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Calzari S, Villa M, Mauro S, Mirto V, Bulloni P, Zini P, Deelen P, Grassellini PR, Bernasconi S, Cassina T. The intensive care unit diary as a valuable care tool: A qualitative study of patients' experiences. Intensive Crit Care Nurs 2024; 80:103558. [PMID: 37826962 DOI: 10.1016/j.iccn.2023.103558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/18/2023] [Accepted: 09/22/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVES The aim is to learn about patients' experience of reading the diary, assess attributed meaning and explore patients' experience and memories during their stay in the intensive care unit. SETTING Eleven patients who received the diary after a stay in a nine-bed cardiac intensive care unit in Southern Switzerland, from November 2019 to October 2021. MAIN OUTCOME MEASURES Descriptive qualitative research was performed using semi-structured interviews, followed by thematic analysis. Three research nurses conducted individual telephone or face-to-face interviews. FINDINGS Fifteen sub-themes emerged from the data interviews and were grouped into five main categories: a) the experience in the intensive care unit; b) Post Intensive Care Syndrome symptoms; c) the patient diary; d) new meaning of life; and e) sharing. Patients showed difficulties in remembering and understanding what happened during the hospitalization period. Reading the diary enabled them to understand the impact that the illness had on their daily experience. For some of them, reading the diary was helpful in reacting positively during moments of discouragement. CONCLUSION Qualitative approach allowed us to assess how patients perceive the diary in the intensive care unit in a cultural context of Central and Southern Europe, which is still poorly investigated. The diary responded to the person's need to know what happened during a period that they had no memory of. Its use demonstrated important benefits, allowing people to understand the impact that the illness had on everyday life. It allowed them to relate to the difficulties encountered during the healing process. Thus, the diary played an important role during the healing process. IMPLICATIONS FOR CLINICAL PRACTICE The diary was appreciated by patients during all stages of recovery from severe and acute illness. Gaps within the narration were avoided, in order to provide patients with a better timeline of the events occurred during the time they were unconscious.
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Affiliation(s)
- Sergio Calzari
- Department of Intensive Care, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Michele Villa
- Department of Intensive Care, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland.
| | - Stefania Mauro
- Department of Intensive Care, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Valentina Mirto
- Urgent Care Department, Intensive Care Unit, Royal Berkshire NHS Foundation Trust, Reading, United Kingdom
| | - Patrizia Bulloni
- Department of Intensive Care, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Piergiorgio Zini
- Department of Intensive Care, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Paula Deelen
- Department of Intensive Care, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Paola Rusca Grassellini
- Department of Intensive Care, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Stefano Bernasconi
- Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Tiziano Cassina
- Department of Intensive Care, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland
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Qi Y, Lepe A, Almansa J, Ots P, de Kroon ML, Vrooman JC, Reijneveld SA, Brouwer S, Deelen P, Lanting P, Vonk JM, Nolte I, Ori AP, Claringbould A, Boulogne F, Dijkema MX, Wiersma HH, Warmerdam R, Jankipersadsing SA, Vrooman JC, Reijneveld SA, Brouwer S. Increases in symptoms of depression and anxiety in adults during the initial phases of the COVID-19 pandemic are limited to those with less resources: Results from the Lifelines Cohort Study. J Psychiatr Res 2022; 154:151-158. [PMID: 35940000 PMCID: PMC9286758 DOI: 10.1016/j.jpsychires.2022.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 05/30/2022] [Accepted: 07/01/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND The COVID-19 pandemic may have a differential impact on mental health based on an individual's capital, i.e. resources available to maintain and enhance health. We assessed trajectories of depression and anxiety symptoms, and their association with different elements of capital. METHODS Data on 65,854 individuals (mean baseline age = 50·4 (SD = 12·0) years) from the Lifelines COVID-19 cohort were used. Baseline mental health symptoms were on average measured 4.7 (SD = 1·1) years before the first COVID-19 measurement wave, and subsequent waves were (bi)weekly (March 30─August 05, 2020). Mental health symptom trajectories were estimated using a two-part Latent Class Growth Analysis. Class membership was predicted by economic (education, income, and occupation) and person capital (neuroticism, poor health condition, and obesity) FINDINGS: Most individuals were unlikely to report symptoms of depression (80·6%) or anxiety (75·9%), but stable-high classes were identified for both conditions (1·6% and 6·7%, respectively). The stable-high depression class saw the greatest increase in symptoms after COVID, and the stable-high anxiety class reported an increase in the probability of reporting symptoms after COVID. At the first COVID-measurement, the mean number of symptoms increased compared to baseline (depression:4·7 vs 4·1; anxiety:4·3 vs 4·2); the probability of reporting symptoms also increased (depression:0·96 vs 0·65; anxiety:0·92 vs 0·70). Membership in these classes was generally predicted by less capital, especially person capital; odds ratios for person capital ranged from 1·10-2·22 for depression and 1·08-1·51 for anxiety. INTERPRETATION A minority of individuals, possessing less capital, reported an increase in symptoms of depression or anxiety after COVID. FUNDING This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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Affiliation(s)
- Yuwei Qi
- University Medical Center Groningen, University of Groningen, Department of Health Sciences, Groningen, the Netherlands.
| | - Alexander Lepe
- University Medical Center Groningen, University of Groningen, Department of Health Sciences, Groningen, the Netherlands
| | - Josué Almansa
- University Medical Center Groningen, University of Groningen, Department of Health Sciences, Groningen, the Netherlands
| | - Patricia Ots
- University Medical Center Groningen, University of Groningen, Department of Health Sciences, Groningen, the Netherlands
| | - Marlou L.A. de Kroon
- University Medical Center Groningen, University of Groningen, Department of Health Sciences, Groningen, the Netherlands
| | - Lifelines Corona Research InitiativeBoezenH.M.cMierauJ.O.deFrankeH.L.fDekensJ.fgDeelenP.fLantingPaulinefVonkJudith M.fNolteIljacOriAnil P.S.fhClaringbouldAnniquefBoulogneFlorannefDijkemaMarjolein X.L.fWiersmaHenry H.fWarmerdamRobertfJankipersadsingSoesma A.fDepartment of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the NetherlandsFaculty of Economics and Business, University of Groningen, Groningen, the NetherlandsAletta Jacobs School of Public Health, Groningen, the NetherlandsDepartment of Genetics, University of Groningen, University Medical Center Groningen, Groningen, the NetherlandsCenter of Development and Innovation, University of Groningen, University Medical Center Groningen, Groningen, the NetherlandsDepartment of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - J. Cok Vrooman
- Department of Sociology/ICS, Utrecht University, Netherlands Institute for Social Research, the Netherlands
| | - Sijmen A. Reijneveld
- University Medical Center Groningen, University of Groningen, Department of Health Sciences, Groningen, the Netherlands
| | - Sandra Brouwer
- University Medical Center Groningen, University of Groningen, Department of Health Sciences, Groningen, the Netherlands
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Sansalone A, Vicari R, Orlando F, Dell'Avo A, Giuffrida S, Deelen P, Bernasconi S, Villa M. Needle-free connectors to prevent central venous catheter occlusion at a tertiary cardiac center: A prospective before and after intervention study. J Vasc Access 2021; 24:475-482. [PMID: 34396802 DOI: 10.1177/11297298211039653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To evaluate the effectiveness of needle-free connectors to maintain Central Venous Catheter-CVC patency. BACKGROUND Loss of patency is a common complication associated with CVC. For patients, this can be stressful and painful, and can result in a delay in infusion therapy. Pressure-activated anti-reflux needle-free connectors are one of the most modern devices; however, no studies have compared this connector with the open-system three-way stopcock in terms of the incidence of CVC occlusion. METHODS This study is a prospective before and after intervention study. From March to August 2018, an observation phase was conducted with the three-way stopcock as the standard central venous catheter hub and closure system (phase 1). After implementation of needle-free connectors (phase 2), post-intervention observations were made from September 2019 to January 2020 (phase 3). RESULTS Of 199 CVCs analyzed, 41.2% (40/97) occluded in at least one lumen in the first phase, and 13.7% (14/102) occluded after introducing the technological device, absolute risk reduction 27.5% (95% confidence interval 15.6%-39.4%). The lumens supported by needle-free connectors showed a higher probability of maintaining patency compared with three-way stopcocks. No differences were observed in the rate of infection. CONCLUSIONS Pressure-activated anti-reflux needle-free connectors are effective and safe devices suitable for the management of vascular access in cardiac patient care. Staff training, even on apparently simple devices, is essential to avoid the risk of infection.
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Affiliation(s)
- Andrea Sansalone
- Department of Cardiology and Cardiac Surgery, Cardiocentro Ticino, Lugano, Switzerland
| | - Raffaello Vicari
- Department of Cardiology and Cardiac Surgery, Cardiocentro Ticino, Lugano, Switzerland
| | - Fabio Orlando
- Department of Cardiology and Cardiac Surgery, Cardiocentro Ticino, Lugano, Switzerland
| | - Alessandro Dell'Avo
- Department of Cardiology and Cardiac Surgery, Cardiocentro Ticino, Lugano, Switzerland
| | - Silvia Giuffrida
- Department of Cardiology and Cardiac Surgery, Cardiocentro Ticino, Lugano, Switzerland
| | - Paula Deelen
- Department of Cardiovascular Anesthesia and Intensive Care, Cardiocentro Ticino, Lugano, Switzerland
| | - Stefano Bernasconi
- Department of Cardiology and Cardiac Surgery, Cardiocentro Ticino, Lugano, Switzerland.,Department of Cardiovascular Anesthesia and Intensive Care, Cardiocentro Ticino, Lugano, Switzerland
| | - Michele Villa
- Department of Cardiovascular Anesthesia and Intensive Care, Cardiocentro Ticino, Lugano, Switzerland
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Boulogne F, CLAUS L, Wiersma H, Schukking F, de Klein N, Li S, Westra H, Genomics England Research Consortium U, Deelen P, Knoers N, van Eerde A, Franke L. POS-421 KIDNEYNETWORK: A NEW METHOD TO PREDICT KIDNEY DISEASE GENES USING KIDNEY DERIVED GENE EXPRESSION DATA IDENTIFIES A NEW CANDIDATE GENE FOR MILD ADPKD / PCLD. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Szperl AM, Ricaño-Ponce I, Li JK, Deelen P, Kanterakis A, Plagnol V, van Dijk F, Westra HJ, Trynka G, Mulder CJ, Swertz M, Wijmenga C, Zheng HCH. Exome sequencing in a family segregating for celiac disease. Clin Genet 2011; 80:138-47. [PMID: 21627641 DOI: 10.1111/j.1399-0004.2011.01714.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Celiac disease is a multifactorial disorder caused by an unknown number of genetic factors interacting with an environmental factor. Hence, most patients are singletons and large families segregating with celiac disease are rare. We report on a three-generation family with six patients in which the inheritance pattern is consistent with an autosomal dominant model. To date, 27 loci explain up to 40% of the heritable disease risk. We hypothesized that part of the missing heritability is because of low frequency or rare variants. Such causal variants could be more prominent in multigeneration families where private mutations might co-segregate with the disease. They can be identified by linkage analysis combined with whole exome sequencing. We found three linkage regions on 4q32.3-4q33, 8q24.13-8q24.21 and 10q23.1-10q23.32 that segregate with celiac disease in this family. We performed exome sequencing on two affected individuals to investigate the positional candidate regions and the remaining exome for causal nonsense variants. We identified 12 nonsense mutations with a low frequency (minor allele frequency <10%) present in both individuals, but none mapped to the linkage regions. Two variants in the CSAG1 and KRT37 genes were present in all six affected individuals. Two nonsense variants in the MADD and GBGT1 genes were also present in 5 of 6 and 4 of 6 individuals, respectively; future studies should determine if any of these nonsense variants is causally related to celiac disease.
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Affiliation(s)
- A M Szperl
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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