| 1. |
- Hommel, Ami, et al.
(författare)
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Influence of optimised treatment of people with hip fracture on time to operation, length of hospital stay, reoperations and mortality within 1 year.
- 2008
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Ingår i: Injury. - : Elsevier BV. - 1879-0267 .- 0020-1383. ; 39, s. 1164-1174
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Tidskriftsartikel (refereegranskat)abstract
- Hip fractures are a major cause of hospital stay among the elderly, and result in increased disability and mortality. In this study from 1 April 2003 to 31 March 2004, the influence of optimised treatment of hip fracture on time to operation, length of hospital stay, reoperations and mortality within 1 year were investigated. Comparisons were made between the first 210 patients in the period and the last 210 patients, who followed the new clinical pathway introduced at the University Hospital in Lund, Sweden. Early surgery, within 24h, was not associated with reduced mortality, but was significantly associated with reduced length of stay (p<0.001). Significantly more cases of osteosynthesis for femoral neck fracture were reoperated compared with all other types of surgery (p<0.001) when reoperations with extraction of the hook pins in healed fractures were excluded. Mortality was significantly higher among men than women at 4 (p=0.025) and 12 (p=0.001) months after fracture and among medically fit patients with administrative delay to surgery compared with patients with no delay (p<0.001).
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| 2. |
- Houkes, Ruben, et al.
(författare)
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Classification systems of cleft lip, alveolus and palate : results of an international survey
- 2021
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Ingår i: The Cleft Palate-Craniofacial Journal. - : SAGE Publications. - 1055-6656 .- 1545-1569. ; , s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study aimed to identify commonly used classification systems by cleft providers around the world, including the perceived indications and limitations of each system. Design: A cross-sectional survey. Participants: A total of 197 registrants from three international cleft/craniofacial meetings. Interventions: Participants were sent a web-based questionnaire concerning cleft classification systems. Main outcome measures: Frequency of commonly used classification systems, their perceived indications and limitations. Results: A total of 197 respondents from 166 different centers completed the questionnaire. Healthcare professionals from all disciplines responded, with the most frequent respondents being plastic surgeons (38.1%), maxillofacial surgeons (28.4%) and orthodontists (23.9%). Eighteen different classification systems were in use. The most frequently used systems were the International Statistical Classification of Diseases and Related Health Problems (ICD-10) (35.5%), LAHSHAL (34.0%), and Veau (32.5%) classification systems. Most respondents (32.5%) indicated that anatomical and morphological characteristics are essential components of a classification system. However, respondents indicated that their current classification systems lacked sufficient description of cleft extension and severity. Conclusions: Great variety in the use of classification systems exists among craniofacial specialists internationally. The results recommend the usage of the LAHSHAL classification of OFCs, due to its comprehensiveness, relatively high implementation rate globally, convenience of usage and complementarity with the ICD-10 system. Moreover, it can overcome deficiencies inextricably linked to ICD-10, such as incapacity to describe laterality and clefts of the alveolus. More international exposure to the merits of using the LAHSHAL classification system would be highly recommended.
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| 3. |
- Paganini, Anna, 1979, et al.
(författare)
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Being Normal yet Different : A Qualitative Study on the Dualistic Experience of Living With Unilateral Cleft Lip and Palate
- 2022
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Ingår i: The Cleft Palate-Craniofacial Journal. - : SAGE Publications. - 1055-6656 .- 1545-1569. ; , s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Objective The aim of the present study was to describe the experiences of young adults living with cleft lip and palate (CLP) and to explore potential gender differences. Design A descriptive qualitative study was designed involving semi-structured interviews. The interviews were analyzed using qualitative content analysis, as described by Graneheim and Lundman. Participants A total of 9 women and 8 men, aged 22 to 26 years with UCLP. Results The main theme identified was: the duality of living with a cleft—being normal yet different, and 2 subcategories: “My cleft and me” and “My cleft and the World.” The participants described themselves as normal yet different, both in relation to themselves and in relation to others. They also stated that gender norms regarding appearance affected their lives and how they saw the cleft. Conclusion This study adds to the growing body of qualitative research on CLP. It highlights the dualistic experiences of feeling normal and different at the sametime. The interviews indicated that this dualism was based on context and gender, showing the psychological complexity of an individual. The clinical implications of this study emphasizes the need of a person-centered care approach in the cleft care setting where the clinicians are aware of the potential dualistic experience that also may differ over time that individuals with cleft can experience. This can also help clinicians better understand and help patients reduce distress and strengthen positive coping mechanisms.
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| 4. |
- Stiernman, Mia, et al.
(författare)
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Comparison of Corresponding Scores From the Cleft Hearing Appearance and Speech Questionnaire (CHASQ) and CLEFT-Q in Swedish Patients With Cleft Lip and/or Palate
- 2020
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Ingår i: Cleft Palate - Craniofacial Journal. - : SAGE Publications. - 1055-6656 .- 1545-1569.
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The primary aim of this study was to compare corresponding scores between 2 existing cleft-specific patient-reported outcome measures (PROMs)—Cleft Hearing Appearance and Speech Questionnaire (CHASQ) and CLEFT-Q. The second aim of the study was to investigate patient opinion on the 2 PROMs. Design: Cross-sectional questionnaire study. Setting: Participants were recruited from a University Hospital. They answered CHASQ and CLEFT-Q either in the hospital or at home. Participants: Thirty-three participants with cleft lip and/or palate, aged 10 to 19 years. Main Outcome Measure: CHASQ and CLEFT-Q. Results: The CHASQ scores and the corresponding CLEFT-Q scores on appearance correlated significantly. Corresponding scores regarding speech did not correlate significantly. A majority, 15 (58%) participants, answered that they liked CLEFT-Q more than CHASQ, 18 participants (69%) thought CHASQ was easier to complete, and 19 (76%) thought CLEFT-Q would better inform health care professionals. Conclusion: Both instruments showed strengths and limitations. Clinicians will have to consider each instrument’s respective qualities when choosing to implement either PROM.
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| 5. |
- AlRiyami, Fatma M., et al.
(författare)
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Healthcare costs and outcomes associated with surgical site infections after coronary artery bypass grafting surgeries in Oman
- 2023
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Ingår i: Annals of Medicine. - : Informa Healthcare. - 0785-3890 .- 1651-2219 .- 1365-2060. ; 55:1, s. 793-799
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Tidskriftsartikel (refereegranskat)abstract
- Background: Surgical site infection (SSI) after coronary artery bypass graft (CABG) surgeries is considered a key indicator of the quality of healthcare services. Objective : This study aimed to estimate the healthcare outcomes associated with SSIs after CABG surgeries in Oman in terms of mortality rate, case-fatality rate, LOS, readmission rate and healthcare costs. Methods : The nested case-control study design was used based on retrospective data, which was conducted from 2016 to 2017. The case group encompassed all CABG patients with confirmed SSIs within 30 days of the surgery (n = 104) while controls were CABG patients without SSIs (n = 404). Results : Forty-four (42.3%) of the SSI patients were readmitted to the hospital compared to eight (2%) of the control group (p <.001). Patients in the case group had a longer LOS (M = 24.4, SD = 44.6 days) compared to those in the control group (M = 11, SD = 21 days, p =.003). The mean healthcare costs of cases (M = Omani Rial [OMR] 3823, SD = OMR 2516) were significantly greater than controls (M = OMR 3154, SD = OMR 1415, p =.010). Conclusion : Results from this study can be baseline data for formulating new hypotheses and testing the causal relationship between SSIs after CABG surgeries and the readmission rate, LOS and health care costs.
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| 6. |
- Hommel, Ami, et al.
(författare)
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Differences in complications and length of stay between patients with a hip fracture treated in an orthopaedic department and patients treated in other hospital departments
- 2008
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Ingår i: Journal of Orthopaedic Nursing. - : Elsevier. - 1361-3111 .- 1873-4839 .- 1878-1292. ; 12:1, s. 13-25
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Tidskriftsartikel (refereegranskat)abstract
- The health care system has to deal with substantial health care costs, which are expected to continue to rise due to increasingly elderly populations. One way of saving has been a reduction of the number of beds in hospitals. The consequence is that acute patients are inappropriately admitted to non-specialized wards because of limited beds. These patients are also known as “outliers”. In this study, consecutive patients with a hip fracture treated at the orthopaedic department (n = 273) are compared with patients treated at other departments (n = 147) according to the incidence of complications and the length of stay (LOS) before and after the introduction of an evidence-based clinical pathway. There was no medical difference between the populations. However, the strict demands of saving costs, with limited beds, have resulted not only in economic consequences with prolonged hospitalization, but also in patient suffering and the inconvenience of increased postoperative complications.Patients treated at non-specialized wards had an extra LOS of 3.7 days in the acute hospital settings and furthermore, 13.6 days of LOS including rehabilitation compared to patients treated at the orthopaedic department. In addition, we consider the implemented evidence-based clinical pathway to be successful since the number of complications was reduced. It is a major challenge to establish effective treatment and rehabilitation for patients after a hip fracture aiming to avoid complications and reduce LOS. These fragile patients with a hip fracture ought to be treated at the orthopaedic department, or at departments with geriatric and rehabilitation knowledge. Physiotherapists, occupational therapists and nurses specialising in orthopaedics and geriatricians should take an active part in the care of these patients.
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| 7. |
- Paganini, Anna, 1979, et al.
(författare)
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A gender perspective on appearance-related concerns and its manifestations among persons born with unilateral cleft lip and palate
- 2021
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Ingår i: Psychology Health & Medicine. - : Informa UK Limited. - 1354-8506 .- 1465-3966. ; 26:6, s. 771-778
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Tidskriftsartikel (refereegranskat)abstract
- Cleft lip and palate (CLP) affects a person's facial appearance and can cause appearance-related distress. Appearance-related distress and its manifestations are not fully understood. Women with CLP tend to experience a higher degree of distress as well as undergo more aesthetic revisions than men. The aim of this study was to investigate if self-reported appearance-related gender differences occur among adults born with unilateral CLP using the Derriford Appearance Scale 24 (DAS24). One hundred sixty two consecutive patients, 107 men and 55 women, with unilateral CLP and no associated syndromes treated at the same hospital were asked to answer the DAS24. A mixed methods approach was used to analyse the questionnaires both quantitively and qualitatively. Fifty men and 30 women participated, the results showed that the aspects of appearance considered most disturbing was cleft-related among both genders, most common in regards to the nose. Three themes were found: acceptance, cleft features, and general appearance issues. The quantitative part showed that women reported higher appearance-related social anxiety and avoidance than men. This study demonstrated that appearance-related distress is present in both genders; however, women expressed more distress than men. Moreover, non-cleft as well as cleft features are of importance for self-reported dissatisfaction.
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| 8. |
- Paganini, Anna, 1979, et al.
(författare)
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Influence of Gender, Dispositional Optimism, and Coping Strategies on Appearance-Related Distress Among Swedish Adults With Cleft Lip and Palate
- 2022
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Ingår i: Cleft Palate-Craniofacial Journal. - : SAGE Publications. - 1055-6656 .- 1545-1569. ; 59:6, s. 715-723
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the influence of gender, dispositional optimism, and coping strategies on appearance-related distress among individuals with unilateral cleft lip and palate (UCLP). Design: Cross-sectional design with self-report questionnaires analyzed primarily with Spearman correlations (r (s)) and multivariate regression analyses. Setting: A tertiary cleft center in Sweden. Participants: Eighty individuals with UCLP born 1966 to 1986. The mean age for men (n = 50) and women (n = 30) was 38.8 and 37.4 years, respectively. Main Outcome Measures: The Derriford Appearance Scale 24 measured appearance-related distress, the Life Orientation Test-Revised, short version measured dispositional optimism and pessimism, and the Coping Orientation to Problems Experienced, short version included 14 coping strategies. Results: Women had higher appearance-related distress than men, which was significantly (P < .05) related to self-blame (r (s) = 0.59), pessimism (r (s) = 0.59), and low optimism (r (s) = -0.56). Men's appearance-related distress was significantly associated with low active coping (r (s) = 0.35), low use of emotional support (r (s) = 0.29), denial (r (s) = 0.39), behavioral disengagement (r (s) = 0.41), and pessimism (r (s) = 0.28). The only significant gender interaction reflected greater impact of optimism in reducing appearance-related distress for women (beta = -0.06). Conclusions: This study showed that high levels of dispositional optimism decrease appearance-related distress, particularly for women. The coping strategies used differed between men and women, and the results suggest that both gender and psychosocial facto r (s) need to be considered in regard to appearance-related distress among individuals with UCLP in both clinical and research settings. A possible way to decrease distress is to strengthen positive coping strategies and dispositional optimism.
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