OBJECTIVES: 1) To determine elderly patients' preference regarding home versus hospital as the site of treatment of their medical illnesses. 2) To formulate guidelines at the VMMC out patient department on home care.
DESIGN: Descriptive study (survey).
PARTICIPANTS: One hundred fifty elderly patients seen at the VMMC out patient department, 65-82 years of age, diagnosed with chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF) and pneumonia from September 2001 to July 2002.
INTERVENTION: Questionnaires consisting of a sequence of items were administered to the subjects seen at the out patient department, prompting participants to provide specific preference of care received in the home versus a hospital setting.
RESULTS: Of a total of 150 patients included in this study, 114 patients (76 percent) felt safer being treated in the hospital than at home. One hundred and twenty four patients (82.7 percent) reported that clinical recovery was faster in the hospital. One hundred patients (66.7 percent) believe that home treatment would consequently result in complications. One hundred and twenty four (82.7 percent) think that the promptness of an emergency response is delayed in the home.
CONCLUSION: This study shows that the elderly patients prefer the hospital rather than the home as the site of treatment of their medical illnesses.

Human ; Male ; Female ; Aged 80 And Over ; Aged ; Patient Preference ; Pulmonary Disease, Chronic Obstructive ; Pneumonia ; Home Care Services ; Heart Failure

Dialysis is one of the treatment options for ESRD. Several investigators have estimated that depression occurs in about 20 to 30 percent of dialysis patients. The treatment of End Stage Renal Disease (ESRD) successfully prolongs the survival of patients with kidney disease but requires that ESRD patients cope with frequent deleterious changes in their health and life situation and shortened survival. Several studies on coping up mechanisms of ESRD patients were collected and reviewed. Self-management of everyday life entailed achieving/maintaining "normalcy" in everyday roles and functioning. Meaning in life is an important motivator in the coping process. Understanding their own needs and accepting support from members of his family and health care community can help them have a quality life.

Human ; Male ; Middle Aged ; Depression ; Self Care ; Quality Of Life ; Adaptation, Psychological ; Depressive Disorder ; Motivation ; Kidney Diseases ; Kidney Failure, Chronic

In many instances, the differences between the two types of Diabetes may not always be easily perceived. What is seen in current practice is a combination of signs and symptoms that make diagnosis a bit more complex. This is an illustration of such. Clinical judgment alone may not be enough and laboratory findings will be extremely helpful. The clinician has to develop the skill in decision-making based on all the available data.

Human ; Female ; Adolescent ; Nutritional And Metabolic Diseases ; Glucose Metabolism Disorders ; Diabetes Mellitus, Type 1 ; Diabetes Mellitus, Type 2 ; Diabetes Mellitus

This article discusses some methods by which the facilitator can evaluate effectiveness of small groups in promoting learning. The paper focuses on evaluation of the small group process using the sociogram and Bales' checklist. Additionally, it presents checklists for evaluating facilitation skills. Combination of the tools presented in this article and revision of the content of the checklists to make it more context-specific and attuned to the realities of your small group settings is suggested to maximize the evaluative potential of these tools.

Human ; Male ; Female ; Checklist ; Group Processes ; Learning ; Evaluation Studies As Topic

Human ; Community Medicine ; Family

BACKGROUND

As the aging population increases, health conditions in older adults require increased attention. Geriatric syndromes are clinical conditions that do not belong to specific disease categories but are concomitantly occurring that significantly affect the functionality and quality of life of older adults. The importance of routine screening of geriatric syndromes was emphasized as this will help in identifying the current conditions and health-related problems of the elderly population in the community, and its implication to their quality of life.

OBJECTIVE

This study aimed to determine the prevalence of the geriatric syndromes among elderly patients seen in the Rizal Tagak Community Geriatrics clinic.

METHODS

This research is a cross-sectional descriptive using the locally available DOH Geriatric Screening Tool for Senior Citizens and FRAIL Index Assessment tool.

RESULTS

Forty-six patients were included in the study. The results of the study showed that the most prevalent geriatric syndrome is frailty (78.26%), followed by polypharmacy (73.91%), visual problems (67.40%), fall risk (56.62%), urinary incontinence (45.65%), and memory impairment (41.30%). Less prevalent geriatric syndromes were malnutrition (13.04%), depression (10.87%), physical functional incapacity (8.7%), and hearing problems (6.52%).

CONCLUSION

Routine screening for geriatric syndromes among the elderly is very important as these conditions have serious consequences and impact on the quality of life of the older adults. Early detection of geriatric syndromes will help in implementing early and appropriate interventions to prevent further complications which will be beneficial in promoting healthy aging.

Human ; Aging

BACKGROUND

Advance care planning (ACP) discussions are vital, but they remain largely neglected and met with resistance in the Philippines. The general population, especially non-medical individuals, has not actively engaged in ACP. To address this, we developed the ‘ACP-READY’ program for primary care settings.

OBJECTIVE

This study aimed to assess the effectiveness of ‘ACP-READY’ in facilitating the completion of Advance Directives (ADs) among non-medical personnel and identifying barriers to their completion.

METHODS

A randomized, controlled, single-blind approach with a quantitative survey followed by qualitative semi-structured interviews enrolled 161 English-literate, legally competent individuals aged 18-65 from a hospital’s non-medical staff. Participants were randomly assigned to control (n=77) or intervention (n=84) groups. We initially evaluated participants’ readiness for ACP (ACPRe)1. Subsequently, both groups were instructed to complete an AD form in their preferred language, with the experimental group receiving an interactive ACP seminar. Post-test assessments gauged participants’ willingness to complete their AD. A focused-group discussion was conducted to explore their experiences.

RESULTS

Baseline characteristics were similar between groups. There was no statistical difference in readiness improvement and AD completion rates between the control and intervention groups. Well-worded brief instruction and comprehensive seminars were equally effective in enhancing readiness and promoting AD completion (pCONCLUSION

Concise and well-presented instruction on ACP is as effective as comprehensive seminars in promoting AD completion among medically stable individuals. Family physicians, with their longitudinal, patient-centered approach, can address some of the identified barriers.

Human ; Advance Care Planning ; Patient Engagement ; Patient Participation ; Primary Care ; Primary Health Care

BACKGROUND

Palliative Care focuses on the needs of both the patient and their families, aiming to enhance their overall quality of life. It achieves this by anticipating, preventing, reducing, and treating suffering through comprehensive support across various aspects of life. This approach promotes patient autonomy, provides access to information, and encourages the freedom to make choices. Referring patients to Supportive and Palliative Care in a timely manner enhances their quality of life, improving symptom control, mood, and understanding of their illness. Additionally, it reduces distress for both the patient and their caregiver during the end-of-life period.

OBJECTIVE

This study aimed to determine the proportion of late referrals among patients diagnosed with debilitating illnesses consulting at the Emergency Department of Batangas Medical Center from July to December 2022 and who needed Supportive and Palliative Care using the Palliative Care and Rapid Emergency Screening Tool, considering age, sex, and the specific diagnosis of the debilitating illness. Additionally, the timing of referrals for both discharged and admitted patients requiring Supportive and Palliative Care was described, with categories including those referred within one week, beyond one week, and those not referred at all.

METHODS

This retrospective study was conducted via chart review of all patients with debilitating illnesses who visited the Emergency Department of Batangas Medical Center, admitted or discharged, from July 2022 to December 2022. Timing of referral to Supportive and Palliative Care was obtained from the admission charts and/or the SPC referral logbook. Frequency analysis specifically frequency tabulation was used to summarize data.

RESULTS

Between July and December 2022, 2,097 patients diagnosed with debilitating illnesses at the Emergency Department were identified. Only 2.52% of them received referrals to Supportive and Palliative Care, and among this group, more than half (38) were referred later than one week after diagnosis.

CONCLUSION

This study identified the need for comprehensive improvements in the referral process, emphasizing timely access to Supportive and Palliative Care for patients of all demographic facing debilitating illnesses. The call for systemic changes advocates for clear protocols and guidelines, reducing oversight and delays. The Palliative Care and Rapid Emergency Screening Tool can streamline referrals, while collaboration between healthcare providers and the palliative care team ensures a more efficient system. Strategies advocating for healthcare infrastructure improvement and awareness campaigns may be developed to facilitate timely referrals for patients across age and gender spectrums.

Human ; Palliative Care ; Emergency Department ; Emergency Service, Hospital

BACKGROUND

Th Philippines has faced challenges in quality end-of-life care and ranks poorly on the 2015 Quality of Death Index. This study explores the perceptions of a good death among patients, caregivers, and bereaved family members within the Palliative and Hospice Care Program of Ospital ng Makati.

OBJECTIVE

The research aimed to offer insights into the factors that influence end-of-life care preferences in the Philippine context.

METHODS

The study involved 38 participants – patients, caregivers, and bereaved family members. It adapted and modified the Good Death Inventory, a validated scale with 47 questions covering 18 domains related to end-of-life care.

RESULTS

Results show significant differences in perceptions of a good death among patients, caregivers, and bereaved family members. Maintaining hope and pleasure, having control over the future, and a good relationship with medical staff were identified as top priorities while dying in a favorite place was of lower importance. Caregivers and bereaved members valued patient autonomy, with higher importance placed on being respected as an individual and feeling that one’s life is worth living. Additionally, spiritual comfort was more significant for caregivers and bereaved family members. The study highlights the importance of understanding distinct preferences in the context of end-of-life care. The findings also call for longer data collection periods, larger sample sizes, and potential qualitative research methods.

CONCLUSION

By addressing these nuances, healthcare providers can better improve end-of-life care, ensuring that patients and their families experience a more positive and meaningful transition at this crucial stage of life.

Human ; Palliative Care ; Hospice Care

BACKGROUND

Hospitals in the Philippines have been a workhorse even before the COVID-19 pandemic hit the country. Risk of burnout is high among healthcare providers and it can have a significant impact on the efficiency and effectiveness of healthcare delivery. Identification of employee burnout is important since it is usually overlooked and it is presumed to be related to a lower level of life satisfaction.

OBJECTIVE

To correlate the Level of Life Satisfaction and Work-Related Burnout among the Hospital Operation and Patient Support Service Employees of a tertiary government gospital in 2023.

METHODS

A cross-sectional study was used to evaluate the correlation of work-related burnout and level of life satisfaction using self-administered questionnaires to regular HOPSS employees. Data gathered was then analyzed to get the descriptive statistics and to test the Pearson’s correlation coefficient (r).

RESULTS

Most of the respondents are of the male gender and belonged in the 31 to 40 years age group. The average age of the respondents is marked at 40.3 years old and the average stay in the institution is 7.8 years. Burnout assessment revealed a majority of low burnout levels across the three dimensions of burnout, whereas level of life satisfaction was generally high. Pearson’s correlation coefficient was -0.46578 with a p-value of 0.00305.

CONCLUSION

The study has shown a statistically significant negative correlation between the level of work-related burnout and the level of life satisfaction, wherein there is a higher level of life satisfaction among those with lower levels of work-related burnout.

Human ; Burnout, Psychological ; Life Satisfaction ; Personal Satisfaction