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2020-04-29 Research Article

Influence of adverse socio-emotional risk factors on the physical and mental health needs of children and young people in public care of a South-West England local authority

Abstract

Introduction: There is increasing published evidence confirming the long-term adult mental and physical health impact of childhood exposure to adverse events including different forms of abuse and family dysfunction. Looked-after Children and young people (LACYP) living in public care are known to be a highly vulnerable group, who have often experienced several pre-care poor socio-economic and family circumstances with subsequent placement instability, as well as inadequate compensatory care within the social care system. We aimed to evaluate the relationship between the adverse socio-emotional risk factors experienced by a cohort of LACYP and their emotional, behavioural and physical health needs within a South-West England Local Authority between Jan and Dec 2018.

Methods: We carried out a retrospective review of the medical records of all looked-after children and young people (LACYP) within one year (Jan to Dec 2018) at the North Somerset Local Authority (NSLA). This was an audit project of the LAC Health team completed as part of the Clinical Governance strategies of the NSLA.

Results: 93% (89/96) of the LACYP experienced at least one or more socio-emotional adverse risk factors. The commonest socio-emotional risk factors recorded were parent-related including poor mental health (67%), neglectful parenting (59%), drugs/alcohol abuse (45%) and domestic violence (47%). Forty-six (48%) of the LACYP had at least one or more emotional problems, 48 (50%) had neurodevelopmental conditions, while 63 (66%) had at least one or more physical problems. The most common emotional needs were behavioural problems (35%), anxiety/ depression (17%), nicotine/substance misuse (10%) and self-harm (6%).

Conclusion: High levels of physical, emotional, behavioral, developmental and neurodisability disorders are prevalent among LACYP due to their high vulnerabilities to adverse life experiences and trauma while living within their biological families. Present and future clinical implications of the socio-emotional risk factors and the need for more integrated multi-agency services for addressing the diverse health needs of the LACYP were discussed.

What is known?
•    There is increasing awareness of the relationship between childhood exposure to adverse events and long-term adult mental and physical health
•    Looked after children and young people (LACYP) are highly vulnerable to early traumatic and poor socio-economic circumstances exposure
What this study adds:
•    Over 90% of LACYP experienced at least one ACE which disproportionately affected the youngest age-group
•    Parental factors such as childhood abuse, alcohol/substance abuse and mental health problems were the most common adverse factors experienced by the LACYP

Abstract Read Full Article HTML DOI: 10.29328/journal.cjncp.1001021 Cite this Article

2020-05-29 Mini Review

Patients suffer when healthcare stocks rise

When a stock price rises or has a better P/E ratio, this is generally considered a measure of success. Is this true for health insurance stocks? Stock holders certainly are happy, but what about the purchasers of the carriers’ policies? Are patients smiling when the stock price goes up?

Abstract Read Full Article HTML DOI: 10.29328/journal.cjncp.1001022 Cite this Article

2020-06-26 Research Article

Level of Nurses to Patients Communication and Perceived Barriers in Government Hospitals of Bahir Dar City, Ethiopia, 2020

Abstract

Background: Communication is the process of exchanging information or messages from one group to the other through mutually understood verbal or non-verbal ways. Communication barrier is anything that prevents receiving and understanding the messages. poor communication between patients and the nurses’ result in an increased length of stay, wastage of the resource, patient dissatisfaction, absence of confidence, and frustration for both the nurses and the patients. This study will provide basic information on the level of nurses to patients’ communication and perceived barriers in government hospitals of Bahir Dar city.

Objective: The objective of this study was to assess the level of the nurse to patient communication and perceived barriers in government hospital of Bahir Dar city, Ethiopia, 2020.

Methods: Institution based cross-sectional mixed-methods study was conducted from February 24 – March 9/2020 in government hospitals of Bahir Dar city. A total of 380 nurses were included in the quantitative study by using simple random sampling. For both the quantitative and qualitative study, at the initial stage of data collection and interview; informed consent was obtained from respondents. Data were entered into Epi Data 4.6 and analyzed with a statistical package of social science version 25. Data were mainly analyzed using descriptive statistics and binary logistic regression. For the qualitative study, purposive sampling technique was employed, and 7 participants were interviewed. Thematic analysis was used.

Results: From the total participants 36.5% of nurses were found to have poor communication. Variables which have statistically significant associations with the level of communication were educational level, work experience, the unwillingness of nurses, and lack of communication skill. The highest perceived communication barriers were lack of continuous training with 82.7% followed by workload with 80.7% and lack of medical facilities with 79.2% as reported by nurses. All environmental-related barriers were the perceived barriers of the nurse to patient communication.

Conclusion: In this study, the communication of nurses to patients is found to low. To enhance communication with the patients; nurses and other stakeholders like the ministry of health, the health bureau, and hospital authorities need to recognize the communication barriers. Giving awareness on the communication barrier for the nurses helps to minimize the barriers and improve the nurses to patients’ communication.

Abstract Read Full Article HTML DOI: 10.29328/journal.cjncp.1001023 Cite this Article

2020-07-22 Research Article

Expectations versus reality: Improvement of symptom control and quality of life of oncology patients using medical cannabis

Abstract

Aim: To compare the expectations and the reality of oncology patients in terms of to the use of medical cannabis, including symptom control and related quality of life.

Research question: Is there a difference between oncology patients expectations and their reality concerning the use of medical cannabis and what do oncology patients experience regarding symptom control and quality of life?

Method: This research was done in a tertiary hospital in Israel at the oncology clinic A comparative study that used self- administered questionnaires for patients who received authorization to use medical cannabis. The first questionnaire was given to patients after receiving the authorization to use medical cannabis and asked about their expectations related to its use. Patients filled out the same questionnaire for the second time, approximately two months after. Comparison of the respondent’s answers, before and after using medical cannabis, showed reality of improving symptom control and Quality of Life.

Results: Seventy-four patients completed both questionnaires. Most patients reported advantage in symptom control when using medical cannabis, although their expectations were somewhat higher than the reality experienced. Advantage of using medical cannabis was also found concerning improvement of quality of life. Seventy-five of patients still used medical cannabis once completing the second questionnaire and most of them reported that they would recommend the use of medical cannabis.

Conclusion: It can be seen from this study that for many oncology patients the use of medical cannabis may be very helpful. However, the use of cannabis is not free of side effects, as can be seen from the patients’ reports. This has clear implications for oncology nursing practice and may lead to a better understanding of patients using medical cannabis in the future, in terms of its benefit and side effects.

Abstract Read Full Article HTML DOI: 10.29328/journal.cjncp.1001024 Cite this Article

2020-10-05 Research Article

Knowledge and attitude of workers towards HIV post-exposure prophylaxis and exposure of staffs to sharp injuries in Dessie Referral Hospital: 2020; A cross sectional study

Abstract

Background: Post exposure chemoprophylaxis can prevent human immunodeficiency virus (HIV) infection in risk healthcare workers; however routine adoptions of these practices by the workers have been limited.

Objective: To assess knowledge and attitude of health workers on HIV post-exposure prophylaxis and exposure to sharp injuries in Dessie referral hospital.

Methods: Across-sectional study was conducted on 422 health care workers of Dessie referral Hospital. The study subjects were selected by proportional allocation of each sample in its respective department/ward. Simple random sampling method was used to select study participants. The data was cleaned coded and analyzed by using statistical package for social sciences (SPSS) version 23. Finally the result was presented by graphs, pie chart and statements.

Results: A total of 422 study subjects were participated in the study. Among 422 participants 72.5% had good knowledge of post exposure prophylaxis for HIV and the rest 27.5% had poor knowledge of post exposure prophylaxis for HIV. Among 422 study participants 75.2% had positive attitude towards PEP. 

283(67.1%)   of them had exposure to sharp injuries.

Conclusion: Generally most of health care workers had good knowledge about post exposure prophylaxis against HIV/AIDS. This study had shown that a significant number of individuals had a negative attitude with regard to post exposure prophylaxis. Therefore, formal training that aims to improve attitudes and support to improve PEP implementation and completion are needed.

Abstract Read Full Article HTML DOI: 10.29328/journal.cjncp.1001025 Cite this Article

2020-10-20 Review Article

StatesCare–The Cure for “Patient” Healthcare

Abstract

Fifty years of Washington’s fixes for healthcare have brought us to the brink: insurance is unaffordable and care is unavailable, certainly not in time. The way to make healthcare work for We the Patients (all Americans) is to take healthcare authority away from third-parties – government and insurance – and restore the direct doctor-patient connection with no bureaucrat in between. The cure for patient Healthcare is StatesCare combined with market-based medicine. Financial models confirm this approach will make care both affordable and accessible in a timely manner.

Abstract Read Full Article HTML DOI: 10.29328/journal.cjncp.1001026 Cite this Article