Publish in OALib Journal

ISSN: 2333-9721

APC: Only $99


Any time

2020 ( 4 )

2019 ( 41 )

2018 ( 141 )

2017 ( 169 )

Custom range...

Search Results: 1 - 10 of 7094 matches for " patient delay "
All listed articles are free for downloading (OA Articles)
Page 1 /7094
Display every page Item
Diagnosis delay of breast cancer and its associated factors in Malaysian women
Bachok Norsa'adah, Krishna G Rampal, Mohd A Rahmah, Nyi N Naing, Biswa M Biswal
BMC Cancer , 2011, DOI: 10.1186/1471-2407-11-141
Abstract: This study had a cross-sectional design. Respondents had histologically confirmed breast cancer and were registered at five medical centres between 2005 and 2007. All breast cancer patients who attended hospital clinics at the East Coast were included. Patients at Kuala Lumpur hospitals were selected by systematic sampling. A standardised questionnaire was developed to interview respondents. We measured the time from the first recognition of symptoms to the first general practitioners' consultation and to the histological diagnosis of breast cancer. Diagnosis delay was defined when there was more than 6 months from the recognition of symptoms to the histological diagnosis. Multiple logistic regression was used for analysis.In total, 328 respondents were included. The mean (standard deviation) age was 47.9 (9.4) years. Most respondents were of Malay ethnicity, were married housewives with a median family income of RM1500 a month. Most respondents had ductal carcinoma (89.3%) and the stage distribution was as follows: 5.2% stage I, 38.7% stage II, 44.8% stage III and 11.3% stage IV. The median time to consultation was 2 months and the median time to diagnosis was 5.5 months. The frequency of diagnosis delay of more than 3 months was 72.6% and delay of more than 6 months occurred in 45.5% of the cases. The factors associated with diagnosis delay included the use of alternative therapy (odds ratio (OR) 1.77; 95% confidence interval (CI): 1.06, 2.94), breast ulcer (OR 5.71; 95% CI: 1.59, 20.47), palpable axillary lymph nodes (OR 2.19; 95% CI: 1.23, 3.90), false-negative diagnostic test (OR 5.32; 95% CI: 2.32, 12.21), non-cancer interpretation (OR 1.68; 95% CI: 1.01, 2.78) and negative attitude toward treatment (OR 2.09; 95% CI: 1.15, 3.82).Delays in consultation and diagnosis are serious problems in Malaysia. Diagnosis delay was influenced by complex interactions between many factors. Breast awareness and education are required to promote early detection, diagnosis and t
Patient and health service delay in the diagnosis of pulmonary tuberculosis in Ethiopia
Meaza Demissie, Bernt Lindtjorn, Yemane Berhane
BMC Public Health , 2002, DOI: 10.1186/1471-2458-2-23
Abstract: A cross sectional survey that included all the public health centres was conducted in Addis Ababa from August 1 to December 31 1998. Patients were interviewed on the same day of diagnosis using structured questionnaire.700 pulmonary TB patients were studied. The median patient delay was 60 days and mean 78.2 days. There was no significant difference in socio-demographic factors in those who delayed and came earlier among smear positives. However, there was a significant difference in distance from home to health institute and knowledge about TB treatment among the smear negatives. The health service delay was low (median 6 days; mean 9.5 days) delay was significantly lower in smear positives compared to smear negatives. Longer health service delay (delay more than 15 days) was associated with far distance.The time before diagnosis in TB patients was long and appears to be associated with patient inadequate knowledge of TB treatment and distance to the health centre. Further decentralization of TB services, the use of some components of active case finding, and raising public awareness of the disease to increase service utilization are recommended.Early diagnosis of the disease and prompt initiation of treatment is essential for an effective tuberculosis control programme. Delay in the diagnosis may worsen the disease, increase the risk of death and enhance tuberculosis transmission in the community [1]. Patients' alertness to tuberculosis symptoms combined with health workers' readiness to diagnose the disease are important factors to control the spread of the infection in a community [1].In developing countries, emphasis is laid on passive case finding and diagnosing infectious cases of tuberculosis mainly through direct microscopy of sputum specimens obtained from persons who present themselves to the health services [2]. This, however, is known to be influenced by a set of factors such as patient motivation, degree of diagnostic suspicion by health workers and qu
Delay in Breast Cancer: Implications for Stage at Diagnosis and Survival
Lee Caplan
Frontiers in Public Health , 2014, DOI: 10.3389/fpubh.2014.00087
Abstract: Breast cancer continues to be a disease with tremendous public health significance. Primary prevention of breast cancer is still not available, so efforts to promote early detection continue to be the major focus in fighting breast cancer. Since early detection is associated with decreased mortality, one would think that it is important to minimize delays in detection and diagnosis. There are two major types of delay. Patient delay is delay in seeking medical attention after self-discovering a potential breast cancer symptom. System delay is delay within the health care system in getting appointments, scheduling diagnostic tests, receiving a definitive diagnosis, and initiating therapy. Earlier studies of the consequences of delay on prognosis tended to show that increased delay is associated with more advanced stage cancers at diagnosis, thus resulting in poorer chances for survival. More recent studies have had mixed results, with some studies showing increased survival with longer delays. One hypothesis is that diagnostic difficulties could perhaps account for this survival paradox. A rapidly growing lump may suggest cancer to both doctors and patients, while a slow growing lump or other symptoms could be less obvious to them. If this is the case, then the shorter delays would be seen with the more aggressive tumors for which the prognosis is worse leading to reduced survival. It seems logical that a tumor that is more advanced at diagnosis would lead to shorter survival but the several counter-intuitive studies in this review show that it is dangerous to make assumptions.
Delay in referring and related factors in patients with advanced breast cancer - Emam Hospital (2000)
"Ghaem Maghami F,Harirchi I,Moghimi R,Mazaheri H "
Tehran University Medical Journal , 2002,
Abstract: Background: The aim of study was to determine the frequency of delay referring and related factors in patients with advanced breast cancer, in Imam Khomeini Hospital in the 2000. Materials and Methods: Successively 200 patients were entered the study if they were consentient. A questionnaire was constructed and information was obtained through interviewing. Results: From the cases, 64 patients (32 percent) referred without delay and 136 patients (68 percent) referred tardily. The patients who were late in comparison with patients who didn’t late, had significantly higher mean age (P=0.004), lower education level (P=0.002), and lower economic status (P=0.001). The frequency rate of single were lower among them (P=0.001), fewer percent were residual of big cities (P=0.01) and they had less rate of available physician (P=0.004). 24.3 percent of delay referring patients and 53.1 percent of patients without delay has a positive family history of breast cancer (P=0.001). 62.5 percent of delay referring patients and 85 percent of patients without delay were aware about importance of Self Breast Examination (S.B.E) (P=0.002) and respectively 84.4 percent and 98.4 percent were award about symptoms of breast cancer (P=0.01). 23.5 percent and 33 percent of patients with and without delay Knew the method of B.S.E respectively. It wasn’t a significant difference. Conclusion: Lack of awareness about necessity of medical consultation, fear, carelessly, unavailable physician and poverty were the major causes of delay in patients who referred late.
Does diagnostic delay of colorectal cancer result in malpractice claims? A retrospective analysis of the Swedish board of malpractice from 1995–2008
Larsolof Hafstr?m, Henry Johansson, Jon Ahlberg
Patient Safety in Surgery , 2012, DOI: 10.1186/1754-9493-6-13
Abstract: Between January 1, 1995 and December 31, 2008, a total of 80 patients filed claims for negative effects resulting from delays in the diagnosis of CRC. Review of the claims led to identification of delay for 62 patients. The clinical symptoms that were overlooked and other causes of delay that had any relation to therapy, prognosis and economic compensation were evaluated.The median delay in the diagnosis of CRC was six months. This delay was considered to have had an impact on the therapy in 20?% of the cases. The prognosis was postulated to have been adversely affected for 15?% of the patients. The delay was mainly caused by incomplete consideration of the symptoms hematoschisis or anaemia, changed bowel routine, or incomplete clinical or radiological examination and by misinterpretations of the results. No impact of duration of delay on survival was identified. The importance of identifying concomitant metastatic disease at diagnosis was overwhelming. Economic compensation was given in 79?% of the cases.This study found that claims for compensation for delay in diagnosis of CRC are rare. The delay in the diagnosis of the primary tumour was considered to have had an impact on the magnitude of therapeutic measures for a fifth of the patients who filed claims. Economic compensation for the patients′ injuries was given in almost 80?% of the cases.
Study on the Patient Delay among Oral Cancer Patients.

冯雪峰, 黄海涛, 王如
FENG Xue-feng
, HUANG Hai-tao, WANG Ru. The First Affiliated Hospital of Dalian Medical University, Dalian , China

- , 2016, DOI: 10.13701/j.cnki.kqyxyj.2016.07.013
Abstract: 摘要 目的: 探讨口腔癌患者就医延迟现状及其主要影响因素。方法: 采用口腔癌患者一般资料调查表、汉密尔顿焦虑及抑郁量表、就医情况问卷和家庭支持量表对72例口腔癌患者进行调查。结果: 口腔癌患者就医延迟发生率为48.5%;时间最短2 d,最长5年余,中位时间为120 d;就医延迟患者在居住状况、自觉疾病严重程度、焦虑及家庭支持与未延迟患者比较,其差异有统计学意义。结论: 口腔癌患者就医延迟现象较为普遍,且居住状况、自觉疾病严重程度、焦虑及家庭支持均为影响口腔癌患者就医延迟的主要因素
Evaluation of the Quality of Life in newly Recognized Cancer Patients
Tabari F,?Zakeri Moghadam M,?Bahrani N,?Monjamed Z
Hayat Journal of Faculty of Nursing & Midwifery , 2007,
Abstract: Background & Objective: The chronic diseases such as cancer could seriously affect health and consequently quality of life of individuals. The purpose of this study is to evaluate the quality of life in the patients who have been recently diagnosed with caner."nMethods & Materials: This research is a descriptive - analytical study aims to determine quality of life in newly diagnosed cancer patients in selected oncology clinics of Tehran University of Medical Sciences. In this research, 196 newly diagnosed cancer patients were selected by simple sampling method and based on aim. The data were collected by a questionnaire including demographic data, disease characteristic and questions about quality of life in physical, physiological and socioeconomic aspects. The socioeconomic questionnaire presented to the patients after his/ her permission and giving necessary descriptions to him/ her about the objectives of the research. The questions were read for illiterate patients by researcher. The SPSS program was used for data analysis. Descriptive statistics such as absolute/ relative and average sufficiency and deductive statistics such as 2 test were used as well."nResults: The research results show that the quality of life in physical aspect is desirable in majority (67/9%) of patients. The quality of life in physiological aspect is desirable in majority (63.3%) of patients and as well the quality of life in socioeconomic aspect is desirable in majority (76.5%) of patients. The research conclusion shows that there is a meaningful relationship between number of children and economic status (P<0.001) and quality of life in physical aspect. There is a meaningful relationship between economic status with quality of life in psychological aspect and with quality of life in socioeconomic aspect (P<0.05). There is a meaningful relationship between type of cancer, disease stage at the time of diagnosis (P<0.001), and quality of life in physical aspect. There is a meaningful relationship between disease stage (P=0.002), and quality of life in psychological aspect and quality of life in socioeconomic aspect (P<0.05)."nConclusion: The research result shows that the quality of life in physical, psychological and socioeconomic aspects is desirable in the society. Thus the nurses can play an important role in increasing the quality of life of such patients.
Views and Experience on Patient Engagement in Healthcare Professionals and Patients—How Are They Different?  [PDF]
Eliza L. Y. Wong, Siufai Lui, Annie W. L. Cheung, Carrie H. K. Yam, Nicole F. Huang, Wilson W. S. Tam, Engkiong Yeoh
Open Journal of Nursing (OJN) , 2017, DOI: 10.4236/ojn.2017.76046
Abstract: A patient-centered approach is used to build a therapeutic alliance between patients and the healthcare professionals in care process which should be supported by a good engagement of both parties. The study aimed to explore the gap between healthcare professionals and patients on patient engagement in hospital. It was a cross-sectional survey. 2774 doctors and nurses from Department of Medicine of public hospitals completed the self-administered questionnaire and 1042 patients discharged from corresponding wards completed the telephone interviews. Participants were interviewed using structural questionnaires. The Mann-Whitney test or Pearson’s chi-square test was used to analyze the agreement between health-care professionals and patients on the views and experiences of patient engagement. A difference was considered to be statistically significant when the p-value was <0.05. Although both groups valued the importance of patient engagement, there was a discrepancy on understanding, views and experiences. More healthcare professionals particularly in nursing were concerned about the possible negative impact of the engagement. The majority of healthcare professionals reported that they engaged well with patients, and perceived more difficulties than patients did. The findings highlighted the mutual understanding of patient engagement, involvement and challenges encountered by both groups in Department of Medicine, which was crucial in efforts to provide meaningful patient engagement in regards to jurisdictions, health system, specialty, discipline and background of patients. It provided insight that a collaborative strategy involving both healthcare professional and patients might be an alternative approach to improving patient engagement.
Diagnosis of HIV Delay: Lost Opportunities  [PDF]
P. Jiménez-Aguilar, A. Romero Palacios, G. García-Dominguez, J. Borrallo-Torrejon, E. Vergara-Moragues, E. Cruz-Rosales, A. Vergara de Campos
World Journal of AIDS (WJA) , 2013, DOI: 10.4236/wja.2013.33026

The diagnosis delay in new cases of HIV infection is a frequent fact. Our objective was to detect and analyse the lost opportunities and describe the characteristics of these patients. Method: The search was done by a revision of personal histories of new diagnosis of HIV infection from 1st January to 31st December 2011 in the database of VACH. We selected those that had consulted a doctor in the previous year in the Emergency area, Primary Care and Specialised Consultations in the database of the histories of the Public Health Service. We called low attendance if they came 1 - 3 times and high if over 3. We grouped patients into those that fulfilled criteria of diagnosis delay by count of CD4s. We called no diagnosis delay to those that had count of CD4 over 350, diagnosis delay under 350 and advanced disease under 200. Results: There were 107 new cases. The global percentage of DD was 61.7% of cases. From these, 45.38% fulfilled criteria of AD. It was possible to find information about the existence of previous sanitary attendance in 59 patients. From these 58% were diagnosed with delay, fulfilling criteria of AD in 27%. The predominant means of infection was sexual. 35 patients attended a healthcare level, 19 two and 5 three. 47.5% consulted over 3 times. They requested a total of 274 consultations. Discussion: The diagnosis delay is a reality. It took our attention that from 59 patients having requested previous medical assistance 58% were diagnosed with delay and 27% fulfilled criteria of AD. We found that almost half of them had been attended in 4 and up to 14 times, in some occasions with suggestive symptoms of HIV infection. Facing this discovery we think that some interventions should be undertaken to get an early diagnosis and the control of the outbreak.

Determinants of Treatment Delays among Pulmonary Tuberculosis Patients in Enugu Metropolis, South-East, Nigeria  [PDF]
Omotowo Ishola Babatunde, Eke Christopher Bismark, Nwobi Emmanuel Amaechi, Eyisi Ifeanyi Gabriel, Agwu-Umahi Rebecca Olanike
Health (Health) , 2015, DOI: 10.4236/health.2015.711164
Abstract: Introduction: Globally, the burden of Tuberculosis is escalating. Early diagnosis and prompt initiation of treatment are essential to achieve an effective tuberculosis control programme. Objective: To investigate the duration of delay for treatment and assess the determinants of treatment delays among pulmonary tuberculosis patients in Enugu metropolis, South-East, Nigeria. Methods: This cross sectional study was conducted among 219 pulmonary tuberculosis patients in six randomly selected DOTS centres in the three LGAs in Enugu metropolis. Data were analysed using SPSS version 17, and statistical significance of association between variables was assessed using Chi-square test at p < 0.05. STATA version 13.1 was used to calculate the positive predictors of TB treatment delays using logistic regression. Ethical clearance was obtained from the Health Research Ethics Committee of UNTH and verbal informed consent was obtained from the participants. Results: Overall, 291 respondents took part in the study, 55.7% were males, 84.4% were aged between 16 to 60 years, while their mean age was 35.4 ± 12.6 years. Most of the participants 32.9%, 26.9%, 15.5% were traders, civil servants, and students respectively. Among the respondents, 3.6% knew that Mycobacterium tuberculosis is the cause of tuberculosis. Among the participants, only 23.3% presented for first appropriate treatment consultation within 1 - 30 days of onset of symptoms. The reasons given by the respondents for the delay are: ignorance of necessity treatment (36.1%), Lack of money (24.2%), no health facility close to the house (13.2%), and other reasons 26.5%. Delay in treatment was found to be significantly associated with HIV status (X2 = 23.412, df = 8, p = 0.003), knowledge of the cause of TB (X2 = 42.322, df = 28, p = 0.040), TB symptoms experienced (X2 = 46.857, df = 20, p = 0.001), occupation (X2 = 34.217, df = 20, p = 0.025), and distance of the health facility from the respondents’ residence (X2 = 34.908, df = 8, p = 0.000). The positive predictors of delayed treatment, using logistic regression, were first presentation at: patent medicine dealer (OR 12.3 CI: 3.22 - 36.23), private hospital (OR 10.6 CI: 5.73 - 17.94), prayer house (OR 7.2 CI: 2.75 - 23.64), and traditional healer (OR 11.9 CI: 6.87 - 32.85). Conclusion: Majority of TB patients in this study did not present early to health facilities. The positive predictors of delayed presentation for appropriate PTB treatment were first presentations at inappropriate treatment centres.
Page 1 /7094
Display every page Item

Copyright © 2008-2017 Open Access Library. All rights reserved.