A Nationwide Survey and System Analysis of Emergency Triage System in Lao People's Democratic Republic

Objective: To assess the present status of the emergency department (ED) triage system in 162 hospitals across the Lao People's Democratic Republic (Lao PDR). Materials and Methods: The Lao PDR nationwide survey participants recruited ED administrators. The EDs were randomly recruited. The standard questionnaire package was used for data collection including patients’ demographics and triage systemic factors. Descriptive analysis was applied to analysis the outcome of interest. Results: A majority of triage officers were emergency room nurses (58.6%), general physicians (20.4%), or both (11.1%). Most hospitals (89.5%) used informal triage scales such as clinical experiences or colors to prioritize ED patients. Only 17 hospitals (10.5%) had a formal triage scale in their ED care systems and used it in their practice. Conclusion: These findings provide knowledge of the ED triage system in the Lao PDR. The results indicate that the Lao PDR lacks a formal ED triage scale but uses a variety of informal scales. Thus, it is necessary to set up a standard triage system at all hospitals to standardize ED healthcare across the country

Coping and Health Problems of Caregivers of Survivors with Traumatic Brain Injury

DOI: 10.5294/aqui.2014.14.2.5 Objectives: To evaluate coping and the health problems of caregivers at the time of survivor discharge and at one month after discharge and to determine correlations among personal data, coping and health problems of caregivers and disability of survivors. Method: Eighty-five dyads of survivors with traumatic brain injury and their caregivers were included. The instruments employed for data collection were the 27-item Thai version of the Coping and Adaptation Processing Scale-Short Form, the Health Problem Questionnaire for caregivers and the Disability Rating Scale for survivors. The Roy Adaptation Model was used as a conceptual framework for this study. Pearson’s product moment correlation coefficient was employed for analysis. Results: No statistical differences were found between coping and health problems among caregivers. The health problems most frequently reported by caregivers were headache on the day of discharge and no health problems after one month of caregiving engagement. The disability level and marital status of the caregivers were correlated negatively with coping (r = -.245, p = .024, r = -.220, p = .043, respectively). Conclusions: The findings delineated that the caregivers remained able to handle the difficulties involved in caring for survivors at home with fewer health problems. Married caregivers were likely to manage this burden better than other caregivers. DOI: 10.5294/aqui.2014.14.2.

Coping and Health Problems of Caregivers of Survivors with Traumatic Brain Injury

Objectives: To evaluate coping and the health problems of caregivers at the time of survivor discharge and at one month after discharge and to determine correlations among personal data, coping and health problems of caregivers and disability of survivors. Method: Eighty-five dyads of survivors with traumatic brain injury and their caregivers were included. The instruments employed for data collection were the 27-item Thai version of the Coping and Adaptation Processing Scale-Short Form, the Health Problem Questionnaire for caregivers and the Disability Rating Scale for survivors. The Roy Adaptation Model was used as a conceptual framework for this study. Pearson’s product moment correlation coefficient was employed for analysis. Results: No statistical differences were found between coping and health problems among caregivers. The health problems most frequently reported by caregivers were headache on the day of discharge and no health problems after one month of caregiving engagement. The disability level and marital status of the caregivers were correlated negatively with coping (r = -.245, p = .024, r = -.220, p = .043, respectively). Conclusions: The findings delineated that the caregivers remained able to handle the difficulties involved in caring for survivors at home with fewer health problems. Married caregivers were likely to manage this burden better than other caregivers. Objetivos: avaliar a adaptação e os problemas de saúde dos cuidadores no momento em que o sobrevivente recebe alta e um mês depois disso, e determinar as correlações entre os dados de caráter pessoal, adaptação e os problemas de saúde dos cuidadores e a incapacidade dos sobreviventes. Método: 85 díades de sobreviventes com lesões cerebrais traumáticas e seus cuidadores foram incluídos na pesquisa. Os instrumentos utilizados para a coleta de dados foram a versão tailandesa da Escala de Medição do Processo de Enfretamento e Adaptação – formatação curta, com 27 itens, o Questionário de Problemas de Saúde para os cuidadores e a Classificação de Escala de Deficiência para os sobreviventes. O Modelo de Adaptação de Roy foi utilizado como marco conceitual para este estudo. A correlação produto-momento de Pearson foi utilizada para a análise. Resultados: não se constataram diferenças estatísticas entre os problemas de adaptação e de saúde nos cuidadores. Os problemas de saúde relatados mais frequentemente pelos cuidadores foram dor de cabeça no dia da alta e nenhum problema de saúde depois de um mês de participação no cuidado do sobrevivente. O nível da deficiência dos sobreviventes e o estado civil dos cuidadores se correlacionaram negativamente com o afrontamento (r = - 0,245 , p = 0,024 , r = - 0,220 , p = 0,043 , respectivamente). Conclusões: os resultados demonstram que os cuidadores permaneceram capazes de lidar com as dificuldades que implica o cuidado dos sobreviventes em casa com menos problemas de saúde. Os cuidadores casados eram propensos a lidar com essa carga melhor que outros cuidadores.Objetivos: Evaluar el afrontamiento y los problemas de salud de los cuidadores en el momento en que el sobreviviente fue dado de alta y un mes después de que el sobreviviente fue dado de alta y determinar las correlaciones entre los datos de carácter personal, afrontamiento y los problemas de salud de los cuidadores y la incapacidad de los sobrevivientes. Método: Ochenta y cinco díadas de supervivientes con lesiones cerebrales traumáticas y sus cuidadores fueron incluidos en la investigación. Los instrumentos utilizados para la recolección de datos fueron la versión tailandesa de la Escala de Medición del Proceso de Afrontamiento y Adaptación – Formato Corto, con 27 ítems, el Cuestionario de Problemas de Salud para los cuidadores y la Clasificación de Escala de Discapacidad para los sobrevivientes. El Modelo de Adaptación de Roy se utilizó como marco conceptual para este estudio. La correlación producto-momento de Pearson se utilizó para el análisis. Resultados: No se encontraron diferencias estadísticas entre los problemas de afrontamiento y de salud en los cuidadores. Los problemas de salud reportados más frecuentemente por los cuidadores fueron dolor de cabeza en el día de alta y ningún problema de salud después de un mes de participación en el cuidado del sobreviviente. El nivel de la discapacidad de los sobrevivientes y el estado civil de los cuidadores se correlacionaron negativamente con el afrontamiento (r = - 0,245 , p = 0,024 , r = - 0,220 , p = 0,043 , respectivamente). Conclusiones: Los resultados demuestran que los cuidadores permanecieron capaces de manejar las dificultades que implica el cuidado de los sobrevivientes en casa con menos problemas de salud. Los cuidadores casados eran propensos a manejar esta carga mejor que otros cuidadores

Reliability and Validity of the Chinese Version of the Perceived Access to Health Care Questionnaire

Background: The Perceived Access to Health Care Questionnaire (PAHCQ) is the latest specific tool used to evaluate patients’ accessibility to the health system. Objectives: This study aimed to translate and verify the item analysis, test-retest reliability, content validity, construct validity, and known-group analysis of the PAHCQ in a Chinese population. Methods: This study developed and validated the Chinese version of the PAHCQ. The translation of the PAHCQ was based on the back translation of Brislin. This study used simple random sampling to include a sample of 591 subjects in Jiangsu, China. Item analysis was used to verify the questionnaire’s expert consistency and cultural adaptation. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to evaluate the effectiveness of the structure. Internal consistency was determined using Cronbach’s α, and item validity and test-retest reliability were analyzed. Results: The CFA results indicated that the modified PAHCQ is reasonable. The Cronbach alpha value of the PAHCQ was 0.96. The correlation coefficients for the six domains in test-retest reliability were between 0.67 and 0.91. Comparison of the total PAHCQ scores among participants in different groups of age, gender, maternal status, education level, per capita monthly income, and CCI levels showed statistically significant differences (P \u3c 0.05). Conclusions: The Chinese version of the PAHCQ is a feasible, effective, and reliable tool that can be used to evaluate Chinese patients’ perception of health system accessibility

Adaptação e Problemas de Saúde Cuidadores de Sobreviventes com Lesões Cerebrais Traumáticas

DOI: 10.5294/aqui.2014.14.2.5 Objectives: To evaluate coping and the health problems of caregivers at the time of survivor discharge and at one month after discharge and to determine correlations among personal data, coping and health problems of caregivers and disability of survivors. Method: Eighty-five dyads of survivors with traumatic brain injury and their caregivers were included. The instruments employed for data collection were the 27-item Thai version of the Coping and Adaptation Processing Scale-Short Form, the Health Problem Questionnaire for caregivers and the Disability Rating Scale for survivors. The Roy Adaptation Model was used as a conceptual framework for this study. Pearson’s product moment correlation coefficient was employed for analysis. Results: No statistical differences were found between coping and health problems among caregivers. The health problems most frequently reported by caregivers were headache on the day of discharge and no health problems after one month of caregiving engagement. The disability level and marital status of the caregivers were correlated negatively with coping (r = -.245, p = .024, r = -.220, p = .043, respectively). Conclusions: The findings delineated that the caregivers remained able to handle the difficulties involved in caring for survivors at home with fewer health problems. Married caregivers were likely to manage this burden better than other caregivers. DOI: 10.5294/aqui.2014.14.2.5DOI: 10.5294/aqui.2014.14.2.5Objetivos: Evaluar el afrontamiento y los problemas de salud de los cuidadores en el momento en que el sobreviviente fue dado de alta y un mes después de que el sobreviviente fue dado de alta y determinar las correlaciones entre los datos de carácter personal, afrontamiento y los problemas de salud de los cuidadores y la incapacidad de los sobrevivientes. Método: Ochenta y cinco díadas de supervivientes con lesiones cerebrales traumáticas y sus cuidadores fueron incluidos en la investigación. Los instrumentos utilizados para la recolección de datos fueron la versión tailandesa de la Escala de Medición del Proceso de Afrontamiento y Adaptación – Formato Corto, con 27 ítems, el Cuestionario de Problemas de Salud para los cuidadores y la Clasificación de Escala de Discapacidad para los sobrevivientes. El Modelo de Adaptación de Roy se utilizó como marco conceptual para este estudio. La correlación producto-momento de Pearson se utilizó para el análisis. Resultados: No se encontraron diferencias estadísticas entre los problemas de afrontamiento y de salud en los cuidadores. Los problemas de salud reportados más frecuentemente por los cuidadores fueron dolor de cabeza en el día de alta y ningún problema de salud después de un mes de participación en el cuidado del sobreviviente. El nivel de la discapacidad de los sobrevivientes y el estado civil de los cuidadores se correlacionaron negativamente con el afrontamiento (r = - 0,245 , p = 0,024 , r = - 0,220 , p = 0,043 , respectivamente). Conclusiones: Los resultados demuestran que los cuidadores permanecieron capaces de manejar las dificultades que implica el cuidado de los sobrevivientes en casa con menos problemas de salud. Los cuidadores casados eran propensos a manejar esta carga mejor que otros cuidadores. DOI: 10.5294/aqui.2014.14.2.5Objetivos: avaliar a adaptação e os problemas de saúde dos cuidadores no momento em que o sobrevivente recebe alta e um mês depois disso, e determinar as correlações entre os dados de caráter pessoal, adaptação e os problemas de saúde dos cuidadores e a incapacidade dos sobreviventes. Método: 85 díades de sobreviventes com lesões cerebrais traumáticas e seus cuidadores foram incluídos na pesquisa. Os instrumentos utilizados para a coleta de dados foram a versão tailandesa da Escala de Medição do Processo de Enfretamento e Adaptação – formatação curta, com 27 itens, o Questionário de Problemas de Saúde para os cuidadores e a Classificação de Escala de Deficiência para os sobreviventes. O Modelo de Adaptação de Roy foi utilizado como marco conceitual para este estudo. A correlação produto-momento de Pearson foi utilizada para a análise. Resultados: não se constataram diferenças estatísticas entre os problemas de adaptação e de saúde nos cuidadores. Os problemas de saúde relatados mais frequentemente pelos cuidadores foram dor de cabeça no dia da alta e nenhum problema de saúde depois de um mês de participação no cuidado do sobrevivente. O nível da deficiência dos sobreviventes e o estado civil dos cuidadores se correlacionaram negativamente com o afrontamento (r = - 0,245 , p = 0,024 , r = - 0,220 , p = 0,043 , respectivamente). Conclusões: os resultados demonstram que os cuidadores permaneceram capazes de lidar com as dificuldades que implica o cuidado dos sobreviventes em casa com menos problemas de saúde. Os cuidadores casados eram propensos a lidar com essa carga melhor que outros cuidadores

Factors Influencing Pre-Cardiopulmonary Arrest Signs among Post-General Surgery Patients in Critical Care Service System

Health service system factors can lead to pre-cardiopulmonary arrest signs (pre-CA), which refer to a critical condition in the body leading to a circulatory and respiratory system disruption. The purpose of this study was to assess the incidence rate of an event leading to pre-cardiopulmonary arrest signs within the first 24 h, and also to analyze the factors influencing the health service system in critical post-general surgery patients in the intensive care unit. These results of the study found the incidence rate of pre-CA was 49.05 per 1000 person-hours, especially 1 h after admission to the ICU. Hemodynamic instability, respiratory instability, and neurological alteration were the most common pre-CA symptoms. The patient factors associated with high pre-CA arrest sign scores were the age from 18–40 years, with an operation status as emergency surgery, elective surgery compared with urgent surgery, and the interaction of operation status and age in critical post-general surgery patients. The organization factors found advanced hospital level and nurse allocation were associated with pre-CA. To improve quality of care for critical post-general surgery patients, critical care service delivery should be delegated to nurses with nurse allocation and critical care nursing training. Guidelines must be established for critically ill post-general surgery patient care

Factors influencing the presence of peripheral arterial disease among Thai patients with type 2 diabetes

Background: Little is known about factors predicting peripheral arterial disease (PAD) development in Thai type 2 diabetes patients. This study aims to identify factors related to PAD in type 2 diabetes and the best predictors for PAD development. Methods and results: A case-control study was conducted in which 405 type 2 diabetes patients were recruited from four tertiary care hospitals in Bangkok, Thailand. Cases were type 2 diabetes patients with PAD who were compared to those without PAD. An ankle-brachial index (ABI) 70 years, having coronary heart disease as a comorbid illness, and having a body mass index of 25–29.9 kg/m2 were predictive for PAD development (all p < 0.05). These three variables explained 12.3% of the variance in the incidence of PAD among type 2 diabetes patients. The demographic and clinical factors were the best predictors for PAD development. Conclusion: Thai type 2 diabetes patients who are elderly, have coronary heart disease as a comorbid condition, or have a normal weight should be considered at risk for PAD development