36 ◽  
Gi Symptoms ◽  
Significant Difference ◽  
The Mean

Abstract Background In this trial, we investigated the effect of a group-based education program on gastrointestinal (GI) symptoms and quality of life (QOL) in patients with celiac disease (CD). Method In the present study, 130 patients with CD who were on a GFD for at least 3 months, randomly assigned to receive group-based education (n = 66) or routine education in the celiac clinic (n = 64) for 3 months. We assessed gastrointestinal symptoms and quality of life using the gastrointestinal symptom rating scale (GSRS) questionnaire and SF-36 questionnaire at baseline and 3 months after interventions. Results The mean age of the participants was 37.57 ± 9.59 years. There were no significant differences between the two groups regarding the baseline values. Results showed that the mean score of total GSRS score in the intervention group was significantly lower compared with the control group 3 months post-intervention (p = 0.04). Also, there was a significant difference in the mean score of SF-36 between the two groups 3 months post-intervention (p = 0.02). Conclusion Results showed that group-based education was an effective intervention in patients with celiac disease to improve gastrointestinal symptoms and quality of life. Trial registration IRCT code: IRCT20080904001197N21; registration date: 5/23/2019.

scholarly journals Effects of a short educational program about aphasia (SEPA) on the burden and quality of life of family caregivers of people with aphasia

CoDAS ◽  
2019 ◽  
Vol 31 (4) ◽  
Author(s):  
Bruna Homem Magnus ◽  
Roberta Freitas Dias ◽  
Bárbara Costa Beber
Keyword(s):  
Quality Of Life ◽  
Family Caregivers ◽  
Educational Program ◽  
Group Analysis ◽  
Group Setting ◽  
Post Intervention ◽  
Significant Difference ◽  
The Individual ◽  
New Strategies

ABSTRACT Purpose To develop a short educational program about aphasia (SEPA) for family caregivers of people with aphasia and verify its effect in their burden and quality of life. Methods This is a quantitative experimental study. The participants included in the study were family caregivers of people with aphasia. They completed the Zarit interview scale and WHOQOL-Bref instruments pre- and post-intervention. The intervention was a short educational program about aphasia, administered in a group setting and conducted in two didactic sessions. Results Four participants were included in the study. In the group analysis, there was no significant difference in any measure. However, looking into the individual performances, all participants presented a trend for improvement in most of the scores. Conclusion Possibly, family caregivers of people with aphasia might benefit from the SEPA. It would be relevant for future studies to include larger samples and consider new strategies to improve inclusion of participants.

scholarly journals Influence of Voxel Size on CBCT Images for Dental Implants Planning

2021 ◽  
Author(s):  
Ricardo Kehrwald ◽  
Hebert Sampaio de Castro ◽  
Samira Salmeron ◽  
Ricardo Alves Matheus ◽  
Gustavo Machado Santaella ◽  
...  
Keyword(s):  
Gold Standard ◽  
Three Dimensional ◽  
Reference Points ◽  
Bone Thickness ◽  
Voxel Size ◽  
Significance Level ◽  
Significant Difference ◽  
Bone Height ◽  
Digital Caliper

Abstract Objective This study was developed to evaluate the influence of voxel size on bone measurements for implant planning. Materials and Methods The research was performed by using edentulous synthetic human mandibles with different levels of bone resorption. For each mandible, height and bone thickness were measured with a digital caliper. The PaX-i3d device was used to acquire the volumes of the five mandibles, with 50kVp, 4 mA, and a voxel size of 0.08 mm. After the acquisition, the images were reconstructed in the software CS three-dimensional Imaging, with four different sizes of voxels: 0.1, 0.2, 0.3, and 0.4 mm. All volumes were analyzed by a single evaluator who performed measurements to obtain bone height and thickness, using the reference points that were considered in obtaining the gold standard. The data were analyzed by ANOVA with a significance level of 5%. Results There was no significant difference in the measurements obtained with different voxel sizes, both for bone height measurements and bone thickness. There was no statistically significant difference in measurements in thickness in comparison to the gold standard. Conclusion When necessary, to measure height and bone thickness, it is possible to recommend voxel images of larger size (0.40 mm) without compromising the quality of the patient's clinical planning.

scholarly journals Penerapan Auricular Acupressure Untuk Mengurangi Konstipasi Pasien Kemoterapi

JKEP ◽  
2020 ◽  
Vol 5 (2) ◽  
pp. 161-170
Author(s):  
Edianto Edianto ◽  
Agung Waluyo ◽  
Sri Yona ◽  
Yunisar Gultom
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Cancer Patients ◽  
Nursing Intervention ◽  
Chemotherapy Treatment ◽  
Post Intervention ◽  
Treatment Room ◽  
Auricular Acupressure ◽  
Significant Difference

Most cancer patients receive chemotherapy which contributes to prolong life, with the most common side effects of constipation. Constipation causes general symptoms that are bad and affect the quality of life of patients. The purpose of evidance based nursing (EBN) is to identify the effectiveness of Auricular acupressure in overcoming symptoms of constipation in cancer patients receiving chemotherapy. This EBN uses quasi experiments involving 14 participants in the chemotherapy treatment room with pre and post intervention assessments. The results of the analysis of the independent t-test showed that there was a significant difference in the form of faeces on day 6 with p <0.000 (95% CI). Conclusion: Auricular acupressure can be used as a constipation management nursing intervention in cancer patients undergoing chemotherapy.

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