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Greene E, Walcott M, Guerra L, Tieu HV, Nandi V, Soler J, Diaz J, Curriero F, Latkin C, Bosompem A, Frye V. Correlates of concordance between self-reported and lab-confirmed viral load among Black and Latine men who have sex with men (BLMSM) living with HIV in New York City. AIDS Care 2024; 36:661-671. [PMID: 37399515 PMCID: PMC10761596 DOI: 10.1080/09540121.2023.2229816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/20/2023] [Indexed: 07/05/2023]
Abstract
Sustained viral suppression is one of the four strategies in the U.S. Department of Health and Human Services' (HHS) plan to end the HIV epidemic in the United States. Individuals living with HIV must understand their viral load accurately for this strategy to be effective. We conducted cross-sectional analyses using baseline data from the NNHIV longitudinal study among men who have sex with men (MSM) living with HIV in New York City to identify factors associated with concordant knowledge between self-reported and lab-confirmed viral load. Of 164 Black and/or Latine participants, 67% (n = 110) reported that their viral load was undetectable, however lab tests showed only 44% (n = 72) had an undetectable viral load (<20 copies/ml). Overall, 62% of the sample (n = 102) had concordant HIV viral load knowledge (agreement of self-reported and lab viral load). In multivariable regression, those with unstable housing (PR = 0.52, 0.30-0.92) and those who had higher levels of beliefs of racism in medicine scale (PR = 0.76, 0.59-0.97) were less likely to have concordant knowledge. Our study underscores the need for implementing measures to improve viral load knowledge, U = U messaging, and strategies to achieve and maintain undetectable viral load status to reduce the burden of HIV at the population level.
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Affiliation(s)
| | - Melonie Walcott
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, NY, NY
| | - Lauren Guerra
- Department of Epidemiology, Columbia University Mailman School of Public Health, NY, NY
| | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, NY, NY
- Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, NY, NY
| | - Vijay Nandi
- Laboratory of Data Analytic Services, Lindsley F. Kimball Research Institute, New York Blood Center, NY, NY
| | - Jorge Soler
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, NY, NY
| | - Jose Diaz
- Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY
| | - Frank Curriero
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Carl Latkin
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | | | - Victoria Frye
- CUNY School of Medicine, NY, NY
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, NY, NY
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Bhatt LD, Ghimire S, Khanal K. Patient satisfaction and their determinants in outpatient department of a tertiary public hospital in Nepal: a cross-sectional study. J Patient Rep Outcomes 2024; 8:26. [PMID: 38416325 PMCID: PMC10902242 DOI: 10.1186/s41687-024-00696-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 02/04/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Patient satisfaction is a vital metric for assessing healthcare quality and delivering patient-centered care. It can predict service utilization patterns by determining healthcare users' contentment with their providers. Consequently, evaluating patient satisfaction and its underlying factors is crucial to maintaining the quality of healthcare services. The present study aimed to assess patient satisfaction and its determinants in a tertiary care public hospital in Nepal. In this research, a cross-sectional design was employed to examine patient satisfaction within the Outpatient Department of Mental Hospital Lagankhel, Nepal. The study adopted a systematic random sampling approach for respondent selection, and stringent measures were implemented to uphold the validity and reliability of the collected data. To assess patient satisfaction comprehensively, the Patient Satisfaction Questionnaire-III (PSQ-III), developed by the RAND Corporation, was employed in conjunction with relevant sociodemographic variables. Utilizing mean scores and percentages, we calculated satisfaction levels across various dimensions. Additionally, a multinomial logistic regression analysis was conducted to investigate the relationships between patient satisfaction dimensions and sociodemographic characteristics. RESULTS This study encompassed perspective of 206 participants, with 57.3% representing patient relatives and 51% being male, median age of 32 years (standard deviation: 12.53). Notably, patients reported higher levels of satisfaction, particularly within the interpersonal relationship dimension, while the technical quality domain received comparatively lower satisfaction ratings. Multinomial logistic regression analysis underscored the significance of sociodemographic factors in shaping patient satisfaction, with age (p = 0.008), type of residence (p = 0.001), occupation (p = 0.0019), income status (p = 0.014), time to reach the healthcare facility (p = 0.013), and insurance enrollment status (p = 0.017) all demonstrating significant associations. These findings illuminate the intricate qualities of patient satisfaction within our healthcare context, offering actionable insights for enhancement and guiding the trajectory of future research endeavors. CONCLUSIONS Overall patient expressed satisfaction with service provided by tertiary care hospital, however continuous improvement remains essential. Conducting large-scale, nationwide studies across hospital tiers is vital. This data-driven approach empowers policymakers to allocate resources effectively, inform decision-making, and enact policies that exceed patient expectations, fostering a healthcare system of unparalleled excellence.
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Affiliation(s)
- Laxman Datt Bhatt
- Faculty of Management Studies, Department of Healthcare Management, National Open College, Pokhara University, Lalitpur, Nepal.
- Division of Population Health and Applied Health Sciences, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, A1C 5S7, Canada.
| | - Sandhaya Ghimire
- Department of Pharmacy, Government of Nepal, Mental Hospital, Lalitpur, Nepal
| | - Kabita Khanal
- Faculty of Management Studies, Department of Healthcare Management, National Open College, Pokhara University, Lalitpur, Nepal
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Reed JE, Johnson JK, Zanni R, Messier R, Asfour F, Godfrey MM. Quality of locally designed surveys in a quality improvement collaborative: review of survey validity and identification of common errors. BMJ Open Qual 2024; 13:e002387. [PMID: 38365431 PMCID: PMC10875491 DOI: 10.1136/bmjoq-2023-002387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 01/09/2024] [Indexed: 02/18/2024] Open
Abstract
OBJECTIVE Surveys are a commonly used tool in quality improvement (QI) projects, but little is known about the standards to which they are designed and applied. We aimed to investigate the quality of surveys used within a QI collaborative, and to characterise the common errors made in survey design. METHODS Five reviewers (two research methodology and QI, three clinical and QI experts) independently assessed 20 surveys, comprising 250 survey items, that were developed in a North American cystic fibrosis lung transplant transition collaborative. Content Validity Index (CVI) scores were calculated for each survey. Reviewer consensus discussions decided an overall quality assessment for each survey and survey item (analysed using descriptive statistics) and explored the rationale for scoring (using qualitative thematic analysis). RESULTS 3/20 surveys scored as high quality (CVI >80%). 19% (n=47) of survey items were recommended by the reviewers, with 35% (n=87) requiring improvements, and 46% (n=116) not recommended. Quality assessment criteria were agreed upon. Types of common errors identified included the ethics and appropriateness of questions and survey format; usefulness of survey items to inform learning or lead to action, and methodological issues with survey questions, survey response options; and overall survey design. CONCLUSION Survey development is a task that requires careful consideration, time and expertise. QI teams should consider whether a survey is the most appropriate form for capturing information during the improvement process. There is a need to educate and support QI teams to adhere to good practice and avoid common errors, thereby increasing the value of surveys for evaluation and QI. The methodology, quality assessment criteria and common errors described in this paper can provide a useful resource for this purpose.
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Affiliation(s)
- Julie E Reed
- Julie Reed Consultancy Ltd, London, UK
- Halmstad University School of Health and Welfare, Halmstad, Sweden
| | - Julie K Johnson
- Northwestern Quality Improvement, Research, and Education in Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Robert Zanni
- Robert Wood Johnson Barnabas Health Medical Group, Monmouth Medical Center, Long Branch, New Jersey, USA
| | - Randy Messier
- University of New Hampshire, Durham, New Hampshire, USA
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Liapi F, Chater AM, Kenny T, Anderson J, Randhawa G, Pappas Y. Evaluating step-down, intermediate care programme in Buckinghamshire, UK: a mixed methods study. BMC Public Health 2023; 23:1087. [PMID: 37280556 DOI: 10.1186/s12889-023-15868-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 05/10/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Intermediate care (IC) services are models of care that aim to bridge the gap between hospital and home, enabling continuity of care and the transition to the community. The purpose of this study was to explore patient experience with a step-down, intermediate care unit in Buckinghamshire, UK. METHODS A mixed-methods study design was used. Twenty-eight responses to a patient feedback questionnaire were analysed and seven qualitative semi-structured interviews were conducted. The eligible participants were patients who had been admitted to the step-down IC unit. Interview transcripts were analysed using thematic analysis. FINDINGS Our interview data generated five core themes: (1) "Being uninformed", (2) "Caring relationships with health practitioners", (3) "Experiencing good intermediate care", (4) "Rehabilitation" and (5) "Discussing the care plan". When comparing the quantitative to the qualitative data, these themes are consistent. CONCLUSIONS Overall, the patients reported that the admission to the step-down care facility was positive. Patients highlighted the supportive relationship they formed with healthcare professionals in the IC and that the rehabilitation that was offered in the IC service was important in increasing mobility and regaining their independence. In addition, patients reported that they were largely unaware about their transfer to the IC unit before this occurred and they were also unaware of their discharge package of care. These findings will inform the evolving patient-centred journey for service development within intermediate care.
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Affiliation(s)
- Fani Liapi
- Institute for Health Research, University of Bedfordshire, Luton, LU2 8LE, UK.
| | - Angel Marie Chater
- Institute for Sport and Physical Activity Research, University of Bedfordshire, MK41 9EA, Bedford, UK
- University College London, Centre for Behaviour Change, WC1E 7HB, London, UK
| | - Tina Kenny
- Buckinghamshire Healthcare NHS Trust, Aylesbury, HP21 8AL, UK
| | - Juliet Anderson
- Buckinghamshire Health and Social Care Academy, Aylesbury, HP21 7Q, UK
| | - Gurch Randhawa
- Institute for Health Research, University of Bedfordshire, Luton, LU2 8LE, UK
| | - Yannis Pappas
- Institute for Health Research, University of Bedfordshire, Luton, LU2 8LE, UK
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Jamshidi H, Jazani RK, Khani Jeihooni A, Alibabaei A, Alamdari S, Kalyani MN. Facilitators and barriers to collaboration between pre-hospital emergency and emergency department in traffic accidents: a qualitative study. BMC Emerg Med 2023; 23:58. [PMID: 37248455 DOI: 10.1186/s12873-023-00828-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 05/22/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Death caused by traffic accidents is one of the major problems of health systems in low- and middle-income countries. Rapid handover of the traffic accident victims and proper collaboration between the pre-hospital and emergency departments (EDs) play a critical role in improving the treatment process and decreasing the number of accidental deaths. Considering the importance of the collaboration between pre-hospital and emergency departments, this study was designed to investigate the facilitators and barriers of collaboration between pre-hospital and emergency departments in traffic accidents. METHOD This research is a qualitative study using content analysis. In order to collect data, semi-structured interviews were used. Seventeen subjects (including pre-hospital and emergency department personnel, emergency medicine specialists, and hospital managers) were selected through purposive sampling and were interviewed. After transcribing and reviewing interviews, data analysis was performed with the qualitative content analysis approach. RESULTS The participants consisted of 17 individuals (15 persons in pre-hospital and emergency departments with at least three years of work experience, one emergency medicine specialist and one hospital manager) who were selected by purposive sampling. The interviews were analyzed and three main categories and seven sub-categories were extracted. The main categories included "individual capabilities", "development of mutual understanding", and "infrastructures and processes". DISCUSSION Proper and practical planning and policymaking to strengthen facilitators and eliminate barriers to collaborate between pre-hospital and emergency departments are key points in promoting collaboration between these two important sectors of health system and reducing the traffic accident casualties in Iran.
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Affiliation(s)
- Hasan Jamshidi
- Department of Nursing, School of Nursing, Fasa University of Medical Sciences, Fasa, Iran
| | - Reza Khani Jazani
- Department of Health in Disaster and Emergencies, School of Health, Safety and Environment, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Ali Khani Jeihooni
- Nutrition Research Center, Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmad Alibabaei
- School of Health, Safety and Environment, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahram Alamdari
- Research Institute for Endocrine Sciences, Obesity Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Najafi Kalyani
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Sachan D, Shukla SK, Bajpai PK, Srivastava DK, Kumar S, Jain PK, Pathak P. Validation of satisfaction questionnaire for services provided in the labour rooms of government health facilities. J Healthc Qual Res 2023; 38:76-83. [PMID: 36163149 DOI: 10.1016/j.jhqr.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 06/20/2022] [Accepted: 08/21/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION AND OBJECTIVES Using the assessment of satisfaction of patients of labour room services, the caregiver or policymakers can identify the gaps in the implemented programmes and health policies. This study was aimed to design a valid and reliable satisfaction questionnaire that will help in identifying the aspects of gaps that need improvement. METHODS A facility and community-based observational cross-sectional study was conducted in the district of western Uttar Pradesh (India) between January 2019 and August 2020. Validation of the structured questionnaire with 34 dichotomous questions categorized under five subscales was performed by evaluating its validity and reliability. A total of 380 beneficiaries were selected from 48 government health facilities. RESULTS The calculated Content validity index was calculated to be 9.5 which was adequate as per the guidelines. The reliability analysis of the questionnaire showed that the internal consistency was high with an overall Cronbach's alpha of 0.710. The variation in Cronbach's alpha on the elimination of any question from the questionnaire ranged from 0.676 to 0.767. The mean patient satisfaction score in the total surveyed population was 24.39±4.684 (total score=34) and there was a greater variation in the satisfaction score of infrastructure when compared with other subscales. CONCLUSION The findings from this study support the reliability and validity of the patient satisfaction questionnaire as it is capable of evaluating the satisfaction in terms of delivery services provided in labour rooms as a whole.
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Affiliation(s)
- D Sachan
- Department of Community Medicine, Uttar Pradesh University of Medical Sciences, Saifai, India
| | - S K Shukla
- Department of Community Medicine, Uttar Pradesh University of Medical Sciences, Saifai, India.
| | - P K Bajpai
- Department of Community Medicine, Uttar Pradesh University of Medical Sciences, Saifai, India
| | - D K Srivastava
- Department of Community Medicine, Uttar Pradesh University of Medical Sciences, Saifai, India
| | - S Kumar
- Department of Community Medicine, Uttar Pradesh University of Medical Sciences, Saifai, India
| | - P K Jain
- Department of Community Medicine, Uttar Pradesh University of Medical Sciences, Saifai, India
| | - P Pathak
- Department of Community Medicine, Uttar Pradesh University of Medical Sciences, Saifai, India
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Using general practitioners with an extended role in spinal practice for the initial assessment of patients referred to spinal surgeons: preliminary experience and challenges. Prim Health Care Res Dev 2023; 24:e9. [PMID: 36700455 PMCID: PMC9884532 DOI: 10.1017/s1463423622000494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
AIM To describe experience using general practitioners (GPs), with an extended role (GPwER) in spinal medicine, to expedite assessment, triage, and management of patients referred from primary care for specialist spinal surgical opinion. BACKGROUND Low back and neck pain are common conditions in primary care. Indiscriminate or inappropriate referral to a spinal surgeon contributes to long waiting times. Previous attempts at triaging patients who really require a surgical opinion have used practice nurses, physiotherapists, clinical algorithms, and interdisciplinary screening clinics. METHODS Within the setting of an independent spinal care centre, we have used GPs specially trained in spinal practice to expedite the assessment and triage of new referrals between 2015 and 2021. We reviewed feedback from a Patient Satisfaction Questionnaire and the postgraduate backgrounds, training, practice with regard to triage of new referrals, and experiences of the GPs who were recruited. FINDINGS Six GPwER had a mean of 26 years of postgraduate experience before appointment (range 10-44 years). The first four GPwER, appointed between 2015 and 2018, underwent an ad hoc in-house, interdisciplinary training programme and saw 2994 new patients between 2016 and 2020. After GPwER, assessment in only 18.9% (range 12.6 to 22.7%) of these patients was a spinal surgical opinion deemed necessary. Waiting times to see the spinal surgeon remained at 6-8 weeks despite a three-fold annual increase (from 340 to 1058) in new referrals. A Patient Satisfaction Questionnaire revealed high levels of satisfaction with the performances of the GPwER across seven dimensions. A dedicated training programme was designed in 2020, and the last two appointees underwent 20 h of clinical teaching prior to practice. Initial experience using GPwER, here termed 'Spinal Clinicians', suggests they are efficient at screening for patients needing spinal surgical referral. Establishing a recognised training programme, assessment, and certification for these practitioners are the next challenges.
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Cao F, Hong F, Ruan Y, Lin M. Effect of Patient-Empowerment Interaction Model on Self-Management Ability of Peritoneal Dialysis Patients: A Randomized Controlled Trial. Patient Prefer Adherence 2023; 17:873-881. [PMID: 37009428 PMCID: PMC10065006 DOI: 10.2147/ppa.s402698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/09/2023] [Indexed: 03/29/2023] Open
Abstract
OBJECTIVE Patient empowerment can be achieved through the PBL model. The purpose of the present study was to evaluate the effectiveness and feasibility of patient empowerment through the PBL model in health continuing education of peritoneal dialysis (PD) patients. METHODS From March 2017 to April 2017, a total of 94 participants were randomly assigned to the PBL group and the traditional group, with 47 patients in each group. Patients of the PBL group were divided into 5 study groups; and six PBL health education activities were held. The basic knowledge, self-management behavior, quality of life, anxiety, and depression were assessed among the traditional group and the PBL group. The average follow-up duration was 10.6±1.5 months. RESULTS Compared with patients in the traditional group, patients in the PBL group had higher scores of basic knowledges for PD (84.33±3.55 vs 91.19±3.07; P<0.001), higher scores of self-management (61.19±3.71 vs 71.47±2.89; P< 0.001), better scores of quality of life (85.99±14.33 vs 102.64±9.43; P < 0.001), and better scores of satisfaction (90.78±1.32 vs 98.21±1.25; P < 0.001). Furthermore, the scores of anxieties (52.39±4.55 vs 46.46±4.63; P < 0.001) and the scores of depressions were lower (49.95±6.76 vs 45.80±8.77; P =0.01) in patients who participated in the PBL mode of education than in the traditional educational group. CONCLUSION The empowerment model of PBL health education can effectively improve the knowledge, skills and quality of life of PD patients. RELEVANCE TO CLINICAL PRACTICE The findings identified in this study will help to improve the quality of nursing care and health education for PD patients. PATIENT OR PUBLIC CONTRIBUTION The study design involved patients on PD training. The knowledge and skills of PD and quality of life will improve after they participate the PBL health education activities.
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Affiliation(s)
- Fang Cao
- Department of Nephrology, Provincial Clinical College, Fujian Medical University, Fujian Provincial Hospital, Fuzhou, 350001, People’s Republic of China
- Correspondence: Fang Cao; Miao Lin, Department of Nephrology, Provincial clinical college, Fujian Medical University, Fujian Provincial Hospital, 134 East Street, Fuzhou, People’s Republic of China, 350001, Tel/Fax +86-591-87557768, Email ;
| | - Fuyuan Hong
- Department of Nephrology, Provincial Clinical College, Fujian Medical University, Fujian Provincial Hospital, Fuzhou, 350001, People’s Republic of China
| | - Yiping Ruan
- Department of Nephrology, Provincial Clinical College, Fujian Medical University, Fujian Provincial Hospital, Fuzhou, 350001, People’s Republic of China
| | - Miao Lin
- Department of Nephrology, Provincial Clinical College, Fujian Medical University, Fujian Provincial Hospital, Fuzhou, 350001, People’s Republic of China
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Gandhi P A, Goel K, Gupta M, Singh A. Effect of digitization of medical case files on doctor patient relationship in an Out Patient Department setting of Northern India: A comparative study. INDIAN JOURNAL OF COMMUNITY HEALTH 2022. [DOI: 10.47203/ijch.2022.v34i04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Background: Digitization of health records and health delivery processes in health care settings may have an impact on the Patient-Physician communication, wait times, that affect the overall patient satisfaction with the health care services. Aim & Objective: We ascertained the effect of digitization of medical case files on the doctor patient relationship (DPR) domain of patient satisfaction at an urban primary health center in India. Settings and Design: Comparative, cross-sectional study in primary health centres. Methods and Material: The patient satisfaction was compared between the patients attending the Public Health Dispensary (PHD) that uses digitized medical case file system and a Civil Dispensary (CD) which follows the conventional paper based medical records, using a Patient Satisfaction Questionnaire (PSQ). Statistical analysis used: Univariate analysis was done by chi-square test and adjusted analysis was done by multiple linear regression. Results: Patient satisfaction in DPR was found to be same between the digitized medical case files based and conventional OPD (p=0.453). Significantly higher overall patient satisfaction was reported in the conventional paper based OPD than the digitized OPD (p<0.001). Conclusions: Patient satisfaction towards the doctor-patient relationship (DPR) was same between paper based OPD and the digitized medical case files based OPD.
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Sommer J, Torre AC, Bibiloni N, Plazzotta F, Vázquez Peña F, Terrasa SA, Boietti B, Bruchanski L, Mazzuoccolo L, Luna D. Telemedicina: validación de un cuestionario para evaluar la experiencia de los profesionales de la salud. Rev Panam Salud Publica 2022; 46:e173. [PMID: 36320203 PMCID: PMC9595219 DOI: 10.26633/rpsp.2022.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 05/23/2022] [Indexed: 11/24/2022] Open
Abstract
Objetivo. El siguiente trabajo tiene como objetivo desarrollar y validar un cuestionario para evaluar la experiencia de los profesionales de la salud con los sistemas de telemedicina. Métodos. A partir de la versión abreviada en español y validada localmente del cuestionario para pacientes desarrollado por Parmanto y col., un grupo de expertos consensuó una versión para evaluar la experiencia de profesionales de la salud que brindan servicios de telemedicina. El comportamiento psicométrico de los ítems se testeó en una primera muestra de 129 profesionales a través de un análisis factorial exploratorio. Luego, se evaluó su comprensibilidad a través de entrevistas cognitivas. Por último, en una nueva muestra de 329 profesionales, se evaluó la validez de constructo del cuestionario mediante un análisis factorial confirmatorio (AFC), y su validez de criterio externo, mediante la evaluación de su puntaje con el de una pregunta de resumen. Resultados. Se obtuvo un cuestionario de 12 ítems con una estructura de dos factores con indicadores de ajuste aceptables, documentada mediante AFC. La fiabilidad, la validez convergente y la validez discriminante fueron apropiadas. La validez de criterio externo mostró resultados óptimos. Conclusiones. El instrumento obtenido cuenta con propiedades psicométricas adecuadas y contribuirá a la evaluación objetiva de la experiencia de los profesionales que realizan telemedicina.
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Affiliation(s)
- Janine Sommer
- Departamento de Informática en salud, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Ana Clara Torre
- Servicio de Dermatología, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Nuria Bibiloni
- Servicio de Dermatología, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Fernando Plazzotta
- Departamento de Informática en salud, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Fernando Vázquez Peña
- Departamento de Investigación, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Sergio Adrián Terrasa
- Departamento de Investigación, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Bruno Boietti
- Departamento de Investigación, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Lucila Bruchanski
- Departamento de Informática en salud, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Luis Mazzuoccolo
- Servicio de Dermatología, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - Daniel Luna
- Departamento de Informática en salud, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
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Hsieh FC, Lin LP, Wu TP, Hsu SW, Lai CY, Lin JD. Factors Associated with patient satisfaction towards a prison detention Clinic Care among male drug-using inmates. BMC Health Serv Res 2022; 22:1255. [PMID: 36253743 PMCID: PMC9578243 DOI: 10.1186/s12913-022-08609-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 09/26/2022] [Indexed: 12/02/2022] Open
Abstract
This study assessed patient satisfaction and its associated factors among male drug-using inmates utilizing a prison detention clinic in Taiwan. A cross-sectional design and structured questionnaire were employed to recruit 580 drug-using inmates into the study. The Patient Satisfaction Questionnaire Short Form (PSQ-18), developed by the RAND Corporation, was used as the basis for the short scale of patient satisfaction, and the research data were analyzed using the SPSS for Windows 20.0 statistical software package. The results showed that the research subjects had low patient satisfaction in all the factors assessed compared with the scale’s general norms. Among the original seven satisfaction subscales in this study, the highest score was for the financial aspects, and the lowest was for the amount of time spent with doctors. This study also investigated satisfaction with medical lab exams and the pharmacy at the prison’s clinic, and the satisfaction scores were higher than the original seven subscales. In multiple logistic regression analyses, the final model indicated that the inmates undergoing observed rehabilitation (OR = 13.837, 95% CI = 2.736–69.983) were more likely satisfied with prison detention clinic c than those serving prison sentences. Those inmates with custodial deposits (high vs. low; OR = 1.813, 95% CI = 1.038–3.168), and meet their physical health needs (met vs. unmet; OR = 4.872, 95% CI = 2.054–11.560) had significant correlated with detention clinic care satisfactory level. Although there is only one study setting cannot give a generalizability for people who are incarcerated in Taiwan, this study highlights that the prison authorities should scrutinize factors associated with detention clinic care satisfaction, such as the type of inmate, economic status in the prison, self-reported health status, and their physical health needs, to increase the level of patient satisfaction.
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Affiliation(s)
- Fang-Chun Hsieh
- Civilian Division, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Lan-Ping Lin
- Institute of Long-Term Care, MacKay Medical College, No.46, Sec. 3, Zhongzheng Rd., Sanzhi District, 252, New Taipei City, Taiwan
| | - Te-Pin Wu
- Sanitation and Health Section, Sindian Drug Abuser Treatment Center, Agency of Corrections, Ministry of Justice, New Taipei City, Taiwan
| | - Shang-Wei Hsu
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Chao-Ying Lai
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Jin-Ding Lin
- School of Public Health, National Defense Medical Center, Taipei, Taiwan. .,Institute of Long-Term Care, MacKay Medical College, No.46, Sec. 3, Zhongzheng Rd., Sanzhi District, 252, New Taipei City, Taiwan.
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Bhojak NP, Modi A, Patel JD, Patel M. Measuring patient satisfaction in emergency department: An empirical test using structural equation modeling. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2022. [DOI: 10.1080/20479700.2022.2112440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Nimesh P. Bhojak
- Department of Hospital Management, Hemchandracharya North Gujarat University, Patan, India
| | - Ashwin Modi
- Department of Commerce and Management, Hemchandracharya North Gujarat University, Patan, India
| | - Jayesh D. Patel
- Ganpat University - V. M. Patel Institute of Management, Mehsana, Gujarat, India
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13
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Aboosalehi A, Kolivand P, Jalali A, Saberian P, Sarabi Asiabar A, Baratloo A, Jamshididana M. Clients' Satisfaction with Services Provided by Ambulances and Motor Ambulances of Tehran Emergency Medical Services: A Cross-sectional Study. Med J Islam Repub Iran 2022; 36:78. [PMID: 36128313 PMCID: PMC9448455 DOI: 10.47176/mjiri.36.78] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 07/13/2022] [Indexed: 11/09/2022] Open
Abstract
Background: To improve the quality of services provided by emergency medical services (EMS), a correct understanding of the current situation and analysis of possible problems is required. The purpose of this study was to investigate the level of clients' satisfaction regarding the missions performed by ambulances and motor ambulances (motorlances) of the Tehran EMS center, and also identify the factors affecting their satisfaction. Methods: This cross-sectional study was conducted for 1 month in Tehran, Iran. All clients in the age range of 18 to 87 years who were approached by Tehran EMS motorlances or ambulances were eligible. Those with wrong registered phone numbers, uninformed callers (passers, coworkers), and those who were not willing to participate in the study were excluded. A valid and reliable researcher-made questionnaire was used to assess the clients' satisfaction. Missions were surveyed routinely, 1 to 2 days following their performance. The questionnaires were filled out by the investigators via a telephone call to the patients or the patients' siblings. The collected data were statistically analyzed using IBM SPSS Statistics 24.0. An independent t test and 1-way analysis of variance were used to compare the mean satisfaction score between the groups. Other tests, such as the Pearson correlation coefficient, were also used to examine the relationship between quantitative variables. P<0.05 were considered statistically significant. Results: In total, the data of 1100 missions were analyzed. The age range of the patients was between 1 and 100 years and their mean age was 52.1 ± 19.2 years, and the mean age of interviewees was 44.4 ± 13.4 years (18-87 years); of all the interviewees, 610 (55.5%) were women. The overall satisfaction of people with the Tehran EMS was rated as "very satisfied" in 78.5% of the cases; However, 11.2% of the participants had moderate and low satisfaction. We found that overall satisfaction was related to dependence on the health group (p≤0.001), educational status (p=0.006), economic status (p=0.002), sent vehicle (p=0.040), and diagnosis (p<0.001). Conclusion: Almost 80% of the participants were highly satisfied with the services provided by Tehran EMS motorlances/ambulances, according to this study. Those with a higher educational level, higher socioeconomic class, accurate diagnosis, proper sent car, and health dependency showed a higher level of happiness than the others.
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Affiliation(s)
- Ali Aboosalehi
- Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran,Tehran Emergency Medical Service Center, Tehran, Iran
| | - Pirhossein Kolivand
- Department of Health Economics, Faculty of Medicine, Shahed University, Tehran, Iran
| | - Alireza Jalali
- Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran,Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Peyman Saberian
- Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran,Anesthesiology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran,Corresponding author: Dr Peyman Saberian,
| | - Ali Sarabi Asiabar
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Baratloo
- Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran,Research Center for Trauma in Police Operation, Directorate of Health, Rescue and Treatment, Police Headquarter, Tehran, Iran
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14
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Ali J, Jusoh A, Idris N, Nor KM, Wan Y, Abbas AF, Alsharif AH. Applicability of healthcare service quality models and dimensions: future research directions. TQM JOURNAL 2022. [DOI: 10.1108/tqm-12-2021-0358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe purpose of this study is to explore the literature of healthcare service quality for identifying and analyzing the healthcare service quality models and dimensions and to present future research insights pertaining to the applications of these models and dimensions.Design/methodology/approachA literature review of healthcare service quality has been performed on 59 relevant studies after applying inclusion and exclusion criteria. Google Scholar and Scopus are the primary sources to find the relevant documents. Search was limited to keywords of “service quality,” “healthcare,” “models” and “dimensions.”FindingsThe results revealed that different models and dimensions have been evolved and developed after SERVQUAL in healthcare service quality literature. There is still a need to develop new models, add new contextual dimensions and items in existing models on different aspects of healthcare services. There is also a need to incorporate the perspective of service providers as respondents. Moreover, healthcare service quality models can be devolved or narrowed down at department and individual levels.Originality/valueThis study presents valuable research insights for the researchers and practitioners in ways that healthcare service quality models and dimensions can be developed, modified and tested further in different research contexts and settings. Besides, the literature on healthcare services can be enhanced and enriched.
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15
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Li S, Wang K. Sharing Online Health Information With Physicians: Understanding the Associations Among Patient Characteristics, Directness of Sharing, and Physician-Patient Relationship. Front Psychol 2022; 13:839723. [PMID: 35432074 PMCID: PMC9005643 DOI: 10.3389/fpsyg.2022.839723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/17/2022] [Indexed: 11/18/2022] Open
Abstract
Patients increasingly share online health information with their physicians. However, few studies have investigated factors that may facilitate or inhibit such sharing and subsequent impact on physician-patient relationship. This study conducted a cross-sectional survey among 818 Chinese patients to examine if two patient characteristics -communication apprehension and eHealth literacy- influence their ways of sharing online health information with physicians and subsequently impact physician-patient relationship. The results showed that a majority of surveyed participants searched health information online, and about half of them used such information during their doctor visits. Less apprehensive patients tend to share the information with their physicians more directly, which can positively affect perceived physician reactions and patient satisfaction. eHealth literacy, however, is not found to be associated with patients’ sharing of online information with physicians. This study underscores the importance of identifying patient characteristic’s role in patient-physician interaction.
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Affiliation(s)
- Siyue Li
- College of Media and International Culture, Zhejiang University, Hangzhou, China
| | - Kexin Wang
- College of Media and International Culture, Zhejiang University, Hangzhou, China
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16
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Novel Way to Improve Satisfaction, Comprehension, and Anxiety in Caregivers: A Randomized Trial Exploring the Use of Comprehensive, Illustrated Children's Books for Pediatric Surgical Populations. J Am Coll Surg 2022; 234:263-273. [PMID: 35213488 DOI: 10.1097/xcs.0000000000000057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Surgery generates anxiety and stress, which can negatively impact informed consent and postoperative outcomes. This study assessed whether educational, illustrated children's books improve comprehension, satisfaction, and anxiety of caregivers in pediatric surgical populations. METHODS A prospective randomized trial was initiated at a tertiary care children's hospital. All patients ≤ 18 years old with caregiver and diagnosis of 1) uncomplicated appendicitis (English or Spanish speaking); 2) ruptured appendicitis; 3) pyloric stenosis; 4) need for gastrostomy tube; or 5) umbilical hernia were eligible. Conventional consent was obtained followed by completion of 17 validated survey questions addressing apprehension, satisfaction, and comprehension. Randomization (2:1) occurred after consent and before operative intervention with the experimental group (EG) receiving an illustrated comprehensive children's book outlining anatomy, pathophysiology, hospital course, and postoperative care. A second identical survey was completed before discharge. Primary outcomes were caregiver apprehension, satisfaction, and comprehension. RESULTS Eighty caregivers were included (55: EG, 25: control group [CG]). There were no significant differences in patient or caregiver demographics between groups. The baseline survey demonstrated no difference in comprehension, satisfaction, or apprehension between groups (all p values NS). After intervention, EG had significant improvement in 14 of 17 questions compared with CG (all p < 0.05). When tabulated by content, there was significant improvement in comprehension (p = 0.0009), satisfaction (p < 0.0001), and apprehension (p < 0.0001). CONCLUSION The use of illustrated educational children's books to explain pathophysiology and surgical care is a novel method to improve comprehension, satisfaction, and anxiety of caregivers. This could benefit informed consent, understanding, and postoperative outcomes.
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Akunne M, Heise T, Ukwe C, Okonta M, Anosike C, Ekwunife O. Satisfaction of Nigerian Patients with Health Services: A Systematic Review. NIGERIAN JOURNAL OF MEDICINE 2022. [DOI: 10.4103/njm.njm_139_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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18
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Quinn B, Laurent S, Dargan S, Lapuente M, Lüftner D, Drudge-Coates L, Palma MD, Lago LD, Flynn J, Panter C, Seesaghur A. Managing Advanced Cancer Pain Together (MACPT) conversation tool: an evaluation of use in clinical practice. Pain Manag 2021; 12:435-446. [PMID: 34866400 DOI: 10.2217/pmt-2021-0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To investigate use of the 'Managing Advanced Cancer Pain Together' conversation tool between individuals with advanced cancer and healthcare professionals (HCPs) during routine consultations. Methods: Twenty-one patients and six HCPs completed questionnaires before and after use of the tool (at their routine consultation 1 and consecutive consultation 2, respectively). Results: Patients and HCPs were satisfied with communication during both consultations. When using the tool, patients most frequently selected physical pain descriptors (95.2%), followed by emotional (81.0%), social (28.6%) and spiritual (28.6%) descriptors. Patients found the tool useful, stating that it helped them describe their pain. HCPs considered the tool difficult to incorporate into consultations. Conclusion: The study highlighted the need to consider the various aspects of cancer pain.
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Affiliation(s)
| | | | - Susan Dargan
- Ashford & St Peter's Hospital NHS Foundation Trust, Surrey, TW15 3AA, UK
| | | | | | | | - Mario Di Palma
- Hôpital Américain de Paris, Neuilly-sur-Seine, 92200, France
| | | | - Jessica Flynn
- Adelphi Values, Patient-Centered Outcomes, Cheshire, SK10 5JB, UK
| | - Charlotte Panter
- Adelphi Values, Patient-Centered Outcomes, Cheshire, SK10 5JB, UK
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Bosch-Capblanch X, Oyo-Ita A, Muloliwa AM, Yapi RB, Auer C, Samba M, Gajewski S, Ross A, Krause LK, Ekpenyong N, Nwankwo O, Njepuome AN, Lee SM, Sacarlal J, Madede T, Berté S, Matsinhe G, Garba AB, Brown DW. Does an innovative paper-based health information system (PHISICC) improve data quality and use in primary healthcare? Protocol of a multicountry, cluster randomised controlled trial in sub-Saharan African rural settings. BMJ Open 2021; 11:e051823. [PMID: 34326056 PMCID: PMC8323359 DOI: 10.1136/bmjopen-2021-051823] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 07/07/2021] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Front-line health workers in remote health facilities are the first contact of the formal health sector and are confronted with life-saving decisions. Health information systems (HIS) support the collection and use of health related data. However, HIS focus on reporting and are unfit to support decisions. Since data tools are paper-based in most primary healthcare settings, we have produced an innovative Paper-based Health Information System in Comprehensive Care (PHISICC) using a human-centred design approach. We are carrying out a cluster randomised controlled trial in three African countries to assess the effects of PHISICC compared with the current systems. METHODS AND ANALYSIS Study areas are in rural zones of Côte d'Ivoire, Mozambique and Nigeria. Seventy health facilities in each country have been randomly allocated to using PHISICC tools or to continuing to use the regular HIS tools. We have randomly selected households in the catchment areas of each health facility to collect outcomes' data (household surveys have been carried out in two of the three countries and the end-line data collection is planned for mid-2021). Primary outcomes include data quality and use, coverage of health services and health workers satisfaction; secondary outcomes are additional data quality and use parameters, childhood mortality and additional health workers and clients experience with the system. Just prior to the implementation of the trial, we had to relocate the study site in Mozambique due to unforeseen logistical issues. The effects of the intervention will be estimated using regression models and accounting for clustering using random effects. ETHICS AND DISSEMINATION Ethics committees in Côte d'Ivoire, Mozambique and Nigeria approved the trials. We plan to disseminate our findings, data and research materials among researchers and policy-makers. We aim at having our findings included in systematic reviews on health systems interventions and future guidance development on HIS. TRIAL REGISTRATION NUMBER PACTR201904664660639; Pre-results.
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Affiliation(s)
- Xavier Bosch-Capblanch
- Swiss Tropical and Public Health Institute, Basel, Basel-Stadt, Switzerland
- University of Basel, Basel, Basel-Stadt, Switzerland
| | - Angela Oyo-Ita
- Department of Community Medicine, University of Calabar Teaching Hospital, Calabar, Cross River, Nigeria
| | | | - Richard B Yapi
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Lagunes, Côte d'Ivoire
| | - Christian Auer
- Swiss Tropical and Public Health Institute, Basel, Basel-Stadt, Switzerland
- University of Basel, Basel, Basel-Stadt, Switzerland
| | - Mamadou Samba
- Ministère de la Santé et de l'Hygiène Publique, Abidjan, Lagunes, Côte d'Ivoire
| | - Suzanne Gajewski
- Swiss Tropical and Public Health Institute, Basel, Basel-Stadt, Switzerland
- University of Basel, Basel, Basel-Stadt, Switzerland
| | - Amanda Ross
- Swiss Tropical and Public Health Institute, Basel, Basel-Stadt, Switzerland
- University of Basel, Basel, Basel-Stadt, Switzerland
| | | | - Nnette Ekpenyong
- Department of Community Medicine, University of Calabar Teaching Hospital, Calabar, Cross River, Nigeria
| | - Ogonna Nwankwo
- Department of Community Medicine, University of Calabar Teaching Hospital, Calabar, Cross River, Nigeria
| | | | | | - Jahit Sacarlal
- Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Tavares Madede
- Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Salimata Berté
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Lagunes, Côte d'Ivoire
| | - Graça Matsinhe
- Expanded Program on Immunization, Ministério da Saúde, Maputo, Mozambique
| | - Abdullahi Bulama Garba
- Planning, Research and Statistics, National Primary Healthcare Development Agency, Abuja, Nigeria
| | - David W Brown
- BCGI LLC / pivot-23.5°, Chapel Hill, North Carolina, USA
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Mancini R, Bartolo M, Pattaro G, Ioni L, Picconi T, Pernazza G. The role of telemedicine in the postoperative home monitoring after robotic colo-rectal cancer surgery: a preliminary single center experience. Updates Surg 2021; 74:171-178. [PMID: 34313956 DOI: 10.1007/s13304-021-01132-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 07/07/2021] [Indexed: 10/20/2022]
Abstract
The telemedicine studies, takes care and prevents diseases at distance basing on the interaction among physicians and patients remotely. Few data are available on its application to early postoperative after surgery. The endpoints of our preliminary experience were the detection, as primary, of feasibility and safety of home telemonitoring after robotic colo-rectal resection and, as secondary, perception and satisfaction of the patients. From December 2019 to March 2020, at the Division of Robotic Surgery of San Giovanni Hospital of Rome, 20 of 29 colorectal cancer patients, submitted to Robotic resection, were prospectively included in a program of postoperative home telemonitoring. Telemonitoring was considered feasible if at least 75% of data were available and safe if morbidity ≤ II by Clavien-Dindo classification. Perception and patients' satisfaction were evaluated through a dedicated questionnaire. Out of 20 patients, the median age was 68 years, overall postoperative morbidity was 30%, all events classified Clavien-Dindo Grade I or II. Only 2 patients were corresponded to surgical consult without readmission during home telemonitoring. Compliance of patients was > 80%, overall grade of satisfaction was very high: 4.2 as median (range 0-5). In this preliminary study, the procedures of postoperative home telemonitoring were feasible and safe and high rate of patients' satisfaction was observed. The telemedicine could enhance the role of robotic technique in decrease the hospital stay and improving postoperative recovery after surgery. Further structured prospective trial are needed to validate the routine application of telemedicine in healthcare.
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Affiliation(s)
- Raffaello Mancini
- Division of Robotic Surgery of San Giovanni Hospital of Rome, Via dell'Amba Aradam, 8, 00184, Rome, Italy.
| | - Michelangelo Bartolo
- Service of Telemedicine of San Giovanni Hospital of Rome, Via dell'Amba Aradam, 8, 00184, Rome, Italy
| | - Giada Pattaro
- Division of Robotic Surgery of San Giovanni Hospital of Rome, Via dell'Amba Aradam, 8, 00184, Rome, Italy
| | - Luigi Ioni
- Division of Robotic Surgery of San Giovanni Hospital of Rome, Via dell'Amba Aradam, 8, 00184, Rome, Italy
| | - Tullio Picconi
- Division of Robotic Surgery of San Giovanni Hospital of Rome, Via dell'Amba Aradam, 8, 00184, Rome, Italy
| | - Graziano Pernazza
- Division of Robotic Surgery of San Giovanni Hospital of Rome, Via dell'Amba Aradam, 8, 00184, Rome, Italy
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Bishop F, Al-Abbadey M, Roberts L, MacPherson H, Stuart B, Carnes D, Fawkes C, Yardley L, Bradbury K. Direct and mediated effects of treatment context on low back pain outcome: a prospective cohort study. BMJ Open 2021; 11:e044831. [PMID: 34006548 PMCID: PMC8130743 DOI: 10.1136/bmjopen-2020-044831] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Contextual components of treatment previously associated with patient outcomes include the environment, therapeutic relationship and expectancies. Questions remain about which components are most important, how they influence outcomes and comparative effects across treatment approaches. We aimed to identify significant and strong contextual predictors of patient outcomes, test for psychological mediators and compare effects across three treatment approaches. DESIGN Prospective cohort study with patient-reported and practitioner-reported questionnaire data (online or paper) collected at first consultation, 2 weeks and 3 months. SETTING Physiotherapy, osteopathy and acupuncture clinics throughout the UK. PARTICIPANTS 166 practitioners (65 physiotherapists, 46 osteopaths, 55 acupuncturists) were recruited via their professional organisations. Practitioners recruited 960 adult patients seeking treatment for low back pain (LBP). PRIMARY AND SECONDARY OUTCOMES The primary outcome was back-related disability. Secondary outcomes were pain and well-being. Contextual components measured were: therapeutic alliance; patient satisfaction with appointment systems, access, facilities; patients' treatment beliefs including outcome expectancies; practitioners' attitudes to LBP and practitioners' patient-specific outcome expectancies. The hypothesised mediators measured were: patient self-efficacy for pain management; patient perceptions of LBP and psychosocial distress. RESULTS After controlling for baseline and potential confounders, statistically significant predictors of reduced back-related disability were: all three dimensions of stronger therapeutic alliance (goal, task and bond); higher patient satisfaction with appointment systems; reduced patient-perceived treatment credibility and increased practitioner-rated outcome expectancies. Therapeutic alliance over task (ηp2=0.10, 95% CI 0.07 to 0.14) and practitioner-rated outcome expectancies (ηp2=0.08, 95% CI 0.05 to 0.11) demonstrated the largest effect sizes. Patients' self-efficacy, LBP perceptions and psychosocial distress partially mediated these relationships. There were no interactions with treatment approach. CONCLUSIONS Enhancing contextual components in musculoskeletal healthcare could improve patient outcomes. Interventions should focus on helping practitioners and patients forge effective therapeutic alliances with strong affective bonds and agreement on treatment goals and how to achieve them.
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Affiliation(s)
- Felicity Bishop
- Department of Psychology, University of Southampton, Southampton, UK
| | - Miznah Al-Abbadey
- Department of Psychology, University of Southampton, Southampton, UK
- Department of Psychology, University of Portsmouth, Portsmouth, UK
| | - Lisa Roberts
- Health Sciences, University of Southampton, Southampton, UK
- Therapy Services, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Beth Stuart
- Primary Care and Population Sciences, University of Southampton, Southampton, UK
| | - Dawn Carnes
- Institute of Population Health Sciences, Queen Mary University of London, London, UK
| | - Carol Fawkes
- Institute of Population Health Sciences, Queen Mary University of London, London, UK
| | - Lucy Yardley
- Department of Psychology, University of Southampton, Southampton, UK
- School of Psychological Science, University of Bristol, Bristol, UK
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22
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Schulz-Moore JS, Bismark M, Jenkinson C, Mello MM. Assessing Patients' Experiences with Medical Injury Reconciliation Processes: Item Generation for a Novel Survey Questionnaire. Jt Comm J Qual Patient Saf 2021; 47:376-384. [PMID: 33836941 DOI: 10.1016/j.jcjq.2021.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 03/07/2021] [Accepted: 03/08/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Many health care organizations want to improve their responses to patients who suffer medical injuries. Their ability to understand how well they meet patients' needs is limited by the lack of suitable instruments for assessing injured patients' experiences. METHODS This study aimed to generate items for a patient experience questionnaire that medical facilities can use to assess how well resolution met patients' needs. The Medical Injury Reconciliation Experiences Survey (MIRES) was based on findings from previous studies of New Zealand and American patients' experiences of non-litigation resolution of medical injuries. The researchers performed a content analysis of 24 transcripts from a stratified random sample of 92 interviews from the prior studies. Themes were extracted to develop a draft questionnaire, which was revised following feedback from experts. Cognitive debriefing interviews were conducted with 24 New Zealand and American injured patients. RESULTS There were 40 items in the following domains: perceptions of communications with health care providers after the injury (15 items), perceptions of remedial gestures (11 items), indicia of the patient's overall satisfaction with the reconciliation process (4 items), the nature and impacts of the injury (5 items), and patients' characteristics (5 items). Participants' feedback about the questionnaire was predominantly positive. Their suggestions led to 37 revisions. CONCLUSION The MIRES was comprehensible and acceptable to this group of post-injury patients. While further testing is desirable, the MIRES offers promise as a practicable approach that health care organizations can use to assess how well their reconciliation processes met patients' needs.
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Vanotti S, Cabral N, Eizaguirre MB, Marinangeli A, Roman MS, Alonso R, Silva B, Garcea O. Coping strategies: Seeking personalized care in relapsing-remitting multiple sclerosis. A patient reported measure-coping responses inventory. Mult Scler J Exp Transl Clin 2021; 7:2055217320987588. [PMID: 33633866 PMCID: PMC7887687 DOI: 10.1177/2055217320987588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 12/01/2020] [Indexed: 11/23/2022] Open
Abstract
Coping is defined as a set of cognitive and behavioral efforts made to master stressful specific demands. Adaptation to chronic diseases, such as Multiple Sclerosis (MS), depends on the effectiveness of coping. Objective: To assess the psychometric properties of the Coping Responses Inventory (CRI-A) in persons with MS (PwMS), verifying the transferability of the measure, already validated in the Argentine general population, and to describe the types of coping strategies available for PwMS. Methods: 90 PwMS were included. Outcome measures: CRI-A Inventory, Expanded Disability Status Scale (EDSS), Beck Depression Inventory, Fatigue Severity Scale and MS International Quality of Life questionnaire. Results: Descriptive data is as follows: mean age (years): 40.97 ± 12.85; years of education: 13.46 ± 3.93; EDSS: 2.48 ± 1.79; disease evolution (years): 10.76 ± 9.72; depression: 13.92 ± 10.45; fatigue 3.77 ± 1.72. The psychometric properties of the CRI-A Inventory observed in the Argentine general population are present in the MS sample as well, with adequate validity and reliability. The respondents most frequently utilized a problem-focused coping style. Conclusions: Results showed the CRI-A has good transferability properties from the Argentine general population to the MS population.
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Affiliation(s)
- Sandra Vanotti
- Multiple Sclerosis Unit, José María Ramos Mejía General Hospital, Buenos Aires, Argentina
| | - Nadia Cabral
- Multiple Sclerosis Unit, José María Ramos Mejía General Hospital, Buenos Aires, Argentina
| | | | - Aldana Marinangeli
- Multiple Sclerosis Unit, José María Ramos Mejía General Hospital, Buenos Aires, Argentina
| | - Maria Sol Roman
- Multiple Sclerosis Unit, José María Ramos Mejía General Hospital, Buenos Aires, Argentina
| | - Ricardo Alonso
- Multiple Sclerosis Unit, José María Ramos Mejía General Hospital, Buenos Aires, Argentina
| | - Berenice Silva
- Multiple Sclerosis Unit, José María Ramos Mejía General Hospital, Buenos Aires, Argentina
| | - Orlando Garcea
- Multiple Sclerosis Unit, José María Ramos Mejía General Hospital, Buenos Aires, Argentina
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Balestrieri M, de Girolamo G, Rucci P. Construct validity and psychosocial correlates of the Italian version of the 21-item Medical Interview Satisfaction Scale in primary care. BJPsych Open 2021; 7:e57. [PMID: 33597072 PMCID: PMC8058927 DOI: 10.1192/bjo.2020.164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Satisfaction with the medical interview has been rarely explored in primary care outside the UK, despite evidence suggesting that a trustful doctor-patient relationship is a key ingredient to facilitate treatment adherence and relief from illness-related distress. AIMS The aims of this study are to analyse the construct validity of the Italian version of the Medical Interview Satisfaction Scale (MISS-21) and its correlations with two outcome measures, the Inventory of Depressive Symptomatology - Self-Report and World Health Organization Quality Of Life Brief Version, in patients with mild-to-moderate depression, recruited in primary care practices. METHOD The factor structure underlying the MISS-21 was investigated with principal component analysis, and the internal consistency of the factors was evaluated with Cronbach's alpha. Network analysis was used to investigate the interrelationships among items. The importance of individual items in the network structure was determined with centrality analyses. Correlations of MISS-21 scores with changes in depression and quality of life were analysed with Spearman's correlation coefficient. RESULTS The MISS-21 proved to have a robust four-dimensional factor structure. Cronbach's alpha for the factors ranged from 0.77 to 0.93, suggesting good to excellent internal consistency. The four factors identified were positively correlated with improvement in depressive symptoms and three quality-of-life domains. CONCLUSIONS The MISS-21 has sound psychometric properties, and comprises four factors related to clinical outcomes, which makes it suitable for clinical and research applications. The central items in the network should be considered as possible targets for quality improvement interventions in primary care.
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Affiliation(s)
| | - Giovanni de Girolamo
- Unit of Psychiatric Epidemiology and Evaluation, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Italy
| | - Paola Rucci
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Italy
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Hwang J, Vu GT, Tran BX, Nguyen THT, Nguyen BV, Nguyen LH, Nguyen HLT, Latkin CA, Ho CSH, Ho RCM. Measuring satisfaction with health care services for Vietnamese patients with cardiovascular diseases. PLoS One 2020; 15:e0235333. [PMID: 32584904 PMCID: PMC7316281 DOI: 10.1371/journal.pone.0235333] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 06/13/2020] [Indexed: 11/28/2022] Open
Abstract
Patient satisfaction is a useful predictor of adherence and outcomes of cardiovascular diseases (CVDs) treatment. This study explored the satisfaction of Vietnamese CVDs inpatients and outpatients using a scale specifically designed for CVDs patients and examined the factors associated with satisfaction towards CVDs treatment services. Interviews of 600 patients at the Hanoi Heart Hospital were conducted. We developed a measurement scale for both inpatient and outpatient services. Multivariate Tobit regression was used to determine the associated factors with patient satisfaction. For inpatients, Cronbach’s alpha reported for the domains were in the range of 0.72–0.97, while for outpatients, Cronbach’s alpha was within 0.61–0.97. Overall, patients were more satisfied with inpatient services (Mean = 81.8, SD = 5.8) than outpatient services (Mean = 79.7, SD = 5.2, p<0.05). In inpatients, the highest complete satisfaction was in “Attitude of Nurse” item (42.0%), the highest satisfaction score was in “Care and treatment” domain (Mean = 85.6, SD = 9.7) and the lowest in “Hospital facilities” domain (Mean = 78.3; SD = 9.2). Among outpatients, the highest complete satisfaction was in “Attitude of physicians when examining, guiding and explaining to the patient” item (19.7%), the highest satisfaction score was in “Attitude of medical staff” domain (Mean = 82.8; SD = 7.9) and the lowest in “Waiting time” domain (Mean = 76.6; SD = 8.2). People not having health insurances had significantly higher scores in “Waiting time”, “Hospital facilities” and “Attitude of staff” domains (for outpatients) and in “Health service accessibility”, “Hospital facilities” domains (for inpatients) as well as higher total satisfaction score than those having health insurance. Findings discovered through the application of the newly developed instrument showed low satisfaction regarding hospital facilities for inpatients and waiting time for outpatients, suggesting renovation efforts, while inferiority regarding patient satisfaction of health insurance covered patients compared to those without implied policy reform possibility. Further enhancement and validation of the developed instrument was required.
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Affiliation(s)
- Jongnam Hwang
- Division of Social Welfare and Health Administration, Wonkwang University, Iksan, Korea
| | - Giang Thu Vu
- Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States of America
- * E-mail:
| | | | - Bang Van Nguyen
- Department of Hemato-Toxico-Radiology and Occupational Disease, Hospital 103, Military Medical University, Hanoi, Vietnam
| | - Long Hoang Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
| | | | - Carl A. Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States of America
| | - Cyrus S. H. Ho
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
| | - Roger C. M. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
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Mauro E, Marciano S, Torres MC, Roca JD, Novillo AL, Gadano A. Telemedicine Improves Access to Hepatology Consultation with High Patient Satisfaction. J Clin Exp Hepatol 2020; 10:555-562. [PMID: 33311892 PMCID: PMC7719958 DOI: 10.1016/j.jceh.2020.04.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 04/24/2020] [Indexed: 02/06/2023] Open
Abstract
AIMS Telemedicine between health care providers could be useful for improving the access to hepatology consultations, which is challenging in some regions. The primary objective of this study was to estimate the proportion of consultations that were resolved through a telemedicine program. Additionally, we evaluated patient satisfaction with this strategy. METHODS Consecutive telemedicine consultations made by non-hepatologist health care providers from different regions of Argentina to a specialty hepatology team were included. Participants and hepatologists used e-mail, teleconference systems, WhatsApp, or telephone to interact, depending on their preferences. Consultations were considered to be resolved through telemedicine when a diagnosis and an adequate follow-up were achieved without the need to refer the patient to a hepatologist or other specialist. Patient satisfaction with telemedicine was evaluated using the Patient Satisfaction Questionnaire Short Form and Telemedicine Satisfaction Questionnaire. RESULTS A total of 200 telemedicine consultations made by 24 physicians from 10 different provinces of Argentina were evaluated, of which 145 (73%; 95% CI: 66%-79%) were resolved through telemedicine. Practitioners specialities were as follows: family physicians, internists, gastroenterologists, infectious diseases, and obstetrics. The most frequent final diagnoses for those patients whose consultation was resolved through telemedicine were non-alcoholic fatty liver disease, viral hepatitis, and benign hepatic lesions. A high degree of patient satisfaction with telemedicine was observed in both questionnaires. CONCLUSIONS Our results show the effectiveness of telemedicine in hepatology, with high resolution rate of consultations and rapid access to experts' assessment. Additionally, a high degree of patient satisfaction was observed using prevalidated questionnaires.
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Affiliation(s)
- Ezequiel Mauro
- Liver Unit, Hospital Italiano de Buenos Aires, Juan Domingo Perón 4190, 1199 ABH, Buenos Aires, Argentina
| | - Sebastián Marciano
- Liver Unit, Hospital Italiano de Buenos Aires, Juan Domingo Perón 4190, 1199 ABH, Buenos Aires, Argentina,Department of Research, Hospital Italiano de Buenos Aires, Juan Domingo Perón 4190, 1199 ABH, Buenos Aires, Argentina,Corresponding author. Sebastián Marciano, Liver Unit, Hospital Italiano de Buenos Aires, Perón 4190, Buenos Aires, C1199ABB, Argentina. Tel.: +54 11 4959 0200x5370; fax: +54 11 4959 0346.
| | - María C. Torres
- Liver Unit, Hospital Italiano de Buenos Aires, Juan Domingo Perón 4190, 1199 ABH, Buenos Aires, Argentina
| | - Juan D. Roca
- Grupo Integral Clínico Cardiológico, Alvear 154, 6300, Santa Rosa, La Pampa, Argentina
| | - Abel L. Novillo
- Sanatorio 9 de Julio, 25 de Mayo 372, 4000, San Miguel de Tucumán, Tucumán, Argentina
| | - Adrían Gadano
- Liver Unit, Hospital Italiano de Buenos Aires, Juan Domingo Perón 4190, 1199 ABH, Buenos Aires, Argentina,Department of Research, Hospital Italiano de Buenos Aires, Juan Domingo Perón 4190, 1199 ABH, Buenos Aires, Argentina
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[Concepts and assessment methods in lower urinary tract symptoms: From symptom score to Patient-Reported Outcomes and Outcomes (PRO)]. Prog Urol 2019; 30:181-189. [PMID: 31744687 DOI: 10.1016/j.purol.2019.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 10/23/2019] [Accepted: 10/23/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION The evaluation of pelvic perineal treatments has changed significantly in recent years. Initially focused on the assessment of symptoms, quality of life or patient satisfaction, it has gradually turned to new concepts, such as Patient Reported Outcome (PRO) and Goal Attainment (GA). OBJECTIVE To describe the different concepts and methods of assessment available, in recent years, in the context of urinary functional pathologies such as bladder overactivity or urinary incontinence. METHODS We conducted a non-systematic literature review to identify the main questionnaires and tools available to evaluate treatment outcomes. Oncology and pediatrics questionnaire has been excluded. RESULTS In functional pathology (overactive bladder or incontinence), the objective of treatment is to meet the expectations of patients and it is important to be able to assess the feelings of patients. In this context, new specific questionnaires have been developed to evaluate the PROs. For about ten years, these subjective criteria, are more and more widespread in the evaluation of treatments. A new field then appeared, namely Goal Attainment Scaling (GAS) and Self Appreciation Goal Attainment (SAGA), allowing to determine with the patient, the expected objectives of the treatment. CONCLUSION These concepts of PRO and GAS open up a new domain in the evaluation of treatments, with a subjective view of the results. They deserve to be integrated into the usual, objective evaluations, in order to adapt the treatment of the patients, according to the real impact of the treatment.
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Asiamah N, Danquah E. A comparative analysis of the influences of specialized and non-specialized emotional intelligence training on patient satisfaction. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2019. [DOI: 10.1080/20479700.2019.1641652] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Nestor Asiamah
- Africa Centre for Epidemiology, Gerontology and Geriatric Care, Accra, Ghana
| | - Emelia Danquah
- Department of Marketing, Koforidua Technical University, Koforidua, Ghana
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Cant N, Cock K. Bowel clinic survey: telephone versus face-to-face consultations. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2019; 28:830-832. [PMID: 31303046 DOI: 10.12968/bjon.2019.28.13.830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Nadja Cant
- Specialist Registrar, Trauma and Orthopaedics
| | - Karen Cock
- Colorectal Consultant Nurse, Colorectal Consultant Nurse, Gastrointestinal Surgery, Royal Cornwall Hospital Trust
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Abstract
BACKGROUND Pay-for-Performance (P4P) is a payment model that rewards health care providers for meeting pre-defined targets for quality indicators or efficacy parameters to increase the quality or efficacy of care. OBJECTIVES Our objective was to assess the impact of P4P for in-hospital delivered health care on the quality of care, resource use and equity. Our objective was not only to answer the question whether P4P works in general (simple perspective) but to provide a comprehensive and detailed overview of P4P with a focus on analyzing the intervention components, the context factors and their interrelation (more complex perspective). SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, three other databases and two trial registers on 27 June 2018. In addition, we searched conference proceedings, gray literature and web pages of relevant health care institutions, contacted experts in the field, conducted cited reference searches and performed cross-checks of included references and systematic reviews on the same topic. SELECTION CRITERIA We included randomized trials, cluster randomized trials, non-randomized clustered trials, controlled before-after studies, interrupted time series and repeated measures studies that analyzed hospitals, hospital units or groups of hospitals and that compared any kind of P4P to a basic payment scheme (e.g. capitation) without P4P. Studies had to analyze at least one of the following outcomes to be eligible: patient outcomes; quality of care; utilization, coverage or access; resource use, costs and cost shifting; healthcare provider outcomes; equity; adverse effects or harms. DATA COLLECTION AND ANALYSIS Two review authors independently screened all citations for inclusion, extracted study data and assessed risk of bias for each included study. Study characteristics were extracted by one reviewer and verified by a second.We did not perform meta-analysis because the included studies were too heterogenous regarding hospital characteristics, the design of the P4P programs and study design. Instead we present a structured narrative synthesis considering the complexity as well as the context/setting of the intervention. We assessed the certainty of evidence using the GRADE approach and present the results narratively in 'Summary of findings' tables. MAIN RESULTS We included 27 studies (20 CBA, 7 ITS) on six different P4P programs. Studies analyzed between 10 and 4267 centers. All P4P programs targeted acute or emergency physical conditions and compared a capitation-based payment scheme without P4P to the same capitation-based payment scheme combined with a P4P add-on. Two P4P program used rewards or penalties; one used first rewards and than penalties; two used penalties only and one used rewards only. Four P4P programs were established and evaluated in the USA, one in England and one in France.Most studies showed no difference or a very small effect in favor of the P4P program. The impact of each P4P program was as follows.Premier Hospital Quality Incentive Demonstration Program: It is uncertain whether this program, which used rewards for some hospitals and penalties for others, has an impact on mortality, adverse clinical events, quality of care, equity or resource use as the certainty of the evidence was very low.Value-Based Purchasing Program: It is uncertain whether this program, which used rewards for some hospitals and penalties for others, has an impact on mortality, adverse clinical events or quality of care as the certainty of the evidence was very low. Equity and resource use outcomes were not reported in the studies, which evaluated this program.Non-payment for Hospital-Acquired Conditions Program: It is uncertain whether this penalty-based program has an impact on adverse clinical events as the certainty of the evidence was very low. Mortality, quality of care, equity and resource use outcomes were not reported in the studies, which evaluated this program.Hospital Readmissions Reduction Program: None of the studies that examined this penalty-based program reported mortality, adverse clinical events, quality of care (process quality score), equity or resource use outcomes.Advancing Quality Program: It is uncertain whether this reward-/penalty-based program has an impact on mortality as the certainty of the evidence was very low. Adverse clinical events, quality of care, equity and resource use outcomes were not reported in any study.Financial Incentive to Quality Improvement Program: It is uncertain whether this reward-based program has an impact on quality of care, as the certainty of the evidence was very low. Mortality, adverse clinical events, equity and resource use outcomes were not reported in any study.Subgroup analysis (analysis of modifying design and context factors)Analysis of P4P design factors provides some hints that non-payments compared to additional payments and payments for quality attainment (e.g. falling below specified mortality threshold) compared to quality improvement (e.g. reduction of mortality by specified percent points within one year) may have a stronger impact on performance. AUTHORS' CONCLUSIONS It is uncertain whether P4P, compared to capitation-based payments without P4P for hospitals, has an impact on patient outcomes, quality of care, equity or resource use as the certainty of the evidence was very low (or we found no studies on the outcome) for all P4P programs. The effects on patient outcomes of P4P in hospitals were at most small, regardless of design factors and context/setting. It seems that with additional payments only small short-term but non-sustainable effects can be achieved. Non-payments seem to be slightly more effective than bonuses and payments for quality attainment seem to be slightly more effective than payments for quality improvement.
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Affiliation(s)
- Tim Mathes
- University Witten/HerdeckeInstitute for Research in Operative Medicine (IFOM) ‐ Department for Evidence‐based Health Services ResearchOstmerheimer Str. 200 (House 38)CologneGermany51109
| | - Dawid Pieper
- University Witten/HerdeckeInstitute for Research in Operative Medicine (IFOM) ‐ Department for Evidence‐based Health Services ResearchOstmerheimer Str. 200 (House 38)CologneGermany51109
| | - Johannes Morche
- Federal Joint CommitteeMedical Consultancy DepartmentWegelystraße 8BerlinGermany
| | - Stephanie Polus
- University Witten/HerdeckeInstitute for Research in Operative Medicine (IFOM) ‐ Department for Evidence‐based Health Services ResearchOstmerheimer Str. 200 (House 38)CologneGermany51109
| | - Thomas Jaschinski
- University Witten/HerdeckeInstitute for Research in Operative Medicine (IFOM) ‐ Department for Evidence‐based Health Services ResearchOstmerheimer Str. 200 (House 38)CologneGermany51109
| | - Michaela Eikermann
- Medical advisory service of social health insurance (MDS)Department of Evidence‐based medicineTheodor‐Althoff‐Straße 47EssenNorth Rhine WestphaliaGermany51109
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Ramey L, Hayano T, Blatz D, Gedman M, Blauwet C. A Comparison of Self-Reported Unmet Healthcare Needs among Adaptive and Able-Bodied Athletes. PM R 2019; 12:36-42. [PMID: 31199583 DOI: 10.1002/pmrj.12202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 06/03/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Studies have revealed a higher incidence of injury and illness among elite adaptive athletes when compared to able-bodied athletes in competition. However, individuals with disabilities report poorer access to health care. OBJECTIVE The purpose of this study is to identify differences in healthcare access, satisfaction, and unmet needs between recreational adaptive and able-bodied athletes in all sports and within a single sport (hockey). DESIGN Cross-sectional, survey-based study. SETTING Recreation sports programs in Boston, MA and Chicago, IL. PARTICIPANTS Adult, recreational, competitive adaptive, and able-bodied athletes. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE(S) The Short-Form Patient Satisfaction Questionnaire (PSQ-18) for healthcare access and satisfaction; percentage of athletes reporting unmet sports-related healthcare needs in the prior year. RESULTS Sixty adaptive athletes (78% male, age 35.7 ± 12.4 years) and 65 able-bodied athletes (40% male, age 34.9 ± 11.9 years) participated. Mean access and satisfaction scores were not significantly different between groups in all sports (P = .53 and P = .19, respectively) or hockey (P = .28 and P = .55, respectively). Unmet needs were more commonly reported among adaptive athletes (18.3% all sports, 20.0% hockey) as compared to able-bodied athletes (9.2% all sports, 4.0% hockey). This reached statistical significance in the hockey group (P = .03), but not all sports (P = .12). CONCLUSIONS No differences were seen between groups in healthcare access or satisfaction scores. Adaptive athletes of the same sport reported a higher rate of unmet sports-related healthcare needs but with few doctor's visits in the preceding year, suggesting discrepancies in expectations and healthcare-seeking behavior. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Lindsay Ramey
- Department of Physical Medicine & Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX
| | - Todd Hayano
- Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Harvard Medical School, Boston, MA.,Kelley Adaptive Sports Research Institute, Spaulding Rehabilitation Network, Boston, MA
| | - Daniel Blatz
- Department of Physical Medicine & Rehabilitation, Shirley Ryan AbilityLab, Chicago, IL
| | - Marissa Gedman
- Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Harvard Medical School, Boston, MA.,Kelley Adaptive Sports Research Institute, Spaulding Rehabilitation Network, Boston, MA
| | - Cheri Blauwet
- Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Harvard Medical School, Boston, MA.,Kelley Adaptive Sports Research Institute, Spaulding Rehabilitation Network, Boston, MA
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Understanding psychological determinants to promote the adoption of general practitioner by Chinese elderly. HEALTH POLICY AND TECHNOLOGY 2019. [DOI: 10.1016/j.hlpt.2019.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Odumodu IJ, Olufunlayo TF, Ogunnowo BE, Kalu ME. Satisfaction With Services Among Attendees of Physiotherapy Outpatient Clinics in Tertiary Hospitals in Lagos State. J Patient Exp 2019; 7:468-478. [PMID: 33062866 PMCID: PMC7534107 DOI: 10.1177/2374373519847370] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Aim: To determine outpatients’ satisfaction with physiotherapy services in tertiary hospitals in Lagos State, Nigeria. Method: This cross-sectional study utilized a simple random sampling method to recruit 284 participants. Participants responded to a 2-part structured questionnaire with 33-items on a 5-point Likert-type scale. Participants were asked questions about their satisfaction with physiotherapy services, staff attitudes, and the accessibility of outpatient physiotherapy clinics. Data were analyzed using descriptive analysis and χ2. Results: About 28.8% of the participants were satisfied or very satisfied with the location of the outpatient physiotherapy clinics. The majority of the participants were satisfied or very satisfied with these physiotherapy services in maintaining privacy (86.2%), scheduling convenient clinic appointments (78.2%), prompt scheduling of the first physiotherapy clinic appointment (74.6%) and subsequent visits (78.9%), and providing a calm/relaxing atmosphere (90.1%). While 22.5% of the participants were satisfied or very satisfied with the waiting time in these physiotherapy clinics, 86.3% and 97.9% were satisfied or very satisfied with staff attitudes and the cost of the therapy, respectively. Almost all (97.9%) the participants reported being satisfied or very satisfied with their overall experience in the physiotherapy clinics. While there was an association between marital and educational status with overall satisfaction scores, age and gender showed no association. Conclusion: Our findings suggest that patients attending the outpatient physiotherapy clinics in tertiary hospitals in Lagos State, Nigeria, were satisfied or very satisfied with the domain that measured overall satisfaction. Strategies to reduce the waiting time in these physiotherapy clinics and to enhance physical accessibility of the physiotherapy clinics are encouraged.
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Affiliation(s)
| | | | - Babatunde Enitan Ogunnowo
- Department of Community Health & Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Michael Ebe Kalu
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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Le LB, Rahal HK, Viramontes MR, Meneses KG, Dong TS, Saab S. Patient Satisfaction and Healthcare Utilization Using Telemedicine in Liver Transplant Recipients. Dig Dis Sci 2019; 64:1150-1157. [PMID: 30519848 DOI: 10.1007/s10620-018-5397-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 11/24/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Post-liver transplantation care is limited to tertiary care centers. Concentration at expert centers leads to high-volume clinics with long wait times and decreased accessibility. AIM To assess whether telemedicine can be utilized to overcome barriers to care while sustaining strong patient-physician relationships. METHODS The Patient Satisfaction Questionnaire-18, Telemedicine Satisfaction Questionnaire, and Health Utilization Questionnaire were used to assess patient satisfaction and healthcare utilization among patients who received care via video connection (telemedicine group) and in clinic (control group). Propensity matching was performed. Scores for questionnaires were reported as mean and standard deviations (SD) and were compared by one-way multivariate analysis of variance and one-way analysis of variance. RESULTS There were 21 matched telemedicine patients in our study. Overall mean age (± SD) was 51 (± 5.62) years and 52 (± 6.12) years for telemedicine group and control group, respectively. General patient satisfaction was similar between the two groups (p = 0.89). While telemedicine patients were just as satisfied with communication and interpersonal approach compared to clinic patients, they experienced significantly less commute (p < 0.0001) and waiting (p < 0.0001) times. Given ease of using telemedicine without compromising patient-physician interaction, 90% (19/21) of the telemedicine patients opted to use the service again. CONCLUSION Telemedicine appeared to be both a time and cost-saving alternative to clinic follow-up without compromise of the valuable patient-physician relationship. Telemedicine has the potential to improve clinic flow, reduce wait times, and decrease costs for liver transplant recipients.
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Affiliation(s)
- Long B Le
- Olive View Medical Center, University of California at Los Angeles, Sylmar, Los Angeles, CA, USA
| | - Harman K Rahal
- Department of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - Matthew R Viramontes
- Department of Surgery, University of California at Los Angeles, Los Angeles, CA, USA
| | - Katherine G Meneses
- Department of Surgery, University of California at Los Angeles, Los Angeles, CA, USA
| | - Tien S Dong
- Department of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - Sammy Saab
- Department of Medicine, University of California at Los Angeles, Los Angeles, CA, USA.
- Department of Surgery, University of California at Los Angeles, Los Angeles, CA, USA.
- Pfleger Liver Institute, UCLA Medical Center, 200 Medical Plaza, Suite 214, Los Angeles, CA, 90095, USA.
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Ruiz S, Giuriceo K, Caldwell J, Snyder LP, Putnam M. Care Coordination Models Improve Quality of Care for Adults Aging With Intellectual and Developmental Disabilities. JOURNAL OF DISABILITY POLICY STUDIES 2019. [DOI: 10.1177/1044207319835195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A significant gap remains between existing evidence-based care coordination techniques for the general population and those that have been successfully translated for people with intellectual and developmental disabilities (IDD). Two models funded through the Health Care Innovation Awards have dedicated resources to the translation of evidence-based practices in community or clinical settings. This study analyzes quasi-experimental mixed-methods evaluation data, including Medicaid/Medicare claims on more than 600 beneficiaries who participated in the two models and survey data, site visits, and focus groups with participants and caregivers. Qualitative data suggest that both models address key contextual factors, considering residential setting, health disparities, and heterogeneity of the population. We identify key improvements in health care quality related to timeliness, patient safety, and medication reconciliation. In addition, both models show some evidence of reduced claims utilization. This study represents the first step to understand the potential of care coordination to improve the lives of adults aging with IDD. As health systems continue to struggle to manage the cost of their most expensive users and deliver high quality care, these models hold promise as vehicles to reduce utilization and cost among adults who have lived long-term with disability by addressing their unique health care and social needs.
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Affiliation(s)
- Sarah Ruiz
- National Institute on Disability, Independent Living, and Rehabilitation Research, Washington, DC, USA
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Jamshidi H, Jazani RK, Alibabaei A, Alamdari S, Kalyani MN. Challenges of Cooperation between the Pre-hospital and In-hospital Emergency services in the handover of victims of road traffic accidents: A Qualitative Study. INVESTIGACION Y EDUCACION EN ENFERMERIA 2019; 37:e08. [PMID: 31083845 PMCID: PMC7871464 DOI: 10.17533/udea.iee.v37n1e08] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 02/11/2019] [Indexed: 06/01/2023]
Abstract
OBJECTIVES To take a deep look at the challenges of cooperation between the pre-hospital and in-hospital emergency services in the handover of victims of road traffic accidents. METHODS This is a qualitative study and the method used is of content analysis type. Semi-structured interviews were used to collect the data. Through purposive sampling, fifteen employees from ambulance personnel and hospital emergency staff were selected and interviewed. They expressed their experiences of cooperation between these two teams in the handover of traffic accident casualties. The interviews were transcribed verbatim and content analysis method was used to explain and interpret the content of the interviews. RESULTS Three major categories were derived from the analysis of interviews: Shortage of infrastructure resources (Shortage of equipment, Shortage of physical space, and Shortage of manpower); Inefficient and unscientific management (Shaky accountability, Out-of-date information based activities, Poor motivation, and Manpower low productivity); and Non-common language (Difference in understanding and empathy, and Difference in training and experience). CONCLUSIONS The obtained results of this study suggest that the careful planning of resources, the promotion of managerial practices as well as empowerment program of the staff, healthcare managers and policymakers can take a pace forward in order to enter into a hearty coordination between these two services for the attention of victims of road traffic accidents.
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Rapport F, Hibbert P, Baysari M, Long JC, Seah R, Zheng WY, Jones C, Preece K, Braithwaite J. What do patients really want? An in-depth examination of patient experience in four Australian hospitals. BMC Health Serv Res 2019; 19:38. [PMID: 30646962 PMCID: PMC6332615 DOI: 10.1186/s12913-019-3881-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 01/07/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Patient satisfaction is an important outcome measure guiding quality improvement in the healthcare setting while the patient-centred care movement places increasing importance on patient engagement in clinical decision-making. However, the concept of patient satisfaction is not clearly defined, and beliefs of patients are not always evident in health surveys. Researchers rarely follow up on surveys to explore patient views and what they mean in greater depth. This study set out to examine perceptions of hospital care, through in-depth, qualitative data capture and as a result, to gather rich, patient-driven information on user experience and satisfaction in the Australian healthcare setting; and identify influencing factors. METHODS Focus groups were undertaken in four St Vincent's Health Australia (SVHA) hospitals in 2017 where participants discussed responses to eight questions from the Press Ganey Patient Experience Survey. Thirty people who were inpatients at SVHA. RESULTS Good communication and high-quality information at arrival and discharge were found to be important to patients. Communication breakdown was also evident, further exacerbated by a range of environmental factors such as sharing a room with others. Overall, patients' felt that while their spiritual needs were well-supported by the hospital staff at all SVHA hospitals, it was the clinical teams prioritised their emotional needs. Good communication and environments can improve patient experience and follow-up at home is vital. CONCLUSIONS Patient-centred care needs careful planning with patients involved at entry and exit from hospital. Focused communication, environmental changes, attending to complaints, and clearer discharge strategies are recommended.
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Affiliation(s)
- F Rapport
- Australian Institute of Health Innovation, Macquarie University, 75 Talavera Road, North Ryde, Sydney, NSW, 2113, Australia.
| | - P Hibbert
- Australian Institute of Health Innovation, Macquarie University, 75 Talavera Road, North Ryde, Sydney, NSW, 2113, Australia
| | - M Baysari
- Australian Institute of Health Innovation, Macquarie University, 75 Talavera Road, North Ryde, Sydney, NSW, 2113, Australia
| | - J C Long
- Australian Institute of Health Innovation, Macquarie University, 75 Talavera Road, North Ryde, Sydney, NSW, 2113, Australia
| | - R Seah
- Australian Institute of Health Innovation, Macquarie University, 75 Talavera Road, North Ryde, Sydney, NSW, 2113, Australia
| | - W Y Zheng
- Australian Institute of Health Innovation, Macquarie University, 75 Talavera Road, North Ryde, Sydney, NSW, 2113, Australia
| | - C Jones
- St. Vincent's Health Australia, 340 Albert Street, East Melbourne, VIC, 3002, Australia
| | - K Preece
- St. Vincent's Health Australia, 340 Albert Street, East Melbourne, VIC, 3002, Australia
| | - J Braithwaite
- Australian Institute of Health Innovation, Macquarie University, 75 Talavera Road, North Ryde, Sydney, NSW, 2113, Australia
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Tubay AT, Mansalis KA, Simpson MJ, Armitage NH, Briscoe G, Potts V. The Effects of Group Prenatal Care on Infant Birthweight and Maternal Well-Being: A Randomized Controlled Trial. Mil Med 2018; 184:e440-e446. [DOI: 10.1093/milmed/usy361] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 09/08/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Amy Tanner Tubay
- 48th Medical Group, Building 932, RAF Lakenheath, Brandon, Suffolk, UK
| | - Kate A Mansalis
- David Grant USAF Medical Center, 101 Bodin Circle, Travis AFB, CA
| | - Matthew J Simpson
- University of Colorado Denver School of Medicine, 13001 E. 17th Pl, Aurora, CO
| | - Nicole H Armitage
- 711th Human Performance Wing, 2510 Fifth St., Bldg 840, Wright-Patterson AFB, OH
| | - Gabriel Briscoe
- David Grant USAF Medical Center, 101 Bodin Circle, Travis AFB, CA
| | - Vicki Potts
- John Muir Physician Network Clinical Research Center, 2700 Grant St., Suite 202, Concord, CA
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Mimura C, Norman IJ. The relationship between healthcare workers' attachment styles and patient outcomes: a systematic review. Int J Qual Health Care 2018; 30:332-343. [PMID: 29917160 DOI: 10.1093/intqhc/mzy034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 02/15/2018] [Indexed: 11/15/2022] Open
Abstract
Purpose To examine whether attachment styles of healthcare workers influence the quality of their relationships with patients, or impact patients' health outcomes. Data source Literature database searches on the CINAHL, Cochrane Library, Embase, MEDLINE and PsyCinfo, and hand searching of reference lists of the retained articles. Study selection Original empirical studies reporting an analysis of the relationship of interest were selected for review. Data extraction Estimates of association between healthcare workers' attachment style and patients' health outcomes were extracted. Results of data synthesis Results from 13 studies were mixed in terms of which attachment styles related to patients' perceptions of care or health outcomes, and the evidence overall was of poor quality and methodologically heterogeneous. However, there is limited evidence that secure attachment styles of healthcare workers have little or a negative effect on patients' health outcomes or perceptions in the short term but in the long term have a more positive effect. Conversely, insecure styles tend to have a positive effect in the short term but little or a negative effect on long-term relationships. Studies which used self-report attachment measurements tended to report stronger associations with patients' outcome measurements than studies using the interviewer rated Adult Attachment Interview. Conclusion It is unclear whether or not there is a relationship between attachment style of health workers and patients' health outcomes. Further research using consistent data collection tools, especially in relation to the attachment measurement construct selected, and analysis methods across studies is required to draw recommendations for clinical practice.
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Affiliation(s)
| | - Ian J Norman
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, UK
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Nabi G. Editorial Comment: Questionnaire survey-based research: Is there a need for consensus? Indian J Urol 2018; 34:210-211. [PMID: 30034132 PMCID: PMC6034407 DOI: 10.4103/iju.iju_162_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Ghulam Nabi
- Professor of Surgical Uro-Oncology and Chair of Urology, Head of Division of Cancer Research and Lead for Prostate Cancer Surgery, Ninewells Hospital, University of Dundee, Dundee, Scotland, UK
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Cao F, Li L, Lin M, Lin Q, Ruan Y, Hong F. Application of instant messaging software in the follow-up of patients using peritoneal dialysis, a randomised controlled trial. J Clin Nurs 2018; 27:3001-3007. [PMID: 29679398 DOI: 10.1111/jocn.14487] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Fang Cao
- Department of Nephrology; Fujian Provincial Hospital; Fujian Medical University; Fuzhou China
| | - Lanfei Li
- Department of Nephrology; Fujian Provincial Hospital; Fujian Medical University; Fuzhou China
| | - Miao Lin
- Department of Nephrology; Fujian Provincial Hospital; Fujian Medical University; Fuzhou China
| | - Qinyu Lin
- Department of Nephrology; Fujian Provincial Hospital; Fujian Medical University; Fuzhou China
| | - Yiping Ruan
- Department of Nephrology; Fujian Provincial Hospital; Fujian Medical University; Fuzhou China
| | - Fuyuan Hong
- Department of Nephrology; Fujian Provincial Hospital; Fujian Medical University; Fuzhou China
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Hermann EA, Ashburner JM, Atlas SJ, Chang Y, Percac-Lima S. Satisfaction With Health Care Among Patients Navigated for Preventive Cancer Screening. J Patient Exp 2018; 5:225-230. [PMID: 30214930 PMCID: PMC6134547 DOI: 10.1177/2374373517750413] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: Patient navigation (PN) programs can improve cancer screening in underserved populations. PN may advance quality and equity of care by supporting individuals at increased risk of not receiving recommended care. Objective: To evaluate patient satisfaction with medical care and PN for cancer screening. Methods: We conducted a telephone survey of patients enrolled in a randomized control trial evaluating the impact of PN for cancer screening to assess their satisfaction with overall medical care and the PN program. We measured patient satisfaction with medical care using the Patient Satisfaction Questionnaire-18 and evaluated patient satisfaction with PN in the navigated group using the Patient Satisfaction with Interpersonal Relationships with Navigator questionnaire. Key Results: Satisfaction surveys were completed by 114 navigated and 108 non-navigated patients (33% response rate). Patients who received PN had higher satisfaction scores with overall medical care (71.0 vs 66.8; P < .001). Conclusions: Our findings show that patients at high risk of nonadherence with comprehensive cancer screening were satisfied with PN and suggest that PN could positively influence patient satisfaction with overall medical care.
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Affiliation(s)
- Emilia A Hermann
- Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | - Jeffrey M Ashburner
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Steven J Atlas
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Yuchiao Chang
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Sanja Percac-Lima
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
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Mant A, Pape H. A qualitative work-based project exploring general practitioners' views of the Physio Direct telephone service. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2018. [DOI: 10.12968/ijtr.2018.25.1.29] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Aideen Mant
- Senior specialist physiotherapist, Mid Yorkshire Hospitals NHS Trust, Dewsbury and District Hopspital
| | - Hilary Pape
- Admissions tutor for sport rehabilitation, lecturer in sport and physiotherapy, School of Allied Health Professions and Midwifery, University of Bradford
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Barker V, Taylor M, Kader I, Stewart K, Le Fevre P. Impact of crisis resolution and home treatment services on user experience and admission to psychiatric hospital. ACTA ACUST UNITED AC 2018. [DOI: 10.1192/pb.bp.110.031344] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Aims and methodCrisis resolution and home treatment (CRHT) teams began operating in Edinburgh in late 2008. We ascertained service users' and carers' experiences of CRHT using a standardised questionnaire. We also assessed the impact of CRHT on psychiatric admissions and readmissions by analysing routinely collected data from November 2003 to November 2009.ResultsThere was a 24% decrease in acute psychiatric admissions in the year after CRHT began operating, whereas the previous 5 years saw an 8% reduction in the admission rate. The mean duration of in-patient stay fell by 6.5 days (22% decrease) in the 12 months following CRHT introduction, alongside a 4% decrease in readmissions and a 17% reduction in Mental Health Act 1983 admissions. Although the mean response rate was low (29%), 93% of patients reported clinical improvement during CRHT care, 27% of patients felt totally recovered at discharge from CRHT, 90% of patients felt safe during CRHT treatment, and 94% of carers said their friend or relative got better with CRHT input.Clinical implicationsCrisis resolution and home treatment service in Edinburgh had a positive impact during the first 12 months in terms of reduced admissions, reduced duration of in-patient stay and reduced use of the Mental Health Act. The service can catalyse a more efficient use of in-patient care. Service users and carers report high rates of improvement and satisfaction with CRHT.
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Xie Z, Or C. Associations Between Waiting Times, Service Times, and Patient Satisfaction in an Endocrinology Outpatient Department: A Time Study and Questionnaire Survey. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2017; 54:46958017739527. [PMID: 29161947 PMCID: PMC5798665 DOI: 10.1177/0046958017739527] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The issue of long patient waits has attracted increasing public attention due to the negative effects of waiting on patients' satisfaction with health care. The present study examined the associations between actual waiting time, perceived acceptability of waiting time, actual service time, perceived acceptability of service time, actual visit duration, and the level of patient satisfaction with care. We conducted a cross-sectional time study and questionnaire survey of endocrinology outpatients visiting a major teaching hospital in China. Our results show that actual waiting time was negatively associated with patient satisfaction regarding several aspects of the care they received. Also, patients who were less satisfied with the sociocultural atmosphere and the identity-oriented approach to their care tended to perceive the amounts of time they spent waiting and receiving care as less acceptable. It is not always possible to prevent dissatisfaction with waiting, or to actually reduce waiting times by increasing resources such as increased staffing. However, several improvements in care services can be considered. Our suggestions include providing clearer, more transparent information to keep patients informed about the health care services that they may receive, and the health care professionals who are responsible for those services. We also suggest that care providers are encouraged to continue to show empathy and respect for patients, that patients are provided with private areas where they can talk with health professionals and no one can overhear, and that hospital staff treat the family members or friends who accompany patients in a courteous and friendly way.
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Affiliation(s)
| | - Calvin Or
- 1 The University of Hong Kong, China
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46
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Cock K, Kent B. Patient satisfaction with clinicians in colorectal 2-week wait clinics. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2017; 26:319-323. [PMID: 28345973 DOI: 10.12968/bjon.2017.26.6.319] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIM To determine if patient satisfaction is affected by the clinician (nurse or doctor), conducting the colorectal 2-week wait (2ww) clinics. METHODS A prospective non-randomised comparative cohort study of 339 consecutive patients (divided by blind allocation into nurse-led (n=216) and doctor-led (n=123) cohorts) conducted over a 3-month period. Patient satisfaction in both cohorts was assessed by an adapted version of the Grogan et al validated patient satisfaction questionnaire. The questionnaire was piloted first and was found to have high internal reliability (Cronbach's alpha=0.91). RESULTS The study had a response rate of 78% (n=258/331) and overall satisfaction scores showed 85% (n=149/175) of patients in the nurse-led cohort and 65% (n=54/83) of patients in the doctor-led cohort strongly agreed that they were satisfied with the care they received. Mean overall satisfaction scores in the two cohorts revealed that the nurse-led cohort achieved significantly more 'strongly agree' responses than the doctor-led cohort (p<0.001, CI: 95%). Further analysis of the responses to each question demonstrated statistical significance when comparing the two cohorts. CONCLUSIONS The study offered patients the opportunity to reflect on service delivery enabling a more responsive approach to health care within the colorectal 2ww service. It found that patient satisfaction was affected by the clinician conducting the 2ww clinic, in that the nurse-led cohort displayed significantly higher patient satisfaction. However, there are areas that merit further research.
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Affiliation(s)
- Karen Cock
- Lead Colorectal Specialist Nurse, Royal Cornwall Hospital NHS Trust, Treliske, Cornwall
| | - Bridie Kent
- Professor in Leadership in Nursing, Plymouth University/Director of Truro Clinical School (Hon Associate Director of Nursing), Royal Cornwall Hospital NHS Trust
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van Berckel MMG, Bosma NH, Hageman MGJS, Ring D, Vranceanu AM. The Correlation Between a Numerical Rating Scale of Patient Satisfaction With Current Management of an Upper Extremity Disorder and a General Measure of Satisfaction With the Medical Visit. Hand (N Y) 2017; 12:202-206. [PMID: 28344535 PMCID: PMC5349416 DOI: 10.1177/1558944716662019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Patient satisfaction is used as an indicator of quality of care, but the measures currently available are lengthy and cumbersome and may not be feasible in orthopedic surgical practices. We set out to assess the relationship between the Medical Interview Satisfaction Scale (MISS-21) and a numerical rating scale (NRS) of patient satisfaction with current management of an orthopedic upper extremity condition. Methods: In this cross-sectional study, 86 patients from the practices of 2 hand surgeons were included during an initial or follow-up visit. Questionnaires assessing demographics, upper extremity specific disability, pain during rest and activity, satisfaction with the medical visits (MISS-21), and satisfaction with current management of an orthopedic upper extremity condition (NRS satisfaction) were completed. Results: Eighty-six patients completed all questionnaires. A small correlation of .21 (P = .050) was found between the MISS-21 and the NRS satisfaction. In bivariate analysis, NRS pain at rest and during activity had small correlations with the MISS-21 (-.29, P = .05 and -.23, P = .034) and with NRS satisfaction (-.27, P = .011 and -0.27, P = 0.012). Quick Disability of Arm, Shoulder and Hand (QuickDASH) had a small correlation with NRS satisfaction (-0.023, P ≤ 0.001), but did not correlate with MISS-21. Conclusions: Although there is small overlap about the 2 satisfaction measures, a complex patient satisfaction questionnaire consisting of multiple facets of patient satisfaction like MISS-21 is not replaceable by 1 simple NRS patient satisfaction question.
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Affiliation(s)
- Marijn M. G. van Berckel
- Hand and Upper Extremity Service, Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, USA
| | - Niels H. Bosma
- Hand and Upper Extremity Service, Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, USA
| | - Michiel G. J. S. Hageman
- Hand and Upper Extremity Service, Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, USA
| | - David Ring
- Department of Orthopedic Surgery, Dell Medical School, Austin, TX, USA
| | - Ana-Maria Vranceanu
- Hand and Upper Extremity Service, Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, USA
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Zarei E. Service quality of hospital outpatient departments: patients' perspective. Int J Health Care Qual Assur 2017; 28:778-90. [PMID: 26440482 DOI: 10.1108/ijhcqa-09-2014-0097] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Assessment of patient perceptions of health service quality as an important element in quality assessments has attracted much attention in recent years. The purpose of this paper is to assess the service quality of hospital outpatient departments affiliated to Shahid Beheshti University of Medical Sciences from the patients' perspective. DESIGN/METHODOLOGY/APPROACH This cross-sectional study was conducted in 2014 in Tehran, Iran. The study samples included 500 patients who were selected by multi-stage random sampling from four hospitals. The data collection instrument was a questionnaire consisting of 50 items, and the validity and reliability of the questionnaire were confirmed. For data analysis, exploratory and confirmatory factor analysis, Friedman test, and descriptive statistics were used through LISREL 8.54 and SPSS 18 applications. FINDINGS Eight significant factors were extracted for outpatient service quality, which explained about 67 per cent of the total variance. Physician consultation, information provided to the patient, and the physical environment of the clinic were the three determining factors of the quality of outpatient services. The highest and lowest perceptions were related to physician consultation and perceived waiting time dimension, respectively. The mean score of patients' perception of outpatient service quality was 3.89 (±0.60). About 59.5 per cent of patients assessed the quality of outpatient services as good, 38.2 per cent as moderate, and 2.3 per cent as poor. Practical implications - The instrument developed for this study is valid and reliable, and it can help hospital managers to identify the areas needing improvement and correction. ORIGINALITY/VALUE According to the findings of this study, the majority of patients had a positive experience with outpatient departments of teaching hospitals, and the services provided in these centres were of adequate quality, based on patient assessments.
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Affiliation(s)
- Ehsan Zarei
- School of Health, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
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Siddharthan T, Rabin T, Canavan ME, Nassali F, Kirchhoff P, Kalyesubula R, Coca S, Rastegar A, Knauf F. Implementation of Patient-Centered Education for Chronic-Disease Management in Uganda: An Effectiveness Study. PLoS One 2016; 11:e0166411. [PMID: 27851785 PMCID: PMC5112982 DOI: 10.1371/journal.pone.0166411] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 10/29/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The majority of non-communicable disease related deaths occur in low- and middle-income countries. Patient-centered care is an essential component of chronic disease management in high income settings. OBJECTIVE To examine feasibility of implementation of a validated patient-centered education tool among patients with heart failure in Uganda. DESIGN Mixed-methods, prospective cohort. SETTINGS A private and public cardiology clinic in Mulago National Referral and Teaching Hospital, Kampala, Uganda. PARTICIPANTS Adults with a primary diagnosis of heart failure. INTERVENTIONS PocketDoktor Educational Booklets with patient-centered health education. MAIN MEASURES The primary outcomes were the change in Patient Activation Measure (PAM-13), as well as the acceptability of the PocketDoktor intervention, and feasibility of implementing patient-centered education in outpatient clinical settings. Secondary outcomes included the change in satisfaction with overall clinical care and doctor-patient communication. KEY RESULTS A total of 105 participants were enrolled at two different clinics: the Mulago Outpatient Department (public) and the Uganda Heart Institute (private). 93 participants completed follow up at 3 months and were included in analysis. The primary analysis showed improved patient activation measure scores regarding disease-specific knowledge, treatment options and prevention of exacerbations among both groups (mean change 0.94 [SD = 1.01], 1.02 [SD = 1.15], and 0.92 [SD = 0.89] among private paying patients and 1.98 [SD = 0.98], 1.93 [SD = 1.02], and 1.45 [SD = 1.02] among public paying patients, p<0.001 for all values) after exposure to the intervention; this effect was significantly larger among indigent patients. Participants reported that materials were easy to read, that they had improved knowledge of disease, and stated improved communication with physicians. CONCLUSIONS Patient-centered medical education can improve confidence in self-management as well as satisfaction with doctor-patient communication and overall care in Uganda. Our results show that printed booklets are locally appropriate, highly acceptable and feasible to implement in an LMIC outpatient setting across socioeconomic groups.
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Affiliation(s)
- Trishul Siddharthan
- Division of Pulmonary and Critical Care, Johns Hopkins University, Johns Hopkins School of Medicine, Baltimore, Maryland, United States of America
- Department of Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Tracy Rabin
- Department of Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Maureen E. Canavan
- Global Health Leadership Institute, Yale University, New Haven, Connecticut, United States of America
| | - Faith Nassali
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - Phillip Kirchhoff
- Department of Surgery, University Hospital Basel, Basel, Switzerland
| | | | - Steven Coca
- Department of Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut, United States of America
- Department of Nephrology, Mt. Sinai Hospital, Mount Sinai School of Medicine, New York, New York, United States of America
| | - Asghar Rastegar
- Department of Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Felix Knauf
- Department of Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut, United States of America
- Department of Nephrology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Desborough J, Bagheri N, Banfield M, Mills J, Phillips C, Korda R. The impact of general practice nursing care on patient satisfaction and enablement in Australia: A mixed methods study. Int J Nurs Stud 2016; 64:108-119. [PMID: 27768985 DOI: 10.1016/j.ijnurstu.2016.10.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 09/05/2016] [Accepted: 10/13/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND The numbers of nurses in general practice in Australia tripled between 2004 and 2012. However, evidence on whether nursing care in general practice improves patient outcomes is scarce. Although patient satisfaction and enablement have been examined extensively as outcomes of general practitioner care, there is little research into these outcomes from nursing care in general practice. The aim of this study was to examine the relationships between specific general practice characteristics and nurse consultation characteristics, and patient satisfaction and enablement METHODS: A mixed methods study examined a cross-section of patients from 21 general practices in the Australian Capital Territory. The Patient Enablement and Satisfaction Survey was distributed to 1665 patients who received nursing care between September 2013 and March 2014. Grounded theory methods were used to analyse interviews with staff and patients from these same practices. An integrated analysis of data from both components was conducted using multilevel mixed effect models. RESULTS Data from 678 completed patient surveys (response rate=42%) and 48 interviews with 16 nurses, 23 patients and 9 practice managers were analysed. Patients who had longer nurse consultations were more satisfied (OR=2.50, 95% CI: 1.43-4.35) and more enabled (OR=2.55, 95% CI: 1.45-4.50) than those who had shorter consultations. Patients who had continuity of care with the same general practice nurse were more satisfied (OR=2.31, 95% CI: 1.33-4.00) than those who consulted with a nurse they had never met before. Patients who attended practices where nurses worked with broad scopes of practice and high levels of autonomy were more satisfied (OR=1.76, 95% CI: 1.09-2.82) and more enabled (OR=2.56, 95% CI: 1.40-4.68) than patients who attended practices where nurses worked with narrow scopes of practice and low levels of autonomy. Patients who received nursing care for the management of chronic conditions (OR=2.64, 95% CI: 1.32-5.30) were more enabled than those receiving preventive health care. CONCLUSIONS This study provides the first evidence of the importance of continuity of general practice nurse care, adequate time in general practice nurse consultations, and broad scopes of nursing practice and autonomy for patient satisfaction and enablement. The findings of this study provide evidence of the true value of enhanced nursing roles in general practice. They demonstrate that when the vision for improved coordination and multidisciplinary primary health care, including expanded roles of nurses, is implemented, high quality patient outcomes can be achieved.
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Affiliation(s)
- Jane Desborough
- Department of Health Services Research and Policy, Research School of Population Health, Australian National University, Australia.
| | - Nasser Bagheri
- Department of Health Services Research and Policy, Research School of Population Health, Australian National University, Australia
| | - Michelle Banfield
- National Institute for Mental Health Research, Research School of Population Health, Australian National University, Australia
| | - Jane Mills
- Nursing, School of Health & Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Christine Phillips
- Social Foundations of Medicine, Australian National University Medical School, Australia
| | - Rosemary Korda
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Australia
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