Perceptions and satisfaction of patients with chronic heart failure when using a remote monitoring web application named Satelia® Cardio

INTRODUCTION

The use of telehealth, such as remote patient monitoring (RPM), for chronic heart failure (CHF) impacts patient pathways. Patient-centricity in chronic disease management is valuable. Even though RPM is recommended in practice, the evaluation of patient satisfaction has been limited to date. The objective of this study was to assess the perceptions and satisfaction of patients with CHF when using RPM.

METHODS

A voluntary declarative survey was conducted with users of Satelia® Cardio, an RPM web application which was included in an experimental model program in France funded by the ETAPES program initiative sponsored by the French Ministry of Health. Monitoring was based on patient-reported outcomes (seven questions on symptoms, one question on weight) which were answered online (digitally literate patients) or by phone with a nurse (patients with poor digital literacy). The survey included questions on perceived usefulness, ease of use and impact on quality of life (QoL).

RESULTS

Overall, 87% of the 825 patients were satisfied with having their CHF digitally monitored. Patients found that the application was easy to use (94%), problem free (95%), provided well-timed notifications (98%), easily accessible (96.5%), understandable (89%), and did not require an unreasonable amount of time to answer questions (99%). Most patients felt that RPM helped physicians provide better care during their follow-ups (70%, mean score: 7.98/10) and 45% of the digitally literate patients indicated an improved QoL.

CONCLUSION

Poor digitally literate patients may need human-based or assisted RPM. Patients monitored daily for CHF through RPM expressed strong satisfaction and acceptance.

Patients' perception of the quality of care at the Ibn Al Jazzar University Hospital in Kairouan, Tunisia

AIM

This study aims to evaluate the level of satisfaction of patients hospitalized at Ibn Al Jazzar University Hospital of Kairouan in 2018.

METHODS

It's a descriptive cross-sectional study including all patients hospitalized at Ibn Al Jazzar University Hospital in Kairouan over a period of three months, from January 1 to March 31, 2018. The survey was conducted using a questionnaire made up of 27 items to explore seven specific dimensions of satisfaction.

RESULTS

A total of 640 patients was included in the study. The overall satisfaction rate was 41.7%. The dimensions of globality and hospital stay were the least appreciated by hospitalized patients with respective satisfaction rates of 14.4% and 18.3%. Access to care was the most appreciated area with a satisfaction rate of 58.9%. the lowest satisfaction rates, among the items studied at the Kairouan University Hospital in 2018 were: «the places of visits» (9%), «the quality of the catering» (20%), « tranquillity" (23%), and "attentiveness of staff to patient needs" (23%).

CONCLUSION

At Ibn Al Jazzar University hospital of Kairouan, patient satisfaction was low regarding the quality of the services provided, particularly for areas related to the conditions of stay and the globality of care. Intervention measures based on these shortcomings should be undertaken.

Diabetic patient satisfaction on the quality of outpatient health care services

AIM

To assess the degree of satisfaction of diabetic patients with health care services and to determine the factors that influence it.

METHODS

It was a cross sectional study conducted in 2018 among diabetic outpatients of the department of endocrinology of the university hospital La Rabta. Patients general characteristics were noted. Each patient responded to a questionnaire, asked orally, in Tunisian dialect, by two physicians, about health care services including 20 questions grouped into three items. Each question was scored from 1 to 4 according to the degree of satisfaction. The global score as well as the scores of the items were calculated by adding the scores of the corresponding questions.

RESULTS

150 diabetic patients responded to the questionnaire; mean age: 58.9±12.2 years [18-88], sex-ratio: 0.51. Cronbach coefficient was 0.78. The overall score was 62.2±6.5 [46-80]. Ninety-seven patients (64.7%) had a score ≥60. The item concerning 'human contact and communication' was considered good in 98% of cases. The item concerning 'premises, cleanliness, comfort and safety' was considered intermediate in 64% of cases. Patients were very satisfied with the accessibility of the department inside the hospital (76.7%), the attitude of the agents during the administrative formalities (74%) and particularly the behaviour of the doctor (96%). However, they were dissatisfied with the noise (72%) and overcrowding (67.4%) of the waiting room. There were no statistically significant associations between the overall score and the studied data.

CONCLUSION

The diabetic patients were overall satisfied with the provided services. Actions must be taken to reduce overcrowding and long waiting times.

[The effect of therapeutic communication when washing patients]

There is a close link between care and communication. The purpose of the study is to evaluate therapeutic communication when bed washing patients, which dependent patients may experience as an aggressive treatment. Improved comfort, improved serenity, less intense pain, lower pulse and blood pressure have been observed in patients looked after by caregivers practising therapeutic communication.

L'infirmière pivot associée à une expérience de soins oncologiques positive et à une satisfaction accrue des patients

Contexte et objectifs

Un nombre croissant de résultats probants indique que l'infirmière pivot en oncologie (IPO) joue un rôle de premier plan dans l'optimisation des processus et des résultats de soins. Il faudra toutefois mener des études d'envergure pour comparer les perceptions de l'expérience de soins liés au cancer des patients traités par des infirmières pivots et de ceux qui n'ont pas bénéficié de ce type de suivi.

Méthodologie

Des participants (N = 2 858) traités au cours des six derniers mois dans un centre de traitement du cancer situé à Montréal, au Québec, et affilié à une université ont répondu au sondage sur la satisfaction des patients en traitement anticancéreux ambulatoire, c'est-à-dire le Ambulatory Oncology Patient Satisfaction Survey (AOPSS).

Résultats

L'expérience des soins oncologiques était significativement plus positives et la satisfaction plus élevée dans le groupe suivi par une infirmière pivot (n = 2 003) pour les six domaines de soins (différences moyennes de 3,32 à 8,95) et les quatre fonctions infirmières (différences moyennes de 5,64 à 10,39), comparativement au groupe sans IPO (n = 855).

Discussion

L'infirmière pivot joue un rôle important dans l'amélioration de l'expérience de soins et la satisfaction des patients. Les recherches futures devront explorer les potentielles relations de cause à effet entre les infirmières pivots, les processus de soins et les résultats des patients.

[Patients' satisfaction survey after tranvesical prostatectomy in the urology department of Gabriel Touré University Hospital]

AIM

This study was aimed to evaluate patients' satisfaction with tranvesical prostatectomy in the Urology department of University Hospital Gabriel Touré according to the (International Prostate Symptoms Score (IPSS) and the quality of life scores.

PATIENTS AND METHODS

We conducted a prospective descriptive study over a 12-month period including a consecutive cohort of patients who had transvesical prostatectomy. Each patient was evaluated before and six weeks after the surgery. We used the IPSS as an assessment tool, supplemented by the Quality of Life (SQ) questionnaire.

RESULTS

One hundred and thirteen (113) patients aged 71 ± 8 years old on average were evaluated. The mean duration of symptoms associated with benign prostatic hyperplasia was 19 months and 17% of patients had a mechanical complication. All patients had either moderate or severe lower urinary tract symptoms preoperatively, while 99% of them had an IPSS score <8 postoperatively.

CONCLUSION

Transvesical prostatectomy allows an important improvement of the IPSS score of the patients and their satisfaction about their quality of life.

TITRATION: A Randomized Study to Assess 2 Treatment Algorithms with New Insulin Glargine 300 units/mL

OBJECTIVE

It was uncertain whether an algorithm that involves increasing insulin dosages by 1 unit/day may cause more hypoglycemia with the longer-acting insulin glargine 300 units/mL (GLA-300). The objective of this study was to compare safety and efficacy of 2 titration algorithms, INSIGHT and EDITION, for GLA-300 in people with uncontrolled type 2 diabetes mellitus, mainly in a primary care setting.

METHODS

This was a 12-week, open-label, randomized, multicentre pilot study. Participants were randomly assigned to 1 of 2 algorithms: they either increased their dosage by 1 unit/day (INSIGHT, n=108) or the dose was adjusted by the investigator at least once weekly, but no more often than every 3 days (EDITION, n=104). The target fasting self-monitored blood glucose was in the range of 4.4 to 5.6 mmol/L.

RESULTS

The percentages of participants reaching the primary endpoint of fasting self-monitored blood glucose ≤5.6 mmol/L without nocturnal hypoglycemia were 19.4% (INSIGHT) and 18.3% (EDITION). At week 12, 26.9% (INSIGHT) and 28.8% (EDITION) of participants achieved a glycated hemoglobin value of ≤7%. No differences in the incidence of hypoglycemia of any category were noted between algorithms. Participants in both arms of the study were much more satisfied with their new treatment as assessed by the Diabetes Treatment Satisfaction Questionnaire. Most health-care professionals (86%) preferred the INSIGHT over the EDITION algorithm. The frequency of adverse events was similar between algorithms.

CONCLUSIONS

A patient-driven titration algorithm of 1 unit/day with GLA-300 is effective and comparable to the previously tested EDITION algorithm and is preferred by health-care professionals.

[Patient satisfaction, an important part of care: case of a surgical department in Niger]

INTRODUCTION

The aim of this study was to assess patient satisfaction in the surgical emergencies department at the National Hospital of Zinder, Niger.

MATERIALS AND METHOD

This was a cross-sectional study focusing on patients admitted to the surgical emergency department of the National Hospital of Zinder (NHZ). The study was conducted over a period of 2 month - from July 1^st to August 31^st, 2015. During a face to face interview, patients were asked a series of questions.

RESULTS

Of the 227 patients surveyed, 54.62% (n=124) were satisfied with their experience of the surgical emergencies department. The main factors associated with high satisfaction scores were patient reception (OR: 0.27, 95% CI=0.14 to 0.52; p <0.001), and the management of symptoms (OR: 0.28, 95 % CI=from 0.14 to 0.58; p < 0.001). Dissatisfaction factors were: waiting time before receiving treatment (OR 16.57, 95% CI=8.52 to 32.23; P <0.0001), the environment (OR: 3.89, 95% CI=2.12 to 7.12; p <0.001), accessibility (OR: 5.85, 95% CI=2.54 to 13.46, p < 0.001) and poor staff-patient communication (OR, 13.76; 95% CI 6.54 to 28.98; P <0.0001).

CONCLUSION

Despite the shortcomings of the surgical emergencies department of NHZ, a good welcome and prompt patient management have been the key components associated with patient satisfaction.

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Zusammenfassung. Ziel der onkoplastischen Chirurgie ist es, durch Verbindung von onkologisch sicherer Chirurgie und rekonstruktiven plastisch chirurgischen Techniken auch grössere Tumoren brusterhaltend operieren zu können. Durch innovative Techniken wird der ästhetische Outcome verbessert mit dem Ziel die Patientinnenzufriedenheit und Lebensqualität hoch zu halten, möglichst ohne deformierende Resultate als Folge der Brustkrebsbehandlung. Gemäss Patientinnenwunsch kann in der selben Operation die Gegenseite symmetrisierend angeglichen werden, ohne dass für die Patientinnen Kosten entstehen. Onkoplastik ist genauso sicher wie konventionelle brusterhaltende Chirurgie. Es gibt jedoch Hinweise für häufigere postoperative Komplikationen, am ehesten zurückzuführen auf anspruchsvollere Techniken und längere Operationszeit. Letztere führen jedoch nicht zu einer Verzögerung der adjuvanten Therapie. Um die vielfältigen neuen Techniken zu standardisieren, wurde Anfang 2017 in Basel ein sehr erfolgreiches internationales Expertentreffen abgehalten, dessen Resultate hier ebenfalls erläutert werden sollen.

[Comparison of management of ambulatory emergency patients in the family practice and the hospital emergency center]

The increase in health care cost is broadly discussed in the public, either in the hospital or ambulatory setting. With the present study we compared the invoice amount generated by a first doctor's advice in the general practitioner to the one in the emergency room. In addition, we compared the diagnostic procedures used in the general practice to the one in the hospital, and whether the choice of diagnostic procedures would substantially influence the invoice amount. The invoice amount in the hospital setting was on average CHF 197.-, i. e. 134%, higher compared to the general practice. The difference in the invoice amount was largely explained by more diagnostic procedures in the hospital. Moreover, part of the higher invoice amount was generated by the extensive physical examination by doctors in the hospital.