Health services research in colorectal cancer: a quasi-experimental interventional pilot study on in- and outpatient oncology

Introduction Due to frequent treatment side effects and weight loss, colorectal cancer patients require oncologic care and nutritional counseling both during and after hospitalization. The current study evaluated differences in discharge and side effects management and nutritional behavior between colorectal cancer patients of a control group without systematic counseling and of an intervention group with access to structured in- and outpatient oncology nurse and nutritional counseling. Methods The presented explorative, quantitative, single-center, interventional pilot study is a health services research project with a quasi-experimental design. Using a self-designed standardized questionnaire, data were collected from the control group (n = 75) before and from the intervention group (n = 114) after the introduction of in- and outpatient oncology nurse and structured systematic nutritional counseling. The in- and outpatient counseling services were developed and evaluated in the form of a structured nurse-led counseling concept. Results Intervention group patients profited significantly from inpatient oncology nurse counseling in seven different areas of discharge management. No differences were observed concerning patient-reported general and gastrointestinal side effects except for xerostomia and dysphagia, but of the patients participating in both in- and outpatient oncology nurse counseling, 90.0% were better able to cope with general side effects of treatment. Patients with in- and outpatient structured systematic nutritional counseling more frequently received nutritional information (p = 0.001), were better at gauging food intolerances (p = 0.023), and followed the dietician's advice in cases of gastrointestinal side effects significantly more often (p = 0.003) than control patients. Counselor-reported outcomes concerning gastrointestinal side effects showed improvement in most of the patients taking part in systematic in- and outpatient nutritional counseling, except for weight loss in 4 patients. Conclusion In- and outpatient counseling in discharge and side effects management and nutrition improve the outcomes of colorectal cancer patients. Outpatient counseling should be further developed and evaluated in future studies.

Upaya Peningkatan Status Kesehatan Pada Ibu Hamil Melalui Deteksi Dini Pre Eklamsi (Program Penyuluhan Rawat Jalan) Di Puskesmas Mojosari Kecamatan Mojosari Kabupaten Mojokerto

The maternal mortality rate (MMR) and infant mortality rate (IMR) in East Java (Jatim) are still high. Based on 2018 data, MMR in East Java reached 91.45 percent per 1,000 births, while for IMR, it was 13.4 percent per 1,000 births. To support the efforts to reduce MMR and IMR, health service activities for pregnant women have been carried out at various levels of health services. The purpose of this community service activity is to provide experience and increase knowledge of pregnant women about pre-eclampsia, change the attitudes and behavior of pregnant women so that they can prevent pre-eclampsia during pregnancy and the establishment of an Outpatient Counseling Program (Penyuraja) about pre-eclampsia. This activity was carried out at the Mojosari Health Center, Mojosari District, Mojokerto Regency. The target of this activity is pregnant women who have their pregnancy checked at the Mojosari Health Center. This activity is carried out by providing counseling methods and giving leaflets to mothers. The result of this activity is an increase in the knowledge of pregnant women about pre-eclampsia and the establishment of an outpatient counseling program about pre-eclampsia.

The Impact of Counseling on Bowen’s Differentiation of Self

Bowen’s natural systems theory has been identified as a foundational theory in understanding family processes, and yet there is a lack of research examining the impact of counseling on Bowenian constructs of differentiation, emotional reactivity (ER), fusion, and “I” positions (IPs). In order to investigate this potential impact, the present study employed a pre–post quasi-experimental design, sampling 20 adults receiving outpatient counseling services for a 3-month period from a community mental health center in the Northeastern United States. The results revealed that participants demonstrated moderate to large statistically significant improvements in their overall differentiation of self, as well as in the dimensions of ER and taking IPs. However, there were no improvements in the dimensions of emotional cutoff and fusion with others. The results are discussed in relation to Bowenian theory as well as the common factors model.

Badanie regionalnych zróżnicowań stanu zdrowia społeczeństwa i infrastruktury sektora ochrony zdrowia w Polsce w świetle założeń polityki zdrowotnej

In this study of the relationship between the state of health of the population and the level of infrastructure in the regional perspective Spearman coefficient was used. Factors analyzed included mortality rates due to diseases of civilization, average life expectancy in relation to, for example, the number of employed medical staff and the number of outpatient counseling. The highest correlation is observed in case of (a) infant mortality and the number of employed medical staff, (b) mortality due to external causes (including accidents) and the number of rescue teams to one resident. Thus it can be concluded that there are correlations between health and certain aspects of physical and social infrastructure.

Evidence-Based Approach to an Inpatient Tobacco Cessation Protocol

Tobacco use contributes to $53 to $73 billion per year in healthcare expenditures and causes nearly 440 000 deaths per year. Given the strong cause-effect relationship between smoking and poor health outcomes, it is critical that smokers are identified early and advised about smoking cessation. Furthermore, the Joint Commission now mandates that tobacco cessation advice be given to patients admitted with heart failure, pneumonia, and acute myocardial infarction. As such, an interdisciplinary group at an urban academic medical center developed and implemented a tobacco cessation protocol with the goal of identifying and targeting inpatient smokers through evidence-based education and counseling. The protocol focused on admission assessment, education, and provision of standing orders for medication treatment for nicotine withdrawal and/or tobacco cessation therapy during the inpatient encounter and referral for outpatient counseling at discharge.

Social workers and involuntary treatment in mental health

Involuntary treatment is often a reality in mental health social work. The current research examined 330 mental health social workers' involvement in and opinions about involuntary treatment as part of their primary job functions. Varieties of involuntary intervention and typical frequency were investigated. The most often cited areas of involuntary treatment experience proved to be mandated outpatient counseling and emergency hospitalization. In general, participants reported a high level of support for the existence of involuntary intervention, both in "idea" and "implementation." The study also explored the attitudes social workers have about these sometimes "ethically-complex" social work interventions and how these attitudes may have changed over the life of their practice careers due to practice experience and personal growth, job changes, and exposure to the reality of mental illness.