Asunto(s)

Servicios Médicos de Urgencia/métodos , Intestinos/irrigación sanguínea , Isquemia/diagnóstico por imagen , Laparotomía , Tomografía Computarizada Multidetector/métodos , Derivación y Consulta , Diagnóstico Diferencial , Estudios de Seguimiento , Humanos , Isquemia/cirugía , Estudios Retrospectivos , Factores de Tiempo

RESUMEN

BACKGROUND: The care of the critically ill trauma patients is provided by intensivists with various base specialties of training. The purpose of this study was to investigate the impact of intensivists' base specialty of training on the disparity of care process and patient outcome. METHODS: We performed a retrospective review of an institutional trauma registry at an academic level 1 trauma center. Two intensive care unit teams staffed by either board-certified surgery or anesthesiology intensivists were assigned to manage critically ill trauma patients. Both teams provided care, collaborating with a trauma surgeon in house. We compared patient characteristics, care processes, and outcomes between surgery and anesthesiology groups using Wilcoxon tests or chi-square tests, as appropriate. RESULTS: We identified a total of 620 patients. Patient baseline characteristics including age, sex, transfer status, injury type, injury severity score, and Glasgow coma scale were similar between groups. We found no significant difference in care processes and outcomes between groups. In a logistic regression model, intensivists' base specialty of training was not a significant factor for mortality (odds ratio, 1.46; 95% confidence interval; 0.79-2.80; P = 0.22) and major complication (odds ratio, 1.11; 95% confidence interval, 0.73-1.67; P = 0.63). CONCLUSIONS: Intensive care unit teams collaborating with trauma surgeons had minimal disparity of care processes and similar patient outcomes regardless of intensivists' base specialty of training.

Asunto(s)

Cuidados Críticos , Enfermedad Crítica/terapia , Cuerpo Médico de Hospitales/educación , Medicina/organización & administración , Evaluación de Procesos y Resultados en Atención de Salud , Heridas y Lesiones/terapia , Adulto , Anciano , Anestesiología/educación , Anestesiología/organización & administración , Certificación , Cuidados Críticos/organización & administración , Enfermedad Crítica/epidemiología , Femenino , Cirugía General/educación , Cirugía General/organización & administración , Humanos , Incidencia , Unidades de Cuidados Intensivos/organización & administración , Modelos Logísticos , Masculino , Cuerpo Médico de Hospitales/organización & administración , Persona de Mediana Edad , Sistema de Registros , Estudios Retrospectivos , Centros Traumatológicos/organización & administración , Recursos Humanos , Heridas y Lesiones/epidemiología

RESUMEN

Two studies assessed the role of self-compassion as a moderator of the relationship between physical health and subjective well-being in the elderly. In Study 1, 132 participants, ranging in age from 67-90 years, completed a questionnaire that assessed their perceptions of their physical health, self-compassion, and subjective well-being. Participants who were in good physical health had high subjective well-being regardless of their level of self-compassion. However, for participants with poorer physical health, self-compassion was associated with greater subjective well-being. In Study 2, 71 participants between the ages of 63 and 97 completed a questionnaire assessing self-compassion, well-being, and their willingness to use assistance for walking, hearing, and memory. Self-compassionate participants reported being less bothered by the use of assistance than those low in self-compassion, although the relationship between self-compassion and willingness to use assistive devices was mixed. These findings suggest that self-compassion is associated with well-being in later life and that interventions to promote self-compassion may improve quality of life among older adults.