title: [The Status, Change and Health Issues of Inpatients' Sixth Vital Sign in a Medical Center].
abstract: BACKGROUND
  Hospitalized patients generally have elevated levels of emotional distress. Gaining a better under-standing of the problem of emotional distress among hospitalized patients is conducive to providing appropriate emotional care and promoting their recovery.
  
  
  OBJECTIVE
  To analyze the scores for the "sixth vital sign" (i.e., emotional distress), diversification, and the health-related problems of hospitalized patients at a medical center in Taiwan. The results may offer an important reference for providing effective emotional care to hospitalized patients.
  
  
  METHODS
  A retrospective descriptive research design was used. Data were collected from all of the 27,885 inpatients that were registered at the target hospital in 2013. Further, a total of 245,814 attendance records were assessed to extract the data that were relevant to emotional distress.
  
  
  RESULTS
  The findings revealed that 58.3% of hospitalized patients had earned a sixth vital sign score ≥ 1 and that 0.8% of these patients had earned a score ≥ 4. On the whole, the sixth vital sign scores of hospitalized patients were found to decrease progressively with the number of hospitalization days except for hematology and oncology, neurosurgery, and plastic surgery patients. The highest emotional distress scores were found among family medicine, dermatology, and plastic surgery patients. Moreover, emotional distress scores were significantly higher in patients who had health problems that involved pain, anxiety, or sleep disorder.
  
  
  CONCLUSIONS
  The present study suggests that improving the emotional care of hematology, oncology, neurosurgery, family medicine, dermatology, and plastic surgery patients and of patients with health problems involving pain, anxiety, or sleep disorder may significantly improve the quality of inpatient holistic healthcare. Only 0.8% of the subjects in the present study had an emotional distress score ≥ 4, which is significantly lower than the level reported in other similar studies. Our findings suggest that related education and training for nursing staffs may improve their assessment and care practices in caring for patients with emotional distress. Furthermore, using more appropriate words, methods, and environments to evaluate the emotional distress of patients holds the potential to improve assessment and care for these patients.
authors.affiliation: Department of Nursing, Kaohsiung Veterans General Hospital, Taiwan, ROC.
authors.forename: Li-Ying
authors.initials: LY
authors.lastname: Lin
authors.affiliation: Department of Nursing, Kaohsiung Veterans General Hospital, Taiwan, ROC.
authors.forename: Ya-Hui
authors.initials: YH
authors.lastname: Huang
authors.affiliation: Department of Nursing, Kaohsiung Veterans General Hospital, Taiwan, ROC.
authors.forename: Chung-Lung
authors.initials: CL
authors.lastname: Hung
authors.affiliation: Department of Nursing, Kaohsiung Veterans General Hospital, Taiwan, ROC.
authors.forename: Ya-Mei
authors.initials: YM
authors.lastname: Chen
authors.affiliation: Department of Nursing, Kaohsiung Veterans General Hospital, Taiwan, ROC.
authors.forename: Ching-Ju
authors.initials: CJ
authors.lastname: Kuo
authors.affiliation: Department of Nursing, Kaohsiung Veterans General Hospital, Taiwan, ROC. ycku@vghks.gov.tw.
authors.forename: Yan-Chiou
authors.initials: YC
authors.lastname: Ku
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006760:Hospitalization; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013315:Stress, Psychological / Q000453:epidemiology*; D055986:Vital Signs
keywords: emotional distress; hospitalized patients; the sixth vital sign