WCIM 2014 SEOUL KOREA 199
Poster Session
The Korean Journal of Internal Medicine Vol. 29, No. 5 (Suppl. 1)
PS 0586 Psychiatry
Assessment of Depression, Anxiety and Stress among Postnatal Mothers
Nirmala PRADHAN1 Medical Teaching Hospital, Nepal1
Background: Depression often exists co-morbidly with other conditions like anxiety, irritability and stress. Objectives are to assess the levels of depression, anxiety and stress among postnatal mothers and to fi nd the correlation between depression, anxi- ety and stress
Methods: A descriptive survey approach was selected for the study and non-probabil- ity convenient sampling technique was used to select 100 postnatal mothers at M.S.
Ramaiah Medical Teaching Hospital, Bangalore, India.
Results: From the total subject, 16% of the subjects as mild Depression, 13% as moderate depression, 5% as extremely severe Depression and only 1% as in severe Depression. Likewise, 29% as moderate anxiety, 11% of mothers as severe anxiety, 10% as extremely severe anxiety and only 3% as mild anxiety. Considering into the levels of stress, 11% as mild stress, 6% as moderate stress 4% as severe stress and about 2% as extremely stress. The mean percentage of anxiety and stress was high- er than depression. The correlation between depression and anxiety showed highly signifi cant with “r”= 0.643 at p<0.01. Likewise the correlation between anxiety and stress showed a satisfactory signifi cant with “r”= 0.719 at p<0.01. Also the correlation between depression and stress was highly signifi cant with “r”= 0.824 at p<0.01.
Conclusions: Recently delivered mothers are vulnerable to the whole spectrum of general psychiatric disorders, as well as those resulting from the physical and psycho- logical changes of childbirth. Midwives, and public health nurses need to screen for depression, anxiety and stress at every opportunity early in the postpartum period.
PS 0587 Psychiatry
Factors Associated with Relapse and Remission of Alco- hol Dependent Persons after Community Based Treat- ment
Njeri Rahab MBUGUA1, Asunta Wagura WAGURA2, Elizabeth Ann BUKUSI4 Kenya Medical Research Institute, Kenya1, Kenya Network of Women Living with HIV/AIDS, Kenya2, Kenyatta National Hospital, Kenya3, Nairobi University, Kenya4
Background: This study sought to determine the factors associated with remission and relapse in a group of alcohol dependent persons undergoing Community Based Detoxifi cation and Rehabilitation of alcohol dependent persons
Methods: One hundred and eighty eight (188) persons with Alcohol Use Disorder Identi- fi cation Test (AUDIT) positive were subjected to outpatient detoxifi cation for 10 days using a pair of ampoules of high potency Vitamin B and C intravenously daily for 3 consecutive days, diazepam 5 mg and carbamazepine 200 mg for 5 and 10 con- secutive nights respectively on an outpatient basis. The participants were visited twice a week (at home) by the community based health workers and reviewed once a week by the principal investigator and attended a bimonthly group therapy session conduct- ed in groups of 20 s as part of the rehabilitation process. The groups were converted to self-help groups after 4 months to generate income for the participants
Results: Factors signifi cantly associated with relapse to alcohol use included severity of alcohol use and craving for alcohol at intake and the age of onset of alcohol drink- ing. Further there was a statistically signifi cant predictive value in the mean score of alcohol re-lated problems in the community based group (health, social, fi nancial and legal).
Conclusions: Identifying factors that are associated with relapse after alcohol depend- ence treatment is likely to improve the effectiveness of treatment and prevent relapse in persons at risk. Knowledge of factors associated with relapse and remission after treatment for alcohol dependence enables the clinician to offer better individualized treatment. It also enables the clinician to predict which patients are likely to relapse and therefore offer appropriate and effective treatment to prevent relapse.
PS 0588 Psychiatry
Validity and Reliability of Help Autism Rating Scale (HARS) Chart in Bangladesh
Abu Sadat Mohammad NURUNNABI1, Sunjida SHAHRIAH2, A. Z. M. Raihanur RAHMAN3
Bangladesh Medical Research Council, Bangladesh1, BCR Pain Therapy and Wellbeing Centre, Bangla- desh2, Bangabandhu Sheikh Mujib Medical University, Bangladesh3
Background: In Bangladesh, several tools like Autism Behavior Checklist (ABC), Modi- fi ed Checklist for Autism in Toddlers (M-CHAT), Childhood Autism Rating Scale (CARS), and Autism Diagnostic Observation Schedule (ADOS) are widely used for either screen- ing or diagnosis of autism; however, none of these measures have been validated for this population for autism spectrum disorders (ASDs) in Bangladesh. We evaluated the diagnostic reliability and validity of Help Autism Rating Scale (HARS), which was locally developed in 2012 and not widely used.
Methods: This study was conducted in the Centre for Neurodevelopment and Autism in Children (CNAC) of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, on 200 Autistic Spectrum Disorder children in between January and December 2013.
Item level scores of HARS were collected and analyzed. For internal consistency, Cron- bach’s a coeffi cient was calculated. Convergent and divergent validity was calculated.
The factor structure of HARS was demonstrated by principal components analysis.
Results: The adequate face and content validity, HARS demonstrated good internal consistency (Cronbach’s a=0.962) and item-total correlation 0.790. The convergent validity between the HARS and BKT or GDS, calculated with Pearson’s product-mo- ment correlation coeffi cient was 0.741, P=0.01. Divergent validity calculated by cor- relating HARS scores to ACTeRS showed non-signifi cant associations (r=-0.18; P=0.4) demonstrating that HARS discriminates autism from other childhood psychiatric disor- ders like ADHD. A 5-factor structure explained 43.34% of variance.
Conclusions: The HARS has strong psychometric properties and is recommended for clinical and research work in autism spectrum disorders (ASDs) in Bangladesh.
PS 0589 Critical Care Medicine Holistic Care Unit Improves Access Block in Emergency Department in Taiwan
Meng-Chieh WU1, Hsin-Kai HUANG1, Chun-Cheng ZHANG1, Li-Sheng CHANG1, Yung- Ze CHENG2, Chien-Chin HSU2, Kao-Chang LIN1
Holistic Care Unit, Department of Internal Medicine, Chi Mei Medical Center, Taiwan R.O.C1, Department of Emergency Medicine, Chi Mei Medical Center, Taiwan R.O.C2
Background: Emergency department (ED) overcrowding is a problem in many coun- tries including Taiwan. Access block refers to a situation where patients in the emer- gency department requiring inpatient care are unable to gain access to appropriate hospital beds within a reasonable time frame (more than 8 hours total time in the emergency department). Access block is one major reason of ED overcrowding.
Methods: A new holistic care unit was established in our medical center in Taiwan in July 2012, with the attending physicians including internal medicine physicians and a neurologist. The patients who required hospitalized treatment were referred to internal medicine physicians in the emergency department. The new department was comprised of seven experienced medical attending physician to take care of the patients directly, with 8-hour duty work shifts within 24 hours, in collaboration with emergency physicians, radiologists, nurses, social workers and case managers to form a team. This team had similar three-shift work duty, education and training programs, and they shared medical devices and resources. If beds in the intensive care unit or ward are not available immediately, procedures and treatment can be performed in the holistic care unit. The pediatric patients were excluded from this study.
Results: In total, 26,623 patients were admitting to ward from our emergency depart- ment from August 2011 to July 2012, and 23,790 patients from August 2012 to July 2013. The rate of access block decreased from 55.29% to 50.01% ( p < 0.01) after ho- listic care unit was established. The mean time of ED length of stay was also improved from 18.04 hours to 15.43 hours ( p < 0.01).
Conclusions: The newly established holistic care unit in our hospital improved the quality of medical care, not only physiologically but also psychologically.
