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Author: Johan Israelsson
Publisher: Linköping University Electronic Press
ISBN: 9179299431
Category :
Languages : en
Pages : 59
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Book Description
Background: Cardiac arrest is a major health problem worldwide. For many of the afflicted, cardiac arrest is the natural end of life. For others, it is an unexpected event suddenly striking in the middle of life. During the last decades, major efforts in treatment have contributed to more people surviving their cardiac arrest. However, previous research has mainly focused on survival, while the knowledge about health-related quality of life in survivors is sparse. Hence, there is a need for more research in order to extend the knowledge about the living situations among survivors and their spouses. For example, factors associated with health-related quality of life are not sufficiently investigated. Knowledge about such factors is important in order to develop interventions and to be able to improve post cardiac arrest care. In addition, existing research shows incongruent results concerning differences in characteristics and survival between men and women. In order to provide equitable care between sexes, further studies are warranted. Aim: The overall aim of this thesis was to increase the knowledge of survival and health-related quality of life among people suffering cardiac arrest with focus on sex and other related factors. The specific aims were: to describe in-hospital cardiac arrest events with regard to sex and investigate if sex is associated with survival after controlling for known predictors and interaction effects (study I), to describe health status and psychological distress among in-hospital cardiac arrest survivors in relation to sex (study II), to investigate factors associated with health-related quality of life among cardiac arrest survivors treated with an implantable cardioverter defibrillator in relation to sex, and to compare their health-related quality of life with a general population, (study III) and to investigate if type D personality and perceived control among cardiac arrest survivors and their spouses were associated with their own and their partners’ health-related quality of life (study IV). Methods: The general design in all studies (I-IV) was quantitative, cross-sectional and correlational. This thesis is based on four different data collections. Data was systematically collected using national quality registries (I and II) or by sending questionnaires to survivors (III and IV) and their spouses (IV), treated at several different hospitals in Sweden. The sample size varied between 126 and 990 across the studies. The outcomes and explanatory study variables were chosen with respect to Wilson and Cleary’s conceptual model of health-related quality of life. The main outcome variables were survival after resuscitation, survival at hospital discharge, survival at 30 days post cardiac arrest (I), and health-related quality of life measured by the Hospital Anxiety and Depression Scale (II and III) and the EuroQol-5 dimensions (II-IV). In this thesis descriptive and inferential statistics were applied. The main statistics consisted of logistic and linear regression analyses, and structural equation modelling. Results: Male sex was associated with a better chance of survival to hospital discharge, but no associations between sex and survival after resuscitation or at 30 days were identified. More men than women received resuscitation attempts when suffering an in-hospital cardiac arrest (study I). Health-related quality of life among most cardiac arrest survivors was good (II-IV), even when compared to a general population (III). However, a significant proportion reported low health status and symptoms of anxiety and depression (II and III). Women reported worse health-related quality of life compared to men, and female sex was associated with poorer health-related quality of life in the multiple regression models (II and III). Several additional factors were identified to be associated with poorer health-related quality of life: being unemployed, having a type D personality, perceiving less control, suffering from more comorbidities and suffering from more ICD-related concerns (III). In addition, older age was associated with poorer (EQ VAS) or better (HADS Anxiety) health-related quality of life, depending of outcome measure (II). Moreover, perceived control and type D personality among the survivors were associated with health-related quality of life among their spouses, but not vice versa. Conclusions: Although, sex does not appear to be an important predictor for survival, the difference between men and women regarding the proportion of resuscitation attempts should be further investigated. The majority of survivors and their spouses report good health-related quality of life similar to general populations. However, a substantial proportion suffer from health problems. Since women in general report worse health-related quality of life compared to men a higher proportion of women may be in need of support. Several factors associated with worse health-related quality of life were identified and might be used during follow-up and rehabilitation. For example, identifying type D personality might be important when screening patients at risk for health problems. Perceiving more control could be targeted by health-supportive interventions, for example person-centered care. Healthcare professionals should make efforts to identify survivors at risk of poor health-related quality of life and offer individualized support when needed. Characteristics among survivors were associated with health-related quality of life in their spouses. Including spouses in follow-up care is therefore important. Wilson and Cleary’s conceptual model for health-related quality of life appears to be applicable for choosing outcomes in cardiac arrest research and might be helpful when designing interventions to improve post cardiac arrest care.
Author: Johan Israelsson
Publisher: Linköping University Electronic Press
ISBN: 9179299431
Category :
Languages : en
Pages : 59
Get Book
Book Description
Background: Cardiac arrest is a major health problem worldwide. For many of the afflicted, cardiac arrest is the natural end of life. For others, it is an unexpected event suddenly striking in the middle of life. During the last decades, major efforts in treatment have contributed to more people surviving their cardiac arrest. However, previous research has mainly focused on survival, while the knowledge about health-related quality of life in survivors is sparse. Hence, there is a need for more research in order to extend the knowledge about the living situations among survivors and their spouses. For example, factors associated with health-related quality of life are not sufficiently investigated. Knowledge about such factors is important in order to develop interventions and to be able to improve post cardiac arrest care. In addition, existing research shows incongruent results concerning differences in characteristics and survival between men and women. In order to provide equitable care between sexes, further studies are warranted. Aim: The overall aim of this thesis was to increase the knowledge of survival and health-related quality of life among people suffering cardiac arrest with focus on sex and other related factors. The specific aims were: to describe in-hospital cardiac arrest events with regard to sex and investigate if sex is associated with survival after controlling for known predictors and interaction effects (study I), to describe health status and psychological distress among in-hospital cardiac arrest survivors in relation to sex (study II), to investigate factors associated with health-related quality of life among cardiac arrest survivors treated with an implantable cardioverter defibrillator in relation to sex, and to compare their health-related quality of life with a general population, (study III) and to investigate if type D personality and perceived control among cardiac arrest survivors and their spouses were associated with their own and their partners’ health-related quality of life (study IV). Methods: The general design in all studies (I-IV) was quantitative, cross-sectional and correlational. This thesis is based on four different data collections. Data was systematically collected using national quality registries (I and II) or by sending questionnaires to survivors (III and IV) and their spouses (IV), treated at several different hospitals in Sweden. The sample size varied between 126 and 990 across the studies. The outcomes and explanatory study variables were chosen with respect to Wilson and Cleary’s conceptual model of health-related quality of life. The main outcome variables were survival after resuscitation, survival at hospital discharge, survival at 30 days post cardiac arrest (I), and health-related quality of life measured by the Hospital Anxiety and Depression Scale (II and III) and the EuroQol-5 dimensions (II-IV). In this thesis descriptive and inferential statistics were applied. The main statistics consisted of logistic and linear regression analyses, and structural equation modelling. Results: Male sex was associated with a better chance of survival to hospital discharge, but no associations between sex and survival after resuscitation or at 30 days were identified. More men than women received resuscitation attempts when suffering an in-hospital cardiac arrest (study I). Health-related quality of life among most cardiac arrest survivors was good (II-IV), even when compared to a general population (III). However, a significant proportion reported low health status and symptoms of anxiety and depression (II and III). Women reported worse health-related quality of life compared to men, and female sex was associated with poorer health-related quality of life in the multiple regression models (II and III). Several additional factors were identified to be associated with poorer health-related quality of life: being unemployed, having a type D personality, perceiving less control, suffering from more comorbidities and suffering from more ICD-related concerns (III). In addition, older age was associated with poorer (EQ VAS) or better (HADS Anxiety) health-related quality of life, depending of outcome measure (II). Moreover, perceived control and type D personality among the survivors were associated with health-related quality of life among their spouses, but not vice versa. Conclusions: Although, sex does not appear to be an important predictor for survival, the difference between men and women regarding the proportion of resuscitation attempts should be further investigated. The majority of survivors and their spouses report good health-related quality of life similar to general populations. However, a substantial proportion suffer from health problems. Since women in general report worse health-related quality of life compared to men a higher proportion of women may be in need of support. Several factors associated with worse health-related quality of life were identified and might be used during follow-up and rehabilitation. For example, identifying type D personality might be important when screening patients at risk for health problems. Perceiving more control could be targeted by health-supportive interventions, for example person-centered care. Healthcare professionals should make efforts to identify survivors at risk of poor health-related quality of life and offer individualized support when needed. Characteristics among survivors were associated with health-related quality of life in their spouses. Including spouses in follow-up care is therefore important. Wilson and Cleary’s conceptual model for health-related quality of life appears to be applicable for choosing outcomes in cardiac arrest research and might be helpful when designing interventions to improve post cardiac arrest care.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 030937202X
Category : Medical
Languages : en
Pages : 456
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Book Description
Cardiac arrest can strike a seemingly healthy individual of any age, race, ethnicity, or gender at any time in any location, often without warning. Cardiac arrest is the third leading cause of death in the United States, following cancer and heart disease. Four out of five cardiac arrests occur in the home, and more than 90 percent of individuals with cardiac arrest die before reaching the hospital. First and foremost, cardiac arrest treatment is a community issue - local resources and personnel must provide appropriate, high-quality care to save the life of a community member. Time between onset of arrest and provision of care is fundamental, and shortening this time is one of the best ways to reduce the risk of death and disability from cardiac arrest. Specific actions can be implemented now to decrease this time, and recent advances in science could lead to new discoveries in the causes of, and treatments for, cardiac arrest. However, specific barriers must first be addressed. Strategies to Improve Cardiac Arrest Survival examines the complete system of response to cardiac arrest in the United States and identifies opportunities within existing and new treatments, strategies, and research that promise to improve the survival and recovery of patients. The recommendations of Strategies to Improve Cardiac Arrest Survival provide high-priority actions to advance the field as a whole. This report will help citizens, government agencies, and private industry to improve health outcomes from sudden cardiac arrest across the United States.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309083435
Category : Medical
Languages : en
Pages : 213
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Book Description
Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309084377
Category : Medical
Languages : en
Pages : 713
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Book Description
The death of a child is a special sorrow. No matter the circumstances, a child's death is a life-altering experience. Except for the child who dies suddenly and without forewarning, physicians, nurses, and other medical personnel usually play a central role in the lives of children who die and their families. At best, these professionals will exemplify "medicine with a heart." At worst, families' encounters with the health care system will leave them with enduring painful memories, anger, and regrets. When Children Die examines what we know about the needs of these children and their families, the extent to which such needs areâ€"and are notâ€"being met, and what can be done to provide more competent, compassionate, and consistent care. The book offers recommendations for involving child patients in treatment decisions, communicating with parents, strengthening the organization and delivery of services, developing support programs for bereaved families, improving public and private insurance, training health professionals, and more. It argues that taking these steps will improve the care of children who survive as well as those who do notâ€"and will likewise help all families who suffer with their seriously ill or injured child. Featuring illustrative case histories, the book discusses patterns of childhood death and explores the basic elements of physical, emotional, spiritual, and practical care for children and families experiencing a child's life-threatening illness or injury.
Author: Marco Tubaro
Publisher: Oxford University Press
ISBN: 0192589199
Category : Medical
Languages : en
Pages : 800
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Book Description
The ESC Textbook of Intensive and Acute Cardiovascular Care is the official textbook of the Acute Cardiovascular Care Association (ACVC) of the ESC. Cardiovascular diseases (CVDs) are a major cause of premature death worldwide and a cause of loss of disability-adjusted life years. For most types of CVD early diagnosis and intervention are independent drivers of patient outcome. Clinicians must be properly trained and centres appropriately equipped in order to deal with these critically ill cardiac patients. This new updated edition of the textbook continues to comprehensively approach all the different issues relating to intensive and acute cardiovascular care and addresses all those involved in intensive and acute cardiac care, not only cardiologists but also critical care specialists, emergency physicians and healthcare professionals. The chapters cover the various acute cardiovascular diseases that need high quality intensive treatment as well as organisational issues, cooperation among professionals, and interaction with other specialities in medicine. SECTION 1 focusses on the definition, structure, organisation and function of ICCU's, ethical issues and quality of care. SECTION 2 addresses the pre-hospital and immediate in-hospital (ED) emergency cardiac care. SECTIONS 3-5 discuss patient monitoring, diagnosis and specific procedures. Acute coronary syndromes (ACS), acute decompensated heart failure (ADHF), and serious arrhythmias form SECTIONS 6-8. The main other cardiovascular acute conditions are grouped in SECTION 9. Finally SECTION 10 is dedicated to the many concomitant acute non-cardiovascular conditions that contribute to the patients' case mix in ICCU. This edition includes new chapters such as low cardiac output states and cardiogenic shock, and pacemaker and ICDs: troubleshooting and chapters have been extensively revised. Purchasers of the print edition will also receive an access code to access the online version of the textbook which includes additional figures, tables, and videos to better to better illustrate diagnostic and therapeutic techniques and procedures in IACC. The third edition of the ESC Textbook of Intensive and Acute Cardiovascular Care will establish a common basis of knowledge and a uniform and improved quality of care across the field.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309068371
Category : Medical
Languages : en
Pages : 312
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Book Description
Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDSâ€"three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems. To Err Is Human breaks the silence that has surrounded medical errors and their consequenceâ€"but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agendaâ€"with state and local implicationsâ€"for reducing medical errors and improving patient safety through the design of a safer health system. This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes. Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errorsâ€"which begs the question, "How can we learn from our mistakes?" Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care. To Err Is Human asserts that the problem is not bad people in health careâ€"it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocatesâ€"as well as patients themselves. First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine
Author: Mickey S. Eisenberg
Publisher: University of Washington Press
ISBN: 0295988894
Category : Education
Languages : en
Pages : 280
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Book Description
Sudden cardiac arrest can strike anyone at any time. But in many cities, people who suffer sudden cardiac arrest are up to 46 times more likely to die than those who experience cardiac arrest in Seattle and King County, Washington, or Rochester, Minnesota--an astonishing and completely preventable variance in survival rates.
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309451949
Category : Medical
Languages : en
Pages : 137
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Book Description
Cardiac arrest often strikes seemingly healthy individuals without warning and without regard to age, gender, race, or health status. Representing the third leading cause of death in the United States, cardiac arrest is defined as "a severe malfunction or cessation of the electrical and mechanical activity of the heart ... [which] results in almost instantaneous loss of consciousness and collapse". Although the exact number of cardiac arrests is unknown, conservative estimates suggest that approximately 600,000 individuals experience a cardiac arrest in the United States each year. In June 2015, the Institute of Medicine (IOM) released its consensus report Strategies to Improve Cardiac Arrest Survival: A Time to Act, which evaluated the factors affecting resuscitation research and outcomes in the United States. Following the release of this report, the National Academies of Sciences, Engineering, and Medicine was asked to hold a workshop to explore the barriers and opportunities for advancing the IOM recommendations. This publication summarizes the presentations and discussions from the workshop.
Author: I. Leslie Rubin
Publisher: Springer
ISBN: 3319180967
Category : Medical
Languages : en
Pages : 2307
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Book Description
This book provides a broad overview of quality health care for people with intellectual and developmental disabilities (IDD). It focuses on providing the reader a practical approach to dealing with the health and well-being of people with IDD in general terms as well as in dealing with specific conditions. In addition, it offers the reader a perspective from many different points of view in the health care delivery system as well as in different parts of the world. This is the 3rd , and much expanded edition, of a text that was first published in 1989 (Lea and Fibiger). The second edition was published in 2006 (Paul Brookes) and has been used as a formal required text in training programs for physicians, nurses and nurse practitioners as well as by administrators who are responsible for programs serving people with IDD. This book is considered the “Bible” in the field of health care for people with IDD since 1989 when the first edition came out.
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309671035
Category : Social Science
Languages : en
Pages : 317
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Book Description
Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.
