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Objective This study aimed to investigate the complex relationships between demographic factors, oral health indicators, self-compassion, and psychological well-being among elderly individuals by using a path model analysis. Methods The findings of this cross-sectional study are derived from data collected from a sample of 204 patients, including 120 females and 84 males, aged between 60 and 92 years, with an average age of 74.2 years (SD = 7.1). Participants took part in assessments including the Geriatric Oral Health Assessment Index (GOHAI) to measure oral health (physical function, psychosocial function, pain/discomfort), self-compassion scale, and measures of shame and "other as shamer" experiences. Demographic information including age and gender was also collected. Path analysis was employed to examine the direct and indirect effects of demographic variables, oral health indicators, and self-compassion on psychological well-being. Results Older age was consistently associated with poorer oral health outcomes across all GOHAI oral health subscales. However, resilience and self-compassion appear to exert a correspondingly large positive influence, neutralizing the negative effects of increasing age on physical and psychosocial aspects of oral health-related quality of life. Additionally, resilience was positively associated with better physical and psychosocial function related to oral health while oral health was confirmed to be related to internal and external (social) shame. However, resilience and self-compassion outperformed oral health as far as their effect on internal and external (social) shame is concerned. Gender had minimal effects on most outcome variables. Conclusions The findings underscore the importance of addressing both physical and psychological aspects of health in elderly care and oral health interventions. By promoting psychological resilience and self-compassion, healthcare providers can potentially enhance oral health-related quality of life and overall well-being among elderly populations. Our results also highlight that promoting social and leisure activities may be a means of improving mental well-being, enhancing oral health outcomes, and reducing shame-related distress among elderly individuals.
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In the intensive care unit (ICU), patients often experience fragmented memories, primarily comprising dreams and illusions. These experiences can impact psychosocial well-being, correlating with post-traumatic stress symptoms and heightened anxiety. Understanding these phenomena is crucial for holistic care. To systematically explore patients' perspectives concerning the recollection of dreams and unreal encounters during their stay in the ICU, considering pertinent clinical conditions and potential influencing factors, we conducted a comprehensive search in the PubMed/MEDLINE, Web of Science, and Scopus databases until November 20, 2023, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. From an initial pool of 288 records, a thorough screening for eligibility resulted in the inclusion of nine studies for this systematic review. These selected studies underwent evaluation using either the Critical Appraisal Skills Programme (CASP) Qualitative Checklist or the Newcastle-Ottawa Scale (NOS). All studies categorized dreams into three main types: positive, distressing (including nightmares), and neutral experiences. These were further detailed based on aspects such as time, space, senses, emotions, and distinguishing between reality and unreality. Two studies found associations between dreams and conditions like Guillain-Barré syndrome (GBS), mental abnormalities, and delirium. In one study, GBS patients had more vivid dreams, hallucinations, and delusions compared to ICU control group patients; delirious patients tend to report more frequent frightening dreams. Patients in the ICU who recalled dreams often had more severe illness, longer stays, and higher ventilation frequency. Notably, a prolonged ICU stay significantly predicted the likelihood of dream recall, as consistently observed in three other studies. This suggests that patients with prolonged ICU stays, experiencing higher dream recall, underwent extended treatments. This systematic exploration of patients' perspectives on fragmented memories underscores the connections between these experiences, clinical conditions such as GBS and delirium, and extended ICU stays. Recognizing and attending to these psychological aspects in post-ICU care is critical for alleviating the enduring emotional consequences for patients.
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The impact of the coronavirus disease 2019 (COVID-19) pandemic on the global economy is far-reaching and difficult to assess accurately. We aimed to systematically determine the magnitude of the costs and the economic burden of intensive care for hospitalized COVID-19 patients since the onset of the pandemic by means of a systematic review. We conducted a PRISMA 2020-compliant (protocol: PROSPERO CRD42022348741) systematic review by searching PubMed, EMBASE, and Web of Science for relevant literature. We included studies that presented costs based on a primary partial economic evaluation. Using the Consolidated Health Economic Evaluation Reporting Standards checklist and the population, intervention, control, and outcome criteria, we established the risk of bias in studies at the individual level. Daily cost per ICU admission and total cost per ICU patient of the original studies extracted. A random effect model was adopted for meta-analysis whenever possible. Of the 1,635 unique records identified, 14 studies related to ICU-hospitalized costs due to COVID-19 were eligible for inclusion. Included studies represented 93,721 hospitalized COVID-19 patients. Regarding total direct medical costs, the lowest cost per patient at ICU was observed in Turkey ($2,984.78 ± 2,395.93), while the highest was in Portugal ($51,358.52 ± 30,150.38). The Republic of Korea reported the highest length of stay of 29.4 days (±17.80), and the lowest is observed in India for nine days (±5.98). Our findings emphasize COVID-19's significance on health-economic outcomes. Limited research exists on the economic burden of COVID-19 in the ICU. Further studies on cost estimates can enhance data clarity, enabling informed analysis of healthcare costs and aiding efficient patient care organization by care providers and policymakers.