1
|
Barrett CME, Stapleton D, Ringer LCM, Harvey NE, Eustace C, Devereaux A, McPhee C, Mather K, Wadden KP, Cahill LS. Perceptions of Magnetic Resonance Imaging During Pregnancy: A Newfoundland and Labrador Perspective. J Obstet Gynaecol Can 2024; 46:102269. [PMID: 37944816 DOI: 10.1016/j.jogc.2023.102269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/23/2023] [Accepted: 10/25/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVES This study aimed to identify enablers and barriers to participation in MRI for clinical indications and scientific research, and to determine the perceptions of MRI performed during pregnancy. METHODS We conducted a survey of 156 pregnant people in Newfoundland and Labrador including sociodemographic information, obstetrical history, MRI history, and willingness to participate in an MRI. Categorical variables were analyzed using a Fisher exact test and open-ended questions were analyzed using thematic analysis. RESULTS In total, 80% of participants reported willingness to receive an MRI while pregnant for clinical indications compared to 24% for research. Only 10% reported prior knowledge about MRI during pregnancy and most participants (94%) wanted additional information from their physician before feeling comfortable with the procedure. Participants who knew someone with complications during pregnancy were more likely to be willing to participate in an MRI for research (uncorrected P < 0.05). Participants' positive perceptions towards MRI during pregnancy for clinical indications were that it was a necessary and useful procedure, while the negative perceptions identified MRI as unsafe. For research MRI, participants' positive perceptions included that it would add to the advancement of knowledge and the negative perceptions were that it was an unnecessary and risky procedure. CONCLUSIONS Strategies are needed to improve patient knowledge about the benefits and safety of MRI during pregnancy. The present study suggests recruitment for research should incorporate education on safety concerns and relative risk, personal stories about the benefits of MRI in diagnosing pregnancy complications and should highlight the contribution to advancing scientific knowledge.
Collapse
Affiliation(s)
- Catherine M E Barrett
- Department of Chemistry, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Darcie Stapleton
- Department of Chemistry, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Lauren C M Ringer
- Department of Chemistry, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Nikita E Harvey
- Department of Chemistry, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Carolyn Eustace
- Patient Partner, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Alyssa Devereaux
- Patient Partner, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Chelsey McPhee
- NL SUPPORT, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Kathleen Mather
- NL SUPPORT, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Katie P Wadden
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Lindsay S Cahill
- Department of Chemistry, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada; Discipline of Radiology, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.
| |
Collapse
|
2
|
Hussein S, Lim CA, Manokaran T, Kassam S, Earp M, Tang PA, Karim S, Biondo P, Watanabe SM, Sinnarajah A, Tan A, Simon J. Colorectal Cancer Patients' Reported Frequency, Content, and Satisfaction with Advance Care Planning Discussions. Curr Oncol 2024; 31:1235-1245. [PMID: 38534925 PMCID: PMC10969091 DOI: 10.3390/curroncol31030092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/20/2024] [Accepted: 02/20/2024] [Indexed: 04/13/2024] Open
Abstract
(1) Background: This observational cohort study describes the frequency, content, and satisfaction with advance care planning (ACP) conversations with healthcare providers (HCPs), as reported by patients with advanced colorectal cancer. (2) Methods: The patients were recruited from two tertiary cancer centers in Alberta, Canada. Using the My Conversations survey with previously validated questions, the patients were asked about specific ACP elements discussed, with which HCPs these elements were discussed, their satisfaction with these conversations, and whether they had a goals of care designation (GCD) order. We surveyed and analyzed data from the following four time points: enrollment, months 1, 2, and 3. (3) Results: In total, 131 patients were recruited. At enrollment, 24% of patients reported discussing at least one ACP topic. From enrollment to month 3, patients reported a high frequency of discussions (80.2% discussed fears, 71.0% discussed prognosis, 54.2% discussed treatment preferences at least once); however, only 44.3% of patients reported discussing what is important to them in considering health care preferences. Patients reported having ACP conversations most often with their oncologists (84.7%) and cancer clinic nurses (61.8%). Patients reported a high level of satisfaction with their ACP conversations, with over 80% of patients reported feeling heard and understood. From enrollment to month 3, there was an increase in the number of patients with a GCD order from 53% to 74%. (4) Conclusions: Patients reported more frequent conversations compared to the literature and clinical documentation. While the satisfaction with these conversations is high, there is room for quality improvement, particularly in eliciting patients' personal goals for their treatment.
Collapse
Affiliation(s)
- Said Hussein
- Division of Palliative Medicine, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada; (S.H.); (S.K.); (M.E.); (P.B.); (A.S.)
| | - Chloe Ahryung Lim
- Internal Medicine Residency Program, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada; (C.A.L.); (T.M.)
| | - Thulasie Manokaran
- Internal Medicine Residency Program, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada; (C.A.L.); (T.M.)
| | - Shireen Kassam
- Division of Palliative Medicine, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada; (S.H.); (S.K.); (M.E.); (P.B.); (A.S.)
| | - Madalene Earp
- Division of Palliative Medicine, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada; (S.H.); (S.K.); (M.E.); (P.B.); (A.S.)
| | - Patricia A. Tang
- Division of Medical Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N2, Canada; (P.A.T.); (S.K.)
| | - Safiya Karim
- Division of Medical Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N2, Canada; (P.A.T.); (S.K.)
| | - Patricia Biondo
- Division of Palliative Medicine, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada; (S.H.); (S.K.); (M.E.); (P.B.); (A.S.)
| | - Sharon M. Watanabe
- Division of Palliative Care Medicine, Department of Oncology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 1Z2, Canada;
| | - Aynharan Sinnarajah
- Division of Palliative Medicine, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada; (S.H.); (S.K.); (M.E.); (P.B.); (A.S.)
| | - Amy Tan
- Division of Palliative Care, Department of Family Practice, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| | - Jessica Simon
- Division of Palliative Medicine, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada; (S.H.); (S.K.); (M.E.); (P.B.); (A.S.)
| |
Collapse
|
3
|
Tarp K, Christiansen R, Bilberg R, Borkner S, Dalsgaard C, Folker MP, Nielsen AS. Nonuse of Blended Web-Based and Face-To-Face Cognitive Behavioral Therapy for Alcohol Use Disorder: Qualitative Study. JMIR Form Res 2024; 8:e45471. [PMID: 38349711 PMCID: PMC10900073 DOI: 10.2196/45471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/05/2023] [Accepted: 11/12/2023] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND The use of digital technologies for health care has been the focus of social studies, which have concentrated on the digital divide between individuals who use technology and those who do not-with the latter often being considered as individuals with shortcomings. In Denmark, 91% of the population have computers and 97 out of 100 families have internet access, indicating that lack of access to technology is not the primary reason for nonuse. Although previous studies have primarily focused on participants' perspectives of using internet-based treatment for alcohol use disorder (AUD), no study has investigated individuals' reasons to prefer face-to-face treatment over blended face-to-face and internet-based cognitive behavioral therapy (bCBT) for AUD among treatment-seeking populations. OBJECTIVE The aim of this qualitative study was to investigate the nonuse of bCBT among patients with AUD. Specifically, this study aims to explore patients' reasons for choosing not to receive treatment via this format. METHODS This study was conducted among Danish patients with AUD who were enrolled in the study "Blending internet treatment into conventional face-to-face treatment for alcohol use disorder (Blend-A)" but had not used bCBT. The participant group consisted of 11 patients with AUD: 3 women and 8 men. The age range of the participants was 29-78 years (mean 59 years). Individual semistructured interviews were conducted using cell phones to gather participants' reasons for not choosing bCBT. The interviews were recorded, transcribed, and analyzed using thematic analysis. Five authors performed the analysis in 3 steps: (1) two authors read the transcripts and coded themes from their immediate impression of the material, (2) one author provided feedback, which was used to group overlapping themes together or create new themes that better reflected the content, and (3) the remaining two authors provided feedback on the analysis to improve its structure, readability, and relevance to the research aim. RESULTS We found that the participants had various reasons for choosing face-to-face treatment over bCBT; these reasons were more related to personal matters and lesser to digital health literacy. We identified 4 themes related to personal matters for choosing face-to-face treatment over bCBT: (1) patients' need for attending sessions in person, (2) preference for verbal communication, (3) desire for immediate feedback, and (4) feeling more empowered and motivated with face-to-face sessions. CONCLUSIONS This study provides valuable insight into participants' perspectives on blended therapy for AUD and highlights the importance of considering personal factors when designing digital health interventions. Our study indicates that most of the participants choose not to use bCBT for AUD because they perceive such treatment formats as impersonal. Instead, they prefer direct communication with the therapist, including the ability to express and comprehend facial expressions and body language. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s12888-021-03122-4.
Collapse
Affiliation(s)
- Kristine Tarp
- Research Unit of Digital Psychiatry, Centre for Digital Psychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
- Research Unit of Digital Psychiatry, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Regina Christiansen
- Unit of Clinical Alcohol Research, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Psychiatric University Hospital - University Function, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Randi Bilberg
- Unit of Clinical Alcohol Research, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Psychiatric University Hospital - University Function, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
- Department for Finance and Planning, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
| | - Simone Borkner
- Research Unit of Digital Psychiatry, Centre for Digital Psychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Caroline Dalsgaard
- Research Unit of Digital Psychiatry, Centre for Digital Psychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Marie Paldam Folker
- Research Unit of Digital Psychiatry, Centre for Digital Psychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Anette Søgaard Nielsen
- Unit of Clinical Alcohol Research, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Psychiatric University Hospital - University Function, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
- Brain Research Inter-Disciplinary Guided Excellence (BRIDGE), Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Open Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| |
Collapse
|
4
|
Florio KL, Johnson TN, Williams EM, Ramaeker D, Gosch K, Otto A, Ahluwalia A, Schmidt L, Williams A, Lewis E, Chrans M, Rideout R, Spertus JA, Kendig S. Cardiovascular disease and maternal mortality: perceptions in a Midwest birthing population. Am J Obstet Gynecol MFM 2024; 6:101296. [PMID: 38336173 DOI: 10.1016/j.ajogmf.2024.101296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Missouri has one of the highest rates of maternal mortality in the United States. To date, there are currently no studies describing birthing peoples' knowledge or perceptions of contributing causes of maternal mortality. An improved understanding of population-specific knowledge can help to define how best to design targeted interventions to reduce disease-specific causes of maternal mortality. OBJECTIVE This study aimed to examine the knowledge and understanding of maternal mortality in a Missouri birthing population. STUDY DESIGN A 46-question, cross-sectional survey to assess the familiarity with local maternal mortality rates, groups affected, and causality was developed by the Missouri Perinatal Quality Collaborative and the Maternal-Child Learning and Action Network and emailed to a random sample of birthing people across Missouri. Those who identified as someone with birthing potential with a Missouri zip code and who were ≥18 years of age were eligible for inclusion. Unadjusted descriptive statistics were generated and stratified by age, race, and region. RESULTS Among 2196 surveys sent, 1738 people completed the survey. Of those who responded, 78.2% were aware of the risk of pregnancy-related death with 14.7% reporting that they intimately knew someone who died. When asked if a certain group is affected disproportionately more, 66.4% responded affirmatively. Black (58.7%), uninsured (61.8%), poor (71.0%), those with substance abuse disorders (57.4%), and Native American (28.8%) birthing people were identified as groups that were perceived as suffering higher rates of maternal death. When polled on etiology, severe bleeding (56.9%) was believed to be the leading cause of death, and the second stage of labor was thought to be the period of highest risk (42.3%). Beliefs about the timing of death differed by age (P=.042) but not race (P=.81) or region (P=.191). CONCLUSION Missouri birthing people are cognizant of the social factors associated with increased maternal mortality but are unaware of the leading causes of death, namely cardiovascular disease and mental health conditions. Future Perinatal Quality Collaborative work should focus on campaigns that raise public awareness about cardiovascular disease and mental health-related birthing risks and the importance of monitoring early warning signs after delivery.
Collapse
Affiliation(s)
- Karen L Florio
- Department of Obstetrics and Gynecology, University of Missouri, Columbia MO (Dr Florio); Healthcare Institute for Innovations in Quality, University of Missouri - Kansas City, Kansas City, MO (Drs Florio, Johnson, and Ahluwalia, and Drs Schmidt and Spertus); Division of Women's and Children's, Saint Luke's Hospital of Kansas City, Kansas City, MO (Drs Florio and Ramaeker); School of Medicine, University of Missouri-Kansas City, MO (Dr Florio).
| | - Traci N Johnson
- Department of Obstetrics and Gynecology, University of Missouri - Kansas City, Kansas City, MO (Drs Johnson, Williams, and Ramaeker)
| | - Emily M Williams
- Healthcare Institute for Innovations in Quality, University of Missouri - Kansas City, Kansas City, MO (Drs Florio, Johnson, and Ahluwalia, and Drs Schmidt and Spertus); Department of Obstetrics and Gynecology, University of Missouri - Kansas City, Kansas City, MO (Drs Johnson, Williams, and Ramaeker)
| | - Devon Ramaeker
- Division of Women's and Children's, Saint Luke's Hospital of Kansas City, Kansas City, MO (Drs Florio and Ramaeker); Department of Obstetrics and Gynecology, University of Missouri - Kansas City, Kansas City, MO (Drs Johnson, Williams, and Ramaeker)
| | - Kensey Gosch
- Mid-America Heart Institute, Saint Luke's Hospital of Kansas City, Kansas City, MO (Ms Gosch and Dr Schmidt)
| | - Ashlie Otto
- Missouri Department of Health and Senior Services, Jefferson City, MO (Ms Otto)
| | - Amit Ahluwalia
- Healthcare Institute for Innovations in Quality, University of Missouri - Kansas City, Kansas City, MO (Drs Florio, Johnson, and Ahluwalia, and Drs Schmidt and Spertus)
| | - Laura Schmidt
- Healthcare Institute for Innovations in Quality, University of Missouri - Kansas City, Kansas City, MO (Drs Florio, Johnson, and Ahluwalia, and Drs Schmidt and Spertus); Mid-America Heart Institute, Saint Luke's Hospital of Kansas City, Kansas City, MO (Ms Gosch and Dr Schmidt); Mid-America Heart Institute of Saint Luke's Hospital of Kansas City, Kansas City, MO (Dr Spertus and Dr Schmidt)
| | - Alison Williams
- Missouri Hospital Association, Jefferson City, MO (Ms Williams and Lewis)
| | - Elizabeth Lewis
- Missouri Hospital Association, Jefferson City, MO (Ms Williams and Lewis)
| | - Mariah Chrans
- Community Health Council of Wyandotte County, Kansas City, KS (Dr Chrans)
| | | | - John A Spertus
- Healthcare Institute for Innovations in Quality, University of Missouri - Kansas City, Kansas City, MO (Drs Florio, Johnson, and Ahluwalia, and Drs Schmidt and Spertus); Mid-America Heart Institute of Saint Luke's Hospital of Kansas City, Kansas City, MO (Dr Spertus and Dr Schmidt)
| | - Sue Kendig
- SSM Health-Saint Louis, Saint Louis, MO (Ms Kendig)
| |
Collapse
|
5
|
Butt IN, van Eeden C, Kovacs Burns K, Saxinger L, Clifford A, Redmond D, Cohen Tervaert JW, Yacyshyn E. Understanding COVID-19 vaccine hesitancy in vasculitis patients. Front Public Health 2023; 11:1301492. [PMID: 38111485 PMCID: PMC10726054 DOI: 10.3389/fpubh.2023.1301492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/13/2023] [Indexed: 12/20/2023] Open
Abstract
Objective To identify the factors that impact COVID-19 vaccine decision-making in vaccine-hesitant vasculitis patients, and compare their perceptions with other rheumatology patients, given existence of data suggesting rheumatology patients may have disease-specific factors that influence their COVID-19 vaccine decision-making. Methods This cross-sectional study surveyed adult rheumatology patients from the Kaye Edmonton Clinic Rheumatology Clinic, in Canada, between June and August 2021, using an anonymous online questionnaire. Survey responses were analyzed for statistical differences using chi-square analysis. Results The COVID-19 Vaccine Perceptions Survey had a response rate of 70.9%. Of the total 231 respondents, 103 patients were diagnosed with vasculitis. At the time of the survey, 10.6% of vasculitis patients refused to receive a COVID-19 vaccine compared to 6.3% for other rheumatology patients. Compared to other rheumatology patients, vaccine-hesitant vasculitis patients were significantly more concerned about almost every aspect of available COVID-19 vaccines [e.g., safety (p < 0.001), components (p < 0.001)], and feared that they could contract SARS-CoV-2 from a vaccine (p < 0.001). These vaccine-hesitant patients were also significantly less pleased with the government's pandemic response, less confident in healthcare team-provided information (p < 0.001), and more likely to report that healthcare providers had no role in their COVID-19 vaccine decision-making (p < 0.001). Conclusion Vaccine-hesitant vasculitis patients may have multiple considerations influencing COVID-19 vaccine hesitancy, including vaccine and disease-specific concerns, along with unfavorable perceptions of the healthcare system (government and healthcare providers). Healthcare providers can address some of these concerns by initiating patient-centered discussions around immunizations to help support educated decision-making.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Elaine Yacyshyn
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
6
|
Lee GA, Durante A, Baker EE, Vellone E, Caggianelli G, Dellafiore F, Khan M, Khatib R. Patients' perceptions on the facilitators and barriers using injectable therapies in dyslipidaemia: An empirical qualitative descriptive international study. J Adv Nurs 2023; 79:4687-4696. [PMID: 37376717 DOI: 10.1111/jan.15739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 05/31/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Injectable medicines are increasingly used to manage abnormal levels of lipids, which is a major risk factor for cardiovascular events. Enhancing our understanding of patients' perceptions of these injectables, can inform practice with the aim of increasing uptake and medication adherence. AIM To explore patient's experiences of using injectables and to identify potential facilitators and barriers to using injectable therapies in dyslipidaemia. DESIGN A qualitative descriptive study using semi-structured interviews was conducted with patients who were using injectables to manage their cardiovascular conditions. METHODS A total of 56 patients, 30 from the United Kingdom and 26 from Italy, were interviewed online from November 2020 to June 2021. Interviews were transcribed and schematic content analysis performed. RESULTS Four distinct themes emerged from interviews with patients and caregivers: (i) Their behaviours and personal beliefs; (ii) Knowledge and education about injectable medication; (iii) Clinical skills and previous experiences and (iv) Organizational and governance. Participants expressed initial fears such as needle phobia, and their concerns about commencing therapy were compounded by a lack of accessible information. However, patients' pre-existing knowledge of lipid lowering medication, previous experience with statins and history of adverse side effects informed their decision-making regarding using injectables. Organization and governance-related issues were primarily around the distribution and management of medication supply within primary care, and the lack of a standardized clinical support monitoring system. CONCLUSION Changes are needed in clinical practice to better educate and support patients to improve the uptake of injectables and optimize their use of these medications in the management of dyslipidaemia. IMPACT This study suggests that injectable therapies were acceptable to people with cardiovascular disease. However, healthcare professionals need to play a key role in improving education and providing support to aid patients' decision-making regarding commencing and adhering to injectable therapies. REPORTING METHOD The study adhered to the Consolidated Criteria for Reporting Qualitative Research. PATIENT OR PUBLIC CONTRIBUTION There was no patient or public contribution.
Collapse
Affiliation(s)
- Geraldine A Lee
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, James Clerk Maxwell Building, King's College London, London, UK
| | - Angela Durante
- Unidad Predepartemental de Enfermería, Univeridad de la Rioja, Logroño (La Rioja), Spain
| | - Edward E Baker
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, James Clerk Maxwell Building, King's College London, London, UK
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
- Department of Nursing and Obstetrics, Wroclaw Medical University, Poland
| | - Gabriele Caggianelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Federica Dellafiore
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Mutiba Khan
- Cardiology Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Medicines Management and Pharmacy Services, Leeds Teaching Hospitals Trust, Leeds, UK
| | - Rani Khatib
- Cardiology Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Medicines Management and Pharmacy Services, Leeds Teaching Hospitals Trust, Leeds, UK
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| |
Collapse
|
7
|
Calleja L, Glass BD, Cairns A, Taylor S. Pharmacist-Led Interventions for Medication Adherence in Patients with Chronic Kidney Disease: A Scoping Review. Pharmacy (Basel) 2023; 11:185. [PMID: 38133460 PMCID: PMC10748209 DOI: 10.3390/pharmacy11060185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/28/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Patients with chronic kidney disease (CKD) are routinely prescribed complex medication regimes. Medication reconciliation, medicine reviews, patient counselling and disease state and medication education are all key pharmacist-led interventions, which can improve medication adherence in patients with CKD. AIM To characterize peer reviewed literature on the role of pharmacists in supporting medication adherence of patients with chronic kidney disease and highlight the impact they might have in the health outcomes for patients. METHOD This review was performed in accordance with the Scoping Review Framework outlined in the Joanna Briggs Institute Reviewer's Guide. Four electronic databases were searched (Medline (Ovid), Emcare, Scopus and Web of Science) for all relevant literature published up until November 2022. A total of 32 studies were reviewed against an exclusion and inclusion criteria, with findings from each study categorized into barriers, interventions, perceptions, financial implications and outcomes. RESULTS Eight eligible studies were identified, where pharmacists' interventions including medication reconciliation, medicine reviews, patient counselling and disease state and medication education, were all reported to have a positive effect on medication adherence. Although pharmacy services in chronic kidney disease were acceptable to patients and pharmacists, these services were under-utilized and limited by logistical constraints, including staffing shortages and time limitations. Patient education supplemented with education tools describing disease states and medications was reported to increase patient adherence to medication regimes. CONCLUSIONS Pharmacist-led interventions play an integral role in improving medication adherence in patients with chronic kidney disease, with their inclusion in renal care settings having the potential to improve outcomes for patients.
Collapse
Affiliation(s)
- Luke Calleja
- Pharmacy, College of Medicine and Dentistry, James Cook University, Townsville 4811, Australia
| | - Beverley D. Glass
- Pharmacy, College of Medicine and Dentistry, James Cook University, Townsville 4811, Australia
| | - Alice Cairns
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns 4870, Australia
- Murtupuni Mount Isa Centre for Rural and Remote Health, Mount Isa 4825, Australia
| | - Selina Taylor
- Pharmacy, College of Medicine and Dentistry, James Cook University, Townsville 4811, Australia
- Murtupuni Mount Isa Centre for Rural and Remote Health, Mount Isa 4825, Australia
| |
Collapse
|
8
|
van Iersel TP, Tutuhatunewa ED, Kaman I, Twigt BA, Vorrink SNW, van den Bekerom MPJ, van Deurzen DFP. Patient perceptions after the operative and nonoperative treatment of shoulder instability: A qualitative focus group study. Shoulder Elbow 2023; 15:497-504. [PMID: 37811392 PMCID: PMC10557926 DOI: 10.1177/17585732221122363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 10/10/2023]
Abstract
Background Little evidence is available regarding patient perceptions of the treatment of shoulder instability. The aim of this study is to investigate patient perceptions regarding the operative and nonoperative treatment of anterior shoulder instability. Methods Patients who presented to the emergency department or outpatient clinic between 2016 and 2020 were retrospectively selected using diagnosis and procedure codes. Online focus groups and semistructured interviews were conducted, systematically recorded and subsequently transcribed to MaxQDA 2007 for qualitative analysis. Coded transcripts of all focus groups were subjected to a grounded theory-based analysis. Results Six focus groups and two semistructured interviews were hosted with 35 included patients. The mean age of included patients was 34.1 years (±11.5). Eight patients were female (23%), and 27 patients were male (77%). Fear of (recurrent) dislocation, preoperative counseling, communication between surgeon and physiotherapists and need for a consistent postoperative rehab protocol turned out to be important patient perceptions. The most crucial factor for discontent was a lack of communication from the surgeon. Discussion This patient-centered focus group study revealed that fear of (recurrent) dislocation, preoperative counseling, communication between surgeons and physiotherapists and the need for a consistent postoperative rehabilitation protocol was the most frequently discussed themes.
Collapse
Affiliation(s)
- Theodore P van Iersel
- Shoulder and Elbow Unit, Department of Orthopaedic Surgery, OLVG, Amsterdam, The Netherlands
| | - Eric D Tutuhatunewa
- Shoulder and Elbow Unit, Department of Orthopaedic Surgery, OLVG, Amsterdam, The Netherlands
| | - Ithri Kaman
- Shoulder and Elbow Unit, Department of Orthopaedic Surgery, OLVG, Amsterdam, The Netherlands
| | - Bas A Twigt
- Trauma Unit, Department of Surgery, OLVG, Amsterdam, The Netherlands
| | - Sigrid NW Vorrink
- Joint Research, Department of Orthopaedic Surgery, OLVG, Amsterdam, The Netherlands
| | - Michel PJ van den Bekerom
- Shoulder and Elbow Unit, Department of Orthopaedic Surgery, OLVG, Amsterdam, The Netherlands
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Derek FP van Deurzen
- Trauma Unit & Shoulder and Elbow Unit, Department of orthopaedic Surgery, OLVG, Amsterdam, The Netherlands
| |
Collapse
|
9
|
Clarke S. Exploring the voices of children and children's nurses in hospital: implications for nursing practice. Nurs Child Young People 2023; 35:22-27. [PMID: 36872884 DOI: 10.7748/ncyp.2023.e1447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2022] [Indexed: 03/07/2023]
Abstract
Children should have a voice in relation to all aspects of healthcare as respected and credible service users, a belief endorsed by the United Nations Convention on the Rights of the Child. The children's nurse is the healthcare professional who delivers care most frequently to children in hospital and their families, so is in an optimal position to offer valuable insight into children's experiences of being in hospital. Therefore, it is important to listen to the voices of children and children's nurses in relation to this area. This article is informed by a narrative literature review and study, undertaken by the author as part of her doctoral thesis, which explored children's experiences of staying overnight in hospital from the perspective of children and children's nurses. In this article, the author summarises the main findings from the study and considers the implications for children's nursing practice based on her reflection on these findings.
Collapse
Affiliation(s)
- Sonya Clarke
- School of Nursing and Midwifery, Medical Biology Centre, Queen's University Belfast, Belfast, Northern Ireland
| |
Collapse
|
10
|
Walker K. Capturing patient experience. Nurs Stand 2023; 38:78-82. [PMID: 37303209 DOI: 10.7748/ns.2023.e12100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2023] [Indexed: 06/13/2023]
Abstract
Patient experience is a crucial measure of the quality of patient care in healthcare settings. It encompasses all the patient's interactions with staff and their exposure to equipment, procedures, environment and service structure during one care episode. Capturing patient experience is one way of ensuring that patients' voices are heard and can form the basis of an audit or service improvement project designed to evaluate or enhance the patient-centredness of care. Nurses are increasingly involved in audits and service improvement projects, so it is important that they understand what patient experience is, how it differs from patient satisfaction and what approaches can be used to measure it. This article defines patient experience, describes data collection methods and discusses factors to consider when planning to collect patient experience data, notably the validity, reliability and rigour of the data collection tool.
Collapse
Affiliation(s)
- Kathryn Walker
- Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle-upon-Tyne, England
| |
Collapse
|
11
|
Booth MW, Riegler V, King JS, Barrack RL, Hannon CP. Patients' Perceptions of Remote Monitoring and App-based Rehabilitation Programs: A Comparison of Total Hip and Knee Arthroplasty. J Arthroplasty 2023:S0883-5403(23)00388-1. [PMID: 37088222 DOI: 10.1016/j.arth.2023.04.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND Remote monitoring rehabilitation programs are new technologies growing in popularity for patients undergoing lower extremity total joint arthroplasty. The purpose of this study was to assess the patients' perceptions of these technologies. METHODS Patients who underwent total hip (THA), knee arthroplasty (TKA), and unicompartmental knee arthroplasty (UKA) from September 2020 to February 2022 and participated in a clinical study utilizing remote monitoring and an app-based rehabilitation program were given a questionnaire three months postoperatively to assess their perceptions of these technologies. There were 166 patients who completed the survey (42 THA; 106 TKA; 18 UKA). RESULTS There were 92% of patients who found the technology easy to use. A majority of patients felt the technologies motivated them. The TKA/UKA patients felt more strongly that these technologies allowed the surgeon to monitor their recovery closely (81.9% v. 65.9%; P=0.009). There were 85% of THA patients and 94.5% of TKA/UKA patients recommended these technologies. The THA patients felt more strongly that digital rehabilitation could completely replace in-person physical therapy compared to TKA/UKA patients (85.4% v. 41.3%; P<0.001). A majority (83%) of patients recommended a combination of inpatient and technology-assisted rehabilitation (THA 90.2%; 84.4% TKA/UKA). CONCLUSIONS The THA and TKA/UKA patients found remote monitoring rehabilitation easy to use, increased motivation, and recommend it to other patients undergoing lower extremity arthroplasty. They recommend a combination of technology and in-person rehabilitation postoperatively. The THA patients felt these technologies could replace in-person rehabilitation programs.
Collapse
Affiliation(s)
- Matthew W Booth
- Department of Orthopedic Surgery, Washington University in St. Louis, 660S. Euclid Avenue, Campus Box 8233, St. Louis, MO 63110.
| | - Venessa Riegler
- Department of Orthopedic Surgery, Washington University in St. Louis, 660S. Euclid Avenue, Campus Box 8233, St. Louis, MO 63110.
| | - Jackie S King
- Department of Orthopedic Surgery, Washington University in St. Louis, 660S. Euclid Avenue, Campus Box 8233, St. Louis, MO 63110.
| | - Robert L Barrack
- Department of Orthopedic Surgery, Washington University in St. Louis, 660S. Euclid Avenue, Campus Box 8233, St. Louis, MO 63110.
| | - Charles P Hannon
- Department of Orthopedic Surgery, Washington University in St. Louis, 660S. Euclid Avenue, Campus Box 8233, St. Louis, MO 63110.
| |
Collapse
|
12
|
Sanko C, Cox R, Hadley C, Gilmore G, Wood C, Getz C, Namdari S, Davis D. The impact of elective surgery restrictions during the COVID-19 (coronavirus disease 2019) pandemic on shoulder and elbow surgery: patient perceptions. J Shoulder Elbow Surg 2023; 32:662-670. [PMID: 36435483 PMCID: PMC9682864 DOI: 10.1016/j.jse.2022.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 10/03/2022] [Accepted: 10/12/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND In late 2019 and early 2020, a novel coronavirus, COVID-19 (coronavirus disease 2019), spread across the world, creating a global pandemic. In the state of Pennsylvania, non-emergent, elective operations were temporarily delayed from proceeding with the normal standard of care. The primary purpose of this study was to determine the proportion of patients who required prescription pain medication during the surgical delay. Secondarily, we sought to determine the proportion of patients who perceived their surgical procedure as non-elective and to evaluate how symptoms were managed during the delay. MATERIALS AND METHODS A single institutional database was used to retrospectively identify all shoulder and elbow surgical procedures scheduled between March 13 and May 6, 2020. Charts were manually reviewed. Patients who underwent non-shoulder and elbow-related procedures and patients treated by surgeons outside of Pennsylvania were excluded. Patients whose surgical procedures were postponed or canceled were administered a survey evaluating how symptoms were managed and perceptions regarding the delay. Preoperative functional scores were collected. Statistical analysis was performed to determine associations between procedure status, preoperative functional scores, perception of surgery, and requirement for prescription pain medication. RESULTS A total of 338 patients were scheduled to undergo shoulder and elbow surgery in our practice in Pennsylvania. Surgery was performed as initially scheduled in 89 of these patients (26.3%), whereas surgery was postponed in 179 (71.9%) and canceled in 70 (28.1%). The average delay in surgery was 86.7 days (range, 13-299 days). Responses to the survey were received from 176 patients (70.7%) in whom surgery was postponed or canceled. During the delay, 39 patients (22.2%) required prescription pain medication. The surgical procedure was considered elective in nature by 73 patients (41%). One hundred thirty-seven patients (78%) would have moved forward with surgery if performed safely under appropriate medical guidelines. Lower preoperative American Shoulder and Elbow Surgeons scores (r = -0.36, P < .001) and Single Assessment Numeric Evaluation scores (r = -0.26, P = .016) and higher preoperative visual analog scale scores (r = 0.28, P = .009) were correlated with requiring prescription pain medication. Higher preoperative American Shoulder and Elbow Surgeons scores were positively correlated with perception of surgery as elective (r = 0.4, P < .001). CONCLUSION Patients undergoing elective shoulder and elbow surgical procedures during the COVID-19 (coronavirus disease 2019) pandemic experienced a delay of nearly 3 months on average. Fewer than half of patients perceived their surgical procedures as elective procedures. Nearly one-quarter of patients surveyed required extra prescription pain medicine during the delay. This study elucidates the fact that although orthopedic shoulder and elbow surgery is generally considered "elective," it is more important to a majority of patients. These findings may also be applicable to future potential mandated surgical care delays by other third-party organizations.
Collapse
Affiliation(s)
- Cassandra Sanko
- Department of Orthopaedic Surgery, Thomas Jefferson University Hospitals, Philadelphia, PA, USA
| | - Ryan Cox
- Department of Orthopaedic Surgery, Thomas Jefferson University Hospitals, Philadelphia, PA, USA
| | - Christopher Hadley
- Rothman Orthopaedic Institute, Thomas Jefferson University Hospitals, Philadelphia, PA, USA
| | - Griffin Gilmore
- Rothman Orthopaedic Institute, Thomas Jefferson University Hospitals, Philadelphia, PA, USA
| | - Chelsey Wood
- Sidney Kimmel Medical College, Thomas Jefferson University Hospitals, Philadelphia, PA, USA
| | - Charles Getz
- Rothman Orthopaedic Institute, Thomas Jefferson University Hospitals, Philadelphia, PA, USA
| | - Surena Namdari
- Rothman Orthopaedic Institute, Thomas Jefferson University Hospitals, Philadelphia, PA, USA
| | - Daniel Davis
- Rothman Orthopaedic Institute, Thomas Jefferson University Hospitals, Philadelphia, PA, USA.
| |
Collapse
|
13
|
Alanazi E, Alanazi H, Alanazi M, Alsadoun A, Asiri S, Bahari G. Quality Perceptions, Expectations, and Individual Characteristics among Adult Patients Visiting Primary Healthcare Centers in Saudi Arabia: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:healthcare11020208. [PMID: 36673576 PMCID: PMC9859356 DOI: 10.3390/healthcare11020208] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/02/2023] [Accepted: 01/06/2023] [Indexed: 01/12/2023] Open
Abstract
Quality is a main concern of primary healthcare centers, and pursuing quality can lead to service improvement as well as affordable healthcare. The purpose of this cross-sectional study was to describe patients' healthcare quality perceptions and expectations and determine the relationships between them and associated factors. The study was conducted on a convenience sample of 470 patients visiting primary healthcare centers. Data were collected between April and July 2022 using an anonymous questionnaire. Bivariate and multivariate analyses were conducted. Most participants reported high levels of quality perceptions and expectations. Bivariate analyses showed a significant correlation between quality perceptions and expectations. Both being single and having a higher level of education were statistically different in terms of quality perception and expectations, respectively. Further, being single, highly educated, and employed had significant differences in terms of expectations. In regression, primary education and expectations influenced quality perceptions. Marital status, profession, and perception were the only variables that significantly influenced participants' expectations. Patients' healthcare quality perceptions and expectations are important for ensuring the efficiency of healthcare services. Primary healthcare centers are the key avenue for disease prevention and early detection. The optimization of primary healthcare centers' quality and addressing its potential issues should be performed through interdisciplinary teamwork.
Collapse
Affiliation(s)
| | | | | | - Ahmed Alsadoun
- Medical Surgical Department, College of Nursing, King Saud University, Riyadh 11421, Saudi Arabia
| | - Saeed Asiri
- Nursing Administration and Education Department, College of Nursing, King Saud University, Riyadh 11421, Saudi Arabia
| | - Ghareeb Bahari
- Nursing Administration and Education Department, College of Nursing, King Saud University, Riyadh 11421, Saudi Arabia
- Correspondence:
| |
Collapse
|
14
|
Hames K, White K, Ockerby C, Williams R, Hutchinson AM. Patient perceptions of care quality and discharge information following same-day cardiac catheterization laboratory procedures: A mixed-methods study. Nurs Open 2023; 10:3263-3273. [PMID: 36622955 PMCID: PMC10077407 DOI: 10.1002/nop2.1578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/21/2022] [Accepted: 12/10/2022] [Indexed: 01/11/2023] Open
Abstract
AIMS To examine patients' perceptions of care quality following a same-day procedure in the cardiac catheterization laboratory and understand the extent to which they were prepared for discharge. DESIGN Single-centre, mixed-methods study. METHODS Postdischarge, online survey of patients who underwent a same-day procedure in the cardiac catheterization laboratory (n = 150) and one-on-one interviews with 13 of these patients. RESULTS Survey responses were positive with mean scores between 4.39-4.83 out of five and 63.3% of respondents (n = 95) extremely likely to recommend the service to others. Interview data analysis identified three themes: the care experience, information and education for safe discharge, and follow-up needs. Participants spoke highly of their interactions with clinicians and were satisfied with their care experience. Mode and content of information delivered varied, with some participants lacking guidance about postdischarge health management and clarity about follow-up plans. PATIENT OR PUBLIC CONTRIBUTION Participants were patients.
Collapse
Affiliation(s)
- Kate Hames
- Monash Health, Clayton, Victoria, Australia
| | - Kevin White
- Monash Heart, Monash Health, Clayton, Victoria, Australia
| | - Cherene Ockerby
- Centre for Quality and Patient Safety Research - Monash Health Partnership, Monash Health, Clayton, Victoria, Australia
| | - Ruth Williams
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Victoria, Geelong, Australia
| | - Alison M Hutchinson
- Centre for Quality and Patient Safety Research - Monash Health Partnership, Monash Health, Clayton, Victoria, Australia.,School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Victoria, Geelong, Australia
| |
Collapse
|
15
|
Crouch J, Winters K, Zhang L, Stewart MW. Telehealth during the pandemic: Patient perceptions and policy implications. J Nurs Scholarsh 2023; 55:141-148. [PMID: 36218219 PMCID: PMC9874805 DOI: 10.1111/jnu.12832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Telehealth's potential to improve access to specialty health care, increase favorable patient outcomes, and save money demands attention. Unfortunately, patients often fail to embrace telehealth. The COVID-19 pandemic fueled greater telehealth usage globally. Little is known about patient perceptions of telehealth in the context of a pandemic. Therefore, we sought to understand patient perceptions of telehealth during the COVID-19 pandemic and explore relevant policy implications. DESIGN Researchers used a cross-sectional, non-experimental design to survey 366 patients across two telehealth programs at a Mississippi academic health sciences center between November 1, 2021 and November 15, 2021. METHODS As part of a larger, psychometric study on patient acceptance of telehealth, participants rated the item, "The COVID-19 pandemic has made me more open to using telehealth" on a 5-point Likert scale (1 = strongly disagree; 5 = strongly agree). Means of the different groups were analyzed using independent t-test and one-way ANOVA with Bonferroni post-hoc multiple comparisons. RESULTS Of the total participants, 73% (n = 366) either agreed or strongly agreed that the COVID-19 pandemic had made them more open to using telehealth. Significant differences existed by age (p = 0.016), race/ethnicity (p = 0.015), and sex (p < 0.001), however, groups did not differ by age during post-hoc analysis. A significant difference in the mean responses was observed between black participants (M = 4.29) and white participants (M = 3.91; p = 0.011). In addition, female participants (M = 4.11) rated the item higher than male participants (M = 3.65). CONCLUSION As access to telehealth increased due to the COVID-19 pandemic, patients' perceptions to telehealth seem to have shifted in the positive direction as well. Findings may be used to support expansion of telehealth and advocacy for patients in a variety of settings. CLINICAL RELEVANCE Study findings indicate that participants of telehealth are more open to using telehealth due to the COVID-19 pandemic. Implementing telehealth should be a priority to increase access to care for those who have limited access to specialty care, and policymakers should advocate to decrease barriers to telehealth within their institutions.
Collapse
Affiliation(s)
- Jacob Crouch
- The University of Mississippi Medical CenterJacksonMississippiUSA,Mississippi CollegeClintonMississippiUSA
| | - Karen Winters
- The University of Mississippi Medical CenterJacksonMississippiUSA
| | - Lei Zhang
- The University of Mississippi Medical CenterJacksonMississippiUSA
| | - Mary W. Stewart
- The University of Mississippi Medical CenterJacksonMississippiUSA
| |
Collapse
|
16
|
Sinclair J, Foster D, Murrells T, Sandall J. Development and validation of a measure to assess patients' perceptions of their safety in an acute hospital setting. Nurse Res 2022; 30:15-23. [PMID: 36172707 DOI: 10.7748/nr.2022.e1792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Safety measurement tools have traditionally examined safety climate and culture from the perspective of healthcare professionals. A small number of studies have used tools to measure patients' perceptions of safety. AIM To develop and check the validity of a questionnaire, the King's Patient Safety Measure (KPSM), that assesses how patients perceive their safety when receiving acute care. DISCUSSION A cross-sectional survey of 158 patients was undertaken that was constructed to establish the validity and reliability of a 13-item questionnaire. A general linear model statistically tested how patients perceived the safety of their care and whether those views were associated with covariates that included characteristics such as age, gender, ethnic identity, socio-economic factors, how long they stayed in hospital and the way they were admitted to hospital. CONCLUSION The KPSM is a validated tool consisting of a single factor that is internally consistent. IMPLICATIONS FOR PRACTICE The KPSM is appropriate for and potentially applicable to a diverse range of patients and could act as an early warning tool.
Collapse
|
17
|
Riipinen P, Holmes M, Ogilvie S, Newell D, Byfield D, du Rose A. Patient's perception of exercise for management of chronic low back pain: A qualitative study exercise for the management of low back pain. Musculoskeletal Care 2022; 20:848-859. [PMID: 35384268 DOI: 10.1002/msc.1637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 03/22/2022] [Accepted: 03/26/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Pathoanatomical beliefs about the cause of low back pain may negatively influence patients' perceptions of 'best care', such as the inclusion of exercise for low back pain (LBP) management. The aims of this study were to explore what patients receiving manual therapy are told and understand about their LBP diagnosis, and how this affects their perceptions regarding the role of exercise in the management of their LBP. DESIGN An interpretative phenomenological analysis (IPA) study design was utilised using semi-structured telephone interviews of patients who experience persistent LBP and seek care at an outpatient clinic at the University of South Wales. Ten participants were interviewed for the study (six male). Interviews were transcribed verbatim and analysed using an IPA approach. RESULTS Three main themes were generated: (1) Constructing explanation of pain. (2) Expectations of exercise within care seeking behaviours. (3) Resolving conflict between exercise and back pain narratives. Participants linked their pain to a pathoanatomical cause, impacting their beliefs on exercise as a treatment approach. CONCLUSION Diagnostic models used by clinicians which are grounded within a pathoanatomical framework influence patients' perceptions and rationale for exercise. Exercise prescription using contemporary pain science and biopsychosocial approaches should be emphasised in practice and education.
Collapse
Affiliation(s)
- Perttu Riipinen
- Welsh Institute of Chiropractic, University of South Wales, Treforest, UK
| | | | - Samantha Ogilvie
- Welsh Institute of Chiropractic, University of South Wales, Treforest, UK
| | | | - David Byfield
- Welsh Institute of Chiropractic, University of South Wales, Treforest, UK
| | | |
Collapse
|
18
|
Hijji FY, Goodwin TM, Sich MA, Thier Z, Guehl AC, Peters P, Jackson JB. A Survey Analysis of Patient Understanding and Preferences for Podiatrists Versus Foot and Ankle Orthopaedic Surgeons. Foot Ankle Spec 2022:19386400221126209. [PMID: 36217981 DOI: 10.1177/19386400221126209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Recent studies suggest poorer outcomes and higher costs associated with patients treated by podiatrists, yet no studies have evaluated patient perception and preference for foot and ankle providers. This study aims to determine patient perception of training for podiatrists compared to orthopaedic surgeons and patient preference for type of provider seen. METHODS A 20-question survey was administered to new patients seeing either a podiatrist or foot and ankle orthopaedic surgeon. Questions pertained to demographics, patient knowledge of their provider, perception of training requirements, number of years in professional training, and differences in surgical volume during training. Patients were asked their preference for a particular type of foot and ankle provider, and whether they perceived a difference in surgical skillset or a provider's ability to manage different pathology. RESULTS In all, 147 podiatry and 115 orthopaedic patients were included in the study. Demographics were similar between groups. Both groups believed orthopedists required more years of education and surgical training. In all, 61.5% of orthopaedic patients believed that orthopedists performed more foot and ankle surgeries and were more skilled as compared to podiatrists, while only about a third of podiatry patients believed this to be true (68.7% vs 38.6%; P < .001). Most patients believed orthopedists were more skilled in treating fractures. In all, 48.7% of orthopaedic patients preferred seeing an orthopedist compared to only 3.5% of podiatry patients. CONCLUSIONS Our study demonstrates that patients are knowledgeable about the type of foot and ankle provider they are seeing. Most patients believe orthopaedic surgeons require more years of education and surgical training compared to podiatrists and believe they are more skilled in fracture-related surgery. Fewer podiatry patients expressed a preference for an orthopaedic surgeon. Providers must play an active role in discussing their training background prior to treating foot and ankle patients, especially in the setting of fracture-related pathology. CLINICAL RELEVANCE This study demonstrates that most patients seeking care from a podiatrist or foot and ankle orthopaedic surgeon are relatively knowledgeable about the type of provider they are seeing; however, there are some differences. Most patients understand that orthopaedic surgeons require more years of education and surgical training and also believe orthopaedic surgeons are more skilled in fracture work and taking care of arthritic conditions. In general, podiatry patients have less preference for seeing an orthopaedic surgeon; however, many of these patients are seeking care for wounds and infections. With expanding roles and scope of practice among podiatry providers, it is important that providers become more active in explaining their training background and qualifications when treating foot and ankle conditions. LEVELS OF EVIDENCE Level II: Prospective.
Collapse
Affiliation(s)
- Fady Y Hijji
- Department of Orthopaedic Surgery, Wright State Boonshoft School of Medicine, Fairborn, Ohio
| | - Tyler M Goodwin
- Department of Orthopaedic Surgery, The University of Tennessee College of Medicine Chattanooga, Chattanooga, Tennessee
| | - Melanie A Sich
- Department of Orthopaedic Surgery, Wright State Boonshoft School of Medicine, Fairborn, Ohio
| | - Zachary Thier
- Department of Orthopaedic Surgery, Prisma Health and University of South Carolina, Columbia, South Carolina
| | - Allen C Guehl
- Department of Podiatry, Premier Health Network, Dayton, Ohio
| | - Paul Peters
- Department of Orthopaedic Surgery, Wright State Boonshoft School of Medicine, Fairborn, Ohio
| | - J Benjamin Jackson
- Department of Orthopaedic Surgery, Prisma Health and University of South Carolina, Columbia, South Carolina
| |
Collapse
|
19
|
Nickles MA, Haber RN. Social media voices on the treatment of skin psoriasis with biologics. J DERMATOL TREAT 2022; 33:3208-3209. [PMID: 36121182 DOI: 10.1080/09546634.2022.2126276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Social media is an outlet for patients to share medical experiences with a large audience. However, the impact of such content on individual patient treatment decisions has yet to be fully explored. We characterized patient experiences posted on social media surrounding biologic use for skin psoriasis. We analyzed content from YouTube, Instagram, and TikTok and identified patient experiences with a variety of biologics, most commonly Humira (20.7%), Cosentyx (14.0%), and Stelara (14.0%). The biologic was described as burdensome in about half of all videos/posts (46.4%), and the most commonly cited reasons included adverse effects or abnormal blood tests (12.8%), cost or insurance issues (11.7%), lack or loss of efficacy (11.7%), and pain with injection or injection site reaction (11.7%). Nevertheless, the majority (60.9%) of videos/posts reported an overall positive experience with a biologic for their skin psoriasis, which may inspire reluctant patients to try a biologic recommended by their physician.
Collapse
Affiliation(s)
- Melissa A Nickles
- Department of Dermatology, University of Illinois at Chicago College of Medicine, Chicago, IL, USA
| | - Roger N Haber
- Department of Dermatology, University of Illinois at Chicago College of Medicine, Chicago, IL, USA
| |
Collapse
|
20
|
Metzger M, Benloukil S, Alisa Z, Foxx L. A Study Describing Patients' Perspectives on Cognitive Function Screening During Hemodialysis. Nephrol Nurs J 2022; 49:265-271. [PMID: 35802364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Routine screening of cognitive function in patients with end stage kidney disease (ESKD) is recommended, yet rarely it happens. This study sought to identify barriers to cognitive function screening for patients with ESKD receiving in-center hemodialysis. To ascertain their perceptions of cognitive function screening, 100 patients aged 50 years and older (48% female, 49% Black/African-American) from seven hemodialysis centers participated in structured interviews after completing the Montreal Cognitive Assessment and Geriatric Depression Scale. Participants rated the screening experience favorably, indicating cognitive function screening is acceptable to patients receiving hemodialysis. The level of cognitive impairment was the only factor significantly associated with screening evaluation scores, with participants with scores indicating mild or moderate impairment evaluating screening less favorably than those with normal cognitive function scores. Next steps include identifying systems level barriers and establishing appropriate follow up for patients with abnormal screening results.
Collapse
Affiliation(s)
- Maureen Metzger
- Assistant Professor of Nursing, the University of Virginia School of Nursing, Charlottesville, VA
| | - Souad Benloukil
- Licensed Clinical Research Coordinator, the University of Virginia School of Nursing, Charlottesville, VA
| | - Zahra Alisa
- Student, the University of Virginia School of Nursing, Charlottesville, VA
| | - Liza Foxx
- Student, the University of Virginia School of Nursing, Charlottesville, VA
| |
Collapse
|
21
|
Tarp K, Rasmussen J, Mejldal A, Folker MP, Nielsen AS. Blended Treatment for Alcohol Use Disorder (Blend-A): Explorative Mixed Methods Pilot and Feasibility Study. JMIR Form Res 2022; 6:e17761. [PMID: 35468082 PMCID: PMC9086873 DOI: 10.2196/17761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 05/05/2020] [Accepted: 02/28/2022] [Indexed: 11/25/2022] Open
Abstract
Background In Denmark, approximately 150,000 people have alcohol use disorder (AUD). However, only approximately 10% seek AUD treatment, preferably outside conventional health care settings and opening hours. The AUD treatment area experiences low adherence to treatment, as well as high numbers of no-show and premature dropouts. Objective The purpose of the Blend-A (Blended Treatment for Alcohol Use Disorder) feasibility and pilot study was to describe the process of translating and adapting the Dutch treatment protocol into Danish and Danish culture with a high amount of user involvement and to report how patients and therapists perceived the adapted version, when trying it out. Methods The settings were 3 Danish public municipal outpatient alcohol clinics. Study participants were patients and therapists from the 3 settings. Data consisted of survey data from the System Usability Scale, individual patient interviews, and therapist group interviews. Statistical analyses were conducted using the Stata software and Excel. Qualitative analysis was conducted using a theoretical thematic analysis. Results The usability of the treatment platform was rated above average. The patients chose to use the blended treatment format because it ensured anonymity and had a flexible design. Platform use formed the basis of face-to-face sessions. The use of the self-determined platform resulted in a more thorough process. Patient involvement qualified development of a feasible system. Managerial support for time use was essential. Guidance from an experienced peer was useful. Conclusions This study indicates that, during the processes of translating, adapting, and implementing blended, guided, internet-based, and face-to-face AUD treatment, it is relevant to focus on patient involvement, managerial support, and guidance from experienced peers. Owing to the discrete and flexible design of the blended offer, it appears that it may reach patient groups who would not otherwise have sought treatment. Therefore, blended treatment may increase access to treatment and contribute to reaching people affected by excessive alcohol use, who would not otherwise have sought treatment. In addition, it seems that the blended offer may enhance the participants’ perceived satisfaction and the effect of the treatment course. Thus, it appears that Blend-A may be able to contribute to existing treatment offers. Such findings highlight the need to determine the actual effect of the Blend-A offer; therefore, an effectiveness study with a controlled design is warranted.
Collapse
Affiliation(s)
- Kristine Tarp
- Centre for Telepsychiatry, Mental Health Services, Region of Southern Denmark, Odense, Denmark.,Research Unit for Telepsychiatry and E-mental Health, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Anna Mejldal
- Unit of Clinical Alcohol Research, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,OPEN Odense Patient data Explorative Network, Odense, Denmark
| | - Marie Paldam Folker
- Centre for Telepsychiatry, Mental Health Services, Region of Southern Denmark, Odense, Denmark
| | - Anette Søgaard Nielsen
- Unit of Clinical Alcohol Research, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Psychiatry, Mental Health Services, Region of Southern Denmark, Odense, Denmark.,BRIDGE, Brain Research - Inter-Disciplinary Guided Excellence, Odense, Denmark
| |
Collapse
|
22
|
Kim W, Sivesind T. Patient Perceptions of Dermatologic Photography: Scoping Review. JMIR Dermatol 2022; 5:e33361. [PMID: 37632867 PMCID: PMC10334897 DOI: 10.2196/33361] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 12/05/2021] [Accepted: 12/15/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Medical photography is used extensively in dermatology to record disease progression, measure treatment response, and help teach patients about skin disease; such photos are also commonly utilized in teledermatology, medical education, research, and medical reference websites. Understanding patient perceptions of medical photographs obtained during dermatologic care in the clinic or hospital setting is critical to enable the delivery of high-quality, patient-centered medical care. OBJECTIVE The aims of this study were to elucidate patient perceptions of skin photos in dermatology and to explore possible next steps in improving the patient experience with medical photography in the hospital or clinic setting. METHODS A scoping review of the literature was performed using the PubMed database, with clinic- or hospital-based full-text publications in English spanning the last 10 years considered for inclusion. RESULTS The majority of included studies (10/11, 91%) found positive patient attitudes toward medical photographs. The majority of patients (1197/1511, 79.2%) felt that medical photographs could improve medical care in the clinic setting. Written consent detailing all photo uses, including secondary uses (such as research or teaching), was preferred, apart from in 1 study. Patients preferred or found it acceptable for the photographer of their medical photos to be a physician (1301/1444, 90.1%). Clinic-owned cameras with departmental record storage were the preferred modality. Latinx and African American patients expressed less trust in the utility of medical photographs to improve care, compared with Asian and White patients. The minimal number of available publications on this topic and the inclusion of articles older than 5 years are limitations, since patient perceptions of medical photography may have rapidly changed during this time span, particularly in light of the COVID-19 pandemic and the subsequent increase in teledermatology visits. CONCLUSIONS Patients reported positive perceptions of dermatologic photography for improving their medical care. Ethnic disparities in patient perceptions require further exploration to better elucidate nuances and develop interventions to improve the experience of marginalized patients. Building patient trust in nonphysician photographers may enhance clinic efficiency. Although clinic-owned cameras are well-accepted by patients, improved patient education surrounding the safety of electronic medical record phone applications is needed.
Collapse
Affiliation(s)
- William Kim
- Department of Dermatology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Torunn Sivesind
- Department of Dermatology, University of Colorado School of Medicine, Aurora, CO, United States
| |
Collapse
|
23
|
Song N, Frean M, Covington CT, Tietschert M, Ling E, Bahadurzada H, Kerrissey M, Friedberg M, Singer SJ. Patients' Perceptions of Integrated Care Among Medicare Beneficiaries by Level of Need for Health Services. Med Care Res Rev 2022; 79:640-649. [PMID: 35012390 DOI: 10.1177/10775587211067897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Requirements for integrating care across providers, settings, and over time increase with patients' needs. Health care providers' ability to offer care that patients experience as integrated may vary among patients with different levels of need. We explore the variation in patients' perceptions of integrated care among Medicare beneficiaries based on the beneficiary's level of need using ordinary least square regression for each of four high-need groups: beneficiaries (a) with complex chronic conditions, (b) with frailties, (c) below 65 with disability, and (d) with any (of the first three) high needs. We control for beneficiary demographics and other factors affecting integrated care, and we conduct sensitivity analyses controlling for multiple individual chronic conditions. We find significant positive associations with level of need for provider support for self-directed care and medication and home health management. Controlling for multiple individual chronic conditions reduces effect sizes and number of significant relationships.
Collapse
Affiliation(s)
- Nancy Song
- Stanford University School of Medicine, CA, USA
| | - Molly Frean
- University of Pennsylvania, Philadelphia, USA
| | | | | | - Emilia Ling
- Stanford University School of Medicine, CA, USA
| | | | | | | | - Sara J Singer
- Stanford University School of Medicine, CA, USA.,Stanford Graduate School of Business, CA, USA
| |
Collapse
|
24
|
Schmaderer M, Miller JN, Mollard E. Experiences of Using a Self-management Mobile App Among Individuals With Heart Failure: Qualitative Study. JMIR Nurs 2021; 4:e28139. [PMID: 34406966 PMCID: PMC8386366 DOI: 10.2196/28139] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 06/17/2021] [Accepted: 07/04/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Interventions that focus on the self-management of heart failure are vital to promoting health in patients with heart failure. Mobile health (mHealth) apps are becoming more integrated into practice to promote self-management strategies for chronic diseases, optimize care delivery, and reduce health disparities. OBJECTIVE The purpose of this study was to explore the experience of using a self-management mHealth intervention in individuals with heart failure to inform a future mHealth intervention study. METHODS This study used a qualitative descriptive design. Participants were enrolled in the intervention groups of a larger parent study using a mobile app related to self-management of heart failure. The purposive, convenient, criterion-based sample for this qualitative analysis comprised 10 patients who responded to phone calls and were willing to be interviewed. Inclusion criteria for the parent study were adults who were hospitalized at Nebraska Medical Center with a primary diagnosis and an episode of acute decompensated heart failure; discharged to home without services such as home health care; had access to a mobile phone; and were able to speak, hear, and understand English. RESULTS Study participants were middle-aged (mean age 55.8, SD 12 years; range 36-73 years). They had completed a mean of 13.5 (SD 2.2) years (range 11-17 years) of education. Of the 10 participants, 6 (60%) were male. Half of them (5/10, 50%) were New York Heart Association Classification Class III patients and the other half were Class IV patients. The intervention revealed four self-management themes, including (1) I didn't realize, and now I know; (2) It feels good to focus on my health; (3) I am the leader of my health care team; and (4) My health is improving. CONCLUSIONS Participants who used a self-management mHealth app intervention for heart failure reported an overall positive experience. Their statements were organized into four major themes. The education provided during the study increased self-awareness and promoted self-management of their heart failure. The mHealth app supported patient empowerment, resulting in better heart failure management and improved quality of life. Participants advocated for themselves by becoming the leader of their health, especially when communicating with their health care team. Finally, the mHealth app was used by the participants as a self-management tool to assist in symptom management and improve their overall health. Future research should study symptom evaluation, medication tracking, and possibly serve as a health provider communication platform to empower individuals to be leaders in their chronic disease management.
Collapse
Affiliation(s)
- Myra Schmaderer
- College of Nursing, University of Nebraska Medical Center, Lincoln, NE, United States
| | - Jennifer N Miller
- College of Nursing, University of Nebraska Medical Center, Lincoln, NE, United States
| | - Elizabeth Mollard
- College of Nursing, University of Nebraska Medical Center, Lincoln, NE, United States
| |
Collapse
|
25
|
Lugtenberg RT, Kaptein A, Matsuda A, Inoue K, Murray M, Kobayashi K, Kubota K, Putter H, Yamaoka K, Nortier JWR, Kroep JR, Fischer MJ. Perceptions of Japanese and Dutch women with early breast cancer about monitoring their quality of life. J Psychosoc Oncol 2021; 40:527-540. [PMID: 34266363 DOI: 10.1080/07347332.2021.1936741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Monitoring quality of life (QoL) in patients with cancer can provide insight into functional, psychological and social consequences associated with illness and its treatment. The primary objective of this study is to examine the influence of cultural factors on the communication between the patient and the health care provider and the perceived QoL in women with breast cancer in Japan and the Netherlands. METHODS In Japanese and Dutch women with early breast cancer, the number, content and frequency of QoL-related issues discussed at the medical encounter were studied. Patients completed questionnaires regarding QoL and evaluation of communication with the CareNoteBook. RESULTS The total number, frequency and content of QoL-related issues discussed differed between the two countries. Japanese women (n = 134) were significantly more reticent in discussing QoL-issues than the Dutch women (n = 70) (p < .001). Furthermore, Dutch patients perceived the CareNoteBook methodology significantly more positively than the Japanese patients (p < .001). Both groups supported the regular assessment via a CareNoteBook methodology. CONCLUSIONS Japanese women are more reluctant in expressing their problems with the illness, its treatment and patient-physician communication than Dutch women.
Collapse
Affiliation(s)
| | - Adrian Kaptein
- Medical Psychology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Ayako Matsuda
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | | | - Michael Murray
- School of Psychology, Keele University, Stoke-on-Trent, UK
| | | | | | - Hein Putter
- Medical Statistics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Kazue Yamaoka
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Johan W R Nortier
- Medical Oncology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Judith R Kroep
- Medical Oncology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Maarten J Fischer
- Medical Psychology, Leiden University Medical Centre, Leiden, The Netherlands
| |
Collapse
|
26
|
Goula A, Stamouli MA, Alexandridou M, Vorreakou L, Galanakis A, Theodorou G, Stauropoulos E, Kelesi M, Kaba E. Public Hospital Quality Assessment. Evidence from Greek Health Setting Using SERVQUAL Model. Int J Environ Res Public Health 2021; 18:3418. [PMID: 33806126 PMCID: PMC8036995 DOI: 10.3390/ijerph18073418] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/19/2021] [Accepted: 03/23/2021] [Indexed: 11/17/2022]
Abstract
(1) Background: Health care service quality has been equated with preparedness to provide, accessibility, suitability, adequacy, friendliness and ongoing support and has been connected to service excellence. The main aim of this study was to investigate patients' perceptions and expectations regarding the quality of health services. (2) Materials and Methods: A cross-sectional analysis was carried out in 5 public general hospitals and convenience sampling was used as the sampling technique. Questionnaires were distributed to inpatients and outpatients and 700 valid questionnaires were returned. The SERVQUAL questionnaire was used for data collection in this survey. (3) Results: Overall, in this study, it became apparent that patients' expectations as regarding the quality of the provided services were not met. All of the five quality dimensions had a negative gap between patients' expectations and perceptions. (4) Conclusions: The findings suggested that hospital managers and health care professionals should be interested about patient expectations and subsequently they should search out ways and means to meet them. Open communication with patients, individualized attention, as well as responsiveness to their requirements, polite behavior, trustful atmosphere across the hospital and better physical facilities are the key elements that determine the patient's judgment about quality.
Collapse
Affiliation(s)
- Aspasia Goula
- Master of Health and Social Care Management, Department of Business Administration, School of Administrative, Economics and Social Sciences. University of West Attica, 12243 Athens, Greece; (M.-A.S.); (M.A.); (L.V.); (A.G.); (G.T.); (E.S.)
| | - Maria-Aggeliki Stamouli
- Master of Health and Social Care Management, Department of Business Administration, School of Administrative, Economics and Social Sciences. University of West Attica, 12243 Athens, Greece; (M.-A.S.); (M.A.); (L.V.); (A.G.); (G.T.); (E.S.)
| | - Maria Alexandridou
- Master of Health and Social Care Management, Department of Business Administration, School of Administrative, Economics and Social Sciences. University of West Attica, 12243 Athens, Greece; (M.-A.S.); (M.A.); (L.V.); (A.G.); (G.T.); (E.S.)
| | - Lemonia Vorreakou
- Master of Health and Social Care Management, Department of Business Administration, School of Administrative, Economics and Social Sciences. University of West Attica, 12243 Athens, Greece; (M.-A.S.); (M.A.); (L.V.); (A.G.); (G.T.); (E.S.)
| | - Aristeidis Galanakis
- Master of Health and Social Care Management, Department of Business Administration, School of Administrative, Economics and Social Sciences. University of West Attica, 12243 Athens, Greece; (M.-A.S.); (M.A.); (L.V.); (A.G.); (G.T.); (E.S.)
| | - Georgios Theodorou
- Master of Health and Social Care Management, Department of Business Administration, School of Administrative, Economics and Social Sciences. University of West Attica, 12243 Athens, Greece; (M.-A.S.); (M.A.); (L.V.); (A.G.); (G.T.); (E.S.)
| | - Emmanouil Stauropoulos
- Master of Health and Social Care Management, Department of Business Administration, School of Administrative, Economics and Social Sciences. University of West Attica, 12243 Athens, Greece; (M.-A.S.); (M.A.); (L.V.); (A.G.); (G.T.); (E.S.)
| | - Martha Kelesi
- Department of Nursing, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece; (M.K.); (E.K.)
| | - Evridiki Kaba
- Department of Nursing, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece; (M.K.); (E.K.)
| |
Collapse
|
27
|
Jones RM, Vesel L, Kimenju G, Ogolla T, Munson M, Little S, Rajasekharan S, Wegner MN, Langer A, Pearson N. Implementation of the INTERGROWTH-21 st gestational dating and fetal and newborn growth standards in Nairobi, Kenya: women's experiences with ultrasound and newborn assessment. Glob Health Action 2021; 13:1770967. [PMID: 32544027 PMCID: PMC7480435 DOI: 10.1080/16549716.2020.1770967] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background In order to make further gains in preventing newborn deaths, effective interventions are needed. Ultrasounds and newborn anthropometry are proven interventions to identify preterm birth complications, the leading cause of newborn deaths. The INTERGROWTH-21st global gestational dating and fetal and newborn growth standards prescribe optimal growth in any population. Jacaranda Health in Kenya was the first low-resource health facility to implement the standards and evaluate their feasibility and acceptability. Objective To capture patients’ perceptions of ultrasound and newborn care before and during implementation of the INTERGROWTH-21st standards. Methods The study was conducted over two years before and during the introduction of the INTERGROWTH-21st standards. Fifty pregnant and/or newly delivered women were selected for in-depth interviews and focus group discussions using convenience and purposive sampling. Interviews were conducted by research assistants using semi-structured guides once in the pre-implementation phase and twice in the implementation phase. Interviews were transcribed, double-coded by two independent researchers and thematically analyzed together. Demographic information was obtained from hospital records. Results Patients reported being generally satisfied with ultrasound care when providers communicated effectively. Women reported a priority for ultrasound was that it allowed them to feel reassured. However, a clear need for better pre-screening information emerged consistently from patients. Women noted that factors facilitating their choosing to have an ultrasound included ensuring the well-being of the fetus and learning the sex. Barriers included wait times and financial constraints. Patients were generally satisfied with care using the newborn standards. Conclusions As the INTERGROWTH-21st standards are implemented worldwide, understanding ways to facilitate implementation is critical. Increased and standardized communication about ultrasound should be provided before the procedure to increase satisfaction and uptake. Considering patient perspectives when integrating new standards or guidelines into routine clinical care will inform effective strategies in care provision, thus improving maternal and newborn health and survival.
Collapse
Affiliation(s)
- Rachel M Jones
- Department of Research & Design, Jacaranda Health , Nairobi, Kenya
| | - Linda Vesel
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health , MA, USA
| | - Grace Kimenju
- Department of Research & Design, Jacaranda Health , Nairobi, Kenya
| | - Teresa Ogolla
- Department of Research & Design, Jacaranda Health , Nairobi, Kenya
| | - Meghan Munson
- Department of Research & Design, Jacaranda Health , Nairobi, Kenya
| | - Sarah Little
- Department of Research & Design, Jacaranda Health , Nairobi, Kenya
| | | | - Mary Nell Wegner
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health , MA, USA
| | - Ana Langer
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health , MA, USA
| | - Nicholas Pearson
- Department of Research & Design, Jacaranda Health , Nairobi, Kenya
| |
Collapse
|
28
|
Abstract
The cost of the NHS, wastage within it and how much trusts have overspent is a national obsession. Despite these widespread opinions, the costs of individual treatments and impacts of non-attendance appear to be little understood. There is a paucity of literature with regards to patients' awareness of costs associated with services provided by the NHS. The authors aim to ascertain whether patients are aware of the costs associated with care services provided, and if these data could aid educating patients on NHS costs to reduce missed appointments. A questionnaire was randomly distributed to new and review patients in our Oral and Maxillofacial outpatient and emergency departments from November-December 2017 asking them to estimate the cost of common services they may encounter, such as an outpatient appointment, an orthopantomogram (OPT), a CT head, and a full blood count test (FBC). The results demonstrate that 81% of patients surveyed underestimated the cost of their new patient appointment, with 34% underestimating the cost of their review appointment. The cost of an overnight stay in hospital was underestimated by 65% of patients, with 89% of patients underestimating the cost of an hours's operating. The costs of a full blood count, an OPT and a CT head have been mostly overestimated by 89%, 77%, and 54% of patients respectively. The results show there is a wide variation in patients' estimates of costs, with over 50% of patients overestimating the costs of investigations but underestimating the cost of their appointment/A&E attendance.
Collapse
Affiliation(s)
- A M Nijamudeen
- Oral & Maxillofacial Surgery, Chester Wing, Sunderland Royal Hospital, Kayll Road, Sunderland, SR4 7TP.
| | - R J Banks
- Oral & Maxillofacial Surgery, Chester Wing, Sunderland Royal Hospital, Kayll Road, Sunderland, SR4 7TP.
| |
Collapse
|
29
|
Payne H, Brooks SDM. A Qualitative Study of the Views of Patients With Medically Unexplained Symptoms on The BodyMind Approach ®: Employing Embodied Methods and Arts Practices for Self-Management. Front Psychol 2020; 11:554566. [PMID: 33364994 PMCID: PMC7750328 DOI: 10.3389/fpsyg.2020.554566] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 10/28/2020] [Indexed: 12/28/2022] Open
Abstract
The arts provide openings for symbolic expression by engaging the sensory experience in the body they become a source of insight through embodied cognition and emotion, enabling meaning-making, and acting as a catalyst for change. This synthesis of sensation and enactive, embodied expression through movement and the arts is capitalized on in The BodyMind Approach® (TBMA). It is integral to this biopsychosocial, innovative, unique intervention for people suffering medically unexplained symptoms (MUS) applied in primary healthcare. The relevance of embodiment and arts practices in TBMA are discussed in relation to the views of participants in the pursuit of self-management. If widely employed TBMA could have an enormous impact, reach, and significance for patients and global health services. This original pre-clinical trial of qualitative research reports on the perceptions of participant patients with generic MUS, a world-wide issue usually treated by either psychological therapy or physiotherapy. TBMA is not a therapy but a health education program founded upon the concept of an integration of psychological elements with physiological, bodily, and sensory experiences. Thematic analysis of qualitative data sets from open-ended questions in semi-structured interviews and a written questionnaire post intervention is presented. Five aspects which appear to be key to learning self-management were derived from analyzing the data: (1) body with mind connections; (2) importance of facilitation; (3) potential benefits; (4) preparedness for change; (5) self-acceptance/compassion. This article advances the discourse on the nature of self-management for MUS through changing the mind-set and the relationship participants have with their bodily symptom/s through employing embodied methods and arts practices, challenging current, and solely verbal, psychological conceptual frameworks. Rigor lies in the method of data analysis using cross verification of credibility between reported findings and scrutiny by stakeholders. We conclude that facilitated TBMA groups employing embodied methods and arts practices can act as a method for developing the self-management of MUS and improving wellbeing.
Collapse
Affiliation(s)
- Helen Payne
- School of Education, University of Hertfordshire, Hatfield, United Kingdom
| | | |
Collapse
|
30
|
Spicer JO, Roberts RM, Hicks LA. Perceptions of the Benefits and Risks of Antibiotics Among Adult Patients and Parents With High Antibiotic Utilization. Open Forum Infect Dis 2020; 7:ofaa544. [PMID: 33335939 PMCID: PMC7731524 DOI: 10.1093/ofid/ofaa544] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/02/2020] [Indexed: 01/21/2023] Open
Abstract
Background Inappropriate antibiotic use is common. Understanding how patients view antibiotic risks and/or benefits could inform development of patient education materials and clinician communication strategies. We explored current knowledge, attitudes, and behaviors related to antibiotics among populations with high antibiotic use. Methods We conducted 12 focus groups with adult patients and parents across the United States by telephone in March 2017. Purposive sampling was used to identify participants with high antibiotic use. We transcribed the discussions verbatim and performed thematic analysis. Results We identified 4 major themes. First, participants expressed uncertainty regarding which clinical syndromes required antibiotics, and emotion often influenced their desire for antibiotics. Second, they had a limited understanding of antibiotic risks. Antibiotic resistance was viewed as the primary risk but was seen as a “distant, future” issue, whereas immediate adverse events, such as side effects, were minimized; however, patients expressed concern when told about the risk of serious adverse events. Third, they prioritized antibiotic benefits over risks in their decision-making, both due to an inaccurate estimation of antibiotic risks and/or benefits and a tendency to prioritize instant gratification. Fourth, most participants were willing to defer to their clinicians’ decisions about antibiotics, especially if their clinician provided symptomatic treatment and anticipatory guidance. Conclusions Patients have a limited understanding of antibiotic risks, potentially explaining why they are willing to try antibiotics even if it is unclear antibiotics will help. Educating patients on the potential antibiotic risks versus benefits, rather than just antibiotic resistance, may have a bigger impact on their decision-making.
Collapse
Affiliation(s)
- Jennifer O Spicer
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Rebecca M Roberts
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lauri A Hicks
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| |
Collapse
|
31
|
Abstract
OBJECTIVE The coronavirus disease (COVID-19) pandemic has been recognized as causing a wide variety of behavioral health problems. Society must mitigate this impact by recognizing that COVID-19 can trigger people's fears of exacerbating an existing mental illness. A survey about COVID-19 for people with mental illness was developed. METHODS Two hundred fourteen people responded to the survey, of whom 193 self-identified as living with a mental illness. RESULTS Almost all participants living with a mental illness (98%) said they had at least one major concern regarding the COVID-19 pandemic, and 62% said they had at least three major concerns. CONCLUSIONS People living with a mental illness are very concerned about disruption of services, running out of medication, and social isolation during this pandemic. Providers and mental health services could address these fears by connecting with people living with mental illness through text messaging and social media.
Collapse
Affiliation(s)
- Mark Costa
- Yale School of Medicine, Yale University, New Haven, Connecticut (Costa, Pavlo, Reis, Davidson); ForLikeMinds, New York City (Ponte)
| | - Anthony Pavlo
- Yale School of Medicine, Yale University, New Haven, Connecticut (Costa, Pavlo, Reis, Davidson); ForLikeMinds, New York City (Ponte)
| | - Graziela Reis
- Yale School of Medicine, Yale University, New Haven, Connecticut (Costa, Pavlo, Reis, Davidson); ForLikeMinds, New York City (Ponte)
| | - Katherine Ponte
- Yale School of Medicine, Yale University, New Haven, Connecticut (Costa, Pavlo, Reis, Davidson); ForLikeMinds, New York City (Ponte)
| | - Larry Davidson
- Yale School of Medicine, Yale University, New Haven, Connecticut (Costa, Pavlo, Reis, Davidson); ForLikeMinds, New York City (Ponte)
| |
Collapse
|
32
|
Iqbal MZ, Bukhamsin EY, Alghareeb FY, Almarri NM, Aldajani LM, Busaleh HA. Participation of medical students in patient care: How do patients perceive it? J Family Med Prim Care 2020; 9:3644-3651. [PMID: 33102344 PMCID: PMC7567193 DOI: 10.4103/jfmpc.jfmpc_130_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/13/2020] [Accepted: 03/21/2020] [Indexed: 11/04/2022] Open
Abstract
Introduction Clinical teaching helps students develop clinical reasoning, decision-making, professionalism, empathy, and patient management. These benefits can only be obtained if patients show reasonable acceptance towards medical students. The aim of this study was to assess patients' perceptions regarding their level of acceptance towards students' participation in their healthcare. Methods This descriptive cross-sectional study was conducted at King Fahd University hospital between December 2018 and March 2019. The data were collected via face-to-face interviews with patients from four clinical departments using a self-administered questionnaire. A total of 196 patients were approached for an interview, of whom 187 agreed to participate (a response rate of 95.4%). Results Overall, patients showed a positive attitude towards students' participation in their care. The acceptance rate was higher in cases where there was minimal or no student-patient physical contact, such as reading patient's medical records (88.8%) and attending outpatient clinics (83.3%). On the other hand, the refusal rate increased dramatically (from 11% to 43.3%) when permission was sought from patients to perform diagnostic procedures. In a comparison of specialties, the highest refusal rate was observed in the obstetrics/gynecology department, whereas the lowest refusal rate was observed in the pediatrics department. Conclusions Patients seeking healthcare services in a tertiary care teaching hospital have an overall positive attitude towards the involvement of undergraduate students in their medical care. The higher refusal rate with regard to students performing a physical examination and diagnostic procedures is alarming and demands alternative clinical teaching solutions, such as simulation-based training.
Collapse
Affiliation(s)
- Muhammad Zafar Iqbal
- Medical Education Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Eman Yasin Bukhamsin
- MBBS, Graduate of College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Fatimah Yousef Alghareeb
- MBBS, Graduate of College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Norah Mohammed Almarri
- MBBS, Graduate of College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Laila Mohammed Aldajani
- MBBS, Graduate of College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hawraa Ahmed Busaleh
- MBBS, Graduate of College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| |
Collapse
|
33
|
Perlmutter A, Benchoufi M, Ravaud P, Tran VT. Identification of Patient Perceptions That Can Affect the Uptake of Interventions Using Biometric Monitoring Devices: Systematic Review of Randomized Controlled Trials. J Med Internet Res 2020; 22:e18986. [PMID: 32915153 PMCID: PMC7519434 DOI: 10.2196/18986] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/23/2020] [Accepted: 07/26/2020] [Indexed: 12/24/2022] Open
Abstract
Background Biometric monitoring devices (BMDs) are wearable or environmental trackers and devices with embedded sensors that
can remotely collect high-frequency objective data on patients’ physiological, biological, behavioral, and environmental
contexts (for example, fitness trackers with accelerometer). The real-world effectiveness of interventions using biometric monitoring devices depends on patients’ perceptions of these interventions. Objective We aimed to systematically review whether and how recent randomized controlled trials (RCTs) evaluating interventions using BMDs assessed patients’ perceptions toward the intervention. Methods We systematically searched PubMed (MEDLINE) from January 1, 2017, to December 31, 2018, for RCTs evaluating interventions using BMDs. Two independent investigators extracted the following information: (1) whether the RCT collected information on patient perceptions toward the intervention using BMDs and (2) if so, what precisely was collected, based on items from questionnaires used and/or themes and subthemes identified from qualitative assessments. The two investigators then synthesized their findings in a schema of patient perceptions of interventions using BMDs. Results A total of 58 RCTs including 10,071 participants were included in the review (the median number of randomized participants was 60, IQR 37-133). BMDs used in interventions were accelerometers/pedometers (n=35, 60%), electrochemical biosensors (eg, continuous glucose monitoring; n=18, 31%), or ecological momentary assessment devices (eg, carbon monoxide monitors for smoking cessation; n=5, 9%). Overall, 26 (45%) trials collected information on patient perceptions toward the intervention using BMDs and allowed the identification of 76 unique aspects of patient perceptions that could affect the uptake of these interventions (eg, relevance of the information provided, alarm burden, privacy and data handling, impact on health outcomes, independence, interference with daily life). Patient perceptions were unevenly collected in trials. For example, only 5% (n=3) of trials assessed how patients felt about privacy and data handling aspects of the intervention using BMDs. Conclusions Our review showed that less than half of RCTs evaluating interventions using BMDs assessed patients’ perceptions toward interventions using BMDs. Trials that did assess perceptions often only assessed a fraction of them. This limits the extrapolation of the results of these RCTs to the real world. We thus provide a comprehensive schema of aspects of patient perceptions that may affect the uptake of interventions using BMDs and which should be considered in future trials. Trial Registration PROSPERO CRD42018115522; https://tinyurl.com/y5h8fjgx
Collapse
Affiliation(s)
- Alexander Perlmutter
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States.,School of Global Public Health, New York University, New York, NY, United States
| | - Mehdi Benchoufi
- UMR1153 (METHODS team), Centre de Recherche en Epidemiologie et StatistiqueS, Institut national de la santé et de la recherche médicale, Paris, France
| | - Philippe Ravaud
- UMR1153 (METHODS team), Centre de Recherche en Epidemiologie et StatistiqueS, Institut national de la santé et de la recherche médicale, Paris, France
| | - Viet-Thi Tran
- UMR1153 (METHODS team), Centre de Recherche en Epidemiologie et StatistiqueS, Institut national de la santé et de la recherche médicale, Paris, France
| |
Collapse
|
34
|
Abstract
Purpose: This study sought to determine whether the necessitated use of telemedicine due to coronavirus disease 2019, and limited choice of both the provider and patient, impacts the perceptions of telemedicine by patients who experienced telemedicine prepandemic and those who first experienced telemedicine during the pandemic. Methodology: Participants for this survey were a convenience sample. An invitation to participate was shared through social media and e-mail listservs. To participate, individuals had to be at least 18 years of age and gave consent to their data being used. The online survey took ∼10-15 min to complete, the survey was available from March 31 to April 20, 2020. Results: Two hundred sixty-four (n = 264, 60.8%) individuals had used telemedicine on or before December 2019 and 170 (39.2%) individuals used telemedicine for the first time January 2020 or later. There were no significant differences in demographics between groups, except that new users were more likely to have a primary care physician [F(407) = 13.51, p < 0.001]. Satisfaction of telemedicine was measured using a 10-item scale, demonstrating that all participants were overall satisfied with their telemedicine experience(s), (mean = 1.67, standard deviation = 0.61). Broadly, the differences in perceptions between the groups included the reasons for using telemedicine, perceptions of quality of in-person care, continuity of care, and a technical issue. Conclusions: Overall, patients are satisfied using telemedicine, however, for new users, both providers and patients, some acclimation needs to occur.
Collapse
Affiliation(s)
- Bree E Holtz
- Department of Advertising and Public Relations, Michigan State University, East Lansing, Michigan, USA
| |
Collapse
|
35
|
Molloy L, Fields L, Trostian B, Kinghorn G. Trauma-informed care for people presenting to the emergency department with mental health issues. Emerg Nurse 2020; 28:30-35. [PMID: 32096370 DOI: 10.7748/en.2020.e1990] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2019] [Indexed: 11/09/2022]
Abstract
There is a high prevalence of exposure to traumatic events in childhood among people who have mental health issues. Presentation to the emergency department (ED) can be challenging for these patients because the environment and their experience of care can trigger traumatic memories. Trauma-informed care is an approach to practice that is guided by knowledge of how trauma affects people's lives and their healthcare needs. Despite the increasing prevalence of mental health care delivery in EDs, the level of translation of trauma-informed care into nursing practice in this setting is largely unknown. Therefore, the authors undertook a narrative literature review, the aim of which was to gather evidence relevant to trauma-informed care in the ED and provide guidance on this practice for emergency nurses. Several databases were searched, and the relevant articles found were thematically analysed. Three emergent themes were identified from the literature: an access point for mental health care; staff attitudes; and the ED experience. Emergency nurses need to be aware of the effects of childhood trauma on people presenting with mental health issues and plan their approach to care to avoid potentially re-traumatising patients.
Collapse
Affiliation(s)
- Luke Molloy
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Lorraine Fields
- Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Baylie Trostian
- Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Grant Kinghorn
- Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| |
Collapse
|
36
|
Gildon B, Baldwin J, White R. Perceptions of Visible Body Art Among Radiographers. Radiol Technol 2020; 91:223-239. [PMID: 32060079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 07/12/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE To determine the perceptions among radiographers of visible tattoos and nontraditional body piercings (piercings other than traditional pierced earlobes) in the clinical setting. METHODS An institutional review board-approved survey was delivered electronically to radiography clinical preceptors working at hospitals affiliated with a radiography program in the South Central part of the United States. Discussion board forum posts about the survey were created in the American Society of Radiologic Technologists Communities, targeting radiographers throughout the United States. Responses were collected for 4 weeks and compared quantitatively using linear regression, logistic regression, and chi-square analysis. Qualitative results were examined for themes, and proportions among themes were reported. RESULTS A total of 943 valid responses were received from radiographers working in the United States. Acceptance of body art was lower among individuals without tattoos compared with those who have tattoos (P < .001). Individuals without piercings had a lower acceptance of piercings compared with those who have piercings (P < .001). Acceptance was lower for those who have tattoos but cover them at work compared with those who have visible tattoos at work (P < .001). Acceptance was not statistically significant among those who have piercings who cover them compared with those who have visible nontraditional piercings at work (P = .073). Respondents believed it was more acceptable for members of the public to display a tattoo than for radiographers to display a tattoo at work (P < .001). However, acceptability was higher (P < .001) when the radiographer's tattoo was medically related. DISCUSSION Research links visible body art with negative perceptions of professionalism and skill set ability in other professions, but no studies have addressed radiography. This study reflects findings similar to those professions. A negative perception exists among radiographers regarding the display of body art while working, even among those who have body art. However, the subject of a tattoo might matter more than the location of a tattoo in terms of acceptability. These results have implications for the credibility and appropriateness of radiographers who display body art in the clinical setting because it might adversely affect the perceptions of co-workers and the perceptions of patient care provided during imaging services, and might affect hospital policy management. CONCLUSION Among radiographers working in the United States, a negative perception exists regarding visible body art such as tattoos and nontraditional piercings in the health care setting. Implications include negative perceptions of radiographers displaying body art while working. Future research might influence policy implementation as hospitals work to continually improve satisfaction scores and perceptions of care received.
Collapse
|
37
|
Mull HJ, Shin MH, Engle RL, Linsky AM, Kalver E, Lamkin R, Sullivan JL. Veterans Perceptions of Satisfaction and Convenience with Anticoagulants for Atrial Fibrillation: Warfarin versus Direct Oral Anticoagulants. Patient Prefer Adherence 2020; 14:1911-1922. [PMID: 33116435 PMCID: PMC7569027 DOI: 10.2147/ppa.s279621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 09/29/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Atrial fibrillation (AFib) is associated with high morbidity and mortality. Traditionally, AFib was treated with warfarin, yet recent evidence suggests patients may favor direct oral anticoagulants (DOACs). Variation in preferences is common and we explored patients' perceptions of satisfaction and convenience of DOACs versus warfarin within the Veterans Health Administration (VA). PATIENTS AND METHODS We administered a cross-sectional survey, the Perception of Anticoagulant Treatment Questionnaire 2 (PACT-Q2), to Veterans residing in New England, age ≥65, diagnosed with AFib, and actively taking anticoagulant medication in fiscal year 2018. Survey recipients were randomly selected among patients on warfarin (n=200) or DOACs (n=200). A selection of survey respondents agreed to a follow-up semi-structured interview (n=16) to further investigate perceptions of satisfaction and convenience. RESULTS Of 400 patients, 187 completed the PACT-Q2 survey (49% on DOACs; 51% on warfarin). DOACs received significantly higher convenience ratings than warfarin (87.6, SD 13.5 vs 81.1, SD 18.8; p=0.007); there was no difference in satisfaction (64.2, SD 20.5 SD, warfarin vs, 67.3, SD 19.4, DOACs). Interview results showed that participants perceived their treatment to be convenient. However, participants expressed challenges related to the convenience of taking warfarin or DOACs, such as warfarin users having to follow dietary recommendations or DOAC users desiring some additional monitoring to answer questions or concerns. Overall, warfarin and DOAC users reported satisfaction with ongoing monitoring methods, although a few DOAC users expressed uncertainties with the frequency of monitoring. For most participants, concerns about side effects did not differ by anticoagulant type nor affect satisfaction. CONCLUSION Our survey and interview results showed variable patient satisfaction and perceptions of convenience with both DOACs and warfarin. Although DOACs are increasingly prescribed for AFib, some Veterans felt that regular follow-up on warfarin was advantageous. Our findings demonstrate the importance of patient-centered decision-making in AFib treatment in the VA patient population.
Collapse
Affiliation(s)
- Hillary J Mull
- VA Boston Healthcare System, Center for Healthcare Organization and Implementation Research (CHOIR), Boston, MA, USA
- Department of Surgery, Boston University School of Medicine, Boston, MA, USA
- Correspondence: Hillary J Mull VA Boston Healthcare System, Center for Healthcare Organization and Implementation Research (CHOIR), Boston, MA, USATel +1-857-364-2766 Email
| | - Marlena H Shin
- VA Boston Healthcare System, Center for Healthcare Organization and Implementation Research (CHOIR), Boston, MA, USA
| | - Ryann L Engle
- VA Boston Healthcare System, Center for Healthcare Organization and Implementation Research (CHOIR), Boston, MA, USA
| | - Amy M Linsky
- VA Boston Healthcare System, Center for Healthcare Organization and Implementation Research (CHOIR), Boston, MA, USA
- General Internal Medicine, Boston University School of Medicine, Boston, MA, USA
- General Internal Medicine, VA Boston Healthcare System, Boston, MA, USA
| | - Emily Kalver
- VA Boston Healthcare System, Center for Healthcare Organization and Implementation Research (CHOIR), Boston, MA, USA
| | - Rebecca Lamkin
- VA Boston Healthcare System, Center for Healthcare Organization and Implementation Research (CHOIR), Boston, MA, USA
| | - Jennifer L Sullivan
- VA Boston Healthcare System, Center for Healthcare Organization and Implementation Research (CHOIR), Boston, MA, USA
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA
| |
Collapse
|
38
|
Gustafsson N, Leino-Kilpi H, Prga I, Suhonen R, Stolt M. Missed Care from the Patient's Perspective - A Scoping Review. Patient Prefer Adherence 2020; 14:383-400. [PMID: 32161449 PMCID: PMC7049852 DOI: 10.2147/ppa.s238024] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 01/20/2020] [Indexed: 12/16/2022] Open
Abstract
Missed care, defined as any aspect of patient care that is omitted or delayed, is receiving increasing attention. It is primarily caused by the imbalance between patients' nursing care needs and the resources available, making it an ethical issue that challenges nurses' professional and moral values. In this scoping review, conducted using the five-stage approach by Arksey and O'Malley, our aim is to analyze the patients' perspective to missed care, as the topic has been mainly examined from nurses' perspective. The search was conducted in April 2019 in PubMed, CINAHL, PsycINFO, Web of Science, ProQuest and Philosophers Index databases using the following terms: omitted care, unfinished nursing care, care undone, care unfinished, missed care, care left undone, task undone and implicit rationing with no time limitation. The English-language studies where missed care was examined in the nursing context and had patients as informants on patient-reported missed care or patients' perceptions on nurse-reported missed care were selected for the review. Thirteen studies were included and analyzed with thematic content analysis. Twelve studies were quantitative in nature. Patients were able to report missed care, and mostly reported missed basic care, followed by missed communication with staff and problems with timeliness when they had to wait to get the help they needed. In statistical analysis, missed care was associated with patient-reported adverse events and patients' perceptions of staffing adequacy, and in patients' perception, it was mainly caused by lack of staff and insufficient experience. Furthermore, patients' health status, as opposed to gender, predicted missed care. The results concerning patients' age and education level were conflicting. Patients are able to identify missed care. However, further research is needed to examine patient-perceived missed care as well as to examine how patients identify missed care, and to get a clear definition of missed care.
Collapse
Affiliation(s)
- Noora Gustafsson
- Department of Nursing Science, University of Turku, Turku, Finland
- Correspondence: Noora Gustafsson Department of Nursing Science, 2 University of Turku, Turku20041, FinlandTel +358 440 276 600 Email
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
| | - Ivana Prga
- Andrija Stampar Teaching Institute of Public Health, Zagreb, Croatia
| | - Riitta Suhonen
- Department of Nursing Science, University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
- Welfare Division, Healthcare Services, Turku, Finland
| | - Minna Stolt
- Department of Nursing Science, University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
| | | |
Collapse
|
39
|
Greve V, Veach PM, LeRoy BS, MacFarlane IM, Redlinger-Grosse K. Genetic counselor and proxy patient perceptions of genetic counselor responses to prenatal patient self-disclosure requests: Skillfulness is in the eye of the beholder. J Genet Couns 2019; 29:894-909. [PMID: 31788913 DOI: 10.1002/jgc4.1190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 10/24/2019] [Accepted: 10/27/2019] [Indexed: 11/06/2022]
Abstract
Research demonstrates some genetic counselors self-disclose while others do not when patients' request self-disclosure. Limited psychotherapy research suggests skillfulness matters more than type of counselor response. This survey research assessed perceived skillfulness of genetic counselor self-disclosures and non-disclosures. Genetic counselors (n = 147) and proxy patients, women from the public (n = 201), read a hypothetical prenatal genetic counseling scenario and different counselor responses to the patient's question, What would you do if you were me? Participants were randomized either to a self-disclosure study (Study 1) or non-disclosure study (Study 2) and, respectively, rated the skillfulness of five personal disclosures and five professional disclosures or five decline to disclose and five redirecting non-disclosures. Counselor responses in both studies varied by intention (corrective, guiding, interpretive, literal, or reassuring). Participants also described what they thought made a response skillful. A three-way mixed ANOVA in both studies analyzed skillfulness ratings as a function of sample (proxy patient, genetic counselor), response type (personal, professional self-disclosure, or redirecting, declining non-disclosure), and response intention. Both studies found a significant three-way interaction and strong main effect for response intention. Responses rated highest in skillfulness by both genetic counselors and proxy patients in Study 1 were a guiding personal self-disclosure and a personal reassuring self-disclosure. The response rated highest in skillfulness by both samples in Study 2 was a redirecting non-disclosure with a reassuring intention. Proxy patients in both studies rated all literal responses as more skillful than genetic counselors. Participants' commonly described a skillful response as offering guidance and/or reassurance. Counselor intentions and response type appear to influence perceptions, and counselors and patients may not always agree in their perceptions. Consistent with models of practice (e.g., Reciprocal-Engagement Model), genetic counselors generally should aim to convey support and guidance in their responses to prenatal patient self-disclosure requests.
Collapse
Affiliation(s)
- Veronica Greve
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, USA
| | - Patricia McCarthy Veach
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, MN, USA
| | - Bonnie S LeRoy
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, MN, USA
| | - Ian M MacFarlane
- Department of Psychology, Elizabethtown College, Elizabethtown, PA, USA
| | - Krista Redlinger-Grosse
- Department of Genetics, Cell Biology, and Development, University of Minnesota, Minneapolis, MN, USA
| |
Collapse
|
40
|
Barrett JR, Cherney-Stafford L, Alagoz E, Piper ME, Cook J, Campbell-Flohr S, Weber SM, Winslow ER, Ronnkleiv-Kelly SM, Abbott DE. Smoking and gastrointestinal cancer patients-is smoking cessation an attainable goal? J Surg Oncol 2019; 120:1335-1340. [PMID: 31674041 DOI: 10.1002/jso.25749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 10/20/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND OBJECTIVES Negative consequences of tobacco use during cancer treatment are well-documented but more in-depth, patient-level data are needed to understand patient beliefs about continued smoking (vs cessation) during gastrointestinal (GI) cancer treatment. METHODS We conducted semi-structured interviews with 10 patients who were active smokers being treated for GI cancers and 5 caregivers of such patients. All interviews were audio-recorded, transcribed verbatim, and uploaded to NVivo. We consensus coded data inductively using conventional content analysis and iteratively developed our codebook. We developed data matrices to categorize the themes regarding patient perspectives on smoking as well as presumed barriers to smoking cessation during active therapy. RESULTS Our interviews revealed three consistent themes: (a) Smoking cessation is not necessarily desired by many patients who have received a cancer diagnosis; (b) Failure in past quit attempts may lead to feelings of hopeless about future attempts, especially during cancer treatment; (c) Patients perceived little to no access to smoking cessation treatment at the time of their cancer diagnosis. CONCLUSIONS Well-designed systemic changes that promote the positive and efficacious effects of quitting smoking during cancer treatment, and that provide barrier-free access to such treatments may be helpful in promoting tobacco-free behavior during cancer treatment.
Collapse
Affiliation(s)
- James R Barrett
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Linda Cherney-Stafford
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Esra Alagoz
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Megan E Piper
- Department of Medicine Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Jessica Cook
- Department of Medicine Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.,William S. Middleton Memorial VA Hospital, Madison, Wisconsin
| | - Stephanie Campbell-Flohr
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Sharon M Weber
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Emily R Winslow
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Sean M Ronnkleiv-Kelly
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Daniel E Abbott
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| |
Collapse
|
41
|
Rajagopalan A, Sathananthan D, An YK, Van De Ven L, Martin S, Fon J, Costello SP, Begun J, Bryant RV. Gastrointestinal ultrasound in inflammatory bowel disease care: Patient perceptions and impact on disease-related knowledge. JGH Open 2019; 4:267-272. [PMID: 32280776 PMCID: PMC7144798 DOI: 10.1002/jgh3.12268] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 07/30/2019] [Accepted: 09/12/2019] [Indexed: 12/13/2022]
Abstract
Background and Aim Objective monitoring of disease activity is integral to therapeutic decision-making in inflammatory bowel disease (IBD). Data are sparse on patients' perspectives of tools used to monitor disease activity in IBD. To evaluate patients' perspectives of gastrointestinal ultrasound (GIUS) performed during routine IBD clinical care, along with its impact on IBD-specific knowledge. Methods Patients with a formal diagnosis of IBD who underwent GIUS at two tertiary IBD services between March 2017 and January 2019 participated in this prospective study. Participants completed a questionnaire measuring the acceptability, tolerability, and usefulness of GIUS using a visual analogue scale (VAS) from 0 (disagree) to 10 (strongly agree). Comparative acceptability of IBD monitoring tools and the impact of GIUS on IBD-specific knowledge was measured. Results A total of 121 participants completed the questionnaire, with a mean age of 42 years (range 17-78), 54 (45%) males, and 79 (65%) Crohn's disease patients. In the overall population, GIUS was scored as highly acceptable for monitoring IBD (mean 9.20 ± 1.37) compared to colonoscopy (7.94 ± 2.30), stool sampling (8.17 ± 1.96), blood sampling (8.87 ± 1.62), and imaging (8.67 ± 1.60); P < 0.01 for each comparison. GIUS caused little patient discomfort (1.88 ± 1.83), and 98 (81%) participants ranked GIUS as their preferred IBD monitoring tool. GIUS also improved patients' overall IBD-specific knowledge (VAS IBD-specific knowledge 7.96 ± 1.92), including their understanding of the need for medical therapy and disease extent. Conclusion GIUS is a highly acceptable and well-tolerated tool for monitoring disease activity in IBD patients. GIUS is preferred by patients and enhances IBD-specific knowledge.
Collapse
Affiliation(s)
- Arvind Rajagopalan
- IBD Service, Department of Gastroenterology The Queen Elizabeth Hospital Adelaide South Australia Australia
| | - Dharshan Sathananthan
- IBD Service, Department of Gastroenterology The Queen Elizabeth Hospital Adelaide South Australia Australia.,School of Medicine, Faculty of Health Science University of Adelaide Adelaide South Australia Australia
| | - Yoon-Kyo An
- Department of Gastroenterology Mater Hospital Brisbane Queensland Australia
| | - Lucinda Van De Ven
- IBD Service, Department of Gastroenterology The Queen Elizabeth Hospital Adelaide South Australia Australia
| | - Serena Martin
- IBD Service, Department of Gastroenterology The Queen Elizabeth Hospital Adelaide South Australia Australia
| | - James Fon
- IBD Service, Department of Gastroenterology The Queen Elizabeth Hospital Adelaide South Australia Australia
| | - Samuel P Costello
- IBD Service, Department of Gastroenterology The Queen Elizabeth Hospital Adelaide South Australia Australia.,School of Medicine, Faculty of Health Science University of Adelaide Adelaide South Australia Australia
| | - Jakob Begun
- Department of Gastroenterology Mater Hospital Brisbane Queensland Australia.,Faculty of Medicine University of Queensland Brisbane Queensland Australia
| | - Robert V Bryant
- IBD Service, Department of Gastroenterology The Queen Elizabeth Hospital Adelaide South Australia Australia.,School of Medicine, Faculty of Health Science University of Adelaide Adelaide South Australia Australia
| |
Collapse
|
42
|
Luxton NA, Shih P, Rahman MA, Adams R, MacKenzie R. Use of electronic cigarettes in the perioperative period: A mixed-method study exploring perceptions of cardiothoracic patients in Australia. Tob Induc Dis 2019; 16:53. [PMID: 31516450 PMCID: PMC6659508 DOI: 10.18332/tid/98957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 10/11/2018] [Accepted: 10/14/2018] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Electronic cigarettes (e-cigarettes) may reduce tobacco use and achieve tobacco abstinence in the perioperative period of cardiothoracic surgery for patients who smoke. However, research on patients' views on the role of e-cigarettes as a smoking cessation tool is lacking. This mixed-methods study explored perceptions on the use of e-cigarettes among current smokers and ex-smokers awaiting cardiothoracic surgery in Australia. METHODS A cross-sectional study and semi-structured interviews were conducted with 62 patients who were diagnosed with coronary artery disease or lung cancer and were scheduled for elective cardiothoracic surgery at six metropolitan hospitals in Sydney. Data were collected on demographic characteristics, smoking history, surgical risk index, self-efficacy, interest in, perceived benefits of, and barriers to using e-cigarettes in the perioperative period. RESULTS Current smokers reported significantly higher interest in the use of e-cigarettes (p=0.008), and perceived fewer barriers (p=0.048) and more health benefits (p=0.079), compared to ex-smokers. Current smokers considered e-cigarettes to be either a safer alternative to tobacco or a novel method for quitting. Recent ex-smokers, defined as those who quit 2-8 weeks, were a distinct group with high nicotine dependency, a long history of smoking, and multiple failed quit attempts. Compared to longer-term ex-smokers (8-52 weeks quit), recent ex-smokers were more interested in e-cigarettes (p=0.029) and considered e-cigarettes a useful aid to prevent relapse in the lead up to surgery and to manage their nicotine cravings. CONCLUSIONS E-cigarettes may be considered a short-term novel aid and a bridge to evidence-based methods to reduce harm from continued tobacco use for some patients awaiting cardiothoracic surgery for coronary artery disease or lung cancer. This study presents reasons why patients awaiting cardiothoracic surgery may enquire about or use e-cigarettes, which will help clinicians identify those who need more consistent, sustained cessation support.
Collapse
Affiliation(s)
- Nia A Luxton
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Patti Shih
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | | | - Roger Adams
- Discipline of Physiotherapy, University of Sydney, Sydney, Australia
| | - Ross MacKenzie
- Department of Psychology, Macquarie University, Sydney, Australia
| |
Collapse
|
43
|
O'Brien MB, Copus A, Johnson J, Inglehart MR. Examining the Impact of Dental Hygienists' Professional Appearance: Patients' and dental student providers' perspectives. J Dent Hyg 2019; 93:33-43. [PMID: 31409722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 01/23/2019] [Accepted: 03/24/2019] [Indexed: 06/10/2023]
Abstract
Purpose: Relationships between patients and their health care provider can impact treatment acceptance and patient compliance. The purpose of this study was to explore whether dental hygienists' hairstyle, clinic attire, and accessories affected patients' and dental student providers' perceptions of professionalism and the role gender plays in these perceptions.Methods: Survey data were collected from adult patients and dental student providers from a dental school in the Midwestern United States. Study participants rated the professional qualities of male and female dental hygienists photographed with professional versus unprofessional/ less-traditional hairstyles, clinic attire, and accessories. Descriptive and inferential statistics were used to analyze the data.Results: A total of 402 patients (n=402) and 318 first- and second-year dental students (n=318) consented to participate. Both male and female dental hygienists pictured with less-traditional hairstyles were rated as less professional than clinicians with professional hairstyles on a scale from 1="not at all professional" to 7="very professional (5.28 vs. 6.04; p<.001). Males with less-traditional hairstyles (mean=4.74; p<.001) received the most negative ratings. Dental student providers rated female clinicians with less-traditional hairstyles least positively, while the patients rated male providers with non-traditional hairstyles least positively.Conclusions: Hairstyle, in both male and female dental hygienists, was viewed as a physical characteristic influencing perceptions of professionalism among patients and dental students. Overall, male clinicians were evaluated more negatively than females. Gender was not shown to affect the study participants' perceptions of professionalism.
Collapse
|
44
|
Abstract
PURPOSE To understand the perceptions of patients with cancer regarding the role and purpose of a survivorship care plan (SCP) to inform content and delivery opportunities. PARTICIPANTS & SETTING A mixed-methods evaluation was conducted among patients at a survivorship clinic for high-risk survivors of sarcomas in an academic medical center. METHODOLOGIC APPROACH An electronic survey was administered, followed by qualitative telephone interviews. FINDINGS 51 surveys were delivered, and 23 surveys were completed. Eight telephone interviews were completed. Content analysis revealed that participants value the SCP as a health management tool to address information needs and reduce fear of recurrence. Few participants shared their SCP with other healthcare providers. IMPLICATIONS FOR NURSING Patients use their SCP as a health management tool to understand the details of their cancer history and treatment and to manage their health concerns. Nurses who care for patients with cancer are well positioned to use the SCP as a patient education tool.
Collapse
|
45
|
Haw NJL. Utilization of the Ghana National Health Insurance Scheme and its association with patient perceptions on healthcare quality. Int J Qual Health Care 2019; 31:485-491. [PMID: 30165414 DOI: 10.1093/intqhc/mzy185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 07/14/2018] [Accepted: 08/03/2018] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To determine the association between the utilization of the Ghana National Health Insurance Scheme (NHIS) and patient perceptions of quality of care. METHODS Ghana Demographic and Health Survey (GDHS) 2014 had 19 questions on perceptions of quality of care received during the last reported health visit (n = 4332). These questions were summarized into an overall 100-point perception score using item response theory (IRT). Patients were divided into three utilization categories: those paying with their NHIS card fully, those paying with their card and out-of-pocket (OOP), and those paying fully OOP. A multiple linear regression model was used to measure the association between NHIS utilization and overall perception. RESULTS In general, NHIS utilization was negatively associated with overall perception, and the difference across utilization categories was higher among private facility users than public facility users. Among private facilities, those who paid fully with NHIS reported five points lower than those who paid fully OOP (P = 0.005). Among public facilities, the difference is only 1.7 (P = 0.4342). CONCLUSION NHIS utilization was a negative predictor for patient perceptions, but the differences are more nuanced according to type of facility. Future GDHS rounds should continue measuring perceptions in aid of policy to improve service delivery under the NHIS.
Collapse
Affiliation(s)
- Nel Jason L Haw
- Department of International Health, School of Nursing and Health Studies, Georgetown University, Washington, DC, USA
| |
Collapse
|
46
|
Bargon CA, Zale EL, Magidson J, Chen N, Ring D, Vranceanu AM. Factors Associated With Patients' Perceived Importance of Opioid Prescribing Policies in an Orthopedic Hand Surgery Practice. J Hand Surg Am 2019; 44:340.e1-340.e8. [PMID: 30122303 DOI: 10.1016/j.jhsa.2018.06.118] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 05/18/2018] [Accepted: 06/29/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE The purpose of this study was to survey the attitudes and beliefs about opioids and opioid prescribing policies among patients presenting to an orthopedic hand surgery practice. METHODS Patients (n = 118; median age, 49 years) who presented to their regularly scheduled appointment at a major urban university medical center completed surveys assessing their sociodemographic and clinical characteristics, beliefs about prescription opioids, beliefs about opioid prescribing policies, and perceived importance of opioid prescribing policies in the department. RESULTS Many patients were aware of potential risks of opioids (eg, 80% are aware of addictive properties) and would support opioid prescribing policies that aim to decrease opioid misuse and diversion. However, a small but important number of patients have concerning beliefs about prescription opioids (eg, 28% believe opioids work well for long-term pain) or believe that doctors should prescribe "as much medication as the patient needs" (7%). The vast majority (98%) indicated that they would like more education on opioids and that information about prescription opioids should be provided to all patients in orthopedic practices. Patients with higher educational attainment reported a greater perceived importance of opioid prescribing policies. CONCLUSIONS The results of this study suggest that opioid prescribing strategies that promote safe and effective alleviation of pain and optimal opioid stewardship will be well received by patients. CLINICAL RELEVANCE Efforts to develop and test the effects of opioid prescribing policies and nonopioid pain relief strategies on opioid prescribing are merited.
Collapse
Affiliation(s)
- Claudia Antoinette Bargon
- Orthopaedic Hand Service, Harvard Medical School, Massachusetts General Hospital, Boston, MA; University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Emily L Zale
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA
| | - Jessica Magidson
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA
| | - Neal Chen
- Orthopaedic Hand Service, Harvard Medical School, Massachusetts General Hospital, Boston, MA
| | - David Ring
- Orthopaedic Hand Service, Harvard Medical School, Massachusetts General Hospital, Boston, MA; Dell Medical School, The University of Texas, Austin, TX
| | - Ana-Maria Vranceanu
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA.
| |
Collapse
|
47
|
Liu SY, Lu L, Pringle D, Mahler M, Niu C, Charow R, Tiessen K, Lam C, Halytskyy O, Naik H, Hon H, Irwin M, Pat V, Gonos C, Chan CWT, Villeneuve J, Shani RM, Chaudhry M, Brown MC, Selby P, Howell D, Xu W, Alibhai SMH, Jones JM, Liu G, Eng L. Impact of immigration status on health behaviors and perceptions in cancer survivors. Cancer Med 2019; 8:2623-2635. [PMID: 30897287 PMCID: PMC6537043 DOI: 10.1002/cam4.2079] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 01/29/2019] [Accepted: 02/13/2019] [Indexed: 11/20/2022] Open
Abstract
Background Health behaviors including smoking cessation, physical activity (PA), and alcohol moderation are key aspects of cancer survivorship. Immigrants may have unique survivorship needs. We evaluated whether immigrant cancer survivors had health behaviors and perceptions that were distinct from native‐born cancer survivors. Methods Adult cancer patients from Princess Margaret Cancer Centre were surveyed on their smoking, PA, and alcohol habits and perceptions of the effects of these behaviors on quality of life (QoL), 5‐year survival, and fatigue. Multivariable models evaluated the association of immigration status and region‐of‐origin on behaviors and perceptions. Results Of the 784 patients, 39% self‐identified as immigrants. Median time of survey was 24 months after histological diagnosis. At baseline, immigrants had trends toward not meeting Canadian PA guidelines or being ever‐drinkers; patients from non‐Western countries were less likely to smoke (aORcurrent = 0.46, aORex‐smoker = 0.47, P = 0.02), drink alcohol (aORcurrent = 0.22, aORex‐drinker = 0.52, P < 0.001), or meet PA guidelines (aOR = 0.44, P = 0.006). Among immigrants, remote immigrants (migrated ≥40 years ago) were more likely to be consuming alcohol at diagnosis (aOR = 5.70, P < 0.001) compared to recent immigrants. Compared to nonimmigrants, immigrants were less likely to perceive smoking as harmful on QoL (aOR = 0.58, P = 0.008) and survival (aOR = 0.56, P = 0.002), and less likely to perceive that PA improved fatigue (aOR = 0.62, P = 0.04) and survival (aOR = 0.64, P = 0.08). Conclusions Immigrants had different patterns of health behaviors than nonimmigrants. Immigrants were less likely to perceive continued smoking as harmful and were less likely to be aware of PA benefits. Culturally tailored counselling may be required for immigrants who smoke or are physically sedentary at diagnosis.
Collapse
Affiliation(s)
- Sophia Y Liu
- Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Hospital/University Health Network and University of Toronto, Toronto, ON, Canada
| | - Lin Lu
- Department of Biostatistics, Princess Margaret Cancer Centre/University Health Network and University of Toronto, Toronto, ON, Canada
| | - Dan Pringle
- Ontario Cancer Institute, Toronto, ON, Canada
| | - Mary Mahler
- Ontario Cancer Institute, Toronto, ON, Canada
| | - Chongya Niu
- Ontario Cancer Institute, Toronto, ON, Canada
| | | | | | | | | | - Hiten Naik
- Ontario Cancer Institute, Toronto, ON, Canada
| | | | | | - Vivien Pat
- Ontario Cancer Institute, Toronto, ON, Canada
| | | | | | | | | | - Maha Chaudhry
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | | | - Peter Selby
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada.,Departments of Family and Community Medicine and Psychiatry, University of Toronto, Toronto, ON, Canada
| | | | - Wei Xu
- Department of Biostatistics, Princess Margaret Cancer Centre/University Health Network and University of Toronto, Toronto, ON, Canada.,Ontario Cancer Institute, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Shabbir M H Alibhai
- Department of Medicine, University Health Network and University of Toronto, Toronto, ON, Canada
| | - Jennifer M Jones
- Ontario Cancer Institute, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Cancer Rehabilitation and Survivorship Program, Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Geoffrey Liu
- Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Hospital/University Health Network and University of Toronto, Toronto, ON, Canada.,Department of Biostatistics, Princess Margaret Cancer Centre/University Health Network and University of Toronto, Toronto, ON, Canada.,Ontario Cancer Institute, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Lawson Eng
- Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Hospital/University Health Network and University of Toronto, Toronto, ON, Canada.,Ontario Cancer Institute, Toronto, ON, Canada.,Department of Medicine, University Health Network and University of Toronto, Toronto, ON, Canada
| |
Collapse
|
48
|
Adelani MA, Barrack RL. Patient Perceptions of the Safety of Outpatient Total Knee Arthroplasty. J Arthroplasty 2019; 34:462-464. [PMID: 30579713 DOI: 10.1016/j.arth.2018.11.030] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 11/13/2018] [Accepted: 11/26/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Outpatient total joint arthroplasty is considered safe in a selected group of patients, based primarily on complications. However, patient perception of the safety of outpatient total joint arthroplasty is unknown. This study assesses patient perceptions of the potential benefits of and barriers to outpatient total knee arthroplasty among a cohort of patients who have recently undergone the procedure. METHODS Patients who underwent unilateral primary total knee arthroplasty between March 1, 2017, and September 30, 2017 at our institution were given a questionnaire, in which they were asked about prior knowledge regarding outpatient total knee arthroplasty, their perceived ability to undergo the procedure as an outpatient, and their perceived risks and benefits to outpatient surgery. RESULTS Three hundred forty-six patients completed the survey. Over 70% of patients did not think that they would be able to undergo total knee arthroplasty as an outpatient. Their primary concerns were pain, being able to go to the bathroom, and falls. CONCLUSIONS Patients in this study largely would not feel safe undergoing total knee arthroplasty on an outpatient basis. Payers should not only take into account existing literature but also the concerns and perceived needs of patients, before encouraging widespread implementation of outpatient total knee arthroplasty.
Collapse
Affiliation(s)
- Muyibat A Adelani
- Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, MO
| | - Robert L Barrack
- Department of Orthopaedic Surgery, Washington University School of Medicine, Saint Louis, MO
| |
Collapse
|
49
|
Cosson E, Mauchant C, Benabbad I, Le Pape G, Le Bleis M, Bailleul F, Lalau JD. Perceptions of insulin therapy in people with type 2 diabetes and physicians: a cross-sectional survey conducted in France. Patient Prefer Adherence 2019; 13:251-260. [PMID: 30804666 PMCID: PMC6375534 DOI: 10.2147/ppa.s181363] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To evaluate perceptions of people with type 2 diabetes (T2D) and treating physicians living in France toward insulin therapy. METHODS Adults with T2D receiving oral glucose-lowering treatment alone (INS-) or basal insulin for ≥2 months (INS+) completed an online cross-sectional survey comprising 39 questions, including some regarding perceptions and fears of insulin therapy. Physicians were interviewed by telephone using eleven similar questions. The survey was designed by French clinicians experienced in treating diabetes and conducted under the auspices of an independent market-research agency. RESULTS The questionnaire was completed by 590 adults with T2D (two-thirds INS+) and 130 physicians (65 diabetologists/endocrinologists, 65 general practitioners). INS+ adults reported fewer negative feelings and more positive feelings than INS- adults. Two-thirds of INS+ adults reported that transitioning to insulin therapy was less difficult than expected. Overall, 44% of INS+ adults and 26% of physicians reported a fear of diabetic complications as being important, and 80% of physicians and 21% of INS+ adults considered injections to be a major patient fear. CONCLUSION Most people with T2D reported that transitioning to insulin therapy was less difficult than they had feared. People with T2D and physicians exhibited differing perceptions regarding the transition. Reasons for the apprehension surrounding the transition to insulin therapy in people with T2D need to be better identified. Support from insulin-treated peers may enable this transition to occur with fewer anxieties in insulin-naïve people with T2D.
Collapse
Affiliation(s)
- Emmanuel Cosson
- Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Jean Verdier Hospital, Paris 13 University, Sorbonne Paris Cité, AP-HP, Bondy, Paris, France,
- Nutritional Epidemiology Research Unit, UMR U1153 INSERM/U11125 INRA/CNAM/Paris 13 University, Bobigny, Paris, France,
| | | | | | | | | | | | - Jean-Daniel Lalau
- Department of Endocrinology-Diabetology-Nutrition, Amiens University Medical Center, Amiens, France
- PériTox Laboratory (UMR-I 01), Jules Verne University of Picardy, Amiens, France
| |
Collapse
|
50
|
Abstract
It is acknowledged that the needs of persons living with dementia admitted in acute hospitals are not always met. Previous studies have focused on the perceived needs of professional caregivers or family members whilst the voices of patients with dementia in acute hospitals have not been extensively reported. This may have contributed to the under-recognition of the needs of persons living with dementia. The aim of this study was to categorise the perceived and observed needs of persons with dementia admitted in acute medical wards and to explore whether these needs are being or have been met. Thirteen people with dementia in three medical wards, who could verbally communicate with the researcher, were purposively selected as research participants. Semi-structured interviews were conducted to elicit each participant's experiences of their hospital stay and whether their needs were perceived to have been/are being met. Moreover, routine care with the same participants was observed using Dementia Care Mapping. Maslow's Hierarchy of Needs was used as a framework to categorise care needs. Our findings demonstrate that basic needs such as toileting, feeding, drinking, continence and comfort were not always met. Moreover, the largest gap between met and unmet needs was found in patients who were either under constant observation or unable to communicate. Too much emphasis was perceived and observed to be given on what staff considered as safety needs at the expense of other needs. The patients' need for social contact and self-esteem such as dignity and respect were often ignored and this led to patients feeling devalued. Hospital staff have to be more aware of the holistic needs of patients with dementia in acute settings and the way care is delivered in order to make up for these unmet needs, thus facilitating person-centred care.
Collapse
Affiliation(s)
- Anthony Scerri
- Department of Nursing, Faculty of Health Sciences, University of Malta, Malta
| | - Charles Scerri
- Department of Pathology, Faculty of Medicine and Surgery, University of Malta, Malta
| | - Anthea Innes
- Faculty of Social Sciences, University of Stirling, Salford Institute for Dementia, University of Salford, Manchester, UK
| |
Collapse
|