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Time Patients (time + patient)
Selected AbstractsInvesting time in health: do socioeconomically disadvantaged patients spend more or less extra time on diabetes self-care?HEALTH ECONOMICS, Issue 6 2009Susan L. Ettner Abstract Background: Research on self-care for chronic disease has not examined time requirements. Translating Research into Action for Diabetes (TRIAD), a multi-site study of managed care patients with diabetes, is among the first to assess self-care time. Objective: To examine associations between socioeconomic position and extra time patients spend on foot care, shopping/cooking, and exercise due to diabetes. Data: Eleven thousand nine hundred and twenty-seven patient surveys from 2000 to 2001. Methods: Bayesian two-part models were used to estimate associations of self-reported extra time spent on self-care with race/ethnicity, education, and income, controlling for demographic and clinical characteristics. Results: Proportions of patients spending no extra time on foot care, shopping/cooking, and exercise were, respectively, 37, 52, and 31%. Extra time spent on foot care and shopping/cooking was greater among racial/ethnic minorities, less-educated and lower-income patients. For example, African-Americans were about 10 percentage points more likely to report spending extra time on foot care than whites and extra time spent was about 3,min more per day. Discussion: Extra time spent on self-care was greater for socioeconomically disadvantaged patients than for advantaged patients, perhaps because their perceived opportunity cost of time is lower or they cannot afford substitutes. Our findings suggest that poorly controlled diabetes risk factors among disadvantaged populations may not be attributable to self-care practices. Copyright © 2008 John Wiley & Sons, Ltd. [source] Equity and need when waiting for total hip replacement surgeryJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 1 2004Ray Fitzpatrick PhD Abstract Objectives, To explore sociodemographic and health status factors associated with waiting times both for first outpatient appointment and for total hip replacement surgery (THR). Methods, A survey of THR in five former English regions was conducted between September 1996 and October 1997. Every patient listed for THR was asked to fill out a questionnaire preoperatively. This questionnaire included the 12-item Oxford Hip Score (OHS) questionnaire and two questions on the length of time patients waited for an ,outpatient ,appointment ,and ,subsequently ,for ,their operation. Results, From multiple logistic regression analyses, region, private vs. public sector, housing tenure and preoperative OHS were all independently associated with a waiting time for an outpatient appointment for >,3 months. Region, housing tenure and gender were also independently associated with a wait of ,,6 months on the surgical waiting list. Conclusions, A large proportion of patients had long waiting times both for an outpatient appointment and while on a surgical waiting list. There were significant differences in waiting time according to social, geographical and health care system factors. Patients with a worse pain and disability at surgery waited longer for an outpatient appointment. The longer patient waited, the worse was their pain and disability, suggesting that patients were not prioritized by these criteria. Benefits of prioritizing should be tested. [source] Extent of disease burden determined with magnetic resonance imaging of the bone marrow is predictive of survival outcome in patients with multiple myelomaCANCER, Issue 1 2010Sikander Ailawadhi MD Abstract BACKGROUND: Multiple myeloma (MM) remains an incurable cancer. Treatment often is initiated at the time patients experience a progressive increase in tumor burden. The authors of this report investigated magnetic resonance imaging of the bone marrow (BM-MRI) as a novel approach to quantify disease burden and validated a staging system by correlating BM-MRI with common clinical and laboratory parameters. METHODS: The extent of bone marrow involvement was evaluated by BM-MRI. Clinical and laboratory parameters were assessed in patients with active MM, and correlations between variables were assessed statistically. Bone marrow involvement by BM-MRI was defined as stage A (0%), stage B (<10%), stage C (10%-50%), and stage D (>50%). RESULTS: In total, 170 consecutive patients were evaluated (77 women and 93 men), including 144 patients who had active MM. The median age was 61 years (age range, 35-83 years). Advance stage disease (stage >I) based on Durie-Salmon (DS) staging or International Staging System (ISS) criteria was observed in 122 patients (84%) and 77 patients (53%), respectively. Lytic bone disease was noted in 120 patients (83%). There was a significant association between BM-MRI involvement and DS stage (P = .0006), ISS stage (P = .0001), the presence of lytic bone disease (P < .0001) and mean ,-2 microglobulin levels (P < .0001). Among the patients with previously untreated MM, there was a significant association between BM-MRI stage and overall survival (OS) (univariate P = .013; multivariate P = .045). Plasmacytosis on bone marrow biopsy at diagnosis was not predictive of OS (P = .91). CONCLUSIONS: BM-MRI is a novel approach for quantifying disease burden in patients with MM. The current investigation in a large cohort of nontransplantion MM patients demonstrated that the extent of bone marrow involvement determined by BM-MRI correlates accurately with other conventional parameters of disease burden and can independently predict survival in patients with MM at the time of initial diagnosis. Cancer 2010. © 2010 American Cancer Society. [source] Wait Time and Satisfaction with Care and Service at a Nurse Practitioner Managed ClinicJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 10 2001FAAN, Frank L. Cole PhD Purpose To examine the relationships among the various times patients wait for health care and patient satisfaction with nurse practitioner (NP) care and the service component of care in a NP developed and managed clinic. Data Sources Fortyseven patients (78% response rate) responded anonymously to a 15-item questionnaire that measured satisfaction with NP care and an additional 15 items that measured satisfaction with the service component of care. Actual clock times were recorded on a flow sheet that corresponded to the system of care at this clinic. Conclusions Using Pearson Product-Moment Correlation, there were no statistically significant relationships among various wait times and the measures of satisfaction. Implications for Practice Patient satisfaction with NP care is an important indicator of quality of care. Although satisfaction was not related to wait times, NPs must be respectful of the amount of time that patients wait for health care. [source] The use of patient-controlled epidural fentanyl in elderly patients,ANAESTHESIA, Issue 12 2007T. Ishiyama Summary We studied whether delivering postoperative analgesia, using a patient-controlled epidural analgesia (PCEA) device was effective and safe in elderly patients. We enrolled 40 patients aged >,65 years (elderly group) and 40 patients aged 20,64 years (young group) scheduled for elective major abdominal surgery. PCEA infusion was started following completion of surgery. Mean (SD) fentanyl consumption (10.7 (3.7) compared with 10.5 (2.7) ,g.kg,1, p = 0.76) and number of times patients pressed the bolus switch (32 (36) compared with 44 (38), p = 0.16) during the first 24 h postoperatively were similar in the two groups. Pain scores, which were similar in both groups at rest, were significantly lower in the elderly on coughing (at 24 h, p < 0.05). In addition, average pain scores were similar at the time of PCEA bolus demands in the two groups. Elderly and young adult patients therefore required similar amounts of patient-controlled epidural fentanyl to produce satisfactory pain relief. [source] | ||||||||||