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Current Pain and Headache Reports Aug 2020Headaches are not only responsible for restrictions in everyday life in adults. In children and adolescents, regular headaches lead also to reduced life quality and... (Review)
Review
PURPOSE OF REVIEW
Headaches are not only responsible for restrictions in everyday life in adults. In children and adolescents, regular headaches lead also to reduced life quality and limitations in the social sphere, in school education, and in professional careers. Here, we provide an overview on the frequency of headache in children and adolescents with the aim of increasing awareness about this particular health issue.
RECENT FINDINGS
Overall, headache prevalence in children and adolescents has been increasing in recent years. From various regions worldwide, data describing headache, its forms, and consequences are growing. In addition, factors frequently correlated with headache are repeatedly investigated and named: besides genetic factors, psychosocial and behavioral factors are linked to the prevalence of headache. Increasing evidence indicates that headache is underestimated as a common disorder in children and adolescents. Accordingly, too little emphasis is placed by society on its prevention and treatment. Thus, the extent of the social and health economic burden of frequent headaches in children and adolescents needs to be better illustrated, worldwide. Furthermore, the data collected in this review should support the efforts to improve outpatient therapy paths for young headache patients. Factors correlating with headache in pupils can draw our attention to unmet needs of these patients and allow physicians to derive important therapy contents from this data.
Topics: Adolescent; Child; Headache; Humans; Outpatients; Prevalence; Quality of Life; Surveys and Questionnaires
PubMed: 32840694
DOI: 10.1007/s11916-020-00892-6 -
BMJ Open Aug 2017Depression and depressive symptoms are common mental disorders that have a considerable effect on patients' health-related quality of life and satisfaction with medical... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Depression and depressive symptoms are common mental disorders that have a considerable effect on patients' health-related quality of life and satisfaction with medical care, but the prevalence of these conditions varies substantially between published studies. The aim of this study is to conduct a systematic review and meta-analysis to provide a precise estimate of the prevalence of depression or depressive symptoms among outpatients in different clinical specialties.
DESIGN
Systematic review and meta-analysis.
DATA SOURCES AND ELIGIBILITY CRITERIA
The PubMed and PsycINFO, EMBASE and Cochrane Library databases were searched to identify observational studies that contained information on the prevalence of depression and depressive symptoms in outpatients. All studies included were published before January 2016. Data characteristics were extracted independently by two investigators. The point prevalence of depression or depressive symptoms was measured using validated self-report questionnaires or structured interviews. Assessments were pooled using a random-effects model. Differences in study-level characteristics were estimated by meta-regression analysis. Heterogeneity was assessed using standard χ tests and the I statistic. The study protocol has been registered with PROSPERO under number CRD42017054738.
RESULTS
Eighty-three cross-sectional studies involving 41 344 individuals were included in this study. The overall pooled prevalence of depression or depressive symptoms was 27.0% (10 943/41 344 individuals; 95% CI 24.0% to 29.0%), with significant heterogeneity between studies (p<0.0001, τ=0.3742, I=96.7%). Notably, a significantly higher prevalence of depression and depressive symptoms was observed in outpatients than in the healthy controls (OR 3.16, 95% CI 2.66 to 3.76, I=72.0%, χ =25.33). The highest depression/depressive symptom prevalence estimates occurred in studies of outpatients from otolaryngology clinics (53.0%), followed by dermatology clinics (39.0%) and neurology clinics (35.0%). Subgroup analyses showed that the prevalence of depression and depressive symptoms in different specialties varied from 17.0% to 53.0%. The prevalence of depression and depressive symptoms was higher among outpatients in developing countries than in outpatients from developed countries. Moreover, the prevalence of depression and depressive symptoms in outpatients slightly decreased from 1996 to 2010. Regarding screening instruments, the Beck Depression Inventory led to a higher estimate of the prevalence of depression and depressive symptoms (1316/4702, 36.0%, 95% CI 29.0% to 44.0%, I=94.8%) than the Hospital Anxiety and Depression Scale (1003/2025, 22.0%, 95% CI 12.0% to 35.0%, I=96.6%).
CONCLUSION
Our study provides evidence that a significant proportion of outpatients experience depression or depressive symptoms, highlighting the importance of developing effective management strategies for the early identification and treatment of these conditions among outpatients in clinical practice. The substantial heterogeneity between studies was not fully explained by the variables examined.
Topics: Depression; Depressive Disorder; Humans; Outpatients; Psychiatric Status Rating Scales; Quality of Life
PubMed: 28838903
DOI: 10.1136/bmjopen-2017-017173 -
International Journal of Environmental... Sep 2019Patient satisfaction is a measure of the extent to which a patient is content with the health care they received from their health care provider. Patient satisfaction is...
Patient satisfaction is a measure of the extent to which a patient is content with the health care they received from their health care provider. Patient satisfaction is one of the most important factors to determine the success of a health care facility. The purpose of this study was to determine patient satisfaction with healthcare services and encompass the physician's behavior as moderation between patient satisfaction and healthcare services. The study seeks to measure the health care services, like a laboratory and diagnostic care, preventive healthcare and prenatal care, to patient satisfaction in the public health sectors of Pakistan. A descriptive survey research design was used for this study. The target population was patients from the out-patient department (OPD) of three public hospitals from Pakistan. By using the convenient sampling technique, 290 sample participants were selected from the target population. The reliability scales were tallied by using Cronbach's Alpha. The findings of the study are gleaned by using regression to explore patient satisfaction with the health care services, and whether or not the physician's behavior moderates the link of patient satisfaction and healthcare services. SPSS Hayes process was used for the moderation effect of the physician's behavior. The main results of the regression analysis validate that health care services, such as laboratory and diagnostic care, preventive healthcare, and prenatal care, have a significant and positive effect on patient satisfaction. Specifically, the study suggests that the physician's behavior significantly moderates the effect of health care services on the satisfaction of patients. The overall opinions about the satisfaction level of patients for the availability of health services in the hospitals were good. The degree of satisfaction was satisfactory with respect to laboratory and diagnostic care, preventive healthcare, and prenatal care services. Based on the outcomes, the study confirms that the proposed hypotheses are statistically significant. Furthermore, the directions for future research of the study are offered.
Topics: Adult; Aged; Aged, 80 and over; Female; Health Services; Hospitals, Public; Humans; Male; Middle Aged; Outpatients; Pakistan; Patient Satisfaction; Physicians; Young Adult
PubMed: 31505840
DOI: 10.3390/ijerph16183318 -
Frontiers in Endocrinology 2023With the development of medical care, the safety of thyroidectomy is improving year by year. Due to economic benefits and other advantages of the overnight and... (Review)
Review
With the development of medical care, the safety of thyroidectomy is improving year by year. Due to economic benefits and other advantages of the overnight and outpatient thyroidectomy, more and more patients and medical institutions have favored overnight and outpatient thyroidectomy, and its proportion in thyroidectomy has increased year by year. However, overnight and outpatient thyroidectomy still faces many challenges and remains to be improved. In this review, we focused on the recent progress and the relevant clinical features of overnight and outpatient thyroidectomy, including its safety, economic benefits, etc., which may bring valuable clues and information for further improvements of patient benefits and promotions of overnight or outpatient thyroidectomy in the future.
Topics: Humans; Thyroidectomy; Outpatients
PubMed: 37091845
DOI: 10.3389/fendo.2023.1110038 -
Annals of Internal Medicine Apr 2022This article summarizes the ACP/ COVID-19 Forum VIII held on 9 February 2022.
This article summarizes the ACP/ COVID-19 Forum VIII held on 9 February 2022.
Topics: Ambulatory Care; COVID-19; Humans; Outpatients; SARS-CoV-2
PubMed: 35157494
DOI: 10.7326/M22-0403 -
Urologie (Heidelberg, Germany) Aug 2022Over the past 30 years, outpatient surgery has developed into an indispensable pillar of patient care in Germany, without its full potential coming to light. (Review)
Review
BACKGROUND
Over the past 30 years, outpatient surgery has developed into an indispensable pillar of patient care in Germany, without its full potential coming to light.
QUESTION
What are the reasons for the stagnation of further development of outpatient surgery and its suboptimal status quo?
MATERIALS AND METHODS
Presentation and comparison of outpatient surgery numbers from clinics and practices, and a critical analysis of their development.
RESULTS
After reaching a maximum number of outpatient operations in practices and clinics in 2015, there has been a location-independent decrease and stagnation due to underfunding of outpatient surgical structures and a shortage of resources.
CONCLUSION
Outpatient surgery represents a patient-friendly and cost-effective alternative to inpatient interventions, provided that that medical and social indications rule out an increased risk. The expansion of outpatient surgery has so far provided relieve to the cost-intensive hospital sector and-in view of the shortage of nurses and physicians-will do so to an even greater extent as soon as politicians and payers commit to remuneration that is performance-related and actually covers the costs. Furthermore, the future of the healthcare system also depends on the future of outpatient surgery, which is to be assessed as positive.
Topics: Ambulatory Surgical Procedures; Cost-Benefit Analysis; Germany; Hospital Costs; Humans; Outpatients
PubMed: 35925293
DOI: 10.1007/s00120-022-01878-5 -
Frontiers in Endocrinology 2021Outpatient thyroid surgery is gaining popularity as it can reduce length of hospital stay, decrease costs of care, and increase patient satisfaction. There remains a... (Review)
Review
BACKGROUND
Outpatient thyroid surgery is gaining popularity as it can reduce length of hospital stay, decrease costs of care, and increase patient satisfaction. There remains a significant variation in the use of this practice including a perceived knowledge gap with regards to the safety of outpatient thyroidectomies and how to go about implementing standardized institutional protocols to ensure safe same-day discharge. This review summarizes the information available on the subject based on existing published studies and guidelines.
METHODS
This is a scoping review of the literature focused on the safety, efficacy and patient satisfaction associated with outpatient thyroidectomies. The review also summarizes and editorializes the most recent American Thyroid Association guidelines.
RESULTS
In total, 11 studies were included in the analysis: 6 studies were retrospective analyses, 3 were retrospective reviews of prospective data, and 2 were prospective studies. The relative contraindications to outpatient thyroidectomy have been highlighted, including: complex medical conditions, anticipated difficult surgical dissection, patients on anticoagulation, lack of home support, and patient anxiety toward an outpatient procedure. Utilizing these identified features, an outpatient protocol has been proposed.
CONCLUSION
The salient features regarding patient safety and selection criteria and how to develop a protocol implementing ambulatory thyroidectomies have been identified and reviewed. In conclusion, outpatient thyroidectomy is safe, associated with high patient satisfaction and decreased health costs when rigorous institutional protocols are established and implemented. Successful outpatient thyroidectomies require standardized preoperative selection, clear discharge criteria and instructions, and interprofessional collaboration between the surgeon, anesthetist and same-day nursing staff.
Topics: Ambulatory Surgical Procedures; Feasibility Studies; Humans; Length of Stay; Outpatients; Thyroid Diseases; Thyroidectomy
PubMed: 34394008
DOI: 10.3389/fendo.2021.717427 -
Chirurgie (Heidelberg, Germany) Mar 2023Inguinal hernia operations represent the most frequent operations overall with 300,000 interventions annually in Germany, Austria and Switzerland (DACH region). Despite... (Review)
Review
Inguinal hernia operations represent the most frequent operations overall with 300,000 interventions annually in Germany, Austria and Switzerland (DACH region). Despite the announced political willingness and the increasing pressure from the legislator to avoid costly inpatient treatment by carrying out as many outpatient operations as possible, outpatient treatment has so far played a subordinate role in the DACH region. The Boards of the specialist societies the German Hernia Society (DHG), the Surgical Working Group Hernia (CAH of the DHG), the Austrian Hernia Society (ÖHG) and the Swiss Working Group Hernia Surgery (SAHC) make inroads into this problem, describe the initial position and assess the current situation.
Topics: Humans; Hernia, Inguinal; Outpatients; Germany; Herniorrhaphy
PubMed: 36786812
DOI: 10.1007/s00104-023-01818-9 -
American Family Physician Apr 2020Most patients with burn injuries are treated as outpatients. Two key determinants of the need for referral to a burn center are burn depth and percentage of total body...
Most patients with burn injuries are treated as outpatients. Two key determinants of the need for referral to a burn center are burn depth and percentage of total body surface area involved. All burn injuries are considered trauma, prompting immediate evaluation for concomitant injuries. Initial treatment is directed at stopping the burn process. Superficial (first-degree) burns involve only the epidermal layer and require simple first-aid techniques with over-the-counter pain relievers. Partial-thickness (second-degree) burns are subdivided into two categories: superficial and deep. Superficial partial-thickness burns extend into the dermis, may take up to three weeks to heal, and require advanced dressings to protect the wound and promote a moist environment. Deep partial-thickness burns require immediate referral to a burn surgeon for possible early tangential excision. Full-thickness (third-degree) burns involve the entire dermal layer, and patients with these burns should automatically be referred to a burn center. Prophylactic antibiotics are not indicated for outpatient management and may increase bacterial resistance. People with diabetes mellitus are at increased risk of complications and infection, and early referral to a burn center should be considered. Pruritus, hypertrophic scarring, and permanent hyperpigmentation are long-term complications of partial-thickness burns. Burn injuries are more likely to occur in children and older people. Patient education during primary care visits may be an effective prevention strategy.
Topics: Aged; Ambulatory Care; Child; Humans; Outpatients; Skin; Wound Healing
PubMed: 32293848
DOI: No ID Found -
Deutsches Arzteblatt International May 2022
Topics: Ambulatory Care; Humans; Neoplasms; Outpatients; Palliative Care
PubMed: 35971253
DOI: 10.3238/arztebl.m2022.0192