Browsing by Author "Aryal, Prayush"
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Publication Patterns of Geriatric Patients Visiting Emergency Room at Kirtipur Hospital, Nepal(Public Health Concern Trust-Nepal (phect-NEPAL), 2024) Tamrakar, Nijina; Aryal, PrayushAbstract: Introduction: With the rise in geriatric population in every country, their visit to emergency room has also increased. The diagnosis pattern of geriatric patients in emergency can help recognize and timely address their morbid conditions and help formulate preventive measures. This study aimed to explore the diagnoses of geriatric patients visiting emergency room and find out the common morbid conditions. Methods: The authors performed a retrospective cross-sectional descriptive study. They took data from Emergency Registry from January 2018 to June 2018, including all the elderly population of age group above 65 years. The sample size was 409. The findings were recorded in MS Excel and expressed in numbers and percentages. Results: The percentage of Acute Exacerbation of Chronic Obstructive Pulmonary Disease was 11%, followed by dyselectrolytemia (8%), trauma (7%) and others. Conclusion: Acute Exacerbation of Chronic Obstructive Pulmonary Disease was the most common diagnosis, followed by dyselectrolytemia and trauma.Publication Practices, Attitudes of Doctors and Patient’s Perspectives Regarding Breaking Bad News at a Tertiary Health Centre(Public Health Concern Trust-Nepal (phect-NEPAL), 2024) Aryal, Prayush; Tamrakar, Nijina; Yadav, Bharat Kumar; Pokharel, Yagya RajAbstract: Introduction: Breaking bad news using SPIKES protocol will help effective bad news delivery to the patients. Assessing doctor’s practices and attitudes in bad news delivery and exploring patient’s perspectives on how bad news was delivered to them could give information about doctors’ communication with patients. This study aimed to assess doctors’ practices and attitudes of breaking of bad news and explore patients’ perspectives. Methods: The authors did questionnaire based qualitative and quantitative cross sectional study at a tertiary health centre in Nepal. They asked 75 doctors from various departments regarding their practices of breaking bad news as per SPIKES protocol. They inquired the same number of patients/relatives about how the bad news was broken to them. Practice scores among doctors were analyzed. The response of patients were compared with the doctors’. Results: MD residents and doctors from Pediatric ICU/Neonatal ICU had better practice scores than Medical officers and doctors from Emergency department respectively. Consultants felt more confident in breaking bad news. Eighty four percent of the doctors wanted to deliver the bad news to the family members first than the patient. Most of the doctors believed they broke bad news as per the SPIKES protocol. However, as per patient’s perspectives they were not delivered the news as per the protocol. Conclusion: Most of the doctors agreed to practice breaking bad news as per SPIKES protocol and felt confident in doing so. There was a discrepancy regarding patient’s perspectives and doctor’s practice in how delivery of bad news was done.