Background: The pandemic, COVID-19, has disrupted the delivery of healthcare services. The admissions of patients with stroke to hospitals decreased during the pandemic. There is considerable ...uncertainty about how patients with stroke manage their illnesses beyond the control of healthcare professionals during the pandemic period. Aim: Our study aimed to determine the experiences of patients with stroke regarding disease management during the pandemic period. Methods: This study had a descriptive qualitative design. The study was conducted with 18 patients with stroke registered in the Stroke Outpatient Clinic of Hospital X. A patient information form and a semi-structmed interview form were used, and video-online in-depth interviews were conducted with each patient and recorded. After the interviews, the records were directly transcribed and analyzed. The transcripts were analyzed using thematic content analysis. Results: As a result of our study, five main themes were reached. These themes are; difficulty in access to healthcare, fear, change in the flow of daily life, inability to access sufficient information, and adaptation. Conclusion: As a result of our study, it is seen that patients with stroke have difficulties due to pandemic conditions, and individual and institutional solutions have been developed for these difficulties over time. It is recommended to create accessible health systems, increase online health services, and implement initiatives that support patients with stroke in bio-psycho-social aspects, for all extraordinary conditions that may be experienced.
The aim of the study was to assess anterior cingulate cortex (ACC) neurochemical profile of patients with unipolar major depressive disorder (MDD) before and after electroconvulsive therapy (ECT) by ...using 1H magnetic resonance spectroscopy (1H-MRS).
Using 1H-MRS, the metabolite levels of choline, glutamate + glutamine (Glx), myo-inositol, N-acetylaspartate, and total creatine were measured in ACC before and after 4-week ECT. The Montgomery-Åsberg Depression Rating Scale (MADRS) was implemented by blind raters to evaluate the efficacy of the treatment. Electroconvulsive therapy-remitter (ER) and nonremitter groups were compared using the 1-way repeated measures analysis of variance.
Thirty patients with unipolar MDD (aged 41.3 ± 10.0 years, 66.7% female) were included in the study. The ER group (n = 16, 53.3%) and NR group did not differ regarding baseline Global Assessment of Functioning and MADRS scores. At the end of 4-week ECT treatment, results did not suggest any significant difference for metabolite levels in ACC. When compared with the NR group, the ER group had higher baseline levels of Glx (8.8 ± 1.8 vs 6.3 ± 2.0, P = 0.005) and total creatine (5.3 ± 0.6 vs 4.7 ± 0.5, P = 0.010). In addition, elevated baseline Glx (r = -0.68, P = 0.002) was associated with lower MADRS scores at the end treatment. Finally, the change in Glx levels was correlated with change in MADRS scores after ECT (r = 0.47, P = 0.049).
Modest sample size and 1H-MRS at 1.5 Tesla are limitations of the study.
Results suggested that Glx levels could be a predictor of remission. Studies with larger samples should explore neurochemical correlates of ECT in unipolar MDD.
Background: The pandemic, COVID-19, has disrupted the delivery of healthcare services. The admissions of patients with stroke to hospitals decreased during the pandemic. There is considerable ...uncertainty about how patients with stroke manage their illnesses beyond the control of healthcare professionals during the pandemic period. Aim: Our study aimed to determine the experiences of patients with stroke regarding disease management during the pandemic period. Methods: This study had a descriptive qualitative design. The study was conducted with 18 patients with stroke registered in the Stroke Outpatient Clinic of Hospital X. A patient information form and a semi-structured interview form were used, and video-online in-depth interviews were conducted with each patient and recorded. After the interviews, the records were directly transcribed and analyzed. The transcripts were analyzed using thematic content analysis. Results: As a result of our study, five main themes were reached. These themes are; difficulty in access to healthcare, fear, change in the flow of daily life, inability to access sufficient information, and adaptation. Conclusion: As a result of our study, it is seen that patients with stroke have difficulties due to pandemic conditions, and individual and institutional solutions have been developed for these difficulties over time. It is recommended to create accessible health systems, increase online health services, and implement initiatives that support patients with stroke in bio-psycho-social aspects, for all extraordinary conditions that may be experienced.
Quality of life (QoL) is a growing area of interest in dementia research. However, it remains a controversial topic. This study aimed to determine the QoL of people with Alzheimer's disease (PwAD) ...and investigate the factors affecting patients' and caregivers' QoL scores.
A cross-sectional study design was used. A total of 98 home-dwelling PwADs and their primary caregivers were recruited in the study. Sociodemographic characteristics and QoL scores, activities of daily living (ADL) and instrumental ADL (IADL), Mini-mental State Examination (MMSE) scores, neuropsychiatric inventory (NPI), and NPI-distress were determined to assess the relevant outcomes. All statistical analyses were performed using SPSS version 22.0. Descriptive statistics, t-test, Pearson correlation, and multinomial regression were used for analysis.
The patients' ratings of their QoL were higher than those of the caregivers. Caregiver education, patients' ADL, and IADL were associated with the patients' score on the Quality of Life in Alzheimer's Disease (QoL-AD) scale. In addition to these variables, MMSE, NPI, and NPI-distress were associated with the caregiver scores on QoL-AD.
From a clinical point of view, the proxy-rated scores of QoL cannot replace the self-ratings of the patients. This study suggests that both self- and proxy-rated QoL scores should be applied whenever possible. Focusing on the management of behavioral problems and supporting functionality and cognitive functions may be modifiable factors that may represent targets for intervention to improve the QoL. The findings of this study should also be used to design caregiver educational programs about the determinants of QoL.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background
Dementia is a worldwide public health concern. Implementing lifestyle changes that target modifiable risk factors is crucial for reducing the risk of dementia. The aim of this study was to ...investigate the effect of having family members with dementia on individuals' health beliefs and tendencies towards adopting healthier lifestyles and behaviours.
Methods
A cross‐sectional, comparative study was conducted with 338 people aged 40 years and older, of whom 168 have the experience of having family members with dementia, and 170 have no such experience. Data were collected using a characteristics form, the Motivation to Change Lifestyle and Health Behaviours for Dementia Risk Reduction scale, and the modified Charlson comorbidity index. Descriptive statistics, Pearson's chi‐square and independent t‐tests, were used.
Results
Those with family members with dementia were more likely to have greater motivation to modify their lifestyle (perceived susceptibility, severity, benefits, and cues to action) to reduce their risk of developing dementia. Additionally, they had greater perceived barriers to gain by adopting a healthy lifestyle, in contrast to those without such family members.
Conclusion
The presence of family members with dementia could be an important factor to consider when designing initiatives targeting health beliefs related to dementia prevention behaviours and lifestyle changes.
The support group process effect on caregiver burden on family members of dementia patients based on Watson's theory of human caring was that a significant difference was found between caregivers and ...control groups. Qualitatively, the support group process could reduce caregiver burden and improve coping skills.
The aim was to evaluate the nutritional situation of patients admitted to the Postoperative Acute Care Unit using classic methods of objective anthropometry, systemic evaluation methods, and ...Nutrition Risk in Critically Ill (NUTRIC) score, and to compare them as a predictor of morbidity and mortality.At admission to the postoperative care unit, patients undergoing various surgeries were assessed for the following items: Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Nutritional Risk Screening (NRS)-2002, Mini Nutritional Assessment (MNA), Charlson comorbidity index (CCI), and NUTRIC score, anthropometric measurements, serum total protein, serum albumin, and lymphocyte count. Patients were monitored for postoperative complications until death or discharge. Correlation of complications with these parameters was also analyzed.A total of 152 patients were included in the study. In this study a positive correlation was determined between mortality and NRS-2002, SGA, CCI, Acute Physiology and Chronic Health Evaluation , Sepsis-related Organ Failure Assessment, and NUTRIC score, whereas a negative correlation was determined between mortality and NRI. There was a correlation between NUTRIC score and pneumonia, development of atrial fibrillation, delirium, renal failure, inotrope use, and duration of mechanical ventilation. In our study group of postoperative patients, MNA had no predictive properties for any complication, whereas SGA had no predictive properties for any complications other than duration of hospital stay and mortality.The NUTRIC score is an important indicator of mortality and morbidity in postoperative surgical patients. NRI correlated with many postoperative complications, and though SGA and NRS were correlated with mortality, they were not correlated with the majority of complications. MNA was determined not to have any correlation with any complication, mortality, and duration of hospital stay in our patient group.
Purpose: This study was conducted to determine the effects of gender on caregiver burden among caregivers of persons with Alzheimer's disease.
Design: Comparative descriptive study.
Methods: Factors ...affecting the burden of female and male caregivers (age, total duration of caregiving, mean duration of daily caregiving, education, income, employment status, age of the patients cared for, and Mini‐Mental State Examination MMSE and Neuropsychiatric Inventory NPI scores) were similar (p > .05). The sample consisted of 120 female and 72 male caregivers of patients with Alzheimer's disease. Data were collected from patients by means of the MMSE and demographic variables, and data from the Caregiver Burden Inventory CBI and NPI were obtained from caregivers, as well as from face‐to‐face interviews using a questionnaire. Descriptive statistics and t‐tests were used to describe and analyze data.
Findings: Female caregivers had significantly higher scores for caregiver burden than their male counterparts (p= .002). Subscale analysis on the CSI revealed that female caregivers had significantly higher scores for caregiver burden than male caregivers on time dependence (p= .040), developmental (p= .002), physical (p= .001), and social burdens (p= .045). No difference was found with respect to emotional burden (p= .718).
Conclusions: Results of this study suggest that female caregivers are subjected to a higher level of caregiver burden than male caregivers in Turkey. In subscales, female caregivers experienced more burden than male caregivers in the time dependence, developmental, physical, and social burdens. Emotional burden was similar in both genders.
Clinical Relevance: Although caregiver burden has been a much debated issue for many years, it is a relatively new topic in Turkey. In order to provide appropriate care for the patient's and family's cultural values and needs, more studies are needed to be conducted on family members giving care to Alzheimer's patients. It is thought that the findings of the present study will facilitate cross‐cultural comparisons and culture‐oriented care planning.
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