DEPRESSION, ANXIETY, AND PSYCHOSOCIAL RESOURCES ACROSS THE FIRST YEAR OF NEWLY DIAGNOSED ASIAN CANCER OUTPATIENTS IN SINGAPORE

Master'sMASTER OF SCIENC

Non-Adherence in Patients on Peritoneal Dialysis: A Systematic Review

Background: It has been increasingly recognized that non-adherence is an important factor that determines the outcome of peritoneal dialysis (PD) therapy. There is therefore a need to establish the levels of non-adherence to different aspects of the PD regimen (dialysis procedures, medications, and dietary/fluid restrictions). Methods: A systematic review of peer-reviewed literature was performed in PubMed, PsycINFO and CINAHL databases using PRISMA guidelines in May 2013. Publications on non-adherence in PD were selected by two reviewers independently according to predefined inclusion and exclusion criteria. Relevant data on patient characteristics, measures, rates and factors associated with non-adherence were extracted. The quality of studies was also evaluated independently by two reviewers according to a revised version of the Effective Public Health Practice Project assessment tool. Results: The search retrieved 204 studies, of which a total of 25 studies met inclusion criteria. Reported rates of nonadherence varied across studies: 2.6 1353% for dialysis exchanges, 3.9 1385% for medication, and 14.4 1367% for diet/fluid restrictions. Methodological differences in measurement and definition of non-adherence underlie the observed variation. Factors associated with non-adherence that showed a degree of consistency were mostly socio-demographical, such as age, employment status, ethnicity, sex, and time period on PD treatment. Conclusion: Non-adherence to different dimensions of the dialysis regimen appears to be prevalent in PD patients. There is a need for further, high-quality research to explore these factors in more detail, with the aim of informing intervention designs to facilitate adherence in this patient populatio

Flowchart of Study Selection.

<p>Flowchart of Study Selection.</p

Non-Adherence Rates Documented in PD Patients.

<p>Note: PD  =  Peritoneal Dialysis. HD  =  Haemodialysis. CAPD  =  Continuous Ambulatory PD. APD  =  Automated PD. CCPD  =  Continuous Cycling PD. NA  =  Non-adherence. DDFQ  =  Dialysis Diet and Fluid Questionnaire. EPO  =  Erythropoietin. ^aAge and gender characteristics are presented only if reported in (or able to be calculated from) the study. ^bArticles that included more than one patient sub-group, hence sample size was separated to accurately reflect adherence rates reported in these studies.</p

Educational environments in Asian medical schools: A cross‐national comparison between Malaysia, Singapore, and China.

Introduction: Perceptions of the educational environment (EE) represent an important source of information on medical students' learning experience. Understanding and addressing these perceptions can help inform initiatives designed to improve the learning experience and educational outcomes, while comparison of student perceptions across medical schools can provide an added perspective. The aim of the study was to compare the EEs of three Asian medical schools: Royal College of Surgeons in Ireland and University College Dublin Malaysia Campus, Yong Loo Lin School of Medicine, Singapore and Xiangya School of Medicine, China.Methods: Medical students in the clinical years (N = 1063) participated in a cross-sectional study using the Dundee Ready Educational Environment Measure (DREEM). Data were analyzed using SPSS version 22.Results: There were significant differences between the three medical schools in the total DREEM scores (F [2, 1059] = 38.29, p Discussion: Total DREEM scores at the three medical schools are similar to those reported from other undergraduate settings. However, significant variations occurred in perceptions of the EE, as students progressed through the clinical years. Greater attention to the learning environment and the curriculum may improve students' educational experience.</p