bluuebunny/crossref_metadata_2025_split huggingface dataset:
Web-based interventions for comorbid depression and chronic illness: a systematic review
Authors: Charova Ekaterina , Dorstyn Diana , Tully Phillip , Mittag Oskar 
Published: February 2015

Summary Web-based interventions offer potential benefits for managing and treating depression in the context of chronic physical illness, however their use with this population has yet to be quantitatively assessed. The present systematic review examined the biopsychosocial data from 11 independent studies ( N = 1348 participants), including randomised controlled and quasi-experimental designs most commonly performed with diabetes and multiple sclerosis. Study quality was evaluated using the Downs and Black (1998) index, with most studies being statistically underpowered although internal validity was demonstrated. Treatment outcomes were quantified using Cohen’s d effect sizes. Results indicated significant short-term improvements in depression severity ( dw = 0.36, CI = 0.20-0.52, p < 0.01), in addition to quality of life, problem-solving skills, functional ability, anxiety and pain-related cognitions ( d range = 0.23 to 1.10). Longer-term outcomes could not be determined based on the limited data. Further robust studies are required before wider adoption of web techniques takes place.
Childhood maltreatment and personality disorders in patients with a major depressive disorder: A comparative study between France and Togo
Authors: Kounou Kossi B. , Dogbe Foli Ayoko A. , Djassoa G. , Amétépé Léonard K. , Rieu J. , Mathur A. , Biyong I. , Schmitt L. 
Published: February 2015

Few studies have examined the association between childhood maltreatment (CM) and personality disorders (PDs) in adulthood in two different cultural contexts, including sub-Saharan Africa. The aims of this study were to compare the frequency of CM between patients in treatment in France and Togo for a major depressive disorder (MDD), to explore the link between CM and PDs, and to examine the mediating effect of personality dimensions in the pathway from CM to PDs in 150 participants (75 in each country). The 28-item Childhood Trauma Questionnaire, the International Personality Item Pool, and the Personality Diagnostic Questionnaire (PDQ-4+) were used to assess CM, personality dimensions, and PDs respectively. Togolese participants reported sexual and physical abuse (PA) and emotional and physical neglect significantly more frequently than French participants. In Togo, severe PA was associated with schizoid, antisocial, narcissistic, obsessive-compulsive, depressive, and negativist PDs whereas in France, PA was only linked to paranoid PD. In Togo, emotional instability partly mediated the relationship between CM and PDs while in France, no personality dimension appeared to mediate this link. Our results support the hypothesis that CM is more common in low-income countries and suggest that the links between CM and PDs are influenced by social environment.
Bile duct injuries following laparoscopic cholecystectomy
Authors: Viste A. , Horn A. , Øvrebø K. , Christensen B. , Angelsen J.-H. , Hoem D. 
Published: February 2015

Introduction: Bile duct injuries occur rarely but are among the most dreadful complications following cholecystectomies. Methods: Prospective registration of bile duct injuries occurring in the period 1992–2013 at a tertiary referral hospital. Results: In total, 67 patients (47 women and 20 men) with a median age of 55 (range 14–86) years had a leak or a lesion of the bile ducts during the study period. Total incidence of postoperative bile leaks or bile duct injuries was 0.9% and for bile duct injuries separately, 0.4%. Median delay from injury to repair was 5 days (range 0–68 days). In 12 patients (18%), the injury was discovered intraoperatively. Bile leak was the major symptom in 59%, and 52% had a leak from the cystic duct or from assumed aberrant ducts in the liver bed of the gall bladder. Following the Clavien–Dindo classification, 39% and 45% were classified as IIIa and IIIb, respectively, 10% as IV, and 6% as V. In all, 31 patients had injuries to the common bile duct or hepatic ducts, and in these patients, 71% were treated with a hepaticojejunostomy. Of patients treated with a hepaticojejunostomy, 56% had an uncomplicated event, whereas 14% later on developed a stricture. Out of 36 patients with injuries to the cystic duct/aberrant ducts, 30 could be treated with stents or sphincterotomies and percutaneous drainage. Conclusion: Half of injuries following cholecystectomies are related to the cystic duct, and most of these can be treated with endoscopic or percutaneous procedures. A considerable number of patients following hepaticojejunostomy will later on develop a stricture.
The Impact of Facility Improvements on Hospital Nurses
Authors: Berry Leonard L. , Parish Janet T. 
Published: February 2015

Objectives: The primary purpose of the research was to assess differences in nurses' perceptions of their job, hospital, and building features following the opening of a new hospital wing. Secondary purposes included assessing the impact on nurses left behind in the existing facility after the new wing opened and considering ways that nurses could more effectively contribute to facility design decisions that directly affect them. Background: Research related to the design of healthcare facilities is growing, yet studies of the impact of facility features on hospital staff is far less common than studies of the impact on patients. Methods: Survey data were collected from a hospital's nurses six months before (N=235) and six months after (N=238) some of the nurses (N=65) moved to a new wing. Response rates were 49% and 55% for rounds 1 and 2, respectively. A test study also was conducted two months post-move (N=206) to enable assessment of a novelty effect. Focus groups also were conducted following the completion of round 2 data collection. Results: Significant differences were found between the round 1 and 2 samples for quality of patient rooms, safety, pleasantness, quality of workspace, job stress, job satisfaction, and service quality. Findings from the test study held up in round 2. Conclusion: The design of the hospital impacts nurses and may impact their job satisfaction and stress, even the decision whether or not to remain a hospital nurse. A well-designed hospital is not only important to patients; it also is important to those who serve them.
Relationships between Exterior Views and Nurse Stress: An Exploratory Examination
Authors: Pati Debajyoti , Harvey Tom E. , Barach Paul 
Published: February 2015

Objective: Examine the relationships between acute stress and alertness of nurse, and duration and content of exterior views from nurse work areas. Background: Nursing is a stressful job, and the impacts of stress on performance are well documented. Nursing stress, however, has been typically addressed through operational interventions, although the ability of the physical environment to modulate stress in humans is well known. This study explores the outcomes of exposure to exterior views from nurse work areas. Methods: A survey-based method was used to collect data on acute stress, chronic stress, and alertness of nurses before and after 12-hour shifts. Control measures included physical environment stressors (that is, lighting, noise, thermal, and ergonomic), organizational stressors, workload, and personal characteristics (that is, age, experience, and income). Data were collected from 32 nurses on 19 different units at two hospitals (part of Children's Healthcare of Atlanta) in November 2006. Results: Among the variables considered in the study view duration is the second most influential factor affecting alertness and acute stress. The association between view duration and alertness and stress is conditional on the exterior view content (that is, nature view, non-nature view). Of all the nurses whose alertness level remained the same or improved, almost 60% had exposure to exterior and nature view. In contrast, of all nurses whose alertness levels deteriorated, 67% were exposed to no view or to only non-nature view. Similarly, of all nurses whose acute stress condition remained the same or reduced, 64% had exposure to views (71% of that 64% were exposed to a nature view). Of nurses whose acute stress levels increased, 56% had no view or only a non-nature view. Conclusions: Although long working hours, overtime, and sleep deprivation are problems in healthcare operations, the physical design of units is only now beginning to be considered seriously in evaluating patient outcomes. Access to a nature view and natural light for care-giving staff could bear direct as well as indirect effects on patient outcomes.
Facing the Challenge of Patient Transfers: Using Ceiling Lifts in Healthcare Facilities
Authors: Vieira Edgar Ramos , Miller Linda 
Published: February 2015

Objective: The objective was to review the literature on the use of ceiling lifts to perform patient transfers in healthcare settings. Background: Manual patient transfers present a high risk of injury. Ceiling lifts are increasingly used in healthcare facilities. Despite this, little is known about the effects of this new technology. Methods: Research and review articles were searched on five databases using specific key words and phrases. Literature citations in the articles and gray literature (e.g., technical reports, conference proceedings, magazine articles, Web sites) were also evaluated when relevant for this review. Experts in this area were contacted regarding information on the topic, potential literature, and for their suggestions. Results: Few studies evaluated the use of ceiling lifts in healthcare. The studies available and the experiences of the experts contacted support the use of ceiling lifts. The musculoskeletal safety of healthcare workers and patients can be improved by the use of ceiling lifts. Having lifts available, organizing the workflow, and reducing the steps required during transfers and handling tasks can significantly lessen the risk of musculoskeletal injuries. Conclusions: Evidence supports the installation of ceiling lifts in patient rooms and recommends their use in bathrooms. However, additional studies are needed because the use of ceiling lifts in healthcare is relatively new.
Integrating Electronic Health Records in the Physical Environment: A Systems Approach
Authors: Rich Carrie R. , Day Tama Duffy 
Published: February 2015

Electronic health records (EHRs) are the future of the healthcare industry; however, insufficient attention is paid to where and how the hardware systems that support EHR software are integrated in the existing environment. The physical implementation of EHRs is an underlying component of the technology program that may pose barriers and/or gateways to EHR adoption in terms of patient safety and satisfaction, clinical usability of the EHR system, cultural acceptance, and organizational workflow. After confirming that environmental interventions are most effective when coupled with cultural programs, this article asserts that hardware is a necessary complement to EHR software implementation if usage is to progress strategically and ergonomically. This article then seeks to explain how, based on evidence-based design (EBD) decisions, the built environment that supports EHR software can enhance or hinder communication. The findings of this paper posit that when EHR hardware is designed ergonomically and with provider-patient communication at the forefront of point-of-care services, EHR usage in the healthcare environment can improve the quality of health services delivery. This article is the result of a literature review, case studies, academic lectures, healthcare informatics webinars, and discussions with architects, interior design professionals, and corporate EHR leaders.
Mock-Ups as “Interactive Laboratories”: Mixed Methods Research Using Inpatient Unit Room Mock-Ups
Authors: Watkins Nicholas , Myers Donald , Villasante Ronald 
Published: February 2015

Objective: To establish evidence-based design (EBD) guidelines for inpatient rooms at Department of Veterans Affairs (VA) facilities. Background: Simulation allows clients, designers, and researchers to visualize how users might interact with a proposed design before actual construction of the design. This study used mock-ups as a simulation technique during a study of the VA inpatient room standards. The participants used the inpatient room mock-ups as “interactive laboratory” environments to maximize opportunities for participatory design, qualitative research, and quantitative research of project-specific EBD solutions. Methods: The research used questionnaires, scenarios, on-demand modifications, and observations to evaluate and confirm EBD solutions for inpatient room mock-ups. A total of 71 participants responded to a questionnaire administered across five mock-up work sessions. These 71 participants consisted of administrators, nurses, physicians, support staff, environment and maintenance staff, and patient and staff safety representatives from throughout the VA healthcare system. Results and Discussion: EBD solutions were tested, evaluated, and modified for each inpatient room type and were applicable to two or more of the inpatient room types. The latter included the location of patient beds and standard headwall position, technology and spaces for nurse charting activities, clearances (e.g., equipment, wheelchair, and bariatric patient), universal rooms, and patient and family amenities. Also, EBD solutions were tested, validated, and modified to the needs of each inpatient room. Conclusion: The mock-ups allowed researchers and designers to evaluate and confirm EBD solutions and strategies for the development of VA inpatient room standards. When used as a means for mixed-methods research, mock-ups can successfully integrate research and design during project-related work. EBD research using mock-ups not only addresses project- or organization-specific concerns, but it may contribute to the knowledge base of the healthcare design community.
Environmental Issues Related to Medication Errors in Long-Term Care: Lessons from the Literature
Authors: Mahmood Atiya , Chaudhury Habib , Gaumont Alana 
Published: February 2015

Objective: Medication errors contribute significantly to patient morbidity and mortality and are associated with a considerable cost to the healthcare system. The purpose of this study was to conduct a review and synthesis of the literature on the effect of physical and organizational aspects of the environment on medication and nursing errors in long-term care environments. Methods: Extensive database searches were conducted for relevant publications. In total, 46 empirical and 19 nonempirical (descriptive and conceptual) journal articles, books, book chapters, and reports were analyzed. Results: Environmental variables related to medication and nursing errors are: lighting/illumination, noise, inefficient layout or use of space, disorganized medication storage or administration areas, look-alike or sound-alike drugs, and equipment. Conclusions: A supportive physical environment is important to reduce factors that may directly or indirectly contribute to errors. Both physical and organizational environments need to be addressed for an effective intervention to reduce medication and nursing errors.
Pediatric Art Preferences: Countering the “One-Size-Fits-All” Approach
Authors: Nanda Upali , Chanaud Cheryl M. , Brawn Linda , Hart Robyn , Hathorn Kathy 
Published: February 2015

Objective: To determine the stated art preferences of pediatric patients through an art survey and determine whether preferences vary, with different age groups associated with different stages of cognitive development. Background: Exposure to visual art has been shown to have an impact on improved health and satisfaction outcomes. However, there is little literature on the effect of art on pediatric patients. While designing pediatric wards, a common assumption is to use fantasy and Disney-like themes; but research across all age groups on whether children prefer these themes is limited. Methodology: A survey including 20 images with a variety of subject matter and styles was administered to 64 pediatric inpatients (ages 5–17) at Memorial Hermann Hospital in Houston, TX. Children were asked to rate the selection of, and their emotional response to, the images in the survey. Qualitative comments were recorded. Results were analyzed for each of the three age groups (5–6, 7–10, and 11–17 years) according to Piaget's developmental stages, as well as across all age groups. Results: There were significant differences in art preferences across the different age groups, especially with respect to child art (art created by children). Overall, the results for 5–10-year-olds were more significant than those for 11–17-year-olds (adolescents). Nature elements were preferred across all age groups, but all nature images were not rated similarly. Images that were bright and colorful were rated better than images that were pale. The presence of a strong context that children could associate with was a defining feature of preferred images. Content drove preference more than style, though color was a key determinant. Comments on the artwork tended to be more objective/absolute for the youngest patients and more subjective/relative for the oldest. Conclusions: The combination of bright colors, engaging themes, and nature content is consistently highly rated by pediatric patients. However, pediatric preferences vary significantly among the three operational stages, so one should be careful before using the “one-size-fits-all” approach. Child art, typically used in pediatric wards, is better suited for younger children than for older children.
Private Investment in Hospitals: A Comparison of Three Healthcare Systems and Possible Implications for Real Estate Strategies
Authors: van der Zwart Johan , van der Voordt Theo , de Jonge Hans 
Published: February 2015

Objectives: This article explores lessons to be learned from three different healthcare systems and the possible implications for the management of healthcare real estate, in particular in connection to the Dutch system. It discusses similarities and differences among the different systems, in search of possible consequences on cost, financing, and design innovation. Background: To keep healthcare affordable in the future, the Dutch government is currently in the process of changing legislation to move from a centrally directed system to a so-called regulated market system. The deregulation of real estate investment that accompanies the new healthcare delivery system offers healthcare organizations new opportunities, but also more responsibility and greater risk in return on investment. Consequently, healthcare organizations must find new methods of financing. Private investment is one of the options. Methods: Three healthcare systems were analyzed on the basis of a literature review and document analysis, then schematized to show similarities and dissimilarities with regard to private investment in hospitals. Observations are based on a selection of recently published articles on private-sector financing and its implications for healthcare real estate decision making in the Netherlands, the United Kingdom, and Germany. Results: The strengths and weaknesses of three healthcare systems with differing proportions of private and public investment in hospitals were explored. Research revealed a gap between intended effects and actual effects with regard to quality and cost. Costly private finance does not necessarily lead to “value for money.” Transferring real estate decisions to private investors decreases the influence of the healthcare organization on future costs and quality. Conclusions: The three healthcare systems show substantial differences between public and private responsibilities. Less governmental involvement affords both opportunities and risks for hospitals. Private investment may lead to innovation, improved efficiency, and cost reduction, provided that the costs and benefits of decisions are not separated between different stakeholders. A missing link between infrastructure provision and healthcare delivery may impede design innovation and optimal adaptation to work processes and could lead to an inefficient allocation of risks and benefits.
Hospital Room Design and Health Outcomes of the Aging Adult
Authors: Lorenz Susan Garzon , Dreher H. Michael 
Published: February 2015

Objective: To determine differences in the rate of falls, healthcare-acquired infections (HAIs), and the degree of social isolation in hospitalized older adults admitted to private versus semiprivate rooms. Background: The American Institute of Architects recommends that private rooms become the industry standard for all new construction of acute care hospitals. Healthcare design researchers contend that private rooms decrease infection, facilitate healthcare workers' efficiency, provide space for families, and afford greater access to privacy. Although links between room type and health outcomes have been described in the literature, the actual relationship between these two variables has not been determined, nor is it clear whether a one-size-fits-all approach to hospital design is appropriate for all patient populations, particularly older adults. Methods: This retrospective case comparative design utilized a sample of patients admitted to the University Medical Center of Princeton in 2006 and received full internal review board approval. Patient records were randomly selected through the admission/discharge/transfer system of the hospital and then divided into two groups based on room type. Data collected included demographics, incidence of falls, HAIs, and risk of social isolation. Results: All patients were more than 65 years old and had been admitted to the hospital for a variety of diagnoses. Length of stay was between 3 and 10 days. There was no significant difference between the type of room and the likelihood of falling ( p = .37), however the relative risk of falling in a private room was 4.01. There was no significant difference in the occurrence of HAIs based on room type ( p = 1.0). The risk-of-social-isolation variable was unable to significantly affect which hospitalized older adults would suffer a negative outcome, fall, or HAI ( p = .52). Conclusion: Room type may play a role in the occurrence of falls in hospitalized older adults, but room type alone does not increase the chance of acquiring an infection in the hospital. Nor does the risk of social isolation affect the likelihood of an adverse outcome.