Participation in Social Roles of Adolescents With Cerebral Palsy: Exploring Accomplishment and Satisfaction

Objective

To explore participation in social roles of adolescents (aged 12-18y) with cerebral palsy (CP), in terms of satisfaction compared with accomplishment.

Design

Cohort study as part of a prospective longitudinal research program.

Setting

Clinic.

Participants

Participants were adolescents (N=45; 58% male, mean age 15y 6mo) with CP at levels I-II (88%) and III-IV-V (12%) of the Gross Motor Function Classification System.

Interventions

Not applicable.

Main Outcome Measures

Accomplishment (0-9 scale; with score <8 “having difficulties”) and satisfaction (1-5 scale; with score 3 “neutral”) were assessed using the Life-Habits questionnaire, on 6 domains (Responsibilities, Interpersonal relationships, Community life, Education, Employment, Recreation). Per domain, we analyzed scatterplots of accomplishment vs satisfaction. Additionally, we compared determinant-models (including factors of CP, activity, person, and environment) using regression analysis.

Results

For accomplishment, mean scores were <8.00 except for Interpersonal relationships. For satisfaction, mean scores varied between 3.85 and 4.34. Overall, individuals with similar levels of accomplishment showed large ranges in their levels of satisfaction, which was expressed by low explained variances, especially on Education (6%). Furthermore, different sets of determinants were found for accomplishment (predominantly CP factors) compared with satisfaction (predominantly environment factors).

Conclusions

This study revealed a dissociation between participation accomplishment and satisfaction with participation among adolescents with CP. For practice and research, we recommend not only to focus on accomplishment but also, if not mainly, on satisfaction.

Descriptive study of the satisfaction of nursing degree students in high-fidelity clinical simulation practices

OBJECTIVE

To describe the level of satisfaction of nursing students with clinical simulation in their undergraduate training.

METHOD

a descriptive observational study of a retrospective cross section was conducted in undergraduate students in Nursing during the academic years 2016-17 and 2017-18. The instrument used was the High Fidelity Clinical Simulation satisfaction scale in students (ESSAF), a validated, anonymous and self-administered questionnaire (alpha .857) to measure the level of satisfaction after high-fidelity clinical simulation practices.

RESULTS

Data were collected from a total of 269 students, of which 63.3% were women and the average age of the sample was 21.68±13.46 years. The analysis of frequencies shows results of the grade of satisfaction over 89%, especially in decision-making, the ability to prioritize and learning procedures. Of the answers, 87% exceeded an average of 4 out of 5. The questions in the questionnaire with answers higher than 4.6 were the realism of the cases (4.71), the teacher provides constructive feedback after each session (4.65), the simulation relates theory to practice (4.72), the analysis (debriefing) at the end of the session helps reflection on the cases (4.65) and practical utility (4.69).

CONCLUSIONS

Nursing students from the University of Cantabria (Spain) report high satisfaction in high fidelity clinical simulation, confirming its usefulness in the learning process.

Psychometric validation of the Chinese patient- and family satisfaction in the intensive care unit questionnaires

PURPOSE

To assess the psychometric properties of the Chinese version of the 23-item Patient Satisfaction in the Intensive Care Unit (PS-ICU-23) and 24-item Family Satisfaction in the Intensive Care Unit (FS-ICU-24) questionnaires.

MATERIALS AND METHODS

Patients (n = 243) discharged from an intensive care unit (ICU) in Hong Kong and family members (n = 237) completed the translated questionnaires. We used confirmatory factor analysis to assess the construct validity and measurement equivalence across groups (gender, mechanical ventilation, casemix, length of stay in ICU), coefficient alpha for internal consistency (reliability) and concordance correlation coefficient (ρ_c) for agreement between patients' and family members' perspective on satisfaction.

RESULTS

A three-factor model provided a better fit than the two-factor model for both PS-ICU-23 and FS-ICU-24 questionnaires. Factorial equivalence was present across groups in both questionnaires. Internal consistency was adequate for PS-ICU-23 (coefficient alpha overall domain 0.85; care subscale, 0.83; information subscale, 0.90; decision-making process subscale, 0.67) and for FS-ICU-24 (coefficient alpha overall scale 0.86; care subscale, 0.84; information subscale, 0.89; decision-making process subscale, 0.65). Overall ICU satisfaction agreement was moderate (0.40).

CONCLUSIONS

Both Chinese PS-ICU-23 and FS-ICU-24 questionnaires have sound psychometric properties but family satisfaction may not be a good proxy for patient satisfaction in ICU.

Mobile Web-based Education: Engagement and Satisfaction with HiChart among Pregnant Women

PURPOSE

This study aimed to examine engagement and satisfaction with a mobile web-based education program (HiChart) among pregnant women.

METHODS

A cross-sectional descriptive study was conducted of 97 pregnant women hospitalized for obstetric care. Data were collected from October 1 to November 30, 2016, and were analyzed with descriptive statistics.

RESULTS

Among participants, 16.5% engaged fully with HiChart, while 43.3% engaged partially. The overall satisfaction with HiChart was high. Some main reasons for not engaging with the education were participants' unawareness of the text messages, lack of time, and poor internet connection. The participants suggested that more educational content needed to be covered, such as coping with infant emergencies and information about the neonatal intensive care unit.

CONCLUSION

To increase pregnant women's engagement with mobile web-based education, efforts are needed to strengthen the system of sending text messages as part of mobile web-based education to all patients, to inform pregnant women that an educational web link was sent, and to encourage them to engage with mobile web-based education. Furthermore, it is essential to improve the HiChart service by providing educational content corresponding to users' needs.

Influencing Factors of Sexual Intimacy and Satisfaction among Women within 1 Year after Mastectomy

PURPOSE

The purpose of this study was to identify the levels of body image, sexual intimacy, and sexual satisfaction, and to explore factors affecting sexual intimacy and satisfaction among women within one year of mastectomy.

METHODS

The present study was a cross-sectional survey and involved 101 women who had undergone mastectomy at a University hospital of D city, Korea. Measurement included the scales of body image, sexual intimacy, and sexual satisfaction.

RESULTS

Mean age of the subjects was 51 years. Scores of the body image, sexual intimacy, and sexual satisfaction were 59.62, 90.69, and 69.04, respectively. Body image, sexual intimacy, and sexual satisfaction were significantly related to each other. Sexual intimacy was higher when women were of young age (β=-.32), had a shorter period since surgery (β=-.24), and with higher levels of body image (β=.37). Sexual satisfaction was higher when women had higher levels of body image (β=.19) and greater levels of sexual intimacy (β=.74).

CONCLUSION

Higher levels of body image and greater levels of sexual intimacy were identified as the significant factors influencing sexual satisfaction among these women. Future research with a mixed-method research is needed to gain a deep understanding of the sexuality between women and their husbands.

Effect of a Social Support Program for Mothers of Children with Precocious Puberty: A Preliminary Quasi-Experimental Study

PURPOSE

The purpose of this study was to evaluate the effects of a social support program on the stress, anxiety, guilt, and life satisfaction levels among Korean mothers of children with precocious puberty.

DESIGN AND METHODS

A non-equivalent control group and a non-synchronized design were used in this quasi-experiment study. Thirty-four mothers (divided into equal-sized experimental and control groups), 32-47 years of age, with children aged 6-11 years old, were recruited from a pediatric outpatient department at a national university hospital. The experimental group was involved in four sessions of a 4-week social support program. Descriptive statistics were used for demographic characteristics. Chi-square tests and t-tests were used to evaluate group differences.

RESULTS

The program significantly reduced mothers' stress and guilt and significantly increased their life satisfaction. No significant differences in changes in anxiety were reported between the groups.

CONCLUSIONS

This study confirms that the social support program was a useful nursing intervention for Korean mothers of children with precocious puberty, which can be extensively applied to help mothers in similar situations.

PRACTICE IMPLICATIONS

The preliminary study findings may inform healthcare professionals to develop effective interventions to promote psychosocial well-being of mothers of children with precocious puberty through strengthening their social support and to further improve the quality of life of children with precocious puberty and their families.

The effect of an animation video on consultation time, anxiety and satisfaction in women with abnormal cervical cytology: Animation video reduces colposcopy time

The objective was to assess whether supplementing hospital-dependent standard information with a hospital-independent animation video might reduce consultation time, pre-colposcopy anxiety levels and increase post-colposcopy satisfaction. Between November 2016 and May 2018, women were included if they were referred to the department of Obstetrics and Gynaecology in one of the three participating hospitals in the Netherlands due to an abnormal cervical smear. Exclusion criteria were colposcopy in the medical history or inability to understand, speak or read Dutch. Two consecutive cohorts were created: a control group that received standard information and an intervention group that received the same plus the animation video. Outcome measures were consultation time, pre-colposcopy anxiety level and post-colposcopy satisfaction. Consultation time was measured using stopwatch. Anxiety was measured using the State-Trait Anxiety Inventory (STAI) and the Hospital Anxiety and Depression Scale (HADS). Satisfaction was measured with the Patient's Experience and Attitude Colposcopy Eindhoven questionnaire (PEACE-q). In total, 122 women were included, 61 in each group. Baseline characteristics were similar between the two groups. Pre-colposcopy consultation time was significantly reduced in the intervention group (median 140 s) compared to the control group (median 269 s). However, overall consultation time was not reduced. The outcome measures anxiety and satisfaction were not significantly different. A hospital-independent animation video did significantly reduced pre-colposcopy consultation time but did not reduce anxiety or increase satisfaction in women with abnormal cervical cytology. Further research should focus on the effects of animation video in a primary care setting.

The relationship of individual examinee characteristics and acceptability of smart device-based testing to test score in the practice test of the Korea Emergency Medicine Technician Licensing Examination

PURPOSE

Smart device-based testing (SBT) began to be introduced in the Republic of Korea's high-stakes examination system, starting with the Korea Emergency Medicine Technician Licensing Examination (KEMTLE) in December 2017. In order to minimize how variation in examinees' environment may affect the test score, it aimed to identify any variables related to individual characteristics and acceptability that are related to the examinees' test scores in the SBT practice test.

METHODS

Out of 569 candidate students who were administered the KEMTLE on September 12, 2015, 560 students responded to the survey questionnaire on the acceptability of SBT after the examination. The questionnaire addressed 8 individual characteristics: 2 satisfaction, 9 convenience, and 9 preference items. Comparison analysis between individual variables was performed. Furthermore, generalized linear model (GLM) analysis to find the effect of individual characteristics and acceptability of SBT on test score were conducted.

RESULTS

Among those who preferred SBT compared to paper-and-pencil testing, test scores were higher for male participants (M=4.36, SD=0.72) than for female participants (M=4.21, SD=0.73). According to GLM, no variables evaluated, including gender, experiences of CBT(Computer based test), SBT, and using a tablet PC, were statistically significantly different by total score, scores on multimedia items, or scores on text items.

CONCLUSION

The variables of individual characteristics and acceptability of SBT did not affect the SBT practice test scores of emergency medicine technician students in Korea. Adoption of SBT for the KEMTLE should be possible to execute without interference from the variables examined in this study.

Statistical analysis plan for a cluster-randomized crossover trial comparing the effectiveness and safety of a flexible family visitation model for delirium prevention in adult intensive care units (the ICU Visits Study)

BACKGROUND

Most adult intensive care units (ICUs) worldwide adopt restrictive family visitation models (RFVMs). However, evidence, mostly from non-randomized studies, suggests that flexible adult ICU visiting hours are safe policies that can result in benefits such as prevention of delirium and increase in satisfaction with care. Accordingly, the ICU Visits Study was designed to compare the effectiveness and safety of a flexible family visitation model (FFVM) vs. an RFVM on delirium prevention among ICU patients, and also to analyze its potential effects on family members and ICU professionals.

METHODS/DESIGN

The ICU Visits Study is a cluster-randomized crossover trial which compares an FFVM (12 consecutive ICU visiting hours per day) with an RFVM (< 4.5 ICU visiting hours per day) in 40 Brazilian adult ICUs. Participant ICUs are randomly assigned to either an FFVM or RFVM in a 1:1 ratio. After enrollment and follow-up of 25 patients, each ICU is crossed over to the other visitation model, until 25 more patients per site are enrolled and followed. The primary outcome is the cumulative incidence of delirium measured by the Confusion Assessment Method for the ICU. Secondary and tertiary outcomes include relevant measures of effectiveness and safety of ICU visiting policies among patients, family members, and ICU professionals. Herein, we describe all primary statistical procedures that will be used to evaluate the results and perform exploratory and sensitivity analyses of this study. This pre-specified statistical analysis plan was written and submitted without knowledge of the study data.

DISCUSSION

This a priori statistical analysis plan aims to enhance the transparency of our study, facilitating unbiased analyses of ICU visit study data, and provide guidance for statistical analysis for groups conducting studies in the same field.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT02932358 . Registered on 11 October 2016.

Predictors of happiness among Iranian nurses

Objectives

This study aimed to assess happiness and its predictors among a group of Iranian hospital nurses.

Methods

This cross-sectional study was done in 2016 on 620 hospital nurses who worked in five teaching hospitals affiliated to Kashan University of Medical Sciences, Kashan, Iran. Nurses were recruited through the census method. Data collection instruments were a researcher-made demographic and occupational characteristics questionnaire, the Oxford Happiness Inventory, and the Minnesota Job Satisfaction Questionnaire. Data analysis was done through stepwise multiple linear regression analysis.

Results

Among 620 recruited nurses, 422 returned their questionnaires completely filled. The mean of their happiness was 123.4 ± 18.4 in the possible score range of 29–174. The significant predictors of happiness were satisfaction with mental health, monthly salary, satisfaction with salary, quality of life, current hospital ward, the length of working in the current ward, work shift, age, job satisfaction, and satisfaction with physicians' conduct and performance. These variables explained 50.3% of the total variance of happiness. Satisfaction with mental health had the greatest proportion in explaining the variance of happiness.

Conclusion

Nurses in teaching hospitals in Kashan, Iran, have moderate happiness. Their happiness is affected by different factors, particularly by satisfaction with their mental health. Health policy-makers and authorities, in developing workforce-related plans and programs, need to pay special attention to nurses' happiness and its contributing factors.

Motivational profiles and their relationships with basic psychological needs, academic performance, study strategies, self-esteem, and vitality in dental students in Chile

PURPOSE

To determine dental students' motivational profiles through a person-centred approach and to analyse the associations with the satisfaction of their basic psychological needs, study strategies, academic performance, self-esteem, and vitality.

METHODS

A total of 924 students from the University of San Sebastian (Chile) participated in this cross-sectional cor¬relational study in spring 2016. Data were collected through 5 self-reported instruments, in addition to students' academic performance. The Cronbach alpha, descriptive statistics, and correla¬tion scores were computed. A k-means cluster analysis with intrinsic and controlled motivation was conducted to identify different mo-tivational profiles. Subsequently, multivariate analysis of covariance controlling for the effects of gender and year of study was carried out to assess differences among the retained motivational profiles and learning variables.

RESULTS

All instruments showed acceptable Cronbach alpha scores. A 4-cluster solution was retained for the motivational profile over a 3- or 5-cluster solution. Students' motiva-tional profiles were characterized by different degrees of intrinsic and controlled motivation. The high intrinsic motivation groups showed higher perceptions of their basic psychological, a greater propensity for a deep rather than surface study strategy, better academic performance, and higher scores for self-esteem and vitality than the low intrinsic motivation groups, regardless of the degree of controlled motivation.

CONCLUSION

Students with a high intrinsic motivation profile, regardless of their controlled motivation scores, reported better learning characteristics. Therefore, special attention should be paid to students' motivational profiles, as the quality of motivation might serve as a basis for interventions to support their academic success and well-being.

Length of Stay, Health Care Cost, Postpartum Discomfort, and Satisfaction with Medical Service in Puerperas Giving Birth in Midwifery Clinic and Hospitals

PURPOSE

To determine traits related to pregnancy and delivery, length of stay, health care cost, postpartum discomfort, and satisfaction with medical service of puerperas giving birth in midwifery clinic and hospitals.

METHODS

This study used a comparative survey design. Data were collected from a total of 140 postpartum mothers composed of 70 mothers who gave births in two hospitals and another 70 mothers who delivered in one midwifery clinic.

RESULTS

Delivery in midwifery clinic had higher Apgar score at 1 minute and 5 minutes after birth than hospital. Those who delivered in midwifery clinic had shorter stay in the clinic, fewer health care cost, less postpartum discomfort in physical, environmental, social, and cultural areas, higher satisfaction with medical services than those who delivered in hospitals.

CONCLUSION

Results of this study can be used as a basis for studies on giving birth in midwifery clinic and hospitals. They might increase the autonomy of women in giving birth with positive effect on the delivery experience of the mother and her spouse.

Endoscopic Dilation of Pharyngoesophageal Strictures: There Are More Dimensions than a Diameter

Background/Aims

Dysphagia due to benign pharyngoesophageal strictures (PES) often requires repeated dilations; however, a uniform definition for the therapeutic efficacy of this technique has not been yet established. We aimed to assess the overall efficacy of endoscopic dilation of pharyngoesophageal anastomotic or post-radiotherapy (post-RT) strictures.

Methods

The data of 48 patients with post-RT (n = 29) or anastomotic PES (n = 19) submitted to endoscopic dilation during a 3-year period were retrospectively assessed. The Kochman criteria were used to determine refractoriness and recurrence. Patients were asked to answer a questionnaire determining prospectively the dilation program efficacy as (a) dysphagia improvement, (b) dysphagia resolution, (c) need for further dilations, or (d) percutaneous endoscopic gastrostomy (PEG) during the previous 6 months. Need for additional therapy was considered an inefficacy criterion.

Results

The median number of dilations per patient was 4 (total of 296 dilations) with a median follow-up of 29 months. The mean predilation dysphagia Mellow-Pinkas score was 3 and the initial stenosis diameter was 7 mm. Fifteen and 29% of patients presented with the Kochman criteria for refractory and recurrent strictures, respectively. Moreover, 96 and 60% showed dysphagia improvement and resolution, respectively. Seventy-five-percent did not require dilations during 6 months, and 89% did not require PEG. From the patients' perspective, overall efficacy was achieved in 58% of cases. Nine additional therapies were required. Number of dilations (OR 0.7), stricture diameter (OR 2.2), and nonrecurrence criteria (OR 14.2) appeared as significant predictors of overall efficacy, whereas refractory stenosis criteria did not.

Conclusions

Endoscopic dilation seems to be effective for patients with dysphagia after RT or surgery, especially when assessed as patient perception of improvement. Narrow strictures, recurrent ones, and strictures requiring a higher number of dilations may predict worse outcomes.

Key Message

Health professionals should establish well-defined efficacy criteria for dilations and base their decision beyond exclusively objective measurements.

Intravenous versus Subcutaneous Midazolam Using Jet-injector in Pediatric Sedation; a Randomized Clinical Trial

INTRODUCTION

The quality of interventions in children is largely dependent on their control. Hence, this study compared the sedative effects of subcutaneous (SC) and intravenous (IV) Midazolam in pediatric sedation induction.

METHODS

This randomized clinical trial was conducted on children aged 1-6 years presenting to emergency departments of Shahid Sadoughi and Shahid Rahnemoon Hospitals, Yazd, Iran. Participants were randomly assigned to IV or SC midazolam using a jet injector and success rate, degree of sedation, and satisfaction of parents and physician were compared between groups.

RESULTS

60 cases with the mean age of 3.15±1.43 (1-6) years were randomly assigned to the SC (30 cases) or IV (30 cases) groups (56.7% female). SC and IV groups were similar regarding the mean age (p = 0.165) and sex (p = 0.121). Depth of sedation (p=0.900), control of child (p=0.711), in-charge physician's satisfaction (p=0.467), successful sedation and need for rescue dose (p=0.519) were not different between groups. IV midazolam group had a significantly shorter recovery time (about 10 minutes; p=0.040) and SC midazolam group had a significantly higher level of parent satisfaction (p=0.001).

CONCLUSION

The findings indicate no significant difference in depth of sedation, control of child, in-charge physician's satisfaction, successful sedation (reaching stage 1 of sedation or higher), and need for rescue dose of SC and IV midazolam. Parents' satisfaction was significantly greater with SC administration and IV injection had shorter recovery time.

Prediction of Marital Satisfaction Based on Emotional Intelligence in Postmenopausal Women

Objectives

This study was coperinducted with the aim of prediction of marital satisfaction based on emotional intelligence for postmenopausal women.

Methods

This cross-sectional study was the descriptive-correlation and with a sample size of 134 people to predict marital satisfaction based on emotional intelligence for postmenopausal women was conducted in the Borujen city. The subjects were selected by convenience sampling. Data collection tools included an emotional intelligence questionnaire (Bar-on) and Enrich marital satisfaction questionnaire.

Results

The results of this study showed a significant positive relationship between marital satisfaction and emotional intelligence (P < 0.05, r = 0.25). Also, regression analysis showed that emotional intelligence (β = 0.31) can predict positively and significantly marital satisfaction.

Conclusions

Due to the positive relationship between emotional intelligence and marital satisfaction, adequacy of emotional intelligence is improved as important structural in marital satisfaction. So it seems that can with measuring emotional intelligence in reinforced marital satisfaction during menopause, done appropriate action.

Effectiveness of Balancing Everyday Life (BEL) versus standard occupational therapy for activity engagement and functioning among people with mental illness - a cluster RCT study

BACKGROUND

Many with a mental illness have an impoverished everyday life with few meaningful activities and a sedentary lifestyle. The study aim was to evaluate the effectiveness of the 16-week Balancing Everyday Life (BEL) program, compared to care as usual (CAU), for people with mental illness in specialized and community-based psychiatric services. The main outcomes concerned different aspects of subjectively evaluated everyday activities, in terms of the engagement and satisfaction they bring, balance among activities, and activity level. Secondary outcomes pertained to various facets of well-being and functioning. It was hypothesized that those who received the BEL intervention would improve more than the comparison group regarding activity, well-being and functioning outcomes.

METHODS

BEL is a group and activity-based lifestyle intervention. CAU entailed active support, mainly standard occupational therapy. The BEL group included 133 participants and the CAU group 93. They completed self-report questionnaires targeting activity and well-being on three occasions - at baseline, after completed intervention (at 16 weeks) and at a six-month follow-up. A research assistant rated the participants' level of functioning and symptom severity on the same occasions. Non-parametric statistics were used since these instruments produced ordinal data.

RESULTS

The BEL group improved more than the CAU group from baseline to 16 weeks on primary outcomes in terms of activity engagement (p < 0.001), activity level (p = 0.036) and activity balance (p < 0.042). The BEL group also improved more on the secondary outcomes of symptom severity (p < 0.018) and level of functioning (p < 0.046) from baseline to 16 weeks, but not on well-being. High intra-class correlations (0.12-0.22) indicated clustering effects for symptom severity and level of functioning. The group differences on activity engagement (p = 0.001) and activity level (p = 0.007) remained at the follow-up. The BEL group also improved their well-being (quality of life) more than the CAU group from baseline to the follow-up (p = 0.049). No differences were found at that time for activity balance, level of functioning and symptom severity.

CONCLUSION

The BEL program was effective compared to CAU in terms of activity engagement. Their improvements were not, however, greater concerning other subjective perceptions, such as satisfaction with daily activities and self-rated health, and clustering effects lowered the dependability regarding findings of improvements on symptoms and functioning. Although the CAU group had "caught up" at the follow-up, the BEL group had improved more on general quality of life. BEL appeared to be important in shortening the time required for participants to develop their engagement in activity and in attaining improved quality of life in a follow-up perspective.

TRIAL REGISTRATION

The study was registered with ClinicalTrial.gov. Reg. No. NCT02619318 .

Comparison of the outcomes of robotic cholecystectomy and laparoscopic cholecystectomy

PURPOSE

This study compared the effects of robotic single-port cholecystectomy (RC) and 3-port laparoscopic cholecystectomy (LC) on patients' surgical pain, postoperative complications, and satisfaction.

METHODS

One hundred twenty patients with gallbladder disease scheduled for either LC or RC were recruited. Each patient was followed up for 1 week after hospital discharge.

RESULTS

Time stayed in operating room was longer in patients with RC, however their hospital stay was shorter than those with LC (t = 3.01, P = 0.003). Since patients with RC received more analgesics during the surgery (t = 3.98, P < 0.001), all participants' surgical pain level were analyzed by using analysis of covariance. Patients who underwent RC reported less surgical pain consistently at 6 hours and first day after surgery and 2 days and 1 week later than patients in the LC. Repeated measure analysis of variance also demonstrated that the RC with single-port might cause less pain throughout the postoperative period (F = 25.68, P < 0.001). Participants' conditions appeared stable without complications such as infection or bleeding regardless of the surgical type however, overall satisfaction with RC showed significantly higher than those with LC except for one item, "the cost of surgery."

CONCLUSION

These results suggested that the RC might be a better choice for people who concern about surgical pain and early hospital discharge. Since there were no differences in postoperative health status between the 2 groups, health care providers as an advocate can provide more reliable information to their patients.

Factors influencing professional life satisfaction among neurologists

Background

Predicted shortages in the supply of neurologists may limit patients’ access to and quality of care for neurological disorders. Retaining neurologists already in practice provides one opportunity to support the overall supply of practicing neurologists. Understanding factors associated with professional life satisfaction (and dissatisfaction) and implementing policies to enhance satisfaction may encourage neurologists to remain in clinical practice. In this paper, we present results from the first study examining factors associated with professional life satisfaction among a large sample of U.S, neurologists.

Methods

We collaborated with the AAN to survey a sample of U.S. neurologists about their professional life satisfaction. Analyses examined the association of physician and practice characteristics with aspects of professional life satisfaction, including satisfaction with their career in medicine, medical specialty, current position, relationship with colleagues, relationship with patients, work/life balance, and pay.

Results

The study population consisted of 625 neurologists. In multivariate regression analyses, no single group or population stratum indicated high (or low) responses to all aspects of satisfaction. Older neurologists reported higher satisfaction with career, specialty, and relationship with patients than younger neurologists. Female neurologists had significantly lower satisfaction with pay than male neurologists. Neurologists who spent more time in research and teaching had greater satisfaction with specialty, relationship with colleagues, and relationship with patients than those spending no time in research. Neurologists who practiced in small cities/rural areas reported lower satisfaction across multiple dimensions than those practicing in large urban areas. Neurologists in solo practice had greater satisfaction with the relationship with their patients, but lower satisfaction with pay.

Conclusions

Satisfaction is a multidimensional construct that is associated with physician and practice characteristics. Enhancing professional life satisfaction among neurologists requires multiple strategies, such as promoting comparable wages for men and women, providing collaboration and research opportunities, and providing resources for small and rural practices.

Electronic supplementary material

The online version of this article (doi:10.1186/s12913-017-2343-8) contains supplementary material, which is available to authorized users.

The Effect of Husbands' Education Regarding Menopausal Health on Marital Satisfaction of Their Wives

Objectives

Marital satisfaction has an important effect on people's mental health. Due to the increasing average age and life expectancy of Iranian women, obtaining knowledge about sexual aspects of post-menopause women for partners can improve their health and quality of life. This study aimed to determine the effect of education for the husbands regarding menopause on marital satisfaction of their wives.

Methods

This randomized controlled trial was conducted on 100 women aged 45 to 55 years old and their husbands in Yazd in 2014. Subjects were randomly assigned to intervention group (50 couples) and control group (50 couples). The data gathering tools included two questionnaires, the first one contained questions about demographic information of women and men, and the other one was used to assess knowledge and practice in men about menopause and Enrich marital satisfaction. The second questionnaire was applied twice; before intervention and two months after that. In the intervention group an educational program in the form of three 60-minute sessions were conducted using speech, but the control group received no training. Analysis was performed through the statistical SPSS software, paired t-test, t-test and chi-square.

Results

In the intervention group, two months after the educational program the knowledge of menopausal health and women's marital satisfaction scores increased significantly (P<0.001). But there was no significant difference in control group.

Conclusions

Training menopausal health to husbands can increase women's marital satisfaction in the period of menopausal transition. Therefore, designing and implementing educational programs for husbands is recommended.

Smart device-based testing for medical students in Korea: satisfaction, convenience, and advantages

The aim of this study was to investigate respondents' satisfaction with smart device-based testing (SBT), as well as its convenience and advantages, in order to improve its implementation. The survey was conducted among 108 junior medical students at Kyungpook National University School of Medicine, Korea, who took a practice licensing examination using SBT in September 2015. The survey contained 28 items scored using a 5-point Likert scale. The items were divided into the following three categories: satisfaction with SBT administration, convenience of SBT features, and advantages of SBT compared to paper-and-pencil testing or computer-based testing. The reliability of the survey was 0.95. Of the three categories, the convenience of the SBT features received the highest mean (M) score (M= 3.75, standard deviation [SD]= 0.69), while the category of satisfaction with SBT received the lowest (M= 3.13, SD= 1.07). No statistically significant differences across these categories with respect to sex, age, or experience were observed. These results indicate that SBT was practical and effective to take and to administer.

Self-report health-related quality of life among children and adolescents from Bogotá, Colombia. The FUPRECOL study

OBJECTIVE

To describe by self-report the HRQoL among schoolchildren from Bogotá, Colombia belonging to the FUPRECOL study.

METHODS

A cross-sectional study in 3,245 children and 3,354 adolescents, between 9 and 17.9 years old, participated in the study. Spanish version of the EQ-5D-Y was self-assessment. Percentages of missing values and reported problems were calculated. The data was analyzed by measurement of central tendency stratified by age group, and to compare them to international references.

RESULTS

A total of 58.3%, (n= 3,848) were women. In all ages, the HRQoL was higher in boys than in girls. To compare by sex, the dimensions of the EQ-5D-Y "feeling worried, sad or unhappy" and "having pain or discomfort", showed the highest frequency among women. Overall, our HRQoL were higher than South Africa, Germany and Italy references.

CONCLUSION

The HRQoL was higher in boys than in girls The HRQoL. The dimensions of the EQ-5D-Y "feeling worried, sad or unhappy" and "having pain or discomfort", showed the highest frequency. The HRQoL by age and sex may be used in the evaluation of the health perceived among schoolchildren from Bogotá.

E-learning programs in oncology: a nationwide experience from 2005 to 2014

Background

E-learning is an established concept in oncological education and training. However, there seems to be a scarcity of long-term assessments of E-learning programs in oncology vis-á-vis their structural management and didactic value. This study presents descriptive, nationwide data from 2005 to 2014. E-learning oncology programs in chemotherapy, general oncology, pain management, palliative care, psycho-social-oncology, and radiotherapy, were reviewed from our databases. Questionnaires of self-perceived didactic value of the programs were examined 2008–2014.

Results

The total number of trainees were 4693, allocated to 3889 individuals. The trainees included medical doctors (MDs; n = 759), registered nurses (RNs; n = 2359), radiation therapy technologists (n = 642), and, social and health care assistants (SHCAs; n = 933). The E-learning covered 29 different program classifications, comprising 731 recorded presentations, and covering 438 themes. A total of 490 programs were completed by the trainees. The European Credit Transfer and Accumulation System (ECTS; 1 ECTS point equals 0.60 US College Credit Hours) points varied across the educational programs from 0.7 to 30.0, corresponding to a duration of full-time studies ranging between 15 to 900 h (0.4–24 weeks) per program. The total number of ECTS points for the trainee cohort, was 20,000 corresponding to 530,000 full-time academic hours or 324.0 standard academic working years. The overall drop-out rate, across professions and programs, was 10.6% (499/4693). The lowest drop-out rate was seen for RNs (4.3%; P < 0.0001). Self-reported evaluation questionnaires (2008–2014) were completed by 72.1% (2642/3666) of the trainees. The programs were overall rated, on a 5-categorical scale (5 = excellent; 1 = very inferior), as excellent by 68.6% (MDs: 64.9%; RNs: 66.8%; SHCAs: 77.7%) and as good by 30.6% (MDs: 34.5%; RNs: 32.4%; SHCAs: 21.5%) of the responders.

Conclusions

This descriptive study, performed in a lengthy timeframe, presents high-volume data from multi-professional, oncological E-learning programs. While the E-learning paradigm, across professions, seems to have been well received, it is imperative that prospective studies, benchmarking against traditional training methods, are carried out, examining the hypothesized didactic value of our E-programs.

Electronic supplementary material

The online version of this article (doi:10.1186/s13104-017-2372-8) contains supplementary material, which is available to authorized users.

Work-related stress: A survey of Indian anesthesiologists

Background and Aims:

Work-related stress is common among medical caregivers and concerns all perioperative care providers. Although anesthesiologists are known to experience stress, there are limited Indian data addressing this issue. This survey was conducted among Indian anesthesiologists to determine their awareness about work stress and views regarding prevention programs.

Material and Methods:

A survey questionnaire was distributed to delegates visiting the exhibits at the national anesthesiology conference in 2011. The questionnaire had ten questions on the work pattern, five on work-related stress, nine on opinion regarding the need and willingness to participate in stress-related programs.

Results:

There were 1178 responders. Forty-three percent were faculty in medical institutions, 26% were residents and 25% were in free-lance practice. Ninety-one percent of participants rated their stress as moderate-extreme. There was a significant correlation between the amount of stress and working for more than 8 h (P < 0.001), handling high risk patients (P = 0.002), working on weekends (P = 0.002), and carrying work back home (P < 0.001). Forty-one percent of respondents were very satisfied professionally. Seventy-six percent of doctors agreed that the questionnaire had made them think about work stress. Eighty-four percent of participants felt the need for stress management programs and 69% expressed their willingness to participate in the same.

Conclusion:

The majority of participants rated their stress as moderate-extreme and was higher in anesthesiologists working long hours, over the weekend and those handling high-risk patients. A majority of participants felt the survey made them think about work-related stress and expressed their willingness to participate in stress management programs.

Psychometric assessment of the Family Satisfaction in the Intensive Care Unit questionnaire in the United Kingdom

PURPOSE

To establish the psychometric properties of the Family Satisfaction in the Intensive Care Unit 24-item (FS-ICU-24) questionnaire in the United Kingdom.

MATERIALS AND METHODS

The Family-Reported Experiences Evaluation study recruited family members of patients staying at least 24 hours in 20 participating intensive care units. Questionnaires were evaluated for nonresponse, floor/ceiling effects, redundancy, and construct validity. Internal consistency was evaluated with item-to-own scale correlations and Cronbach α. Confirmatory and exploratory factor analyses were used to explore the underlying structure.

RESULTS

Twelve thousand three hundred forty-six family members of 6380 patients were recruited and 7173 (58%) family members of 4615 patients returned a completed questionnaire. One family member per patient was included in the psychometric assessment. Six items had greater than 10% nonresponse; 1 item had a ceiling effect; and 11 items had potential redundancy. Internal consistency was high (Cronbach α, overall .96; satisfaction with care, .94; satisfaction with decision making, .93). The 2-factor solution was not a good fit. Exploratory factor analysis indicated that satisfaction with decision making encompassed 2 constructs-satisfaction with information and satisfaction with the decision-making process.

CONCLUSIONS

The Family Satisfaction in the Intensive Care Unit 24-item questionnaire demonstrated good psychometric properties in the United Kingdom setting. Construct validity could be improved by use of 3 domains and some scope for further improvement was identified.

Life and health satisfaction in the adult population of Iran

OBJECTIVES

Increasing interest has emerged in the use of subjective well-being as a development indicator and for the evaluation of public policies. The aim of this study was to assess life and health satisfaction and their determinants in the adult population of Iran.

METHODS

We conducted a survey of a sample of 3,150 adults at least 18 years of age in Tehran, the capital of Iran. The subjects were selected using a stratified random sampling method, and they were interviewed face-to-face at their usual residence by trained interviewers. Life satisfaction was used as a measure of subjective well-being. We used ordinary least square regression models to assess the associations of life and health satisfaction with socio-demographic variables.

RESULTS

On a 0-10 scale, the mean (standard deviation) scores for life and health satisfaction were 6.93 (2.54) and 7.18 (1.97), respectively. The average score for life satisfaction in females was 0.52 points higher than in males. A U-shaped relationship was found between age and life satisfaction, with respondents 35 to 44 years of age having the lowest average level of life satisfaction. Satisfaction with life and health among divorced respondents was significantly lower than among never-married and married participants. The scores for life satisfaction in respondents who rated their health status as poor were 3.83 points lower than in those who rated their health status as excellent.

CONCLUSIONS

The majority of the population of Tehran was satisfied with their life and health. Self-rated health status had the greatest impact on life satisfaction.

PATI: Patient accessed tailored information: A pilot study to evaluate the effect on preoperative breast cancer patients of information delivered via a mobile application

OBJECTIVES

The information needs of cancer patients are highly variable. Literature suggests an improved ability to modulate personalised stress, increased patient involvement with decision making, greater satisfaction with treatment choices and reduced anxiety levels in cancer patients who have access to information. The aim of this project was to evaluate the effects of a mobile information application on anxiety levels of patients undergoing surgery for breast cancer.

MATERIALS AND METHODS

An application was developed for use with Apple iPad containing information on basic breast cancer biology, different treatments used and surgical techniques. Content and face validity studies were performed. A randomized control trial was designed, with a 1:2 allocation. Data collected include basic demographics and type of surgery. Questionnaires used included: the HADS, Mini-MAC, information technology familiarity and information satisfaction.

RESULTS

A total of 39 women participated. 13 women had access to an iPad containing additional information and 26 women acted as controls. The mean age was 54 and technology familiarity was similar among both groups. Anxiety and depression scores at seven days were significantly lower in control patients without access to the additional information provided by the mobile application (p = 0.022 and 0.029 respectively).

CONCLUSION

Anxiety and depression in breast cancer patients is both multifactorial and significant, with anxiety levels directly correlating with reduced quality of life. Intuitively, information should improve anxiety levels, however, we have demonstrated that surgical patients with less information reported significantly lower anxiety. We advise the thorough testing and auditing of information initiatives before deployment.

Factors Influencing Parental Satisfaction of Mothers with Preschool Children

PURPOSE

The purpose of the study was to identify degrees of parenting stress, parenting efficacy, parenting behavior and parental satisfaction, and to identify factors influencing parenting satisfaction of mothers who had preschool children.

METHODS

The research participants were 176 mothers. All of mothers had preschool children, aged 2 to 6 years old, and attended one of 3 day care centers or 2 Kindergartens located in J city. Data were collected by convenience sampling using self-report questionnaires which contained items on general characteristics, parenting stress, parenting efficacy, parenting behavior, and parenting satisfaction. Data were analyzed using descriptive statistics, t-test, ANOVA, correlation, and multiple regression.

RESULTS

The average level of parenting satisfaction of mothers with preschool children was 5.38±0.79. Positive parenting behavior and affective parenting efficacy were verified factors influencing parental satisfaction. These factors accounted for 41.4% of parental satisfaction.

CONCLUSION

The results indicate that positive parenting behavior and affective parenting efficacy have the biggest impact on parental satisfaction. The results of this study provide the basic data for the development of parental education program aimed at improving parental satisfaction of mothers who have preschool children.

Permissive Attitude Towards Drug Use, Life Satisfaction, and Continuous Drug Use Among Psychoactive Drug Users in Hong Kong

OBJECTIVES

To examine the effects of a permissive attitude towards regular and occasional drug use, life satisfaction, self-esteem, depression, and other psychosocial variables in the drug use of psychoactive drug users. Psychosocial factors that might affect a permissive attitude towards regular / occasional drug use and life satisfaction were further explored.

METHODS

We analysed data of a sample of psychoactive drug users from a longitudinal survey of psychoactive drug abusers in Hong Kong who were interviewed at 6 time points at 6-month intervals between January 2009 and December 2011. Data of the second to the sixth time points were stacked into an individual time point structure. Random-effects probit regression analysis was performed to estimate the relative contribution of the independent variables to the binary dependent variable of drug use in the last 30 days.

RESULTS

A permissive attitude towards drug use, life satisfaction, and depression at the concurrent time point, and self-esteem at the previous time point had direct effects on drug use in the last 30 days. Interestingly, permissiveness to occasional drug use was a stronger predictor of drug use than permissiveness to regular drug use. These 2 permissive attitude variables were affected by the belief that doing extreme things shows the vitality of young people (at concurrent time point), life satisfaction (at concurrent time point), and self-esteem (at concurrent and previous time points). Life satisfaction was affected by sense of uncertainty about the future (at concurrent time point), self-esteem (at concurrent time point), depression (at both concurrent and previous time points), and being stricken by stressful events (at previous time point).

CONCLUSIONS

A number of psychosocial factors could affect the continuation or discontinuation of drug use, as well as the permissive attitude towards regular and occasional drug use, and life satisfaction. Implications of the findings for prevention and intervention work targeted at psychoactive drug users are discussed.

A Comparative and a Qualitative Analysis of Patient's Motivations, Expectations and Satisfaction with Dental Implants

INTRODUCTION

Dental Implants are the norm of today's prosthetic and restorative dentistry but, is it the answer for edentulism that can affect both individual's appearance and functioning, therefore having an impact on the psychological and the social well being of the person is an ongoing quest. Also, patient's beliefs and personal expectations for dental implants vary, which may influence the treatment outcome, thus emphasizing the importance of a good clinician-patient communication. Hence in this study a qualitative analysis was carried out with an earnest attempt to gain an insight into patient's motivations, personal expectations, satisfaction and impact of clinician's motivation for implant maintenance.

AIM

To learn about patient's expectations and their level of satisfaction from dental implants. To know the impact of clinician's instructions and motivation for implant maintenance, with the patient's level of understanding and compare the level of motivation for implant maintenance and care provided by a dentist with Bachelor's degree to a dentist with a Master's degree.

MATERIALS AND METHODS

A 30 systemically healthy patients who had undergone implant treatment (aged 25-65 years) were considered and divided into two groups: Group A: 15 patients in whom implant placement was done by a dentist with Bachelor's degree (24 years, 18 years in general and implant practice respectively) and Group B: 15 patients in whom implant placement was done by a dentist with a Master's degree (Periodontics; 20 years,17 years in general and implant practice respectively). A qualitative analysis with the help of appropriate questionnaires comprising of multiple choice questions specifically designed for this purpose and few open ended questions was carried out with an earnest attempt to gain an insight into patient's motivations, personal expectations, satisfaction and impact of clinician's motivation for implant maintenance.

RESULTS

Patients motivations for seeking implants and their expectations of treatment differed. Dental implants had met the patient's pre-treatment expectations and they were satisfied. Variations in the knowledge on the maintenance of the implants by the patients and the kind of maintenance care provided by the dentists varied between the two groups.

CONCLUSION

In regard to the patient's compliance towards dental implants, a clinician must ensure that patient's understand the different demands.

Changing medical students' perception of the evaluation culture: Is it possible?

Student feedback is a critical component of the teacher-learner cycle. However, there is not a gold standard course or clerkship evaluation form and limited research on the impact of changing the evaluation process. Results from a focus group and pre-implementation feedback survey coupled with best practices in survey design were used to improve all course/clerkship evaluation for academic year 2013-2014. In spring 2014 we asked all subjected students in University of Utah School of Medicine, United States of America to complete the same feedback survey (post-implementation survey). We assessed the evaluation climate with 3 measures on the feedback survey: overall satisfaction with the evaluation process; time students gave effort to the process; and time students used shortcuts. Scores from these measures were compared between 2013 and 2014 with Mann-Whitney U-tests. Response rates were 79% (254) for 2013 and 52% (179) for 2014. Students' overall satisfaction score were significantly higher (more positive) post-implementation compared to pre-implementation (P<0.001). There was no change in the amount of time students gave effort to completing evaluations (P=0.981) and no change for the amount of time they used shortcuts to complete evaluations (P=0.956). We were able to change overall satisfaction with the medical school evaluation culture, but there was no change in the amount of time students gave effort to completing evaluations and times they used shortcuts to complete evaluations. To ensure accurate evaluation results we will need to focus our efforts on time needed to complete course evaluations across all four years.

Parental satisfaction with pediatric emergency care: a nationwide, cross-sectional survey in Korea

PURPOSE

This study attempted to examine parental satisfaction with pediatric emergency care (PEC) in Korea and investigate the features influencing overall satisfaction.

METHODS

A nationwide, cross-sectional survey was conducted among parents who had taken their children to an Emergency Department (ED) in the three years prior to the study. A 21-item, structured questionnaire was administered to the parents through a web-based system. Participants' satisfaction levels and the strength of the association between PEC components and overall satisfaction were rated using a 7-point Likert scale.

RESULTS

In total, 1,000 parents participated in the survey, of which 402 (40.2%) stated that they were generally satisfied with the delivered PEC. Female participants, mothers, and parents with low-acuity patients were more likely to be dissatisfied with the delivered PEC. Although the ED environment was the lowest level of satisfaction, it did not significantly influence the respondents' overall levels of satisfaction. The most influential factors in terms of overall satisfaction were "nurses' professionalism" and "doctors' attitude and proper explanation".

CONCLUSION

Parents' overall level of satisfaction with PEC is relatively low and is closely related to factors associated with ED personnel.

Satisfaction with facial laceration repair by provider specialty in the emergency department

Objective

We compared patient satisfaction with scarring after facial laceration repair in the emergency department (ED) based on the specialty of the provider.

Methods

Patients with facial lacerations admitted to the ED from 2009 to 2013 were divided into two groups. One group of patients underwent repair by an emergency physician (EP) and the other by a plastic surgeon (PS). From August 2014 to September 2014, we randomly selected 10% of all patients and assessed their degree of satisfaction with scarring over the phone using a 5-point Likert scale.

Results

The male to female ratio was 2.81 in the EP group and 2.05 in PS (P<0.001). The proportion of those aged 0 to 9 years among all the patients was higher in the PS group than in the EP group (50.8% vs. 30.1%, respectively, P<0.001). The duration of ED stay was 107.8±84.6 minutes in the EP group and 225.9 ± 161.8 minutes in the PS group (P<0.001). Among these patients, 228 responded to a telephone survey. A poor satisfaction score of 1 to 2 was more common in female or young patients who underwent repair by an EP (P<0.05). However, the overall satisfaction among all respondents did not differ between the two groups.

Conclusion

Although female patients and the guardians of young children who underwent simple facial laceration repair by a PS were more satisfied than those treated by an EP, the satisfaction of the entire group of patients did not differ according to the treatment provider.

Limb Differences in the Therapeutic Effects of Complex Decongestive Therapy on Edema, Quality of Life, and Satisfaction in Lymphedema Patients

Objective

To investigate the changing patterns of edema, quality of life (QOL), and patient-satisfaction after complex decongestive therapy (CDT) in three trajectories: arm lymphedema (AL), secondary leg lymphedema (LL) and primary leg lymphedema (PL).

Methods

Candidates for AL (n=35), LL (n=35) and PL (n=14) were identified from prospective databases. The patients were treated with CDT for 2 weeks, and lymphedema volume was measured before and immediately following the therapy. Patients then self-administered home therapy for 3 months and presented for a follow-up visit. The Korean version of Short Form-36 (SF-36) was used to assess QOL, and we administered a study-specific satisfaction survey.

Results

There was no significant difference in the volume reductions between the 3 groups. There were no significant differences in all of the measures between PL and LL. Overall initial QOL was significantly lower in patients with LL than in patients with AL. SF-36 scores post-CDT did not differ significantly between AL and LL. Clinically significant differences were noted between AL and LL in the mean values of the satisfaction survey.

Conclusion

AL, LL, and PL may have different longitudinal courses. We suggest that lower extremity lymphedema patients present more favorable outcomes after CDT with respect to QOL and satisfaction than upper extremity lymphedema patients. Clinicians should approach patients with different therapeutic considerations specific to each type or region of lymphedema before using CDT in clinical practice.

Promoting collaboration and cultural competence for physician assistant and physical therapist students: A cross-cultural decentralized interprofessional education (IPE) model

PURPOSE

As the United States health care model progresses towards medical teams and the country's population continues to diversify, the need for health professional education programs to develop and implement culturally specific interprofessional education (IPE) becomes increasingly imperative. A wide range of models exists for delivering and implementing IPE in health education, but none have included the cultural components that are vital in educating the health professional.

METHODS

A cross-cultural decentralized IPE model for physician assistant (PA) and physical therapy (PT) students was developed. This three-part IPE series was created using an established cultural curricular model and began with the exploration of self, continued with the examination of various dimensions of culture, and concluded with the exploration of the intersection between health and culture. We assessed student satisfaction of the IPE experiences and students' engagement and attitudes towards IPE using a three-item open-ended questionnaire administered after each cross-cultural activity and the Interprofessional Education Series Survey (IESS) upon the completion of the series.

RESULTS

IESS responses showed that PA and PT students reported benefits in interprofessional collaboration and cultural awareness and expressed overall satisfaction with the series. Qualitative analysis revealed growth in student response depth consistent with the scaffolded focus of each IPE module in the series.

CONCLUSION

The trends in this three-part series suggest that institutions looking to develop culturally inclusive IPE educational initiatives may have success through a decentralized model mirroring the effective cultural progression focused on addressing exploration of self, examination of various dimensions of culture, and exploration of the intersection between health and culture.

How to encourage intrinsic motivation in the clinical teaching environment?: a systematic review from the self-determination theory

PURPOSE

Internalization of students' motivation towards an intrinsic form is associated with increased interest, commitment, learning, and satisfaction with education. Self-Determination theory postulates that intrinsic motivation and autonomous forms of self-regulation are the desired type of motivation; as they have been associated with deep learning, better performance and well-being. It claims three basic psychological needs have to be satisfied in order to achieve intrinsic motivation. These are the needs for autonomy, competence and relatedness. This study aims to provide a review on how these basic psychological needs are encouraged in undergraduate students so they can be transferred to the clinical teaching environment.

METHODS

Electronic searches were performed across four databases (Medline, Embase, PsycINFO, and ERIC), relevant journals, and retrieved bibliography of selected articles. In total, searches produced 4,869 references, from which 16 studies met the inclusion criteria.

RESULTS

Main themes were coded in three categories: The support of autonomy, competence and relatedness. The research-based evidence appears to be of reasonable quality, and indicates that teachers should work to satisfy students' basic psychological needs to foster internalization of self-regulation. Our findings suggest that teachers should interact with students in a more 'human centred' teaching style, as these actions predict motivational internalization. Several themes emerged from different contexts and further investigation should expand them.

CONCLUSION

This review identified actions that clinical teachers could implement in their daily work to support students' self-determination. Autonomy supportive teaching in health professions educations would benefit students and may actually result in more effective health care delivery.

Higher satisfaction with ethnographic edutainment using YouTube among medical students in Thailand

PURPOSE

At present, transformative learning is one of the most important issues in medical education, since a conventional learning environment is prone to failure due to changing patterns among students. Ethnographic edutainment is a concept that consists of reward, competition, and motivation strategies that be used to effectively engage with learners.

METHODS

A total 321 first-year medical students took part in ethnographic edutainment sessions in 2011. We defined four preset learning objectives and assigned a term group project using clouding technologies. Participatory evaluation was conducted to assess the delivery of and attitudes towards this method.

RESULTS

Career lifestyles in the general population and expected real-life utilization of the final product were used as motivating factors, with competition and rewards provided through a short film contest. Nineteen out of twenty groups (95%) achieved all learning objectives. Females were more satisfied with this activity than males (P<0.001). We found statistically significant differences between lecture-based sessions and field visit sessions, as well as ethnographic edutainment activity sessions and other instructional approaches (P<0.01). The results were consistent in male and female groups.

CONCLUSION

Ethnographic edutainment is well accepted, with higher satisfaction rates than other types of teaching. The concepts of health promotion and the social determinants of health can be learned through ethnographic edutainment activities, which might help train more humanized health professionals.

Factors Influencing Depression in Married Immigrant Women in Korea

PURPOSE

The purpose of this study was to identify the factors influencing depression of married immigrant women in Korea.

METHODS

Participants included 127 married immigrant women who met eligibility criteria and agreed to participate in the study. Participants were evaluated for subjective assessment of married immigrant-related constructs using a self-report questionnaire, for depression, acculturation stress, and social support. The analysis was done using SPSS for Windows, version 18.0, and included stepwise regression.

RESULTS

The major findings were as follows; 1) Depression significantly differed according to native country, length of residence in Korea, education, family monthly income, household and primary support. 2) There were significant relationships between marital life satisfaction (r=-.80, p<.001), acculturative stress (r=.78, p<.001), and social support (r=-.20, p = .025). 3) Marital life satisfaction, family monthly income, acculturative stress, primary support and social support were significant factors, which explained 84.6% of the variance in depression (F=138.04, p<.001). Multiple regression analysis revealed that a powerful predictor of depression for married immigrant women was marital life satisfaction.

CONCLUSION

Based upon the findings, this study provides useful information that could assist in reducing depression among married immigrant women, and indicates that nursing interventions are needed.

Mental health promotion and illness prevention: a challenge for psychiatrists

Mental health is essential for individual and public health. To improve mental health, promotion, prevention, and the treatment of disease are required. These three kinds of interventions are interrelated but independent from one another. Although separate efforts for mental health promotion and prevention are needed as well as the public need of mental health promotion and well-being, psychiatrists usually are not accustomed to mental health promotion and prevention. This review introduces an overview of the concept, subjects according to target populations, and various intervention strategies for mental health promotion and prevention of mental illnesses. Based on literatures to date, understanding of developmental psychology, lifestyle medicine, and biopsychosocial contributors of mental health with a macroscopic perspective might help to practice mental health promotion and illness prevention.

[The unmet needs of the elderly living with functional disabilities in Bobo-Dioulasso (Burkina Faso)]

BACKGROUND

In sub-Sahara Africa, the strong involvement of the family in multidimensional cares/supports of elderly is often presented like the family ensures almost everything to these people. Thus, few studies have focused on unmet needs of the elderly in their family or above. This study was conducted in Bobo-Dioulasso to identify those needs.

METHODS

This is a longitudinal study including 58 people or 15 elderly and 43 caregivers from 15 families in Bobo-Dioulasso. In addition to regular observations of these families during 1 year, we conducted in-depth individual interview with each participant at the beginning and at the end of the study. The data were analyzed using QSR NVivo 8 software.

RESULTS

A priori, respondents let believe that there is no unmet functional needs of the elderly in their family. However, the food, the first and main functional need of the elderly is not qualitatively satisfied by their family as well as other equipments or health needs. The quality of social cares/supports, biomedical cares and community supports are insufficient when these cares/supports are provided. The family demands many free or subsidized services to public or community structures then they are not currently available.

DISCUSSION

In a context of widespread poverty, it is difficult for each actor of the social system of maintaining elderly in functional autonomy to provide services/supports of optimal quality. A synergy of action will reduce the unmet needs of the elderly in Bobo-Dioulasso.

[Satisfaction of professionals taking part in a project of telemonitoring in-home patients with chronic diseases (TELBIL-A project)]

OBJECTIVE

To analyze, through an on-line survey, the satisfaction of professionals (nurses/general practitioners) taking part in a project of telemonitoring in-home patients with chronic diseases (heart failure and/or pulmonary disease) with ≥2 hospital admissions in the last year (TELBIL-A project).

MATERIAL AND METHODS

An on-line questionnaire designed by the researchers (using «easy survey» application) was sent to professionals' email. It consisted of several items to assess satisfaction (Likert scale from 1-strongly disagree, negative appreciation- to 5- strongly agree, positive appreciation-), age, number of years working in Primary Care, and an open question for comments. Data were analyzed using SPSS 18.0.

RESULTS

We received responses from 50 out of 55 professionals (90.9%), of whom 94% were female, and 68% aged ≥40 years, with 90% working >5 years in Primary Care. They chose in 86% answer 4 or 5 for the item on overall satisfaction with the project, with the average score being 4.4. The means for the rest of questions were: 3.8 for interference with other professional daily tasks, 4.5 appreciating advantages in the management of patients, 4.2 for the feeling that patients are more involved in their own care, 3.9 for technological aspects, and 4.3 for recommending to a friend/relative.

CONCLUSIONS

The study explores one aspect, satisfaction with the project, which is critical because of the association with the correct compliance and developing of the intervention. We found a high satisfaction of professionals involved with the TELBIL-A project.

Personal Factors that Affect the Satisfaction of Female Patients Undergoing Esthetic Suture after Typical Thyroidectomy

BACKGROUND

In esthetic surgery, understanding the factors that influence patient satisfaction is important for successful practice. We hypothesize that the factors that influence patient satisfaction include not only aesthetic and functional outcomes, but also personal factors such as the level of familiarity with factors affecting wound healing and expectations regarding aesthetic outcome.

METHODS

One hundred patients who underwent esthetic closure after thyroidectomy were included in this study. In order to evaluate the individual characteristics of the patients, a preoperative survey was administered to the patients. We estimated the patient satisfaction six months postoperatively and assessed the aesthetic and functional outcomes using the Patient and Observer Scar Assessment Scale.

RESULTS

According to the results of correlation analysis, level of familiarity with wound healing factors had a positive correlation with satisfaction. High expectations, pain, itching, and high observer scale score had negative correlations with satisfaction. The factors that were correlated with satisfaction were included in the multiple regression analysis. Level of familiarity with wound healing factors was found to have a positive relationship with satisfaction, while itching and observer scale were found to have a negative relationship with satisfaction. After excluding 10 patients who had hypertrophic scars, only level of familiarity with wound healing factors and expectations affected satisfaction.

CONCLUSIONS

The level of familiarity with factors affecting wound healing and expectations were found to independently affect satisfaction. Improving patients' level of familiarity with wound healing factors and reducing their expectations by providing suitable preoperative education has the potential to improve patient satisfaction.

[Improving a hospital's supply chain through lean management]

OBJECTIVES

Supply management is an area where hospitals have significant opportunities for improvement. The main objective of this paper has been to analyze how the application of Lean principles can improve logistics costs and user satisfaction. In connection with satisfaction, it also aimed to examine which aspects of the service define it and check for differences between different groups of users.

METHODS

The results of an experience to reorganize the hospital logistic system based on some Lean principles have been studied. This is therefore a case study, which combine different methods of data collection. The logistics cost calculation was carried out using the full costing method. To measure satisfaction of healthcare personnel, the internal logistics service users, an anonymous survey was conducted. Processing of the data obtained from the survey have included exploratory analysis, factor analysis and ANOVAs.

RESULTS

The data have showed an improvement in logistics management after the implementation of Lean principles. Logistics costs were reduced and the satisfaction level of the internal users with the new logistics system was increased. Some differences in the degree of satisfaction by different groups of users were also detected, although they did not seem to distinguish between different aspects of logistic service.

CONCLUSIONS

The analyzed experience shows the applicability and suitability of Lean principles to improve logistics operational costs and increase user satisfaction.

Commitment to sport and exercise: re-examining the literature for a practical and parsimonious model

A commitment to physical activity is necessary for personal health, and is a primary goal of physical activity practitioners. Effective practitioners rely on theory and research as a guide to best practices. Thus, sound theory, which is both practical and parsimonious, is a key to effective practice. The purpose of this paper is to review the literature in search of such a theory - one that applies to and explains commitment to physical activity in the form of sport and exercise for youths and adults. The Sport Commitment Model has been commonly used to study commitment to sport and has more recently been applied to the exercise context. In this paper, research using the Sport Commitment Model is reviewed relative to its utility in both the sport and exercise contexts. Through this process, the relevance of the Investment Model for study of physical activity commitment emerged, and a more parsimonious framework for studying of commitment to physical activity is suggested. Lastly, links between the models of commitment and individuals' participation motives in physical activity are suggested and practical implications forwarded.

Satisfaction level of physicians who have undergone corneal refractive surgery

Purpose

To evaluate the levels of satisfaction among physicians who have undergone corneal refractive surgery.

Methods

This study included 212 eyes of 107 consecutive patients who underwent laser in situ keratomileusis or laser sub-epithelial keratomileusis surgery. Patients were divided into two groups: one group of physicians and one group of other healthcare workers (HCWs). The physicians' group was also subdivided into two different groups: surgeons or doctors using microscopes and medical physicians. The main outcome measures were scale scores obtained by using the Visual Function Index-14 questionnaires; uncorrected distance visual acuity (UDVA), residual spherical equivalent (SE), optical zone diameter, and residual corneal thickness were also compared between the groups.

Results

No significant differences in preoperative parameters, with the exception of the ratio of types of refractive surgery, were noted between the physicians and the HCWs group. Additionally, no differences between the groups were noted in the postoperative UDVA, residual SE, optical zone diameter, residual corneal thickness, and level of satisfaction. When comparing the two subgroups of physicians, the differences in satisfaction rates were not statistically significant, even in terms of the performance of delicate manual work.

Conclusions

No statistically significant differences in the clinical outcomes and satisfaction scores were detected after surgery between the physicians and HCWs groups, nor were any significant differences detected between the surgeons and medical physicians groups. Corneal refractive surgery can conceivably be recommended even for physicians who perform intensive near vision-dependent activities and delicate operations.

Effects of Clinical Practice and Simulation-Based Practice for Obstetrical Nursing

PURPOSE

The purpose of this study was to evaluate the effects of clinical practice and simulation-based practice for obstetrical nursing in terms of self-efficacy, practice satisfaction, and practice stress.

METHODS

A non-equivalent control group post test design was used. The participants were 171 junior nursing students, 103 in the experimental group, and 68 in the control group. Simulation-based practice consisted of nursing assessment during labor, nursing assessment and intervention for normal and high risk mother, nursing education for mother and family during labor, and open lab. The experimental group participated in simulation-based practice for two days and the control group participated in clinical practice at delivery room for two weeks.

RESULTS

The experimental group showed higher level of self-efficacy (p=.043), practice satisfaction (p<.001) and practice stress (p=.003) compared to the control group.

CONCLUSION

Simulation-based practice is an effective learning method for obstetrical nursing and can be used as the alternative for clinical practice. However, stress management strategies are needed for simulation-based practice.

Comparison of Stress, Social Support, and Marital Satisfaction between Married Immigrant Women in Urban and Rural Areas

PURPOSE

The purpose of this study was to compare the levels of stress, social support, and marital satisfaction between married immigrant women living in urban areas and women living in rural areas to identify ways to improve their mental health.

METHODS

Two hundred married immigrant women were recruited from multicultural family-support centers located in Daejeon City and Chungcheong Province. From July, 2009 to January, 2010, data were collected using self-administered questionnaire. Study instruments were scales for acculturative stress, housewives life stress, support from spouse, and marital satisfaction.

RESULTS

Urban married immigrant women had lower levels of acculturative stress and higher levels of support from spouse and more positive marital satisfaction compared to rural women. Both groups reported similar levels of stress in life as a housewife. Factors influencing marital satisfaction in both group were lower levels of acculturative and housewives life stress, higher levels of support from spouse, and living with parents-in-law.

CONCLUSION

Rural married immigrant women may have more problems in adjusting to Korean culture and marriage compared to urban women. Therefore, to improve the physical and psychological wellbeing and marital adjustment of married immigrant women, development of nursing strategies according to area of residence is needed.

Influence of additional post-bronchoscopy visit on patient satisfaction after flexible bronchoscopy

BACKGROUND/AIMS

Many patients undergoing a flexible bronchoscopy (FB) experience anxiety and discomfort during the procedure. We assessed whether an additional patient visit after a FB would improve patient satisfaction.

METHODS

The study patients were randomly assigned to a control and post-visit groups. The physicians who were scheduled to perform the FB visited the study patients. The control group had one visit before the FB and the post-visit group had a before and after FB visit. The post-visit group received additional information and support during the second visit. Twenty-four hours after the FB, the participants completed questionnaires about discomfort and satisfaction with the procedure.

RESULTS

The control and post-visit groups included 151 and 153 patients, respectively. The post-visit group reported having more information after the FB than the control group. The additional post-bronchoscopy visit improved the general patient tolerability of the procedure. The willingness to return for another FB was not affected by the post-bronchoscopy patient visit.

CONCLUSIONS

The post-bronchoscopy visit improved patient satisfaction and general tolerability to the procedure. Subjective patient tolerability with the FB may be improved through a post-bronchoscopy visit by providing more information and emotional support to patients.

Stress and Personal Well-being among a Sample of Iranian Disabled Veteran's Wives

OBJECTIVE

The aim of this study was to compare overall life satisfaction, subjective well-being, family stress, and stress symptoms of wives of three groups of Iranian disabled veterans.

METHOD

Participants included 97 wives of three groups of disabled veterans (Group 1with 25-49% disability; Group 2 with 50-69% disability; and Group 3 with larger or equal to 70% disability). The participants were selected randomly by computers of Iranian Martyrs and Veterans Foundations. Personal Well-being Index-Adult, Family Inventory of Life Events and Changes and Stress-related Symptoms Inventory were used to measure overall life satisfaction, family resources of stress and stress symptoms. Data were analyzed by ANOVA and linear multivariate regression analysis.

RESULTS

Results showed that there are no differences in stress symptoms among the 3 groups. However, the wives of group 2 showed less stress and more global life satisfaction and subjective well-being; whereas, wives of group 3 showed more family stress and less global life satisfaction and subjective well-being. However, the wives of group 1 showed less global life satisfaction, subjective well-being and less family stress.

CONCLUSION

Based on other studies, the results of group 1 is abnormal. This abnormality in results is due to two reasons: first, the participants tried to show poorer quality of life. Second, these women have not received enough facilities and services. Therefore, they lost their natural homeostasis. It seems that the last reason is more real because of equality in stress symptoms between the 3 groups.

Personal Well-being and Stress Symptoms in Wives of Iranian Martyrs, Prisoners of wars and Disabled Veterans

OBJECTIVE

This study was conducted to compare the personal well-being among the wives of Iranian veterans living in the city of Qom.

METHOD

A sample of 300 was randomly selected from a database containing the addresses of veteran's families at Iran's Veterans Foundation in Qom (Bonyad-e-Shahid va Omoore Isargaran). The veterans' wives were divided into three groups: wives of martyrs (killed veterans), wives of prisoners of war, and wives of disabled veterans. The Persian translation of Personal Well-being Index and Stress Symptoms Checklist (SSC) were administered for data collection. Four women chose not to respond to Personal Well-being Index. Data were then analyzed using linear multivariate regression (stepwise method), analysis of variance, and by computing the correlation between variables.

RESULTS

Results showed a negative correlation between well-being and stress symptoms. However, each group demonstrated different levels of stress symptoms. Furthermore, multivariate linear regression in the 3 groups showed that overall satisfaction of life and personal well-being (total score and its domains) could be predicted by different symptoms.

CONCLUSION

Each group experienced different challenges and thus different stress symptoms. Therefore, although they all need help, each group needs to be helped in a different way.