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Souhail Chatti Imane Kacem Maher Maoua Houda Kalboussi Mohamed Ayem El Asmi Aicha Brahem Sana El Guedri Olfa El Maalel Faten Debbabi Nejib Mrizak 《Annales médico-psychologiques》2019,177(4):364-369
Purpose
To describe the relationship between psychosocial factors and mental health among housekeepers.Methods
A cross-sectional study was conducted nearby all the housekeepers of Farhat-Hached teaching hospital of Sousse (Tunisia). After their oral consent, employees completed a self-administrated questionnaire including socio-demographic and lifestyle data, the Job Content Questionnaire (JCQ) evaluating psychological stress at work and the Hopkins Symptoms Checklist (HSCL-25) studying mental health.Results
Overall, 136 cleaners were enrolled in the study, corresponding to a response rate of 89.5%. The mean age was 41.9 ± 7.7 years. According to the demand control model, 26.5% of the participants were in the situation of job-strain. The study of HSCL-25 scales revealed a positive mental health disorders in 50% of cases. The study of the psychosocial factors revealed a correlation between job-strain and urban origin (P = 0.007), high psychological demand and seniority in the cleaning sector (P = 0.030) and low decision latitude and the night work (P = 0.015). The mental health association were associated with unmarried status (P = 0.006), high psychological demand (P < 0.001), active employees (P = 0.037), and iso-strain (P = 0.013). Mental disorders were associated with a high psychological demand in the presence of a high decision latitude (OR = 9.2 [2.8–30.8]) and a job-strain in the presence of low social support (OR = 3.5 [1.2–10.4]).Conclusion
Psychosocial factors can deteriorate seriously the mental health of workers. Their identification is the most important step in any efficient preventive strategy. 相似文献94.
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Stephan Koter Tina U. Cohnert Korbinian B. Hindermayr Jörg Lindenmann Maximilian Brückner Wolfgang K. Oswald Georg Werkgartner Doris Wagner 《Journal of vascular surgery》2019,69(4):1227-1232
Objective
Low psoas muscle area is shown to be an indicator for worse postoperative outcome in patients undergoing vascular surgical. Additionally, it has been associated with longer durations of hospital stay in patients with cancer who undergo surgery and subsequently greater health care costs in Europe and the United States. We sought to evaluate this effect on hospital expenditure for patients undergoing vascular repair in a health care system with universal access.Methods
Skeletal muscle mass was assessed on preoperative abdominal computed tomography scans of patients undergoing open aortic aneurysm repair in a retrospective fashion. The skeletal muscle index (SMI) was used to define low muscle mass. Health care costs were obtained for all patients and the relationship between a low SMI and higher costs was explored using linear regression and cross-sectional analysis.Results
We included 156 patients (81.5% male) with a median age of 72 years undergoing elective surgery for infrarenal abdominal aortic aneurysm in this analysis. The median SMI for patients with low skeletal muscle mass was 53.21 cm2/kg and for patients without, 70.07 cm2/kg. Hospital duration of stay was 2 days longer in patients with low skeletal muscle mass as compared with patients with normal (14 days vs 11 days; P = .001), as was duration of intensive care stay (3 days vs 1 day; P = .01). The median overall hospital costs were €10,460 higher for patients with a low SMI as compared with patients with a normal physical constitution (€53,739 [interquartile range, €45,007-€62,471] vs €43,279 [interquartile range, €39,509-€47,049]; P = .001). After confounder adjustment, a low SMI was associated with a 14.68% cost increase in overall hospital costs, for a cost increase of €6521.Conclusions
Low skeletal muscle mass is independently associated with higher hospital as well as intensive care costs in patients undergoing elective aortic aneurysm repair. Strategies to reduce this risk factor are warranted for these patients. 相似文献98.
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Gregory S. Orgel Robert A. Weston Christopher Ziebell Lawrence H. Brown 《The American journal of emergency medicine》2019,37(9):1729-1733
ObjectiveTo evaluate changes in insurance status among emergency department (ED) patients presenting in the two years immediately before and after full implementation of the Affordable Care Act (ACA).MethodsWe evaluated National Hospital Ambulatory Medical Care Survey (NHAMCS) Emergency Department public use data for 2012–2015, categorizing patients as having any insurance (private; Medicare; Medicaid; workers' compensation) or no insurance. We compared the pre- and post-ACA frequency of insurance coverage—overall and within the older (≥65), working-age (18–64) and pediatric (<18) subpopulations—using unadjusted odds ratios with 95% confidence intervals. We also conducted a difference-in-differences analysis comparing the change in insurance coverage among working-age patients with that observed for older Medicare-eligible patients, while controlling for sex, race and underlying temporal trends.ResultsOverall, the proportion of ED patients with any insurance did not significantly change from 2012 to 2013 to 2014–2015 (74.2% vs 77.7%) but the proportion of working-age adult patients with at least one form of insurance increased significantly, from 66.0% to 71.8% (OR 1.31, CI: 1.13–1.52). The difference-in-differences analysis confirmed the change in insurance coverage among working-age adults was greater than that seen in the reference population of Medicare-eligible adults (AOR 1.70, CI: 1.29–2.23). The increase was almost entirely attributable to increased Medicaid coverage.ConclusionIn the first two years following full implementation of the ACA, there was a significant increase in the proportion of working-age adult ED patients who had at least one form of health insurance. The increase appeared primarily associated with expansion of Medicaid. 相似文献
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