All articles by Tyufilin D. S.
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2022 № 9 Health related quality of life as a predictor of the transfer of patients with COVID‑19 to the intensive care unit
Understanding the results of self-assessment of health-related quality of life in patients with COVID‑19 is an important part of the full and objective picture of the medical condition on the first day of hospitalization when making decisions to start early intensive care in the resuscitation and intensive care unit.
H y p o t h e s i s : the values of health-related quality of life indicators in patients with COVID‑19 on the first day of hospitalization are interrelated with the fact of their stay in the resuscitation and intensive care unit.
P u r p o s e : a retrospective study of the relationship of health-related quality of life in patients with COVID‑19 on the first day of hospitalization and the necessity of treatment in the resuscitation and intensive care unit.
M a t e r i a l s a n d m e t h o d s . The study was conducted on the basis of the “Kommunarka” Moscow Multidisciplinary Clinical Center of the Moscow City Health Department from March 2021 to April 2022. Data collection was carried out using a paper- and-pencil Russian version of the EQ‑5D‑5L questionnaire (Tracking Number: 41183). Additional patient data was extracted from electronic medical records. Two types of EQ‑5D‑5L questionnaire results were evaluated: the EQ index and the visual-analogEQ scale. All calculations of the regression model were carried out using the language R4.2.1 in the software environment RStudio 2022.02.3 Build 492.
F i n d i n g s . This study is the first work where health-related quality of life indicators measured during the first 24 hours of hospitalization in order to predict the transfer of patients with COVID‑19 to the intensive care unit. The best results of self-assessment of their medical condition in the course of hospitalization were revealed in those patients who did not require further treatment in the intensive care unit. The worst results of self-assessment of their medical condition were revealed in lethal patients hospitalized in the intensive care unit on the first day. Two logistic regression models demonstrated a significant relationship of the EQ Index and the Mobility domain with the probability of transferring patients to the intensive care unit. The results obtained prove that subjective indicators of health-related quality of life reflecting the perception of one’s illness “here and now” along with objective clinical indicators are independent predictors of the transfer of patients with COVID‑19 to the resuscitation and intensive care unit.
C o n c l u s i o n . Health-related quality of life indicators (EQ Index and MO) can be used to predict the early use of preventive measures to prevent the deterioration of patients’ condition and reduce the load on the intensive care unit -
2022 № 8 Prediction of disease outcomes in patients with COVID-19 based on the EQ 5D 5L questionnaire
In order to provide effective medical care to patients with COVID-19 in hospitals, the disease outcome prognosis is of
considerable importance. The authors of the study suggested a relationship between health-related quality of life indicators and the outcomes of the disease of patients hospitalized because of COVID-19.
P u r p o s e . Retrospective study of the relationship between health-related quality of life in patients with COVID-19 on the first day of hospitalization with the outcomes of the disease in a hospital and at the stages of rehabilitation up to 180 days following the discharge to predict outcomes at the early stages of the disease.
M a t e r i a l s a n d m e t h o d s . The study was conducted at the “Kommunarka” Moscow Multidisciplinary Clinical Center of the Moscow City Health Department from March 2021 to April 2022. Data collection was carried out using a paper-and-pencil Russian version of the EQ-5D-5L questionnaire (Tracking Number: 41183), on the first day of admission of patients to the hospital. Additional patient data was extracted from electronic health records. Two types of EQ-5D-5L questionnaire results were evaluated: Index EQ and the Visual Analog scale (VAS) EQ. All calculations of the regression model were carried out using the R 4.2.1 language in the RStudio 2022.02.3 Build 492 software environment.
F i n d i n g s . In the obtained logistic regression model, the extremely high statistical significance of the variable “Index EQ” (p<0.01) was demonstrated, the greater the value of the variable “Index EQ” is, the less the probability of a fatal outcome is.
At the same time, there is no statistically significant relationship between the variable VAS EQ under study and the probability of a fatal outcome.
C o n c l u s i o n s . An extremely significant relationship between the calculated health-related quality of life index, Index EQ, and outcomes of COVID-19 when patients were admitted to the hospital was revealed, which makes it possible to use it as a predictor of disease outcomes at early stages. No significant relationship between the VAS EQ and the outcomes of the disease in patients with COVID-19 on the first day of hospitalization was revealed, which makes it impossible to use it as a predictor of disease outcomes at the early stages. Application of the health-related quality of life index, Index EQ can be used to make medical decisions in order to early predict tactics of patient management in hospital treatment and rehabilitation. -
2021 № 4 PROFESSIONAL BURNOUT OF NURSES: FEATURES OF GENERATIONS
Professional burnout among nurses is an urgent public health problem, which negatively affects the quality of medical care. A specialist’s belonging to a certain generation determines its own characteristics of the response to stress factors and the development of professional burnout.
Purpose of the study is to determine the main patterns of occurrence of professional burnout among nurses depending on the generation for development and implementation of targeted prevention methods.
Materials and methods. A one-stage comparative study was planned and conducted using a specially designed questionnaire, including a burnout questionnaire MBI (Maslach Burnout Inventory) and questions assessing professional performance and socioeconomic status to determine the factors of professional burnout. All nurses were stratified into three generational groups.
Results. The study involved 2486 nurses. It was found that respondents of all generations were prone to professional burnout, with a high and extremely high degree. At the same time, the third generation was most susceptible to the development of professional burnout, the first was the least. The main predictors of the development of professional burnout in the third generation were: lack of sleep and rest, low salary and large loan payments, excessive work load; in the first – the presence of chronic diseases. The second generation had a smaller percentage of respondents with an extremely high degree of professional burnout, because they were characterized by lower labor intensity, lack of sleep deficit and the highest salary.
Findings. Thus, prevention measures can be individual for each generation, with considering the differences in predictive and protective factors. While, it is necessary to focus on the youngest, third generation, reinforcing factors preventing the development of professional burnout.