Reasons Why Trauma Patients Request for Discharge against Medical Advice in Wesley Guild Hospital Ilesha (original) (raw)
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2022
Background: Studies in the African Sub-region have highlighted injuries and its associated morbidity and mortality as an emerging public health problem, making it necessary to develop a holistic approach to handle injury outcomes in Ghana. The study purposed to assess the preference and reasons for people choosing a place of fracture care among the general population in the Assin North District of the Central region of Ghana. Method: A prospective cross-sectional study was employed in which 237 participants were randomly selected from six communities in the Assin-North District of the Central Region. Structured questionnaires after verbal informed-consent were used to collect data. The data collected was analyzed using descriptive statistics and chi-square test. Results: A total of 237 participants were interviewed, 14.8% of them had a history of fracture for which 60% sought treatment with Traditional Bone Setters (TBS). About 27.8% of respondents preferred TBS treatment over orthodox fracture care. Most of them (69.6%) were females with more than half (56.1%) being young adults. Only gender (p=0.029) and religion (p=0.043) were associated with the study group's preference of fracture care. Common reasons for choosing a particular place of fracture care included "perceived" healing methods (77.6%), past experience (20.7%), time to fracture healing (11.8%), and cost of treatment (9.3%). Generally, fear of complications such as mal-union (60.8%), stiff knee (62.1%), delayed union (69.6%), amputation (63.3%), and infection (76%) were some of the reasons why participants chose hospital care over TBS. Conclusion: People make decisions about where to seek fracture treatment (either at a hospital or with a traditional bonesetter) influenced by cost of treatment and knowledge of complications that may result from poorly handled fracture-care. The study showed the need to improve knowledge about the potential benefits of orthodox fracture-care using scientifically tested and reproducible methods which have been shown to consistently improve outcomes.
The Open Orthopaedics Journal, 2011
In developing nations such as Nigeria, where there is a shortage of surgeons formally trained in fracture care, many of the injured seek care from traditional bonesetters. We conducted a qualitative study of fracture care in two settings in Enugu, Nigeria: The National Orthopaedic Hospital Enugu (NOHE) and a traditional bonesetter practice. Primary assessment measures at the NOHE included evaluations of the structure and process of fracture care according to the Orthopaedic Trauma Association's Level 1 Trauma Center Requirements. Further, we conducted interviews of NOHE patients and hospital staff. We also observed fracture care at a traditional bonesetter practice. We observed the traditional care process and interviewed both bonesetters and patrons of the bonesetter practice.
Clinical spectrum of discharges against medical advice in a developing country
Indian Journal of Surgery, 2008
Background Patients who leave the hospital before clinician certifi cation of fi tness are referred to as discharge against medical advice (DAMA). This phenomenon of discharges against medical advice is an undesirable but relatively common occurrence worldwide. Professional liability and harmful effect of this practice to individual health are of concern. Aims: The essence of this study is to determine the spectrum of patients who DAMA in a Nigerian teaching hospital. Design Descriptive study over a two-year period in an urban teaching hospital in Nigeria. Materials and methods All consecutive patients who discharge against medical advice at the surgical emergency room of University Teaching Hospital, Ilorin from January 2004 to December 2005 were studied prospectively. The patients' demographic details, diagnosis, reason for discharge, signatory to discharge and length of hospital stay were studied. Statistical analysis Analysis of the data was done using Statistical Package for Social Sciences (SPSS) version 11. Results Prevalence rate of DAMA was 4.2%, comprising 110 of a total of 2,617 patients admitted during the study period. Male to female ratio was 3.8:1, the mean age was 30.0 years (range, 4-70 years). Trauma accounted for the highest number of patients 102(97.2%) out of whom 52 (51%) had long bones fracture. Patients who wish to seek alternate medical care accounted for 43.6%, while fi nancial constraint contributed to 29.1% DAMA. Forty-fi ve out of forty-eight (93.7%) of patients who DAMA to seek alternate medical care had fracture. Conclusion Trauma was the most common clinical condition for patients who DAMA. Most common reason for DAMA was to seek alternate treatment followed by fi nancial constraint. Health education on potential benefi t of orthodox treatment of fracture, treatment subsidy and full implementation of national health insurance scheme will reduce incidence of DAMA.
International Journal of Research in Orthopaedics
Background: Leave against medical advice (LAMA) of hospitalized patients is an adverse clinical event in which a patient chooses to leave the hospital before it is medically advisable to do so and it negatively affects the treatment outcome. Because of this, the study was designed to determine the incidence of and indications for LAMA among orthopedic patients who presented at the accident and emergency department of the university college hospital, Ibadan.Methods: This was a prospective hospital-based study determining the incidence of LAMA among orthopedic patients who presented at the accident and emergency department of the university college hospital, Ibadan between September 2019 and March 2020.Results: A total of 289 patients with orthopedic conditions presented within the study period and about 12.46% of these LAMA. The male to female ratio observed in this study is 2:1. The age range was between 8 and 93 years. Trauma from motorbike and motor vehicle accidents accounted for...
International Journal of Research in Orthopaedics
Background: A trauma emergency is any aggression (direct or indirect) external to the body for which no therapeutic delay is allowed at the risk of endangering the patient's life or the functional prognosis of his limbs. The objective of this study was to report the results of the management of traumatological emergencies. Methods: This was a descriptive cross-sectional study from 11 January 2021, to 11 July 2021. It focused on patients seen for traumatological emergencies in the CHU Ignace Deen Orthopaedics-Traumatology department. Results: Trauma emergencies constitute 75.2% of admissions to the emergency department. The average age of the patients was 32.2 years, with extremes of 1 and 91 years. There was a predominance of 76.3% males with a ratio (M/F) of 3.2. Road traffic accidents were the most found aetiology in 82.9%, and motorcycles were involved in 68.7%. Limb fractures were found in 34.7%. The treatment time was ≤6 hours in 67.5%, and 203 patients received drug treatm...
HEALTH SCIENCES AND DISEASES, 2018
RESUME Introduction. Dans les pays en voie de developpement, particulierement au Cameroun, la population utilise encore largement la medecine traditionnelle pour soigner les fractures. L’objectif de notre etude etait d’etudier les facteurs favorisant les consultations chez les guerisseurs traditionnels et les consequences de ce comportement sur la prise en charge. Methodologie. Il s’agit d’une etude descriptive, transversale sur une periode de six (6) mois. Nous avons collige 102 patients. La collecte des donnees a eet faite au niveau des registres de consultation et des registres de compte rendu operatoire. Resultats. Le sexe masculin representait 70,59%. Dans 35,30% il s’agissait des patients jeunes. Les accidents de la voie publique etaient la cause la plus frequente (77,45%). Les conducteurs de motos etaient majoritaires (30,40%) et leurs jeunes passagers (etudiants et ecoliers). Le manque des moyens financiers a ete evoque dans 53,92% des cas come facteur favorisant. En outre, ...
Huria: Journal of the Open University of Tanzania, 2020
The study examined the factors for the preference of Traditional Bone Setting (TBS) in the treatment of fractures among Tanzanians. It sought to unfold other reasons for consulting TBS practitioners besides poverty, ignorance and inaccessibility to modern orthopedic services which are commonly associated with the pull factors. From the available literature, though very popular, TBS is associated with complications like malunion, non-union of the fractured bones, and limb gangrene. In order to find out why there is a paradox, the investigation was mainly done in Muleba, a district of Kagera Region where the treatment is most common according to the