Background: Self-discharge by patients without completing their treatment is a problematic issue in healthcare and is strongly associated with readmission and poor treatment outcome.
Patients And Methods: A descriptive study of the rate and reasons why patients with limb injuries took self-discharge against medical advice (DAMA) from our facility, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria, a tertiary health institution between May 2011 and April 2014.
Results: One hundred and thirty-one (16.2%) patients took DAMA out of 810 patients seen with limb injuries. Age ranges from 3 to 95 years with a mean of 36.31 ± 19.34 years. Road traffic crash accounted for 110 (84%) of the injuries. One hundred and sixteen (88.5%) had fractures and 9 (6.9%) had soft tissue injuries. Fifty-eight (44.3%) of the patients were referred cases, 128 (97.7%) signed DAMA form while 3 (2.3%) absconded from the hospital. Reasons for DAMA were mainly; belief more in traditional bone setters (TBSs) (36.6%); pressure from relations (22.9%) and high cost of hospital care (19.8%). One hundred and one (77.1%) of the patients volunteered that they were going to TBS for continued care.
Conclusion: High percentage of patients DAMA from our facility and majority of them were in favour of unorthodox form of treatment.
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http://dx.doi.org/10.4103/npmj.npmj_88_17 | DOI Listing |
Int J Surg Case Rep
January 2025
School of Postgraduate Studies and Research, Amoud University, Amoud Valley, Borama 25263, Somalia.
Introduction: Spontaneous splenic rupture (SSR) is a rare, life-threatening complication, sometimes associated with infections like malaria and dengue fever. This case report details a unique presentation of SSR.
Case Presentation: A 28-year-old male in Somalia presented with fever, epigastric pain, nausea, vomiting, and body aches, consistent with malaria and dengue.
Health Soc Care Deliv Res
October 2024
Medical School, Swansea University, Swansea, UK.
Introduction: Research has found differences in processes and outcomes of care between people in ethnic minorities and White British populations in some clinical conditions, although findings have been mixed. The Building an understanding of Ethnic minority people's Service Use Relating to Emergency care for injuries study is investigating differences in presentation, experience and health outcomes between people from ethnic minorities and White British people who seek emergency health care for injury.
Objective: Our aim was to consult with stakeholders to define measurable outcomes available in routine ambulance and emergency department data; to assess the appropriateness of existing outcome measures for ethnic minorities and White British people; and to identify any gaps.
Br J Hosp Med (Lond)
August 2024
Department of Cardiology, Doncaster Royal Infirmary, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, UK.
Patients who discharge themselves against medical advice comprise 1%-2% of hospital admissions. Discharge against medical advice (DAMA) is defined as when a hospitalised patient chooses to leave the hospital before the treating medical team recommends discharge. The act of DAMA impacts on both the patient, the staff and their ongoing care.
View Article and Find Full Text PDFRural Remote Health
July 2024
Murtupuni Centre for Rural and Remote Health, James Cook University, PO Box 2572, Mount Isa, Qld 4825, Australia.
Introduction: The aim of the study was to explore, in one remote hospital, emergency department healthcare providers' experience and perceptions of the factors surrounding a patient's decision to discharge against medical advice (DAMA). The secondary objective was to gain insight into staff experiences of the current protocols for managing DAMA cases and explore their recommendations for reducing DAMA incidence.
Methods: This was a cross-sectional study involving a survey and semi-structured interviews exploring healthcare providers' (n=19) perceptions of factors perceived to be influencing DAMA, current practice for managing DAMA and recommendations for practice improvements.
JAC Antimicrob Resist
June 2024
Brighton and Sussex Medical School Department of Global Health and Infection, University of Sussex, 94 N-S Road, Falmer, Brighton BN1 9PX, UK.
Background: Dalbavancin's unique properties have led to an increase in its off-licence use in complex infection and in vulnerable populations including people who inject drugs (PWID), but data remain limited. In this retrospective cohort study, we describe the characteristics, treatment rationale and outcomes for all adult inpatients treated with dalbavancin at a UK tertiary hospital.
Results: Fifty-eight inpatients were treated with dalbavancin between 1 January 2018 and 1 January 2021, 98.
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