Ann Acad Med Singap
-
Ann Acad Med Singap · Oct 2012
Comparative StudyThe health-related quality of life of junior doctors.
It is reported that junior doctors experience a large amount of work related stress and fatigue which has detrimental effects on their well-being and patient safety. We seek to determine the health-related quality of life (HR-QoL) of junior doctors using the Short Form 36 Health Survey (SF-36) and compare their HR-QoL with that of populations of norms and senior doctors. ⋯ Junior doctors have poorer mental health scores compared to senior doctors. Also, the lower vitality scores suggest that junior doctors are more likely to be fatigued than their normative population. More studies and efforts will be needed to identify factors that affect the quality of life in junior doctors and to evaluate the most appropriate measures to improve the efficiency of their work.
-
Suicide is one of the most tragic problems medical schools are facing today. It is an issue that has not escaped medical schools in either developing or developed nations. To combat this trend, medical educators require efficient and effective strategies for the immediate identification of students who are at an elevated risk of harming themselves. ⋯ A number of groups at high risk for suicidal ideation, and thus in greater need of support, were identified. Suicide intervention programmes and depression counselling should target older students and students of lower socioeconomic status. Students presenting to university clinics with non-inflammatory joint pain, headache, and/or sleep disorders should be evaluated for suicidal tendencies. The TDQ and CHQ are potentially valuable screening tests for early detection of potential suicidal students.
-
Ann Acad Med Singap · Jun 2012
Medium to long-term clinical outcomes with everolimus-eluting stents in real-life percutaneous coronary intervention.
Everolimus eluting stents (EES) have demonstrated excellent re-stenosis and thrombosis rates in a number of randomised controlled trials. This study reported the real world experience in a single tertiary centre with EES in predominantly acute coronary syndrome (ACS) patients and compared the outcomes in small and large vessels. We measured the medium to long-term major adverse cardiovascular events (MACE) defined as all-cause mortality, myocardial infarction (MI) and target vessel revascularisation (TVR) and stent thrombosis. ⋯ Everolimus eluting stent appears to be safe in a real world setting with satisfactory median-term outcomes which include low rates of TVR and other adverse events. EES appear to be equally effective in both small and large vessels.
-
Ann Acad Med Singap · Apr 2012
Discrepancies in end-of-life decisions between elderly patients and their named surrogates.
This study aims to determine the attitudes of Asian elderly patients towards invasive life support measures, the degree of patient-surrogate concordance in end-of-life decision making, the extent to which patients desire autonomy over end-of-life medical decisions, the reasons behind patients' and surrogates' decisions, and the main factors influencing patients' and surrogates' decision-making processes. We hypothesize that there is significant patient-surrogate discordance in end-of-life decision making in our community. ⋯ The majority of patients desire autonomy over critical care issues. Relying on the surrogates' decisions to initiate treatment may result in treatment against patients' wishes in up to one-third of critically ill elderly patients.
-
Ann Acad Med Singap · Mar 2012
Prevalence and impact of mental and physical comorbidity in the adult Singapore population.
This study aims to assess the prevalence rates of mental disorders and chronic medical conditions in the Singapore resident population, and examine their association and respective impact on the quality of life. ⋯ Our study re-emphasised the common occurrence of mental and medical disorders and the importance for an integrated care system with the capability to screen and treat both types of disorders. It also identified certain subpopulations which are more likely to have comorbidity for which a more targeted intervention could be planned.