1
|
Yeoh JPS, Spence C. Background Music's Impact on Patients Waiting in Surgery and Radiology Clinics. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2023; 16:278-290. [PMID: 37016842 DOI: 10.1177/19375867231161094] [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] [Indexed: 04/06/2023]
Abstract
OBJECTIVES To assess the impact of different types of background music on patients' anxiety and perceptions in a healthcare setting. BACKGROUND An overwhelming number of studies in the West have been conducted on the use of background music in reducing patients' anxiety and their perception of hospitals. Despite the optimism for Western classical music in such settings, evidence documenting the successful use of this genre of music in waiting rooms across other people groups has, thus far, been inconclusive. METHOD A single-blind randomized study in which a total of 303 participants were recruited from both surgery and radiology clinics using a between-groups experimental design. Patients were seated in the waiting room for at least 20 min while music (Western classical, lo-fi) or no music was playing in the background. Participants were then required to complete a questionnaire that consisted of a shortened 6-item State Trait Anxiety Inventory (STAI-6), and eight questions relating to overall perceptions of the hospital. RESULTS The results from both clinics revealed that patients in the no music condition rated themselves as feeling significantly less anxious than those in either of the two music conditions. Patients' perceptions of the hospital's overall service and expectations were higher in the no music condition. CONCLUSIONS Firstly, the choice of background music should match the differing pace of the day; for example, a more upbeat song would better fit the mood of a busy clinic, leading to a more "congruent" atmosphere. Secondly, playing background music in a "task-oriented" and highly charged/anxious environment may increase arousal levels, which in turn could result in negative perceptions of the hospital and an increase in anxiety among patients. Finally, music is a cultural product and music that primes certain beliefs in one culture may not have similar effects among other people groups. Hence, specific curated playlists are necessary to convey "intentions" to different people groups.
Collapse
Affiliation(s)
- Joanne Pei Sze Yeoh
- Music Department, Faculty of Human Ecology, University Putra Malaysia, Serdang, Malaysia
| | - Charles Spence
- Department of Experimental Psychology, University of Oxford, United Kingdom
| |
Collapse
|
2
|
Rossi A, Heyman NB, Rossi MO, Wolf S, White T. Exploring the Association Between the Healthcare Design Elements and Physician Well-Being: A Scoping Review. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2023; 16:362-378. [PMID: 36722306 DOI: 10.1177/19375867231151687] [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] [Indexed: 02/02/2023]
Abstract
PURPOSE To evaluate the association between elements of the built environment and physician well-being using a scoping review. BACKGROUND Physicians currently report low work satisfaction, high burnout and depression. The built environment has been shown to affect well-being in the general population, but its relationship to physician well-being is not well understood. Gaining a better understanding of this relationship will allow for better evidence-based design for physician well-being. METHODS A scoping review of the literature was conducted of Scopus and PubMed databases using key words for (1) environmental variables such as "environmental design"; (2) physician terms, such as "doctor"; and (3) outcome measures of well-being, such as "burnout." Studies were included if they had at least one measure of the built environment and one measure of physician well-being. Of 1,723 abstracts screened, 146 full-text articles were reviewed, leaving 16 articles to be included for data extraction. RESULTS Included studies were from all around the world, except for, notably, the United States. Robust interpretation of the data was challenging because of the lack of standardization in the assessment of environmental factors and physician well-being. Excessive noise was the variable most linked to well-being. Suitable surroundings, including lighting, furniture, and art, were also linked with satisfaction, but it was unclear whether there was an association with well-being. CONCLUSION Understanding how environmental factors affect physician well-being is paramount but considerably understudied. Standardization of research approach should be developed in order to produce more robust research to create evidence-based designs for physician well-being.
Collapse
Affiliation(s)
- Amerigo Rossi
- New York Institute of Technology, Old Westbury, NY, USA
| | | | | | | | | |
Collapse
|
3
|
Devlin AS, Hetzel C, Rathgeber M. Does Perceived Control Matter in the Outpatient Waiting Room? HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2023; 16:38-54. [PMID: 36683412 DOI: 10.1177/19375867221143104] [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: 01/24/2023]
Abstract
OBJECTIVE The study examined perceived control in the context of the outpatient waiting room to further understand the extent to which patients want to exercise control in that environment. Background: In Ulrich's theory of supportive design, research shows more evidence for positive distraction and social support than for perceived control; its role in outpatient settings has not been examined. METHOD This between-subjects experimental design, in which participants read a written scenario varying the number of patients waiting (1 or 5) and the control available (no information provided, personal controls, and room controls), examined the effect of those variables on stress, satisfaction with the environment, extent of perceived control, and participants' schema of who should control the environment of the waiting room. RESULTS Having individual controls available in the waiting room favorably impacted the perception of the environment but did not significantly impact stress. The data show that people likely have a schema of appropriate behavior in a doctor's waiting room, which does not encourage manipulation of environmental elements. CONCLUSIONS In the doctor's office waiting room, having individual controls, such as on-off knobs on table lamps next to each chair, can improve evaluation of the environment and increase people's perception of control.
Collapse
Affiliation(s)
- Ann Sloan Devlin
- Department of Psychology, Emerita Connecticut College, New London, CT, USA
| | | | | |
Collapse
|
4
|
Halemani K, Issac A, Mishra P, Dhiraaj S, Mandelia A, Mathias E. Effectiveness of Preoperative Therapeutic Play on Anxiety Among Children Undergoing Invasive Procedure: a Systematic Review and Meta-analysis. Indian J Surg Oncol 2022; 13:858-867. [PMID: 36687245 PMCID: PMC9845488 DOI: 10.1007/s13193-022-01571-1] [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: 06/21/2021] [Accepted: 06/25/2022] [Indexed: 01/25/2023] Open
Abstract
Play is an indispensable part of growing up and by using play to distract children while undergoing invasive procedures can have a positive impact. Play can help children to cope with painful procedures and long-term treatment. The aim of the review was to evaluate the evidence concerning the effect of play on anxiety among children undergoing invasive procedures. This is a systematic review and meta-analysis. Data sources: PubMed, The MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Clinical Key, Cochrane Library, and Google Scholar were searched between 2012 and 2020. Review methods: randomized controlled trials (RCTs) that evaluated the effectiveness of play on anxiety among children undergoing invasive procedures were included. Meta-analysis was done using Revman v5.3 software. A total of 451 participants from 5 trials were involved in the systemic review and meta-analysis. Self-reported anxiety, parents reported anxiety, and self-reported pain were found significant in intervention [χ2 = 7.57, df = 2 at P < 0.02]. When compared with control group, the review result revealed that experimental group reduced the anxiety and pain (P < 0.05).
Collapse
Affiliation(s)
- Kurvatteppa Halemani
- College of Nursing, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, Uttar Pradesh India
| | - Alwin Issac
- College of Nursing, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha India
| | - Prabhaker Mishra
- Dept. of Biostatistics & Health Informatics, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, Uttar Pradesh India
| | - Sanjay Dhiraaj
- Dept. of Anaesthesiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, Uttar Pradesh India
| | - Ankur Mandelia
- Dept.of Pediatric Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, Uttar Pradesh India
| | - Edline Mathias
- Manipal College of Nursing, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka India
| |
Collapse
|
5
|
Devlin AS. Seating in Doctors' Waiting Rooms: Has COVID-19 Changed Our Choices? HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2022; 15:41-62. [PMID: 35726212 DOI: 10.1177/19375867221104248] [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: 11/15/2022]
Abstract
OBJECTIVE This study investigates preference for five different seating arrangements (e.g., rows, clusters) in a doctor's office waiting room, whether these reduce stress and improve judgments of medical care, and how such choices may have changed over the pandemic (2013 vs. 2021). BACKGROUND What is called the doctor's office layout, with chairs lining the perimeter of the waiting room, is criticized by designers, yet little empirical evidence exists to support that assessment. METHOD Data collected in 2013 and 2021 used sketches of five different seating arrangements; people saw just one of these. The study examined the effect of time and seating arrangement on anxiety, need for privacy, situational awareness, evaluation of the environment, and perception of the doctor. RESULTS There was no significant impact of the seating arrangement on any of the dependent variables, but ratings were higher for situational awareness, need for privacy, evaluation of the environment, and aspects related to the physician in 2021. In addition, seating preferences favored end, not middle seats, and chair selections with the chair back to a wall. CONCLUSION In this study, no evidence exists that the doctor's office layout is less preferred than four other seating arrangements, but seat choice shows people prefer end seats (not middle seats) across arrangements. The doctor's office layout may offer a supportive familiarity to people; also, given the percentage of people who visit the doctor unaccompanied, layouts designed to encourage social interaction may not always be appropriate.
Collapse
|
6
|
Operating room nurses' experiences of limited access to daylight in the workplace - a qualitative interview study. BMC Nurs 2021; 20:227. [PMID: 34753467 PMCID: PMC8579627 DOI: 10.1186/s12912-021-00751-8] [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: 06/14/2021] [Accepted: 10/29/2021] [Indexed: 12/03/2022] Open
Abstract
Background The operating room nurse is, among other things, responsible for patient safety and maintaining an aseptic environment. For hygienic reasons unnecessary traffic in the operating room should be avoided, which may mean that the operating room nurse works long shifts without relief. Operating departments are usually separated, where there might be no daylight opportunities in the operating room. The purpose of the study was to describe operating room nurses’ experiences of limited access to daylight in the workplace. Method Qualitative design with four semi-structured focus groups of totally 15 operating room nurses. The analysis was performed with a content analysis with an inductive approach. Results The study generated two main categories, difference in light and contact with the outer world. Operating room nurses felt that daylight affected them differently from the light from lamps, where daylight was considered important for experiencing well-being. Daylight could lead to a sensation of joy but also increased awareness and energy which seemed to improve the ability to perform at work. The limited access to daylight contributed to fatigue and led to an internal stress that affected the nurses even after work. Having opportunities to look out through windows under a workday was important to experience contact with the outside world and created a sense of time. Conclusion To look out can reduce the feeling of being trapped in the closed context that the operating department entails. It can also lead to increased well-being and comfort in the workplace. We consider that daylight is an important component in the physical work environment that needs to be taken into consideration in further research as well as in new construction of operations departments.
Collapse
|
7
|
Whitley GA, Hemingway P, Law GR, Siriwardena AN. Ambulance clinician perspectives of disparity in prehospital child pain management: A mixed methods study. Health Sci Rep 2021; 4:e261. [PMID: 33860109 PMCID: PMC8033633 DOI: 10.1002/hsr2.261] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/21/2021] [Accepted: 01/24/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND When children suffer acute pain, the ambulance service is often involved to provide initial assessment, treatment, and transport. Several predictors of effective pain management have been identified, including children who are younger (0-5 years), administered analgesics, and living in homes from more affluent areas. OBJECTIVE To explain previously identified predictors of effective prehospital pain management in children. DESIGN Mixed methods sequential explanatory study. SETTING AND PARTICIPANTS East Midlands Ambulance Service National Health Service Trust paramedics and emergency medical technicians (EMTs) participated in face-to-face semi-structured interviews. These were audio recorded, transcribed verbatim, and coded using thematic analysis. Meta-inferences were generated and illustrated within a joint display. RESULTS Twelve clinicians (9 paramedics and 3 EMTs) were interviewed. Median (interquartile range) age was 43.5 years (41.5, 45.75), 58% were male (n = 7) and 58% were parents (n = 7). Possible explanations were provided for all predictors. Younger children were perceived to express more emotion, were easier to distract, and lived more in the moment than their older counterparts, which explained why younger children were more likely to achieve effective pain management. Analgesics were perceived to have a psychosocial benefit in addition to the pharmacological action. Ambulance clinicians felt that children living in more affluent areas were more likely to achieve effective pain management because the kempt environment facilitated assessment and management and clinicians spent more time on scene; this allowed more time for analgesics to take effect. Participants perceived paramedics to be more confident, and it was found that paramedics were older, more experienced, had a greater scope of practice, and spent more time on scene than EMTs. CONCLUSION Prehospital pain management in children could be improved by facilitating and prioritizing analgesic administration and by ambulance services ensuring a paramedic, or highly trained clinician, is present on each vehicle, necessitating long-term commitment to staff development.
Collapse
Affiliation(s)
- Gregory Adam Whitley
- Community and Health Research Unit, School of Health and Social CareUniversity of LincolnLincolnUK
| | - Pippa Hemingway
- Faculty of Medicine and Health SciencesUniversity of NottinghamNottinghamUK
| | - Graham Richard Law
- Community and Health Research Unit, School of Health and Social CareUniversity of LincolnLincolnUK
| | | |
Collapse
|
8
|
Kearns RA, Neuwelt PM, Eggleton K. Permeable boundaries? Patient perspectives on space and time in general practice waiting rooms. Health Place 2020; 63:102347. [PMID: 32543433 DOI: 10.1016/j.healthplace.2020.102347] [Citation(s) in RCA: 5] [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] [Received: 12/16/2019] [Revised: 04/15/2020] [Accepted: 04/23/2020] [Indexed: 11/16/2022]
Abstract
This paper considers an under-examined space in primary health care - the reception area/waiting room. This space can be challenging to negotiate, particularly for those who experience social marginalisation. We begin by situating the significance of the 'entry into the health care setting' in the patient journey in terms of time as well as space. Through an analysis of interview and focus group data gathered in a New Zealand study, we highlight ways that patients view these spaces as firmly bounded and confronting. In reflecting on the data, we then identify the potential for these spaces to be more permeable. We conclude that this spatio-temporal context need not be one of constraint. Rather, there are ways in which the boundaries of this space can be potentially enabling to those required to pause in the process of enacting patienthood.
Collapse
Affiliation(s)
- Robin A Kearns
- School of Environment, University of Auckland, New Zealand.
| | - Pat M Neuwelt
- School of Population Health, University of Auckland, New Zealand.
| | - Kyle Eggleton
- School of Population Health, University of Auckland, New Zealand.
| |
Collapse
|
9
|
Yeh J, Ostini R. The impact of health literacy environment on patient stress: a systematic review. BMC Public Health 2020; 20:749. [PMID: 32448284 PMCID: PMC7245697 DOI: 10.1186/s12889-020-08649-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 04/02/2020] [Indexed: 11/30/2022] Open
Abstract
Background There exists little literature on situational health literacy - that is, how an individual’s health literacy varies across different health literacy environments. However, one can consider the role of stress when examining the relationship between health situations and decision-making ability, and by proxy health literacy. The aim of this study was to assess the strength of the evidence on the relationship between health situations and patient stress, considered in the context of health professional perception, and determine what health situations act to influence patient stress. Methods A systematic review of English articles using PubMed, PsycINFO, CINAHL and Embase databases was conducted. Search terms focused on ‘patient’, ‘stress’, and ‘health care situations’. Only peer-reviewed original research with data on patient stress in the context of a health facility environment was included. Studies were screened and critically appraised by both authors. Study elements for extraction were defined by RO and extracted by JY. Results Twenty-four studies were included for narrative synthesis. Patients in Intensive Care Units were more stressed about factors relating to their physical discomfort, with some agreement from health care professionals. Parents of children in Intensive Care Units were more concerned with stressors relating to their child’s appearance and behaviour, and alteration in their parental role. Few studies examined health settings other than Intensive Care Units, and those that did varied greatly in terms of study design and population characteristics, lacking generalisability. Conclusions Overall, the findings of what patients find most stressful in Intensive Care Units can guide health care professionals practicing best practice care. However, the evidence on how patient stress is influenced by non-Intensive Care Unit health care settings is weak. Further research is needed to enhance current understanding of the interaction between patient stress and health care environments in both hospital and primary care settings.
Collapse
Affiliation(s)
- John Yeh
- Faculty of Medicine, The University of Queensland, Herston, Queensland, 4006, Australia.
| | - Remo Ostini
- Faculty of Medicine, The University of Queensland, Herston, Queensland, 4006, Australia
| |
Collapse
|
10
|
Retrospective Review of the Safety and Efficacy of Virtual Reality in a Pediatric Hospital. Pediatr Qual Saf 2020; 5:e293. [PMID: 32426648 PMCID: PMC7190243 DOI: 10.1097/pq9.0000000000000293] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 03/26/2020] [Indexed: 12/31/2022] Open
Abstract
Introduction Virtual reality (VR) is an emerging tool for anxiety and fear reduction in pediatric patients. VR use is facilitated by Certified Child Life Specialists (CCLS) at pediatric hospitals. The primary aim of this study was to retrospectively review the safety of VR by analyzing adverse events after the utilization of VR under CCLS supervision. Secondary objectives were to characterize the efficacy of VR in enhancing patient cooperation, describe the integration of VR into Child Life services, and identify interventions that accompanied VR. Methods The Stanford Chariot Program developed VR applications, customized VR interfaces, and patient head straps, and distributed these to CCLS. Chart review analyzed VR utilization through CCLS patient notes. Inclusion criteria were all patients ages 6 to 18-years-old who received a Child Life intervention. Results From June 2017 to July 2018, 31 CCLS saw 8,098 patients, 3,696 of which met age criteria with pre- and post-intervention cooperation data. Two hundred thirteen patients received VR with an accompanying intervention, while 34 patients received only VR. Adverse events were rare, and included increased anxiety (3.8%, n=8), dizziness (0.5%, n=1), and nausea (0.5%, n=1). Patients were more likely to be cooperative after receiving VR (99.5%, n=212) compared to pre-intervention (96.7%, n=206, p=0.041). VR use was most common in the perioperative setting (60%, n=128), followed by outpatient clinics (15%, n=32). Conclusion VR is safe in pediatric patients with appropriate hardware, software, and patient selection. Side effects were rare and self-limited. VR appears to be associated with improvements in cooperation.
Collapse
|
11
|
Mutambo C, Shumba K, Hlongwana KW. User-provider experiences of the implementation of KidzAlive-driven child-friendly spaces in KwaZulu-Natal, South Africa. BMC Public Health 2020; 20:91. [PMID: 31964361 PMCID: PMC6975036 DOI: 10.1186/s12889-019-7712-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 09/30/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND KidzAlive is a child-centred intervention aimed at improving the quality of HIV care for children in South Africa. Through this intervention, 10 child-friendly spaces were created in 10 primary healthcare centres (PHCs) in KwaZulu-Natal to enhance child-centred HIV care. However, the user-provider experiences of these child-friendly spaces in these facilities have not been explored. This paper addresses this gap. METHODS We conducted qualitative interviews with children (n = 30), their primary caregivers (PCGs) (n = 30), and KidzAlive trained healthcare workers (HCWs) (n = 20) using and providing child-friendly spaces, respectively. Data were generated, using a semi-structured interview guide printed in both English and IsiZulu. The interviews were audio-recorded transcribed and translated to English by a research team member competent in both languages. Data were imported to NVivo 10 for thematic analysis. The COREQ checklist was used to ensure that the study adheres to quality standards for reporting qualitative research. RESULTS Child-friendly spaces contributed to the centredness of care for children in PHCs. This was evidenced by the increased involvement and participation of children, increased PCGs' participation in the care of their children and a positive transformation of the PHC to a therapeutic environment for children. Several barriers impeding the success of child-friendly spaces were reported including space challenges; clashing health facility priorities; inadequate management support; inadequate training on how to maximise the child-friendly spaces and lastly the inappropriateness of existing child-friendly spaces for much older children. CONCLUSION Child-friendly spaces promote HIV positive children's right to participation and agency in accessing care. However, more rigorous quantitative evaluation is required to determine their impact on children's HIV-related health outcomes.
Collapse
Affiliation(s)
- Chipo Mutambo
- The Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Howard College Campus, King George Avenue, Durban, 4041, South Africa. .,School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, Howard College Campus, King George Avenue, Durban, 4041, South Africa. .,Department of Public Health Medicine, University of KwaZulu-Natal, George Campbell Building, Room 217, 2nd Floor, King George V Avenue, Glenwood, Durban, KwaZulu-Natal, 4041, South Africa.
| | - Kemist Shumba
- The Discipline of Psychology, School of Applied Human Sciences, University of KwaZulu-Natal, Office IX06 TB Davies Ext, Howard College Campus, Durban, 4041, South Africa
| | - Khumbulani W Hlongwana
- Department of Public Health Medicine, University of KwaZulu-Natal, George Campbell Building, Room 217, 2nd Floor, King George V Avenue, Glenwood, Durban, KwaZulu-Natal, 4041, South Africa
| |
Collapse
|
12
|
Interior renovation of a general practitioner office leads to a perceptual bias on patient experience for over one year. PLoS One 2018; 13:e0193221. [PMID: 29462196 PMCID: PMC5819831 DOI: 10.1371/journal.pone.0193221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 02/07/2018] [Indexed: 11/30/2022] Open
Abstract
Introduction Measuring patient experience is key when assessing quality of care but can be biased: A perceptual bias occurs when renovations of the interior design of a general practitioner (GP) office improves how patients assessed quality of care. The aim was to assess the length of perceptual bias and if it could be reproduced after a second renovation. Methods A GP office with 2 GPs in Switzerland was renovated twice within 3 years. We assessed patient experience at baseline, 2 months and 14 months after the first and 3 months after the second renovation. Each time, we invited a sample of 180 consecutive patients that anonymously graded patient experience in 4 domains: appearance of the office; qualities of medical assistants and GPs; and general satisfaction. We compared crude mean scores per domain from baseline until follow-up. In a multivariate model, we adjusted for patient’s age, gender and for how long patients had been their GP. Results At baseline, patients aged 60.9 (17.7) years, 52% females. After the first renovation, we found a regression to the baseline level of patient experience after 14 months except for appearance of the office (p<0.001). After the second renovation, patient experience improved again in appearance of the office (p = 0.008), qualities of the GP (p = 0.008), and general satisfaction (p = 0.014). Qualities of the medical assistant showed a slight improvement (p = 0.068). Results were unchanged in the multivariate model. Conclusions Interior renovation of a GP office probably causes a perceptual bias for >1 year that improves how patients rate quality of care. This bias could be reproduced after a second renovation strengthening a possible causal relationship. These findings imply to appropriately time measurement of patient experience to at least one year after interior renovation of GP practices to avoid environmental changes influences the estimates when measuring patient experience.
Collapse
|
13
|
Locatelli SM, Turcios S, LaVela SL. Optimizing the patient-centered environment: results of guided tours with health care providers and employees. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2018; 8:18-30. [PMID: 25816378 DOI: 10.1177/1937586714565610] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine providers' perspectives on the care environment and patient-centered care (PCC) through the eyes of the veteran patient, using guided tours qualitative methodology. BACKGROUND Environmental factors, such as attractiveness and function, have the potential to improve patients' experiences. Participatory qualitative methods allow researchers to explore the environment and facilitate discussion. METHODS Guided tours were conducted with 25 health care providers/employees at two Veterans Affairs (VA) health care facilities. In guided tours, participants lead the researcher through an environment, commenting on their surroundings, thoughts, and feelings. The researcher walks along with the participant, asking open-ended questions as needed to foster discussion and gain an understanding of the participant's view. Participants were asked to walk through the facility as though they were a veteran. Tours were audio recorded, with participant permission, and transcribed verbatim by research assistants. Three qualitative researchers were responsible for codebook development and coding transcripts and used data-driven coding approaches. RESULTS Participants discussed physical appearance of the environment and how that influences perceptions about care. Overall, participants highlighted the need to shed the "institutional" appearance. Differences between VA and non-VA health care facilities were discussed, including availability of private rooms and staff to assist with navigating the facility. They reviewed resources in the facility, such as the information desk to assist patients and families. Finally, they offered suggestions for future improvements, including improvements to waiting areas and quiet areas for patients to relax and "get away" from their rooms. CONCLUSIONS Participants highlighted many small changes to the care environment that could enhance the patient experience. Additionally, they examined the environment from the patient's perspective, to identify elements that enhance, or detract from, the patient's care experience.
Collapse
Affiliation(s)
- Sara M Locatelli
- Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, IL, USA Center for Evaluation of Practices and Experiences of Patient-Centered Care, Edward Hines Jr. Veterans Affairs Hospital, Hines, IL, USA
| | - Stephanie Turcios
- Center for Evaluation of Practices and Experiences of Patient-Centered Care, Edward Hines Jr. Veterans Affairs Hospital, Hines, IL, USA
| | - Sherri L LaVela
- Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, IL, USA Center for Evaluation of Practices and Experiences of Patient-Centered Care, Edward Hines Jr. Veterans Affairs Hospital, Hines, IL, USA Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| |
Collapse
|
14
|
Tièche R, da Costa BR, Streit S. Patient satisfaction is biased by renovations to the interior of a primary care office: a pretest-posttest assessment. BMC Health Serv Res 2016; 16:373. [PMID: 27515540 PMCID: PMC4982145 DOI: 10.1186/s12913-016-1647-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 08/10/2016] [Indexed: 11/18/2022] Open
Abstract
Background Measuring quality of care is essential to improve primary care. Quality of primary care for patients is usually assessed by patient satisfaction questionnaires. However, patients may not be able to judge quality of care without also reflecting their perception of the environment. We determined the effect that redesigning a primary care office had on patient satisfaction. We hypothesized that renovating the interior would make patients more satisfied with the quality of medical care. Methods We performed a Pretest-Posttest analysis in a recently renovated single-practice primary care office in Grenchen, Switzerland. Before and after renovation, we distributed a questionnaire to assess patient satisfaction in four domains. We chose a Likert scale (1 = very poor to 6 = very good), and 12 quality indicators, and included two consecutive samples of patients presenting at the primary care office before (n = 153) and after (n = 153) interior design renovation. Results Response rate was high (overall 85 %). The sample was similar to the enlisted patient collective, but the sample population was older (60 years) than the collective (52 years). Patient satisfaction was higher for all domains after the office was renovated (p < 0.01–0.001). Results did not change when we included potential confounders in the multivariable model (p < 0.01). Conclusions Renovating the interior of a primary care office was associated with improved patient satisfaction, including satisfaction in domains otherwise unchanged. Physician skills and patient satisfaction sometimes depend on surrounding factors that may bias the ability of patients to assess the quality of medical care. These biases should be taken into account when quality assessment instruments are designed for patients. Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1647-4) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
| | - Bruno R da Costa
- Institute of Primary Health Care (BIHAM), University of Bern, Gesellschaftsstrasse 49, 3012, Bern, Switzerland
| | - Sven Streit
- Institute of Primary Health Care (BIHAM), University of Bern, Gesellschaftsstrasse 49, 3012, Bern, Switzerland.
| |
Collapse
|
15
|
Lerwick JL. Minimizing pediatric healthcare-induced anxiety and trauma. World J Clin Pediatr 2016; 5:143-150. [PMID: 27170924 PMCID: PMC4857227 DOI: 10.5409/wjcp.v5.i2.143] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 08/14/2015] [Accepted: 03/09/2016] [Indexed: 02/06/2023] Open
Abstract
Frequently, episodes of care such as preventive clinic visits, acute care, medical procedures, and hospitalization can be emotionally threatening and psychologically traumatizing for pediatric patients. Children are often subject to psychological trauma, demonstrated by anxiety, aggression, anger, and similar expressions of emotion, because they lack control of their environment. This sense of helplessness, coupled with fear and pain can cause children to feel powerless in healthcare settings. These emotional responses can delay important medical treatment, take more time to complete and can reduce patient satisfaction. Healthcare professionals are uniquely positioned to prevent healthcare-induced trauma and reduce healthcare-induced anxiety. This article introduces a new way to choice, agenda, resilience and emotion (CARE) for pediatric patients in the healthcare setting by implementing the four following treatment principles called the care process: (1) Choices: Offer power in a powerless environment; (2) Agenda: Let patients and families know what to expect and what is expected of them; (3) Resilience: Highlight strengths and reframe negatives; and (4) Emotional support: Recognize and normalize common fears and responses. Engaging the CARE principles helps patients and families feel empowered and mitigates, reduces, and may even ameliorate risk of anxiety and trauma responses.
Collapse
|
16
|
Biddiss E, McPherson A, Shea G, McKeever P. The design and testing of interactive hospital spaces to meet the needs of waiting children. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2016; 6:49-68. [PMID: 23817906 DOI: 10.1177/193758671300600305] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To design an innovative interactive media display in a pediatric hospital clinic waiting space that addresses the growing demand for accessible, contact-surface-free options for play. BACKGROUND In healthcare settings, waiting can be anxiety provoking for children and their accompanying family members. Opportunities for positive distraction have been shown to reduce waiting anxiety, leading to positive health outcomes. METHODS An interactive media display, ScreenPlay, was created and evaluated using a participatory design approach and a combination of techniques including quality function deployment and mixed data elicitation methods (questionnaires, focus groups, and observations). The user and organizational design requirements were established and used to review contemporary strategies for positive distraction in healthcare waiting spaces and to conceptualize and test ScreenPlay. Ten staff members, 11 children/youths, and 6 parents participated in the design and evaluation of ScreenPlay. RESULTS ScreenPlay provided a positive, engaging experience without the use of contact surfaces through which infections can be spread. It was accessible to children, youth, and adults of all motor abilities. All participants strongly agreed that the interactive media display would improve the healthcare waiting experience. CONCLUSIONS ScreenPlay is an interactive display that is the result of a successful model for the design of healthcare waiting spaces that is collaborative, interdisciplinary, and responsive to the needs of its community. KEYWORDS Design process, healing environments, hospital, interdisciplinary, pediatric.
Collapse
Affiliation(s)
- Elaine Biddiss
- CORRESPONDING AUTHOR: Dr. Elaine Biddiss, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, Canada M4G 1R8; ; (416) 425-6220, ext. 3505
| | | | | | | |
Collapse
|
17
|
Devlin AS, Andrade CC, Carvalho D. Qualities of Inpatient Hospital Rooms: Patients' Perspectives. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2015; 9:190-211. [PMID: 26666814 DOI: 10.1177/1937586715607052] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aim of this qualitative study was to investigate what design features of hospital rooms are valued by inpatients. BACKGROUND Little research has explored how patients evaluate the physical environment of their hospital rooms. Most responses are captured by the Hospital Consumer Assessment of Healthcare Providers and Systems survey, which includes only two questions about the physical environment. METHOD Two hundred thirty-six orthopedic patients (78 in the United States and 158 in Portugal) listed three features of their hospital room that influenced their level of satisfaction with their hospital stay, indicating whether the feature was positive or negative. RESULTS The comments were more positive (71.4%) than negative (28.6%). Using the framework of supportive design from Ulrich, over half the comments (64.31%) could be categorized in one of the three dimensions: 33.2% (positive distraction), 22.4% (perceived control), and 6.0% (social support). This total includes Internet (2.7%), which could be categorized as either social support or positive distraction. Comments called "other aspects" focused on overall environmental appraisals, cleanliness, and functionality and maintenance. CONCLUSIONS The majority of comments could be accommodated by Ulrich's theory, but it is noteworthy that other aspects emerge from patients' comments and affect their experience. Cross-cultural differences pointed to the greater role of light and sun for Portuguese patients and health status whiteboard for U.S. PATIENTS Qualitative research can add significantly to our understanding of the healthcare experience and may inform design decisions.
Collapse
Affiliation(s)
| | - Cláudia Campos Andrade
- Centro de Investigação e Intervenção Social (CIS-IUL), Instituto Universitário de Lisboa (ISCTE-IUL), Lisbon, Portugal
| | | |
Collapse
|
18
|
Lemon TI, Smith RH. Consultation Content not Consultation Length Improves Patient Satisfaction. J Family Med Prim Care 2015; 3:333-9. [PMID: 25657939 PMCID: PMC4311338 DOI: 10.4103/2249-4863.148102] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The suggestion that increased consultation length leads to improved patient satisfaction has some evidence, albeit uncertain. Importantly there are other determinants within the doctor-patient consultation that themselves may be responsible for this improved satisfaction and it is these we investigate in this paper. A systematic review of PubMed and associated papers was carried out using search terms ‘family practice consultation length’, ‘general practice consultation length’, ‘local health authority consultation length’ and ‘primary care consultation length’. 590 papers were originally selected using these search terms, post scoring this number became 9. The results obtained support the idea that consultation length does not directly improve consultation outcome, but rather there are variables integrated within the consultation affecting this. Increased time purely allows a physician to implement management, particularly relating to psychosocial aspects.
Collapse
Affiliation(s)
- Thomas I Lemon
- Department Postgraduate, Dians Princess of Wales Hospital, Scartho, DN33 2BA
| | - Rebecca H Smith
- Department Postgraduate, Royal Glamorgan Hospital, Ynysmaerdy, Pontyclun, Wales Deanery CF72 8XR
| |
Collapse
|
19
|
Biddiss E, Knibbe TJ, McPherson A. The Effectiveness of Interventions Aimed at Reducing Anxiety in Health Care Waiting Spaces. Anesth Analg 2014; 119:433-448. [DOI: 10.1213/ane.0000000000000294] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
20
|
Court H, Greenland K, Margrain TH. Measuring patient anxiety in primary care: Rasch analysis of the 6-item Spielberger State Anxiety Scale. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2010; 13:813-819. [PMID: 20561315 DOI: 10.1111/j.1524-4733.2010.00758.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVES The 6-item Spielberger State Anxiety Scale has been used as a replacement of the original version in many health-care studies. The purpose of this study was to evaluate the measurement properties of the shortened 6-item Spielberger State Anxiety Scale using Rasch analysis in general medical practice patients (N=297). METHODS Participants (aged 16 years or above) were recruited on a consecutive basis from three general medical practices. Prior to their appointment, participants were asked to complete a 6-item Spielberger State Anxiety Scale. RESULTS The results of the study showed that the scale is unidimentional, and each item measures a different level of patient anxiety. The rating scale operated well and item and person reliability was good. Furthermore, principal-components analysis of the residuals confirmed the scale measures a unitary concept. A scoring key was generated to allow conversion of raw scores to a continuous measurement. CONCLUSION The 6-item Spielberger State Anxiety Scale is shorter than the original version and has good psychometric properties. This would suggest the scale is a valid alternative to the full version for use in primary health-care practice and research.
Collapse
Affiliation(s)
- Helen Court
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK.
| | | | | |
Collapse
|
21
|
Unruh KT, Skeels M, Civan-Hartzler A, Pratt W. Transforming Clinic Environments into Information Workspaces for Patients. PROCEEDINGS OF THE SIGCHI CONFERENCE ON HUMAN FACTORS IN COMPUTING SYSTEMS. CHI CONFERENCE 2010; 2010:183-192. [PMID: 21654895 PMCID: PMC3108044 DOI: 10.1145/1753326.1753354] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Although clinic environments are a primary location for exchanging information with clinicians, patients experience these spaces as harsh environments to access, use, exchange, and manage information. In this paper, we present results from an ethnographic-inspired study of breast cancer patients actively interacting with information in clinic environments. Through observations and interviews, we observed information interactions in awkward physical positions; inefficient use of existing clinical space; separation of patients from their information and lack of support for collaborative document viewing. These factors compromised patients' abilities to manage their information work when they experienced bursts of information exchange, lack of advance information, fragmented attention, and heightened stress in clinic environments. To overcome these challenges, we identify formative strategies to focus attention, encourage collaboration, and improve communication in clinical settings.
Collapse
Affiliation(s)
- Kenton T Unruh
- Biomedical & Health Informatics University of Washington Seattle, WA 98195, USA
| | | | | | | |
Collapse
|
22
|
|
23
|
|
24
|
|