1. Interdisciplinary integration of nursing and psychiatry (INaP) improves dizziness‐related disability
- Author
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Shaleen Sulway, Thushanthi Balakumar, Mohamed Attia, Wanda A. Dillon, Anastasia Logotheti, Paul Ranalli, Philip Gerretsen, Parita Shah, David D. Pothier, and John A. Rutka
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Future studies ,Dizziness ,Severity of Illness Index ,Medical care ,Neurotology ,Disability Evaluation ,Young Adult ,030507 speech-language pathology & audiology ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Surveys and Questionnaires ,Humans ,Medicine ,Illness severity ,In patient ,030212 general & internal medicine ,Psychiatry ,Postural Balance ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Retrospective cohort study ,Evidence-based medicine ,Middle Aged ,Treatment Outcome ,INAP ,Otorhinolaryngology ,Quality of Life ,0305 other medical science ,business ,Follow-Up Studies - Abstract
OBJECTIVES/HYPOTHESIS The traditional medical care model of "assess and refer" in a sequential fashion fails to recognize the complexities that arise due to overlapping physical and psychiatric comorbidities experienced by patients with chronic dizziness or imbalance, thus resulting in inadequate treatment outcomes. We aimed to evaluate the impact of a novel interdisciplinary approach to care that integrates nursing and psychiatry (INaP) on dizziness-related disability. STUDY DESIGN Retrospective cohort study. METHODS We compared the change in clinical assessment scores (i.e., Dizziness Handicap Inventory [DHI], Dizziness Catastrophizing Scale) at approximately 8 months follow-up between those who did (INaP+) and did not receive INaP (INaP-). Data from 229 patients with dizziness or imbalance referred to an interdisciplinary neurotology clinic in Toronto, Ontario, Canada were acquired from August 2012 to December 2016 and January 2011 to December 2013 for the INaP+ and INaP- groups, respectively. RESULTS A mean group difference in the percentage change in DHI scores was found, with greater reductions in dizziness-related disability in the INaP+ group (n = 121) versus the INaP- group (n = 108). This remained significant after controlling for age, gender, baseline illness severity, and duration between baseline and follow-up visits. CONCLUSIONS The novel interdisciplinary approach of incorporating INaP appears to be more effective than interdisciplinary care without INaP in reducing dizziness-related disability in patients with chronic dizziness or imbalance. Clinical settings should consider the addition of INaP to achieve better patient outcomes. Future studies are required to test the hypothesis that INaP is more efficient and cost-effective than the traditional model of care. LEVEL OF EVIDENCE 3 Laryngoscope, 130:1800-1804, 2020.
- Published
- 2019
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