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1.
Dorn T Yzermans JC Spreeuwenberg PM van der Zee J 《Journal of psychosomatic research》2007,63(4):381-389
OBJECTIVE: Caregiving has been described in the literature as a risk factor for ill health in the carer. This controlled, prospective study examines the course of physical and mental health problems in parents of adolescent survivors of a mass burn incident. METHODS: Health information was extracted from electronic medical records. Continuous data were available for 1 year before and 4 years after the fire. Cohorts comprised 273 parents of survivors with burns, 199 parents of survivors without burns, and 1756 controls. Post-fire increases in health problems were compared by means of logistic regression. RESULTS: Parents of burn victims were more likely to present mental health problems during the first 2 years after the incident, when compared to the baseline. Moreover, they were more likely to present cardiovascular health problems in every year following the disaster, compared to the baseline. Increases observed in mental and cardiovascular health problems were significantly larger in parents of burn victims compared to controls. Risk factors for presenting mental health problems were female gender of the parent and a large burn size in the child. Lower socioeconomic status and female gender of the parent predicted cardiovascular health problems. CONCLUSION: Evidence gained in longitudinal studies informs on which health problems are most likely to develop in parental caregivers. In the interest of both parent and child, a family-oriented approach is proposed. 相似文献
2.
Goldacre MJ Wotton CJ Yeates D Seagroatt V Flint J 《Social psychiatry and psychiatric epidemiology》2007,42(9):683-689
Background It has been suggested that the risk of cancer may be higher in people with psychological disorders, like depression and anxiety,
than in the general population.
Aims To determine cancer risk in cohorts of people with depression or anxiety, compared with that in a control cohort.
Method Analysis of linked statistical records of hospital admission and mortality.
Results Lung cancer was more common in those with depression (risk ratio 1.36, 95% confidence intervals 1.19–1.54) or anxiety (1.29,
1.12–1.48) than in others. Excluding lung cancer, the risk ratio for all other cancers combined was 0.98 (0.92–1.04) in the
depression cohort and 1.01 (0.95–1.07) in the anxiety cohort. There was a significant association, in the short-term only,
between depression, anxiety and the subsequent diagnosis of brain tumours.
Conclusions With the exception of lung and brain tumours, cancer risk was not increased in people with depression or anxiety. 相似文献
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Race,quality of depression care,and recovery from major depression in a primary care setting 总被引：2，自引：0，他引：2
Rollman BL Hanusa BH Belnap BH Gardner W Cooper LA Schulberg HC 《General hospital psychiatry》2002,24(6):368-390
Racial variations in the use of effective medical care and subsequent clinical outcomes have been identified for many medical conditions. Still, it is unclear whether racial variations in care and clinical outcomes exist for depressed primary care patients. Primary care patients presenting for routine treatment were screened for major depression as part of a study to disseminate a depression treatment guideline. Primary care physicians (PCPs) were informed of their patients’ depression via an electronic medical record system and asked whether they agreed with the diagnosis. Treatment patterns and depressive symptoms over the following six-months were assessed by chart review and the Hamilton Rating Scale for Depression, respectively. Over a 20-month period, 8,944 African-American and Caucasian patients aged 18–64 were approached for screening. African-Americans were less likely to agree to undergo screening than Caucasians (83% vs. 88%; P<.0001), but those doing so were more likely to report mood symptoms (26% vs. 15%; P<.001). 204 patients, including 52 African-Americans (25%), met protocol-eligibility criteria and completed a baseline interview. Baseline sociodemographic and clinical characteristics, and PCPs’ agreement rate with the depression diagnosis were similar. Although PCPs were less likely to counsel their African-American than Caucasian patients for depression (P=.03), this difference resolved after adjusting for education level, employment, and insurance status and we found no other variations in the depression care provided or in clinical outcomes by race. We found little racial variation in either process measures or clinical outcomes for depression in our sample of African-American and Caucasian primary care patients. 相似文献
5.
Introduction
The epidemiology of tamoxifen and venous thromboembolism (VTE) is not well understood, and most data on tamoxifen toxicity are from adjuvant clinical trials. This study examined the relationship between the duration of tamoxifen use in female patients with breast cancer and the risk of VTE in a large population-based setting.Materials and Methods
Retrospective electronic data extraction on tamoxifen utilization was undertaken among a cohort of 3572 women with breast cancer seen at Marshfield Clinic between January 1, 1994 and June 31, 2009. Observational follow-up extended until February, 2010.Results
On initial exposure to tamoxifen, women had a clustering of VTE events. Cox proportional hazards regression, adjusting for multiple clinically-important covariates including age, body mass index, cancer stage, and concurrent diabetes, demonstrated that as use of tamoxifen continued in those without earlier VTE events, risk of subsequent VTE gradually increased, albeit at a lower rate (hazard ratio per year of tamoxifen duration = 1.225, P < 0.0001).Conclusions
In our study population, initiating tamoxifen coincided with an initial clustering of VTE events, with risks due specifically to tamoxifen, increasing during continued exposure. Evidence suggested that the VTE clustering occurred in high risk individuals at initiation of tamoxifen therapy. Careful selection of patients for whom tamoxifen therapy is appropriate based on susceptibility to VTE is thus required prior to initiation of therapy. 相似文献6.
Walshe M McDonald C Boydell J Zhao JH Kravariti E Touloupoulou T Fearon P Bramon E Murray RM Allin M 《Psychiatry research》2011,187(3):335-340
Obstetric complications (OCs) are consistently implicated in the aetiology of schizophrenia. Information about OCs is often gathered retrospectively, from maternal interview. It has been suggested that mothers of people with schizophrenia may not be accurate in their recollection of obstetric events. We assessed the validity of long term maternal recall by comparing maternal ratings of OCs with those obtained from medical records in a sample of mothers of offspring affected and unaffected with psychotic illness. Obstetric records were retrieved for 30 subjects affected with psychosis and 40 of their unaffected relatives. The Lewis-Murray scale of OCs was completed by maternal interview for each subject blind to the obstetric records. There was substantial agreement between maternal recall and birth records for the summary score of “definite” OCs, birth weight, and most of the individual items rated, with the exception of antepartum haemorrhage. There were no significant differences in the validity of recall or in errors of commission by mothers for affected and unaffected offspring. These findings indicate that several complications of pregnancy and delivery are accurately recalled by mother's decades after they occurred. Furthermore, there is no indication that mothers are less accurate in recalling OCs for their affected offspring than their unaffected offspring. When comparing women with and without recall errors, we found those with recall errors to have significantly worse verbal memory than women without such errors. Assessing the cognition of participants in retrospective studies may allow future studies to increase the reliability of their data. 相似文献
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L. Boyer K. Baumstarck-BarrauR. Belzeaux J.M. AzorinJ.M. Chabannes D. DassaC. Lancon J. NaudinF. Poinso M. Rufo J.C. SamuelianA. Loundou M. FieschiP. Auquier 《European psychiatry》2011,26(2):78-84
Background
Electronic medical records (EMR) are currently being implemented in psychiatric hospitals throughout Europe. The perceptions of health care professionals can contribute important information that may predict their acceptance of and desired mode of use for EMR, thus guiding EMR implementation.Aims
To develop a self-administered instrument designed to assess health care professionals’ satisfaction regarding EMR in a psychiatric hospital, based only on the professional point of view, according to the psychometric standards.Methods
The development was supervised by a steering committee and undertaken by three standard steps. Item generation was derived from 115 face-to-face interviews with health care professionals in a French, public, psychiatric hospital. The item-reduction process resulted in a 25-item questionnaire. The validation process was based on construct validity, reliability and some aspects of external validity.Results
The final version of the questionnaire contained 25 items that described five dimensions, leading to a global score. The factor structure accounted for 72% of the total variance. Internal consistency was satisfactory (item-internal consistency over 0.40 and Cronbach's alpha coefficients ranged from 0.86 to 0.95). The scalability was satisfactory with INFIT statistics inside an acceptable range. Scores of dimensions were strongly positively correlated with visual analogue scale scores (all p < 0.001). External validity showed statistical associations between scores and age, gender, seniority in psychiatry and ward type. Participation rate was 66%.Conclusion
The availability of a reliable and valid questionnaire (professionals’ satisfaction questionnaire with electronic medical records [PSQ-EMR]) concerning health care professionals’ satisfaction regarding EMR in psychiatry, exclusively generated from interviews with health care professionals, enables legitimate feedback to be incorporated into EMR implementation in order to formulate a high-quality health care. 相似文献8.
目的:了解精神卫生专科医院的电子病历与传统手写病历质量的差异。方法:随机抽取2009年8月1日至10月31日出院病历342份,其中电子病历(电子病历组)160份,传统手写病历(手写病历组)182份,根据《上海市精神卫生专业病历书写基本规范》对每份出院病历进行评分,比较两组病历得分、住院时间、住院次数、病历项目是否齐全和缺项、出入院诊断是否一致等信息。结果:电子病历组得分平均(98.1±1.7)分,传统手写病历组得分平均(98.0±1.6)分,两组比较差异无统计学意义(t=0.450,df=340,P=0.65)。对病历得分与住院时间进行相关分析显示:病历得分和住院时间存在负相关(r=-0.108,P=0.046),电子病历组的得分与住院时间呈负相关(r=-0.161,P=0.042),但手写病历组得分与住院时间无相关(r=-0.032,P=0.336)。结论:电子病历的质量和传统手写病历质量无明显差别;住院时间与病历质量之间存在负相关。 相似文献
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Objective
The aim of the work described here was to characterize quality of life (QOL) and its determinants in a large cohort of adult patients with epilepsy.Methods
Validated measures reflecting disease severity and psychosocial functioning were electronically collected on all outpatients seen during 2009. Multivariate regression adjusting for repeated measures identified determinants of QOL, as defined by the Quality of Life in Epilepsy Questionnaire-10 (QOLIE-10).Results
Seven thousand seven hundred eighty-four visits from patients with epilepsy were identified. The questionnaire completion rate was 77%, yielding 5960 records corresponding to 1931 individual patients for analysis. Following multivariate modeling, the two most clinically significant QOL predictors were seizure severity (mean QOLIE-10 score = 28.8 if LSSS > 40 vs 19.2 otherwise) and depression (mean QOLIE-10 score = 31.7 if PHQ-9 ≥ 10 vs 19.3 otherwise).Conclusions
Optimizing quality of life in patients with epilepsy requires an approach that extends beyond controlling seizures. Collection of validated health status measures improving patient management is possible within the setting of routine clinical care. 相似文献10.
背景：电子病历中包含大量能够辅助临床诊断和决策的医疗信息。
目的：利用BP人工神经网络进行电子病历的数据挖掘。
方法：针对BP人工神经网络的原理及算法进行了分析，提出BP人工神经网络模型构建的6个步骤，分别为训练数据集的确定，数据准备，网络模型的建立，进行数据挖掘，评估BP网络得到的结果及预测结果的应用。并分析了BP人工神经网络在电子病历中的相关应用。
结果与结论：利用BP人工神经网络可以对电子病历进行分析预测，查找存在的危险因素。证实BP人工神经网络在电子病历系统数据分析中具有实际应用价值。 相似文献