[Characteristics of patient management in emergency departments]. / Caractéristiques de la prise en charge des patients aux urgences.

A national survey carried out in France in June 2013 studied for the first time all emergency department attendances over a 24-hour period. It enables patients' pathways through the emergency department to be described in detail, from their conditions of arrival through to the follow-up care downstream of their attendance.

Pain underreporting associated with profound intellectual disability in emergency departments.

BACKGROUND: Little information is available regarding the visits made by persons with profound intellectual disability (PID) to general hospital emergency departments (ED). This study aims to know whether persons with PID who attend ED are given the same type of diagnoses as people with no such disability. METHODS: Over a period of 18 months, we gathered data from all non-scheduled visits to an ED by persons with PID to identify the reason for consultation (according to the classification used by the Spanish Society for Emergency Nursing) and the final diagnosis upon discharge. The results were compared with data obtained from a control group of people with no ID who attended an ED for any reason during the same period. RESULTS: Somatic complaints were the main reason for ED attendance among persons with PID (90% of consultations). These complaints were more often related to the central nervous system than was the case among non-ID patients (16 vs. 4.7%), whereas other kinds of non-central nervous system somatic complaint were less common among persons with PID (74 vs. 91%). A diagnosis implying physical pain was given less often to people with PID than to controls (3 vs. 20%). CONCLUSIONS: The results suggest that persons with PID are less able to conceptualise and communicate information about their symptoms, especially as regards pain, and that this influences the diagnosis they are given when attending an ED. Professionals working in this environment need to be aware of this possibility so as not to underestimate or overlook such symptoms and the illnesses related to them.

Reasons for elderly patients GP visits: results of a cross-sectional study.

OBJECTIVE: The aim of this study is to describe the frequency of reasons for elderly patients visits to a general practice (GP) setting. SUBJECTS AND METHODS: Cross-sectional data from 8,877 randomly selected patients were assessed during a 1-year period by 209 GPs in the German federal state of Saxony. The reasons for visits, performed procedures, and results of visits were documented. In this study, the data of patients aged 65 years and older are analyzed and the procedural and nonprocedural reasons for visits are described. RESULTS: In all, 2,866 patients aged 65 years and older were included. The majority of patients (1,807) were female. A total of 4,426 reasons for visits were found, distributed on 363 International Classification of Primary Care-2 codes. In the mean, there were 1.5 reasons for a GP visit from each patient. The top five nonprocedural reasons for visiting the GP were: cough (1.8%), back complaints (1.6%), shoulder complaints (1.3%), knee complaints (1.1%), and dyspnea (1.0% of all reasons for visit). The top five procedural reasons for visiting the GP included follow-up investigations of cardiovascular or endocrine disorders and immunizations. The top 30 nonprocedural reasons for visits covered 21.9% of all reasons for visiting. The top 30 procedural reasons covered 54.3% of all reasons for visits. CONCLUSION: The current work indicates that people aged 65 years and older consult the GP more frequently for procedural than for nonprocedural reasons. The top 30 procedural and nonprocedural reasons for visits cover ~75% of all reasons for visits in these patients.

Investigando a associação entre sintomas e queixas depressivas com as estações do ano / Investigating the association between depressive symptoms and complaints in different seasons

A depressão implica diversos prejuízos na vida dos indivíduos, ocasiona desde a incapacitação para o trabalho até o prejuízo nas relações e bem estar. Objetivos Este trabalho buscou investigar se há associação entre queixas e sintomas depressivos e a estação do ano em que pacientes buscam atendimento na área da saúde mental. Método Foi realizado estudo transversal e documental com pacientes adultos e idosos em ambulatório transdisciplinar em Porto Alegre, RS. Resultados Não foi encontrada associação entre motivo de consulta, sintomas depressivos e a estação do ano. Apesar disto, associou-se faixa etária, renda familiar, sexo e fonte de encaminhamento à busca por atendimento psicoterápico em função de patologia depressiva. Conclusões Apesar de não ter encontrado associação entre queixa e sintomatologia depressiva e a estação do ano em que o paciente buscou atendimento, esta pesquisa levantou dados pertinentes e importantes a serem considerados em futuros estudos sobre queixas e sintomas depressivos. (AU)

Depression involves many losses in individuals’ lives. These can vary from the incapacity to work, relationship problems and harmed well-being. This study investigated if there is association between depressive symptoms and depressive complaints and the season in which patients seek care in a mental health institution. Method We conducted a cross and documentary study with adult and elderly patients in outpatient multidisciplinary clinic in Porto Alegre, RS. Results No association was found between depressive complaint and depressive symptoms with the season. Despite this, the search for psychotherapy because of depressive disorder was associated with age, family income, sex and source of referral. Conclusions Even not having found an association between abuse and depressive symptoms with the season in which the patient sought care, this study gathered relevant and important data to consider in future studies. (AU)

Investigando a associação entre sintomas e queixas depressivas com as estações do ano / Investigating the association between depressive symptoms and complaints in different seasons

A depressão implica diversos prejuízos na vida dos indivíduos, ocasiona desde a incapacitação para o trabalho até o prejuízo nas relações e bem estar. OBJETIVOS: Este trabalho buscou investigar se há associação entre queixas e sintomas depressivos e a estação do ano em que pacientes buscam atendimento na área da saúde mental. MÉTODO: Foi realizado estudo transversal e documental com pacientes adultos e idosos em ambulatório transdisciplinar em Porto Alegre, RS. RESULTADOS: Não foi encontrada associação entre motivo de consulta, sintomas depressivos e a estação do ano. Apesar disto, associou-se faixa etária, renda familiar, sexo e fonte de encaminhamento à busca por atendimento psicoterápico em função de patologia depressiva. CONCLUSÕES: Apesar de não ter encontrado associação entre queixa e sintomatologia depressiva e a estação do ano em que o paciente buscou atendimento, esta pesquisa levantou dados pertinentes e importantes a serem considerados em futuros estudos sobre queixas e sintomas depressivos. .

Depression involves many losses in individuals’ lives. These can vary from the incapacity to work, relationship problems and harmed well-being. This study investigated if there is association between depressive symptoms and depressive complaints and the season in which patients seek care in a mental health institution. METHOD: We conducted a cross and documentary study with adult and elderly patients in outpatient multidisciplinary clinic in Porto Alegre, RS. RESULTS: No association was found between depressive complaint and depressive symptoms with the season. Despite this, the search for psychotherapy because of depressive disorder was associated with age, family income, sex and source of referral. CONCLUSIONS: Even not having found an association between abuse and depressive symptoms with the season in which the patient sought care, this study gathered relevant and important data to consider in future studies. .