Objective:This report surveys and evaluates the scientific research on evidence-based healthcare design and extracts its implications for designing better and safer hospitals.Background:It builds o...

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A Review of the Research Literature on Evidence-Based Healthcare Design

Job satisfaction among hospital nurses revisited: A systematic review

Attention deficit hyperactivity disorder (ADHD) is among the most common, intensely investigated, and yet diagnostically controversial neurobehavioral conditions of childhood. The prevalence of ADHD has been reported with great variations among different studies, ranging from 2.2% to 17.8%. The aim of this review was to investigate the variables that influence the prevalence of ADHD and to derive a best estimate for the prevalence of the disorder. We reviewed all the 39 studies on ADHD prevalence appearing in the Pubmed and published since 1992. These studies indicate that ADHD is more common in boys than girls, in younger than older children and adolescents, in one-setting rather than two-setting screening studies, in studies based on DSM-IV rather than DSM-III-R criteria. Additional factors that may well influence prevalence rates include source of information and assessment of clinical impairment. In conclusion, our findings suggest that population characteristics, methodology features, ethnic and cultural differences and diagnostic criteria involved in studies affect the prevalence of ADHD. Standardized designs may lead to firm conclusions on the true prevalence of ADHD, the estimation of which seems impossible to be achieved by reviewing the already existing literature.

Variations in prevalence of attention deficit hyperactivity disorder worldwide

Since publication use of the WHOQOL-Bref has rapidly risen. However, as yet no population norms have been published as a reference point against which researchers can interpret their findings. This study provides preliminary population norms for this purpose. Randomly sampled community residents from two studies were pooled and used to examine the properties of the WHOQOL-Bref by age group, gender and health status. The results showed that general norms for the WHOQOL-Bref domains were 73.5 (SD=18.1) for the Physical health domain, 70.6 (14.0) for Psychological wellbeing, 71.5 (18.2) for Social relationships and 75.1 (13.0) for the Environment domain. In general scores declined slightly by age group. For females scores were stable across the lifespan with an accelerated decline after the age of 60 years. Males exhibited a more consistent and even decline across the lifespan. There were significant differences in WHOQOL-Bref scores when reported by health status, with those in poor health obtaining scores that were up to 50% lower than those in excellent health. Effect sizes between different health status levels are reported. These preliminary norms and effect sizes may be used as reference points for interpreting WHOQOL-Bref scores. They provide additional information to the numerous national studies already reporting on the validity of the WHOQOL-Bref.

Interpreting the WHOQOL-Bref: Preliminary Population Norms and Effect Sizes.

Oppositional defiant disorder (ODD) is often comorbid with other psychiatric disorders in childhood. Its association with attention deficit hyperactivity disorder and conduct disorder has been well studied. Recent studies suggest that children with ODD have substantial comorbidity with anxiety and depressive (internalizing) disorders, as well. Identifying the pattern of internalizing comorbidity with ODD in childhood and adolescence and how this varies across age and gender may help to identify mechanisms of such comorbidity. This systematic review presents evidence on the association of internalizing disorders with ODD across childhood and adolescence. Data from cross-sectional and longitudinal studies in clinic, community and epidemiologic samples are considered separately. Findings suggest that while internalizing comorbidity with ODD is present at all ages, the degree of comorbidity may vary over time in particular groups of children. Girls and boys appear to have different patterns of ODD comorbidity with either anxiety or depression, as well as ages of onset of ODD, however more large studies are required. Children with ODD in early life require further study as they may be a subgroup at increased risk for anxiety and affective disorders. This could have important implications for the treatment of these ODD children and the prevention of sequential comorbidity.

Comorbidity of internalizing disorders in children with oppositional defiant disorder.

Aims and objectives.  The objective of this study was to evaluate and compare sleep quality of the hospitalized patients and matched healthy controls.

Background.  Although the functions of sleep are not clearly understood, it is generally accepted that it is necessary for the maintenance of good health. Hospitalized patients’ sleep may not be refreshing or restorative. The reasons for this can be categorized into three groups: environmental, physiological and psychological.

Design and methods.  This research was conducted at the Cumhuriyet University Hospital in Turkey. One hundred and fifty hospitalized patients (psychiatry = 50; orthopaedic + general surgery + cardiovascular surgery + urology = 50; internal medicine + chest diseases + infectious diseases + physical therapy and rehabilitation = 50) and 50 healthy controls constituted the sample. The researchers administered to the patient and control groups Sociodemographic Information Form and the Pittsburgh Sleep Quality Index. We compared sociodemographic and illness variables with sleep characteristics. The following statistical analyses were used in order to evaluate the data: variance analysis, Tukey HSD test, Student's t-test, Kruskall–Wallis test.

Results.  We found that patients in psychiatric ward experienced worse sleep quality than the other patients, worse in female patients than male patients, and worse sleep characteristics in patients than controls.

Conclusions.  Health professionals must be educated about sleep and must provide intervention when needed.

Relevance to clinical practice.  The enhancing of sleep quality accelerates to the recovery from illness.

Sleep quality in hospitalized patients.

Relationships between coping strategies, individual characteristics and job satisfaction in a sample of hospital nurses: cross-sectional questionnaire survey.

The aim of this study was to determine the prevalence of attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) in school age children in Sivas province centre and to examine the distribution of symptoms according to subtypes. The study population was made up of 1425 children between the ages of 6 and 15 from eight primary schools selected by random sampling method in Sivas province centre. All students were given a questionnaire prepared according to DSMIV criteria that was completed by their parents or teachers. This form includes 18 symptoms of ADHD and eight symptoms of ODD. Student’s t-test and variance analysis were used for statistical evaluation. A prevalence of 8.1% was found for ADHD in our study. According to subtypes, 32.2% of these were “inattentive”, 40% were “hyperactive” and 27.8% were combined type. A prevalence of 11.5% was found for ODD. The boy/girl ratio was > 1 for both ADHD and ODD, and 52.2% of those with ADHD were established as having ODD at the same time. The prevalence of ADHD and ODD in primary school children was not considered to be small. Studies concerning the distribution of symptoms in different societies, cultures, and viewpoints and identification of children with this type of problem are beneficial for early diagnosis and prophylactic treatment.

The distribution of symptoms of attention-deficit/hyperactivity disorder and oppositional defiant disorder in school age children in Turkey.

The effects of patient education in lithium therapy on quality of life and compliance

The objective of this study was to determine how psychosocial approaches to people with schizophrenia, in addition to treatment with psychotropic drugs, affect the course of the illness and family interactions. The project included people who were diagnosed with schizophrenia and hospitalized at least once. Twenty-three people completed the study. Brief Psychiatric Rating Scale (BPRS), WHO Quality of Life (WHOQOL-BREF-TR), Family Assessment Device (FAD), Specific Level of Functioning Scale (SLFS) and Multidimensional Scale of Perceived Social Support (MSPSS) were applied both at the beginning and at the end of the study. Two study teams visited the participants six times in their homes once per two weeks. At the end of the third month, improvements in social interactions and in family relationships were observed. According to the average score at baseline, BPRS average score was found to be significantly lower (p < 0.02); WHOQOL-BREF, SLFS and MSPSS average scores were found to be significantly higher (respectively p < 0.02, p < 0.0001, p < 0.05). The results of this study show that psychosocial approaches are beneficial especially in social skills and family relationships.

Selma Doğan

Papers

Sleep quality in hospitalized patients.

Relationships between coping strategies, individual characteristics and job satisfaction in a sample of hospital nurses: cross-sectional questionnaire survey.

The distribution of symptoms of attention-deficit/hyperactivity disorder and oppositional defiant disorder in school age children in Turkey.

The effects of patient education in lithium therapy on quality of life and compliance

Psychosocial approaches in outpatients with schizophrenia.