Knowledge and attitude of nonpsychiatric physicians regarding suicide in spinal cord injury patients and need for structured psychiatric education for suicide prevention

Nam, Taewoo; Kim, Chul-Hyun; Hwang, Jong-Moon

doi:10.1097/md.0000000000014901

Cited by 6 publications

(6 citation statements)

References 28 publications

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“…Although EA is not a long-term situation, it involves problems such as removal of the endotracheal tube by the patient, removal of the angiocatheter, bleeding and injury to the patient and staff, and prolonged hospitalization. [ 5 6 7 ] EA is usually seen in children, but it is commonly seen in adults, especially in some special surgeries such as nose, ear, throat, head, and neck surgeries. Its occurrence is estimated at 21.3% in children.…”

Section: Introductionmentioning

confidence: 99%

Comparing the effect of ketamine and lidocaine on agitation and pain in rhinoplasty: A randomized clinical trial

Omidvar

Ebrahimi

Amini

et al. 2023

JCAS

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Background: Emergence agitation (EA) is an important clinical problem that occurs during the initial period of recovery from anesthesia. This study aimed to determine the effects of ketamine and lidocaine administered on agitation level, postoperative pain, and hemodynamic changes in adults after rhinoplasty. Materials and Methods: Totally 72 patients scheduled to undergo elective rhinoplasty were enrolled in this prospective study. Patients were randomly divided into three groups including control group ( n = 24), ketamine group ( n = 24), and lidocaine group ( n = 24). Twenty minutes before surgery completion, 1 ml saline was administered intravenously to the saline group, while 0.5 mg/kg ketamine or 1.5 mg/kg lidocaine was administered to two other groups. The emergence agitation level of the patients was evaluated using the Richmond Agitation–Sedation Scale just after extubation and in the post-anesthesia care unit (PACU). Postoperative pain was evaluated by Numerical Rating Scale that scored (from 0 to 10) every 10 min until the patients were discharged from PACU. Results: There was a significant difference between EA level between ketamine ( P = 0.049) and lidocaine ( P = 0.019) groups compared to the control group, and there was a significant difference between pain level between the ketamine ( P = 0.008) and lidocaine ( P = 0.035) groups compared the to control group, while there was no significant difference between the level of agitation ( P = 0.922) and level of pain ( P = 0.845) after extubation between the ketamine and lidocaine groups. Conclusion: Ketamine and lidocaine are highly effective in preventing EA and pain control. Further studies with a greater sample size and longer follow-up period are needed to confirm the current findings.

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Section: Introductionmentioning

confidence: 99%

Comparing the effect of ketamine and lidocaine on agitation and pain in rhinoplasty: A randomized clinical trial

Omidvar

Ebrahimi

Amini

et al. 2023

JCAS

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“…24 However, physicians are reluctant to intervene, and physician education aimed at increasing rates of depression recognition and intervention has been found to be largely ineffective unless additional infrastructure and dedicated support staff are included. [25][26][27][28][29][30] Still, clinical practice guidelines released in 2021 for health care providers treating adults with spinal cord injury recommend screening for depression (and mental health in general) within inpatient and outpatient rehabilitation programs, and endorse referral to a mental health professional. 31 To improve rates of intervention and recognition and given the identified impact of depression on orthopaedic outcomes, the acknowledged reluctance of physicians to intervene, and the insufficiency of physician education to improve rates of depression recognition and intervention, it is clear that support for physicians to intervene with their depressed patients is needed.…”

Section: Introductionmentioning

confidence: 99%

“…However, physicians are reluctant to intervene, and physician education aimed at increasing rates of depression recognition and intervention has been found to be largely ineffective unless additional infrastructure and dedicated support staff are included 25–30. Still, clinical practice guidelines released in 2021 for health care providers treating adults with spinal cord injury recommend screening for depression (and mental health in general) within inpatient and outpatient rehabilitation programs, and endorse referral to a mental health professional 31…”

Section: Introductionmentioning

confidence: 99%

Efficacy of automated electronic medical records (EMR) notification to promote provider intervention for severe depression: a retrospective record review

McKelvey

Lindsey

Castro

et al. 2022

Current Orthopaedic Practice

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Background:Depressive symptoms as measured by the Patient-Reported Outcomes Measurement Information System (PROMIS) Depression (D; PROMIS-D) score is a patient-specific independent predictor of decreased improvement after orthopaedic surgery. Despite evidence that depression predicts worse surgical outcomes, data show orthopaedic surgeons rarely address mental health with their patients. Methods:The authors conducted a retrospective chart review of all patient visit data from October 1, 2018 through December 31, 2020, at Cedars-Sinai Orthopaedic Center outpatient clinics to determine if a best practices alert built into the electronic medical record (EMR) notifying surgeons of their patients who had PROMIS-D scores of 70+ (severe depression) would be impetus enough for providers to intervene. Records with PROMIS-D scores of 70+ (N = 361) were selected and reviewed; the authors examined how often the surgeons documented an action in the record in response to the depression notification. Results:Surgeons were found to take action in only 28.5% (N = 103) of the visits with qualifying scores. Conclusions:Notification of patient depression status alone was insufficient to persuade most surgeons to discuss mental health with their severely depressed patients. To empower surgeons to have these important conversations, extant barriers need to be identified and addressed. The association with rates of intervention and individual-level factors of both patients and providers could be explored.

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“…Ускладнення ТСМ істотно збільшують щорічні витрати, пов'язані із лікуванням та доглядом за спінальними пацієнтами [9,10]. Найвідоміші з них -спастичність [11][12][13][14], хронічний біль [15,16], розлади вегетативної регуляції [17,18] і пов'язані з цим порушення функції серцево-судинної [19], травної [20], сечової [21,22] та статевої систем [23,24], а також, імовірно, афективні [25][26][27][28] і когнітивні розлади [29][30][31][32][33].…”

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Model of spinal cord lateral hemi-excision at the lower thoracic level for the tasks of reconstructive and experimental neurosurgery

Medvediev¹,

Abdallah²,

Draguntsova³

et al. 2021

Ukr Neurosurg J

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Purpose. To test the model of spinal cord lateral hemiexcision in young rats. Materials and methods. Animals ‒ male rats (age about 1 month, body weight about 50 g, inbred derivatives of the Wistar line); the number of experimental groups is: 1) lateral spinal cord hemisection at the level of segments about T12–T13 (Sect; n=11); 2) lateral spinal cord hemiexcision about 1 mm long at the similar level (Exc; n=8). Assessment of motor Function Index (FI) and the Spasticity Index (SI) of the paretic hindlimb was carried out using the Basso–Beattie–Bresnahan (BBB) scale and Ashworth scale, respectively, in our technical modifications. The non-inclusion criteria: the BBB score above 9 points of FI for the ipsilateral hindlimb in a week after injury ‒and / or BBB score less than or equal to 14 points of FI of the contralateral hindlimb during a long follow-up period (in general, 2 animals in the Sect group, 3 animals ‒ in the Exc group). Asymptotic differences in the timing of testing between subgroups and groups were revealed during the first three weeks of follow-up. Interpolation reproduction of individual values of FI and SI was used in exceptional cases. The total follow-up period was 5 months. Statistical analysis was performed using the Mann-Whitney U Test, Wilcoxon Matched Pairs Test, Spearman’s Rank Order Correlation. For pathomorphological study, the method of silver impregnation of the spinal cord longitudinal sections of the Exc group animals obtained in 5 months after the simulation of injury was used. Results. One week after injury, the FI in the Sect group was 5.9±1.1 according to BBB points, a statistically significant increase in the FI lasted for the first 3 weeks (p<0.05; Wilcoxon Matched Pairs Test), the FI maximum in the group was 10.1±1.1 BBB points, and the FI value at the end of the study was 9.5±1.0 BBB points. In the Exc group, 1 week after injury, the FI was 0.9±0.5 BBB points, during the next week it reached the actual maximum (1.9±0.7 BBB points), by the end of the 5th month it significantly decreased to 0.8±0.3 BBB points (p<0.05; Wilcoxon Matched Pairs Test). One week after injury, the SI value in the Sect group was 0.3±0.1 points according to Ashworth scale, in the Exc group ‒ 0.7±0.1 Ashworth points, a significant increase (p<0.05; Wilcoxon Matched Pairs Test) in SI in the Sect group was noted during the 2nd week and the 2nd month, in the Exc group ‒ during the 2nd and 6th week, as well as the 3rd and 5th month after injury. The SI final and maximal score for the Sect group was 0.8±0.2 Ashworth points, and for the Exc group ‒ 3.6±0.3 Ashworth points. For both groups, there was no correlation between the mean FI value and a significant positive correlation of the mean SI value with the value of the follow-up period (p<0.05; Spearman’s Rank Order Correlation), as well as the absence of correlation between the mean FI and SI values during the total follow-up period. A significant negative correlation (p<0.05; Spearman’s Rank Order Correlation) between individual FI and SI values was found after 1 and 4 weeks, 3 and 5 months after the injury for the Sect group, as well as after 5, 7, 8 weeks and after 3 and 4 months for the Exc group. At all periods of follow-up, the difference in both FI and SI mean values of both groups was significant (p<0.05; the Mann-Whitney U Test). Conclusions. The studied model of spinal cord injury in young rats is the means of choice for testing solid neural transplantation means for the spinal cord injury restorative treatment. The interpretation of data obtained using the BBB scale on models of lateral half spinal cord injury should be carried out with caution, and the methodology for verifying spasticity requires significant improvement. We recommend that the optimal timing for the FI and SI monitoring after lateral half spinal cord injury is 7 days, 14 days and in 1, 2, 3, 4, 5, 6, and 7 months.

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Knowledge and attitude of nonpsychiatric physicians regarding suicide in spinal cord injury patients and need for structured psychiatric education for suicide prevention

Cited by 6 publications

References 28 publications

Comparing the effect of ketamine and lidocaine on agitation and pain in rhinoplasty: A randomized clinical trial

Comparing the effect of ketamine and lidocaine on agitation and pain in rhinoplasty: A randomized clinical trial

Efficacy of automated electronic medical records (EMR) notification to promote provider intervention for severe depression: a retrospective record review

Model of spinal cord lateral hemi-excision at the lower thoracic level for the tasks of reconstructive and experimental neurosurgery

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