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PubMed2005

A study on urogenital complaints of postmenopausal women aged 50 and over.

OBJECTIVE: The objective of this study was to determine the prevalence of urogenital complaints in postmenopausal women aged 50 and over. METHODS: The study was carried out in the city of Istanbul on women within the age range of 50 and over. The statistical figures for these women were obtained from the latest national census. The number of sampling was determined to be 500, each representing a population of 10,000 women. Thus, the sampling consisted of 500 postmenopausal women who had applied to various health centers either to seek remedy for their health problems other than urinary incontinence (UI) or to accompany inpatients. Women in the surgical stage of menopause were excluded from the study group. A specifically designed questionnaire was used to gather data on urogenital complaints. The data obtained by this means was analyzed according to Thomas criteria, which classifies incontinence as rare, regularly and serious. UI was defined according to the International Continence Society (ICS) classification. RESULTS: Of the interviewees 68.8% reported UI, 28.8% of whom had serious UI requires continuously the use of ped. It was determined that 37.2% of the women with UI had stress incontinence symptoms, 32.3% urge incontinence symptoms, and 30.5% mixed incontinence. Of the women 46.5% had UI problems for 5 years or longer, and 75% reported that their complaints had started after menopause; 18.2% of the women suffered from vaginal discharge and pruritus, while 23% experienced vaginal dryness; 51.2% of the women were sexually active. However, 83.6% of this group of women reported a decrease in sexual desire and frequency of intercourse. Likewise, 78.1% experienced a decline in sexual satisfaction, 77.7% difficulty in having orgasm, and 45.3% dyspareunia. Logistic regression analysis showed that existence of a chronic illness, frequent urethral infections, a high value of body mass index and chronic constipation increased the prevalence of UI. CONCLUSIONS: Urinary incontinence and sexual problems, particularly decline in sexual desire, are widespread among postmenopausal women. Frequent urinary tract infections, obesity, chronic constipation and other chronic illnesses seem to be the predictors of UI.

Aged↗
PubMed2005

Absence of contact sensitization to Aloe vera (L.) Burm. f.

Aloe vera has been used as a cosmetic and medical remedy since ancient times and has gained increasing popularity in recent years. Despite its widespread use, reports of allergic reactions are rare. We patch tested 702 consecutive patients with an oily extract from the leaves, Aloe pulvis from the entire plant and concentrated Aloe vera gel. A specially designed questionnaire was used for the use of Aloe vera, reasons and location of application, adverse reactions, occupation, hobbies and atopy. None of the subjects showed any reaction to one of the preparations. 2 components of the plant have to be distinguished: the bark of the leaves contains anthrachinones with pro-peristaltic and potential antibiotic and anticancer properties. Constraints have been imposed due to their considerable toxic potential. Today, mostly the Aloe gel from the center of the leaves is processed. It almost exclusively consists of carbohydrates to which also many medical effects have been attributed. Carbohydrates are not likely to induce contact sensitization, which might explain the outcome of our study. However, this does not justify unrestrained promotion of Aloe products, as scientific studies investigating the claims on its constitutional effects are few in number, and the majority of them have been unable to diminish the intuitive scepticism against miracle cures, like Aloe seems to be.

Allergens↗
PubMed1983

Complaints of cold extremities among patients on antihypertensive treatment.

A total of 758 consecutive patients attending three hypertension clinics answered a questionnaire designed to assess the prevalence and severity of complaints of cold extremities among patients on various antihypertensive drugs. Forty-four per cent claimed to have had complaints of cold extremities and about 50% of these had had symptoms already prior to antihypertensive treatment. Among the newly symptomatic patients the prevalence of symptoms was 18% of those on diuretics and 40% of those on beta-blockers (p less than 0.01). No significant association was found between the prevalence of symptoms and age, sex, use of vibrating tools, smoking or history of various conditions associated with atherosclerosis. No significant difference was found in the prevalence of symptoms among patients on propranolol, alprenolol, pindolol, atenolol and metoprolol. It is concluded that cold hands and feet are common among hypertensive patients and may be aggravated by treatment with not only beta-blockers but also diuretics.

Adrenergic beta-Antagonists↗
PubMed1984

The psychological side effects of acebutolol and atenolol.

We have measured the psychological effects of acebutolol and atenolol in sixteen patients with essential hypertension. The drugs were administered in a randomized, placebo-controlled, double-blind manner, in single daily doses of 100 mg atenolol, 400 mg acebutolol or placebo for periods of 6 weeks, each drug period being separated by a placebo period. At each 2 weekly clinic visit, a questionnaire designed for assessment of state anxiety and state arousal was administered for self-completion. Arousal was significantly reduced by atenolol over the whole 6 weeks of administration. It was not affected by acebutolol. Anxiety was significantly reduced by acebutolol but only at the first of the three 2 weekly assessments on treatment. It was not affected by atenolol. Differences in the psychological effects of these two beta-adrenoceptor blockers are discussed in terms of their lipid solubility and haemodynamic effects.

Acebutolol↗
PubMed1982

Rehabilitation after major head and neck surgery--the patients' view.

Forty-nine patients who were free of tumour 5 months to 14 years (mean 30 months) after total laryngectomy or a commando procedure were given questionnaires designed to obtain the patient's assessment of their resulting disability. Sixteen areas of disability were studied grouped under five main headings: speech, eating, cosmetic, employment and social. Following laryngectomy more than half of the patients achieved successful communication by oesophageal speech. Success in this was usually associated with minimal problems in other areas. The disabilities after commando procedures were more varied and complex. More patients reported severe disability in more than one area. Difficulties with chewing and swallowing were prominent. The results are illustrated with patients' comments. Ways in which rehabilitation might be improved are considered.

Adult↗
PubMed2005

Screening for distant metastases in patients with head and neck cancer: what is the current clinical practice?

OBJECTIVES: The detection of distant metastases during screening influences the choice of treatment in patients with head and neck squamous cell carcinoma (HNSCC). There is no consensus on the diagnostic technique that has to be used nor on the subgroup of HNSCC patients that may benefit from screening. DESIGN: Questionnaire on current practice concerning the diagnostic work-up in HNSCC patients for screening for distant metastases. PARTICIPANTS: Investigators in the 12 otolaryngology / head and neck and seven oromaxillofacial departments treating head and neck cancer in the Netherlands. RESULTS: The response rate was 100%. Indications for screening were cervical lymph node metastases (63%), mutilating surgery (58%), locoregional recurrence (47%), advanced T-stage (32%), second primary tumour (21%). Diagnostic techniques routinely used for screening besides chest X-ray were chest CT (84%), liver ultrasound (53%), liver CT (16%) and bone scintigraphy (42%). Forty-two per cent of the clinicians were not satisfied with the current methods of screening. CONCLUSION: This survey shows a substantial variation in indications and diagnostic techniques used for screening for distant metastases between the major institutions treating head and neck cancer in the Netherlands. There is a need for guidelines for screening for distant metastases in patients with head and neck cancer.

Bone and Bones↗
PubMed2004

Attitudes of Saudi Arabian mothers towards the digit-sucking habit in children.

OBJECTIVE: The purpose of this study was to report on the attitudes of Saudi mothers towards the digit-sucking habit in their children and their attempts to stop this fixation. DESIGN: The research took the form of a cross-sectional study. METHODS: Data was collected from a sample of 50 Saudi mothers whose children currently had a digit-sucking habit. One investigator used a specially designed questionnaire to interview all the mothers. RESULTS: The results showed that 48% of mothers did not like to see the habit at any age, and no mother accepted the habit after the age of 4 years. Most mothers (86%) tried to stop their children digit-sucking. Sixty-six per cent of the present sample had noticed the adverse effect of this fixation on their child's occlusion, and this was given as the main reason for their attempts to stop the habit. The most common method used by Saudi mothers to stop their children sucking their digits was the application of a bitter tasting lotion to the fingers (66%). Although 48% of mothers had sought advice about digit-sucking from dentists and paediatricians (30% and 18%, respectively), 60% of the dentists and all of paediatricians had made no suggestions about any solutions. CONCLUSION: No mother accepted the habit in their children after the age of 4 years. The majority of mothers had noticed the adverse effect of the digit-sucking fixation. Non-invasive procedures were most commonly used by Saudi mothers attempting to stop this habit in their children.

Adult↗
PubMed2004

Dental caries experience and its relationship to social and behavioural factors among 3-5-year-old children in Uganda.

OBJECTIVE: The aim of this study was to assess the socio-demographic and behavioural correlates of caries experience and sugar intake patterns among pre-school children in Uganda. METHODS: Five hundred and eighty-nine, 3-5-year-old children (51% boys, response rate = 85%), attending nursery schools in urban and peri-urban settings in central Kampala and Nakawa, respectively, were clinically examined for dental caries using the dmft index. Visible plaque on the labial surfaces of their maxillary incisors was recorded as a proxy for oral hygiene habits. A questionnaire designed to assess socio-demographic factors and sugar habits was completed by their caregivers in face-to-face interviews. RESULTS: The mean dmft scores were 1.7, 2.4 and 3.1, and 42%, 44% and 42% had visible plaque among 3-, 4- and 5-year-olds, respectively. In Nakawa, a total of 64%, 62% and 22% of the subjects had dmft > 0, decayed teeth (dt) > 0 and missing teeth > 0, respectively. The corresponding rates in central Kampala were 56%, 55% and 17%. Multivariate analyses revealed that attending school in Nakawa, having a mother with a lower level of education, reporting the intake of cough syrup, visiting a dentist and scoring positively for plaque were associated with higher odds (1.6, 1.5, 3.7 and 2.7) for having dmft > 0. The adjusted mean frequency sugar scores varied systematically between mothers with low and high levels of education (mean scores = 11.0 vs. 10.4), and for children with negative and positive plaque scores (mean scores = 10.6 vs. 10.9). CONCLUSION: The caries experience was highest among children attending nursery schools in Nakawa and those who had had longer periods of cough syrup consumption, whereas children from the two locations were equally exposed to sugar consumption generally. Both caries experience and frequency of sugar consumption was highest among children of less-well-educated mothers.

Child Behavior↗
PubMed2004

Occupational stress and constructive thinking: health and job satisfaction.

BACKGROUND: Occupational stress is associated with specific situations, characteristics of the work environment, and individual perceptions and reactions in the context of the workplace, but many nursing studies of occupational stress have tended to analyse aspects related to the job itself. In Brazil nursing is acknowledged as a stressful occupation whose stresses are generally associated with the job itself, while the effects of personal characteristics on an individual's response to occupational stress are dismissed. AIMS: The aim of this paper is to describe: (1) occupational stress, job satisfaction and state of health in Brazilian nurses, and (2) the relationship of these variables to a constructive thinking coping style. METHODS: A correlational study was performed during 1999 with 461 nurses recruited from the public health and education system in the Federal District of Brazil. Instruments used were the Nursing Stress Inventory, Constructive Thinking Inventory, subscales of the Occupational Stress Indicator, and a researcher-designed questionnaire. RESULTS: Normal distributions were found for occupational stress, state of health (physical and psychological), and job satisfaction. Results suggest that nurses have fewer psychological health problems and similar job satisfaction compared with other Brazilian government white-collar workers. Occupational stress was directly associated with state of health, and inversely associated with global constructive thinking and job satisfaction. CONCLUSIONS: Brazilian nurses in this study seem to have adapted satisfactorily to their profession, but the finding that constructive thinking was significantly related to psychological ill-health, occupational stress and physical ill-health highlights a need to value individual coping styles in the work environment.

Adaptation, Psychological↗
PubMed2006

Quality of life of cancer patients receiving inpatient and home-based palliative care.

AIMS: This paper reports a comparative study of the symptom experience, physical and psychological health, perceived control of the effects of cancer and quality of life of terminally ill cancer patients receiving inpatient and home-based palliative care, and the factors that predict quality of life. BACKGROUND: Quality of life is a major goal in the care of patients with terminal cancer. In addition to symptom management, psychological care and provision of support, being cared for at home is considered an important determinant of patient well-being. A more comprehensive understanding of the impact of cancer on patients and their families will inform the delivery of palliative care services. METHODS: Fifty-eight patients with terminal cancer (32 inpatients, 26 home-based) were recruited from major palliative care centres in Australia in 1999. A structured questionnaire designed to obtain sociodemographic information, medical details and standard measures of symptoms, physical and psychological health, personal control and quality of life was administered by personal interview. RESULTS: The two groups were similar on most demographic measures, although more home-care patients were married, of Australian descent and had private health insurance cover. The most prevalent symptoms reported were weakness, fatigue, sleeping during the day and pain. Patients receiving home-based services had statistically significantly less symptom severity and distress, lower depression scores, and better physical health and quality of life than those receiving inpatient care. Home-care patients also reported statistically significantly more control over the effects of their illness, medical care and treatment received, and the course of the disease. Multiple regression analyses showed that better global physical health, greater control over the effects of cancer and lower depression scores were statistically significant predictors of higher quality of life. CONCLUSIONS: The main issues arising from the findings for nurses are the early detection and management of both physical and psychological symptoms, particularly fatigue, pain, anxiety and depression, and the need to use strategies that will empower patients to have a greater sense of control over their illness and treatment. Research is needed to identify other factors that may impact on quality of life, and to establish the extent to which inpatient and home-based care meets the needs of both the patient with terminal cancer and their family.

Adult↗
PubMed2006

Scoping workplace aggression in nursing: findings from an Australian study.

AIM: This paper reports a study of workplace aggression among nurses in Tasmania, Australia. There is international concern about a perceived rise in occupational violence as a major worldwide public health problem, with associated financial costs. BACKGROUND: There is reason to suspect that aggression towards nurses is increasing. For example, increased illicit drug use puts nurses at the sharp end in managing patients admitted with drug-related problems. Such people are often resistant to healthcare intervention, and often have associated disorders, including mental illness. Despite this increased awareness, comprehensive data on occupational violence in nursing are not available. METHOD: A specially designed questionnaire was sent to all nurses registered with the Nursing Board of Tasmania (n = 6326) in November/December 2002, with 2407 usable questionnaires returned. The response rate was 38%. FINDINGS: A majority of respondents (63.5%) had experienced some form of aggression (verbal or physical abuse) in the four working weeks immediately prior to the survey. Patients/clients or their visitors were identified as the main perpetrators, followed by medical and nursing colleagues. Abuse influenced nurses' distress, their desire to stay in nursing, their productivity and the potential to make errors, yet they were reluctant to make their complaints 'official'. As well as reporting high levels of verbal and physical abuse, nurses were distressed because they could not provide the appropriate care to meet patients' needs. Few working environments were free of aggression. CONCLUSION: Future research should try to determine the specific factors, including staff characteristics and environment, associated with the high levels of aggression reported in 'hot spots' where, on the basis of the present results, many staff experience high levels of verbal and physical abuse. Unless managers take steps to improve the situation, attrition from the profession for this reason will continue.

Adult↗
PubMed1994

Polydipsia amongst adults with a learning disability in an institution.

A hospital-based adult learning disabled population (n = 371) was screened for polydipsia with the help of a purpose-designed questionnaire. Polydipsia was defined as excessive drinking of more than 3 l of non-alcoholic fluid over a 24-h period. Altogether, 23 (6.2%) subjects were found to have polydipsia. The polydipsic group was compared with the whole hospital population on variables such as age and IQ distribution. A matched group of 23 individuals without a history of polydipsia was drawn from the same hospital population. The polydipsic and the matched group were compared using various biochemical and psychological measures. Thirty-five per cent of polydipsic patients, compared to 13% of the matched group, showed evidence of compensated hyponatraemia. This difference was not significant. There was no significant difference between the polydipsic and the matched group in the frequency of psychiatric illness, behavioural problems or autism. There also was no significant difference in the IQ levels of the polydipsic patients and the total hospital population. Polydipsia in this population is largely seen as part of an abnormal behavioural repertoire without any evidence of possible organic cause, except unidentified diabetes mellitus. Klein Levin syndrome and pica were represented in the polydipsic group, but not amongst the matched group.

Adult↗
PubMed2005

Enhancing primary health care services for adults with intellectual disabilities.

BACKGROUND: Primary health care teams have an important part to play in addressing the health inequalities and high levels of unmet health needs experienced by people with intellectual disabilities (ID). Practice nurses have an expanding role within primary health care teams. However, no previous studies have measured their attitudes, knowledge, training needs, and self-efficacy in their work with people with ID. METHODS: All practice nurses working in a defined area were identified. A purpose-designed questionnaire to measure nurse attitudes, knowledge, training needs and self-efficacy was developed and piloted. All practice nurses were then invited to participate. Data from completed questionnaires were entered onto PC and analysed. RESULTS: Of a total of 292 practice nurses 201 (69%) participated. Whilst 89% (n=179) of participants reported having infrequent contact, 25% (n=50) reported a growing workload with people with ID. Only 8% (n=16) had ever received any training in communicating with people with ID. A knowledge gap regarding the health needs of people with ID was identified. Eighty-six per cent reported having experienced specific difficulties during previous appointments, and only 23% thought they had sufficient case note information at appointments, but 68% did not modify the duration of their appointments with people with ID. Conversely, responses demonstrated that practice nurses have a high level of experience and qualification in general nursing, have positive attitudes to working with people with ID, and high self-efficacy scores were identified for work with people with ID. The practice nurses viewed ID to be a high priority area for future training. CONCLUSIONS: Primary health care teams have a key role in tackling the unmet health needs of people with ID. Whilst this project has identified factors that may impact on the accessibility of services, it has also identified practice nurses as having positive attitudes and high self-efficacy scores in their work with people with ID. This indicates that they should be targeted for specific training in this area, which may make an important contribution in enhancing future accessibility of primary health care services for people with ID.

Adult↗
PubMed1976

Paediatric candidates' attitudes to computerized patient management problems in a certifying examination.

In September 1974 candidates who had taken a computerized patient managment problem examination (CPMP), as part of the certification process in paediatrics required by the Royal College of Physicians and Surgeons of Canada, completed a questionnaire designed to elicit their reactions to CPMPs. The results indicated that respondents were favourable to CPMPs, that there was little distraction caused by the equipment, logic or semantics of the problems, and that CPMPs were an acceptable examination technique. It was recommended that, in the future, CPMP examinees be allowed practice time to familiarize themselves with the equipment, that pre-examination instructions should be clarified, and that problems judged inadequate by candidates be revised.

Attitude of Health Personnel↗
PubMed1979

Medical education: a student perspective.

Discussions with a sample of final year students generated a questionnaire designed to elicit a phenomenological account of their experiences at medical school. Sources of dissatisfaction and stress were identified and the students also offered recommendations for improving the system.

Attitude↗
PubMed1981

A medical curriculum: evaluation by final-year students.

Seventy-five students, at the end of their final year, responded to a postal questionnaire designed to assess their views on their medical curriculum. The responses of those intending to enter general practice were compared with those of intending hospital doctors and comparison were also made between respondents who had enrolled for a 6-year course and those who had enrolled for the newer 5-year course.

Attitude of Health Personnel↗
PubMed1983

The use of computerized learning in intensive care: an evaluation of a new teaching program.

A computer-assisted learning program in respiratory intensive care was introduced into the undergraduate curriculum at University College Hospital. Educational effectiveness was assessed. This method of learning was found to be highly acceptable to students. The improvement in students knowledge of the subject was up to three times greater in those who used the computer program, than a control group of students who received only teaching by conventional means, (P = 0 X 016). The results of a questionnaire designed to elicit students' attitudes to this learning experience are discussed.

Anesthesiology↗
PubMed1986

An assessment of priority and educational value in a medical curriculum.

A randomly selected group of teachers, students, first-year graduates (junior doctors in the first year of postgraduate training after their final medical school examination), general practitioners and specialists responded to a postal questionnaire designed to assess their views on the priorities in medical curriculum and the educational value attributed to its content. Comparisons were made among the five participating groups and the outcome of the assessment was compared with the existing curriculum.

Attitude of Health Personnel↗