What determines health-related quality of life among people living with HIV : an updated review of the literature

Background: As infection with the Human Immunodeficiency Virus (HIV) has evolved to a chronic disease, perceived health-related quality of life (HRQoL) is becoming a prominent and important patient-reported outcome measure in HIV care. Literature discusses different factors influencing HRQoL in this population, however, currently no consensus exists about the main determinants. In this review a clear, up-to-date overview of the determinants influencing HRQOL among people living with HIV is provided. Methods: All studies published before July 2013 that identified determinants of HRQoL among people living with HIV in high-income countries, were considered in this narrative review. PubMed, Web of Science and The Cochrane Library were consulted using the keywords ‘determinants’, ‘quality of life’, ‘HIV’ and ‘AIDS’. To be included, studies should have reported overall health and/or physical/mental health scores on a validated instrument and performed multivariable regression analyses to identify determinants that independently influence perceived HRQoL. Results: In total, 49 studies were included for further analysis and they used a variety of HRQoL instruments: Medical Outcomes Study Short Form-36 or variants, Medical Outcomes Study-HIV, HIV Cost and Services Utilization Study measure, Multidimensional Quality of Life Questionnaire, HIV targeted quality of life instrument, Functional Assessment of Human Immunodeficiency Virus Infection, HIV Overview of Problems Evaluation System, EuroQol, Fanning Quality of Life scale, Health Index and PROQOL-HIV. In this review, the discussed determinants were thematically divided into socio-demographic, clinical, psychological and behavioural factors. Employment, immunological status, presence of symptoms, depression, social support and adherence to antiretroviral therapy were most frequently and consistently reported to be associated with HRQoL among people living with HIV. Conclusions: HRQoL among people living with HIV is influenced by several determinants. These determinants independently, but simultaneously impact perceived HRQoL. Most HRQoL instruments do not capture all key determinants. We recommend that the choice for an instrument should depend on the purpose of the HRQoL assessment

Infection prevention and control strategies in the era of limited resources and quality improvement: a perspective paper

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Implementation of an evidence-based sepsis program in the intensive care unit: evident or not?

Severe sepsis and septic shock are among the most serious health conditions and are associated with unwelcome clinical, social, and economic outcomes. With the introduction of the Surviving Sepsis Campaign guidelines, the campaign leaders aimed to reduce mortality from severe sepsis by at least one quarter by 2009 by means of a six-point action plan, namely, building awareness among health care professionals, improving early and accurate disease recognition and diagnosis, increasing the use of appropriate treatments and interventions, education, getting better post-intensive care unit access, and developing standard processes of care. However, adherence to these recommendations is a first but crucial step in obtaining these goals. A comprehensive evaluation of both, adherence to a sepsis program and whether this results in better outcomes for patients, is therefore essential to guide informed decision-making regarding the implementation of such an evidence-based protocol

Job satisfaction in relation to communication in health care among nurses : a narrative review and pratical recommendations

Worldwide, nurse shortage and high turnover rates are observed. Job satisfaction is a major determinant of retention and is influenced by intraorganizational communication and perceived communication satisfaction. This article presents a narrative review on communication satisfaction, job satisfaction, and their mutual relationship as well as their impact on turnover intention and burnout risk in the nursing profession. A literature search was conducted in the databases PubMed, Web of Science, and The Cochrane Library, and 47 articles were included. Descriptive analysis identified different types of social networks in the health care workplace. There is a positive association between communication and job satisfaction among nurses, translating into decreased turnover intention and burnout risk. Job satisfaction is required both for organizational stability as for coguaranteeing patient safety. This will be best achieved through an organization-wide multimodal prevention and intervention program, aimed at optimizing different modalities of interprofessional communication, workload, and job satisfaction

The impact of www.poisoncentre.be and social media on the number and characteristics of calls to the Belgian Poison Centre

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