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Hoy — Octubre 14th 2025Tus fuentes RSS

Impact of social determinants of health on sepsis outcomes: a retrospective study of a single centre in the USA

Por: Nyelele · M. A. · Estela · K. · Jagneaux · T. · Ikuma · L. H. · Knapp · G. M.
Objectives

Social determinants of health (SDOH) factors are known to influence patient outcomes, but their effect on sepsis remains insufficiently studied. This research aims to investigate the relationship between SDOH factors and sepsis outcomes, highlighting opportunities to reduce health disparities and enhance patient care.

Design

Retrospective study.

Setting

Level I trauma centre in Baton Rouge, Louisiana, USA.

Participants

Patients with sepsis aged 18–89 years. Patients discharged or transferred to hospice were excluded to prevent bias and misinterpretation of the findings.

Main exposure measures

Social Vulnerability Index (SVI), the Gini Index and the average distance to the nearest urgent care, emergency department and clinic.

Main outcome measures

In-hospital mortality, 30-day readmission and hospital length of stay (LOS).

Methods

2 tests, Mann-Whitney U tests and Cox regression.

Results

Distance from urgent care is significantly associated with mortality (4.14 vs 3.24 miles, p

Conclusion

Mortality and LOS are closely linked to proximity to urgent care, while high SVI is notably associated with longer LOS. These findings highlight the significant impact of SDOH factors on sepsis outcomes and underscore the need for targeted interventions to address disparities in healthcare access and contextual health practices.

AnteayerTus fuentes RSS

Developing an Intervention to Improve Sexual Health Assessment and Care in Men With Inflammatory Bowel Disease

ABSTRACT

Aim

To co-produce a prototype intervention to help nurses improve the assessment and care of the sexual health needs of men with inflammatory bowel disease.

Background

Inflammatory bowel disease can have a significant impact on the sexual health and well-being of men, but has largely been neglected in research and clinical guidelines. Men with the disease report that sexual health is not discussed during consultations, while healthcare practitioners describe a lack of confidence to initiate sexual health assessments. At present, no evidence-based tool exists to support nurses in detecting, assessing, and providing care for the sexual health of men with the disease.

Design

A mixed-methods study shaped by phase 1 of the Medical Research Council's framework for the development of complex interventions.

Methods

(1) Cross-sectional surveys of (i) men with inflammatory bowel disease, (ii) nurses, and (iii) inflammatory bowel disease services to determine the current state of sexual health provision across the UK National Health Service. (2) Semi-structured interviews with men and the partners of men with IBD and asynchronous focus groups with health professionals to explore appropriate and acceptable ways to provide sexual healthcare. (3) Three consecutive co-production workshops inclusive of men with the disease, healthcare professionals, and stakeholders to formulate a prototype intervention.

Implications for the Profession and/or Patient Care

This study will create an evidence-based prototype intervention that will provide nurses with the knowledge and skills required to effectively assess the sexual health needs of men with inflammatory bowel disease and provide appropriate, patient-centred care.

Patient Contribution

The study design was supported by a patient group. The study delivery will be supported by a patient co-investigator and stakeholder group inclusive of men with lived experience of the disease.

Reporting Method

This report adheres to the SPIRIT 2013 checklist for standard protocol items for clinical trials.

Trial Registration

clinicaltrials.gov ID: NCT06562751

‘My sexual desires, everything, my normal life just stops’; a qualitative study of male sexual health in inflammatory bowel disease

Abstract

Aim

To describe and interpret the sexual health experiences of men with IBD.

Design

Interpretive qualitative study.

Methods

In-depth, semi-structured interviews were conducted with 22 men with a diagnosis of Inflammatory Bowel Disease. Interviews were digitally audio-recorded and transcribed verbatim. Data were analysed using constant comparative, thematic analysis.

Results

Three themes were identified from interview data: (1) the disease shapes intimate connections, (2) the disease thwarts sexual experiences and (3) the disease disrupts male gender norms. Men reported that active disease lowered libido and could change pre-, inter- and post-coital sexual practices. All participants noted that health professionals did not initiate the discussion of sexual health and well-being needs in the outpatient hospital setting. Men who engaged in receptive anal sex reported a lack of disease-specific guidance and understanding from professionals.

Conclusion

Inflammatory bowel disease can negatively impact the sexual well-being, gender identity and activities of men. Further research is required to identify the care preferences of men with IBD and clarify the barriers and facilitators to sexual health assessment so that nurses may better support the health needs of this population.

Implications for the Profession and Patient Care

This study highlights the need for sexual health and well-being support that is specific to disease and gender in IBD. There is a paucity of information and guidance for men with peri-anal disease and proctitis who engage in receptive anal sex, which requires urgent attention.

Reporting Method

Reporting follows the COREQ checklist.

Patient or Public Contribution

A patient and public involvement group informed the development of the study design. The group reviewed public facing documents and interview guides. One member of the group provided comments on the identified themes.

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