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Grøndahl VA, Kirchhoff JW, Andersen KL, Sørby LA, Andreassen HM, Skaug EA, Roos AK, Tvete LS, Helgesen AK. Health care quality from the patients' perspective: a comparative study between an old and a new, high-tech hospital. J Multidiscip Healthc 2018; 11:591-600. [PMID: 30410346 PMCID: PMC6200069 DOI: 10.2147/jmdh.s176630] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Purpose Previous studies show that the hospital environment and the behavior of health care personnel may predict patients’ perceptions of care quality. The aim of the study was to explore changes in perceived care quality from the patients’ perspective (QPP) when hospital services are relocated from an old to a new high-tech hospital and to describe what is important for patients in the high-tech hospital. Patients and methods A comparative cross-sectional design was used. The questionnaire QPP, which is based on a theoretical model of the quality of care comprising four quality dimensions, was used. Data were collected in 2015 (old hospital) and 2016 (new hospital), with 253 and 324 respondents, respectively, by consecutive sampling. Comparative statistics was used to test differences between patients’ care quality perceptions (perceived reality [PR] and subjective importance [SI]) (P≤0.05). Results The patients rated PR of all four quality dimensions (the care organization’s physical-technical conditions and sociocultural approach and the caregivers’ medical-technical competence and identity-oriented approach) higher in the new hospital. However, only the two quality dimensions concerning the care organization were rated significantly more highly. On an item level, five of the 27 items scored significantly higher on patients’ SI than on patients’ PR of the care in the new hospital, indicating a quality deficiency from the patients’ perspective. This comprised receiving effective pain relief, receiving examination and treatment within an acceptable waiting time, receiving useful information on self-care, receiving useful information on which doctors were responsible for their medical care, and having a comfortable bed. Conclusion The increase in care QPP was associated with improved environmental conditions, and no significant improvement in care quality was associated with the health care personnel. The results indicate that being in a high-tech environment does not improve patients’ perceptions of care quality provided by health care personnel. The results gave valuable information for quality improvement in clinical practice, based on the patients’ perspective.
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Affiliation(s)
| | - Jörg W Kirchhoff
- Faculty of Health and Welfare, Østfold University College, Halden, Norway,
| | | | | | | | - Eli-Anne Skaug
- Faculty of Health and Welfare, Østfold University College, Halden, Norway,
| | | | - Liv Solveig Tvete
- Faculty of Health and Welfare, Østfold University College, Halden, Norway,
| | - Ann Karin Helgesen
- Faculty of Health and Welfare, Østfold University College, Halden, Norway,
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Hjorth M, Sjöberg D, Svanberg A, Kaminsky E, Langenskiöld S, Rorsman F. Nurse-led clinic for patients with liver cirrhosis-effects on health-related quality of life: study protocol of a pragmatic multicentre randomised controlled trial. BMJ Open 2018; 8:e023064. [PMID: 30337316 PMCID: PMC6196856 DOI: 10.1136/bmjopen-2018-023064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Liver cirrhosis affects health-related quality of life (HRQoL) even in its early stages. Morbidity is especially high when the disease decompensates and self-care actions become essential. Nurse involvement in secondary prevention in other chronic diseases has contributed to better symptom control, less need of inpatient care and improved HRQoL. In order to evaluate the impact of nurse involvement in the follow-up of patients with liver cirrhosis, we decided to compare structured nurse-led clinics, inspired by Dorothea Orem's nursing theory and motivational strategies, with a group of patients receiving standard care. The primary outcome is HRQoL and the secondary outcomes are quality of care, visits to outpatient clinics or hospitals, disease progress and health literacy. METHODS AND ANALYSIS This is a pragmatic, multicentre randomised controlled study conducted at six Swedish hepatology departments. Eligible patients are adults with diagnosed cirrhosis of the liver (n=500). Participants are randomised into either an intervention with nurse-led follow-up group or into a standard of care group. Recruitment started in November 2016 and is expected to proceed until 2020. Primary outcomes are physical and mental HRQoL measured by RAND-36 at enrolment, after 1 and 2 years. ETHICS AND DISSEMINATION The study is ethically approved by the Regional Ethical Review Board in Uppsala. The results shall be disseminated in international conferences and peer-reviewed articles. TRIAL REGISTRATION NUMBER NCT02957253; Pre-results.
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Affiliation(s)
- Maria Hjorth
- Center of Clinical Reaerch in Dalarna, Falun, Sweden
- Department of Medical Sciences, Uppsala Universitet Medicinska fakulteten, Uppsala, Sweden
| | | | - Anncarin Svanberg
- Department of Medical Sciences, Uppsala Universitet Medicinska fakulteten, Uppsala, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Falun, Sweden
- Dalarna University, Falun, Sweden
| | - Elenor Kaminsky
- Department of Public Health and Caring Sciences, Uppsala University, Falun, Sweden
| | - Sophie Langenskiöld
- Department of Public Health and Caring Sciences, Uppsala University, Falun, Sweden
| | - Fredrik Rorsman
- Department of Medical Sciences, Uppsala Universitet Medicinska fakulteten, Uppsala, Sweden
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Katarina PL, Sussanne B, Gunilla HF, Henrik H, Marika W. The quality of care questionnaire: development of a valid measure for persons with inflammatory bowel disease. Scand J Gastroenterol 2018; 53:1043-1050. [PMID: 30299173 DOI: 10.1080/00365521.2018.1495759] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Quality of care is important in lifelong illnesses such as inflammatory bowel disease (IBD). Valid, reliable and short questionnaires to measure quality of care among persons with IBD are needed. The aim of this study was to develop a patient-derived questionnaire measuring quality of care in persons with IBD. METHODS AND RESULTS The development of the questionnaire The Quality of Care -Questionnaire (QoC-Q) was based on a literature review of studies measuring quality of care, and the results of two qualitative studies aiming to identify the knowledge need and perception of health care among persons with IBD. Further development and evaluation was done by focus groups, individual testing and cognitive interviews with persons with IBD, as well as evaluation by a group of professionals. After the development, the questionnaire was tested for validity and test-retest reliability in 294 persons with IBD. CONCLUSIONS The QoC-Q is showing promising validity and reliability for measuring the subjective perception of quality of care. Further testing in clinical practice is suggested to assess if the QoC-Q can be used to evaluate care and areas of improvement in health care for persons living with IBD.
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Affiliation(s)
- Pihl Lesnovska Katarina
- a Departments of Gastroenterology and Medical and Health Sciences , Linköping University , Linköping , Sweden
| | - Börjeson Sussanne
- b Department of Medical and Health Sciences, Faculty of Medicine , Linköping University , Linköping , Sweden
| | - Hollman Frisman Gunilla
- c Department of Anaesthesiology and Intensive Care, and Department of Medical and Health Sciences , Linkoping University , Linkoping , Sweden
| | - Hjortswang Henrik
- d Departments of Gastroenterology and Clinical and Experimental Medicine , Linköping University , Linköping , Sweden
| | - Wenemark Marika
- e Department of Medical and Health Sciences, Centre for Organizational support and Development , Linköping University , Linköping , Sweden
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van Belle E, Zwakhalen SMG, Caris J, Van Hecke A, Huisman-de Waal G, Heinen M. Tailoring of the Tell-us Card communication tool for nurses to increase patient participation using Intervention Mapping. J Clin Nurs 2018; 27:621-630. [PMID: 28722789 DOI: 10.1111/jocn.13968] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2017] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To describe the tailoring of the Tell-us Card intervention for enhanced patient participation to the Dutch hospital setting using Intervention Mapping as a systematic approach. BACKGROUND Even though patient participation is essential in any patient-to-nurse encounter, care plans often fail to take patients' preferences into account. The Tell-us Card intervention seems promising, but needs to be tailored and tested before implementation in a different setting or on large scale. DESIGN Description of the Intervention Mapping framework to systematically tailor the Tell-us Card intervention to the Dutch hospital setting. METHODS Intervention Mapping consists of: (i) identification of the problem through needs assessment and determination of fit, based on patients and nurses interviews and focus group interviews; (ii) developing a logic model of change and matrices, based on literature and interviews; (iii) selection of theory-based methods and practical applications; (iv) producing programme components and piloting; (v) planning for adoption, implementation and sustainability; and (vi) preparing for programme evaluation. RESULTS Knowledge, attitude, outcome expectations, self-efficacy and skills were identified as the main determinants influencing the use of the Tell-us Card. Linking identified determinants and performance objectives with behaviour change techniques from the literature resulted in a well-defined and tailored intervention and evaluation plan. CONCLUSIONS The Tell-us Card intervention was adapted to fit the Dutch hospital setting and prepared for evaluation. The Medical Research Council framework was followed, and the Intervention Mapping approach was used to prepare a pilot study to confirm feasibility and relevant outcomes. RELEVANCE TO CLINICAL PRACTICE This article shows how Intervention Mapping is applied within the Medical Research Council framework to adapt the Tell-us Card intervention, which could serve as a guide for the tailoring of similar interventions.
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Affiliation(s)
- Elise van Belle
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sandra M G Zwakhalen
- Research School CAPHRI, Department of Health Services Research, Maastricht University, MD Maastricht, The Netherlands
| | - Josien Caris
- Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Ann Van Hecke
- Faculty of Medicine and Health Sciences, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Getty Huisman-de Waal
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maud Heinen
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
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A patient-centred approach to measuring quality in kidney care: patient-reported outcome measures and patient-reported experience measures. Curr Opin Nephrol Hypertens 2018; 26:442-449. [PMID: 28806191 DOI: 10.1097/mnh.0000000000000357] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE OF REVIEW Chronic kidney disease (CKD) is associated with symptoms that can significantly reduce the health-related quality of life (HRQOL) of patients. Patient-reported outcome and experience measures (PROMs and PREMs) may assist with the evaluation of HRQOL and quality of care from the patient perspective. This review focuses on evidence from recent studies exploring the role of PROMs and PREMs in the measurement of quality in CKD care. RECENT FINDINGS PROMs are increasingly used in CKD research as measures of clinical effectiveness, whereas the current use of PROMs in routine clinical settings and PREMs in all settings is more limited. Electronic PROMs may be sensitive enough to detect clinically relevant patient-reported outcomes changes. Patients on frequent shorter-hours daily haemodialysis may experience better HRQOL compared with those on conventional haemodialysis. PROM data may correlate significantly with clinical parameters. PREMs are being utilized by healthcare professionals to inform service improvements. SUMMARY PROMs and PREMs may facilitate the measurement of quality in renal care and aid the tailoring of care to individual patients. PROMs may have a potential role as prognostic markers.
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Andersson M, Wilde-Larsson B, Carlsson E, Persenius M. Older people's perceptions of the quality of oral care in short-term care units: A cross-sectional study. Int J Older People Nurs 2018; 13:e12185. [PMID: 29363883 DOI: 10.1111/opn.12185] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 12/22/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND There is a lack of knowledge about oral care among older people living in short-term care (STC) units and how the quality of oral care provided by nursing staff is perceived by the older people. AIM To (i) describe person-related conditions among older people in STC, (ii) describe and compare perceptions of the quality of oral care (including perceptions of care received and the subjective importance of such care), within and between older people who have the ability to perform oral self-care and those who are dependent on help with oral care and (iii) examine the relationship between person-related conditions and the quality of oral care. METHODS A cross-sectional study was conducted with 391 older people in STC units in Sweden based on self-reported questionnaire and clinical assessments. RESULTS The older people were assessed as having normal oral health (2%), moderate oral health problems (78%) or severe oral health problems (20%). When comparing older people's perceptions of quality of oral care in terms of perceived reality and subjective importance, significant differences appeared within and between groups. Psychological well-being had a significant relationship with perception of the quality of oral care (both perceived reality and subjective importance), and gender and oral health status had a significant relationship with subjective importance. CONCLUSIONS Older people's perceptions of areas for improvement regarding quality of oral care is a new and important knowledge for nursing staff in STC units. Older people want personalised information regarding oral health and oral care. Registered Nurses who take the responsibility in nursing care for older people's oral health may avoid unnecessary suffering by older people caused by oral health problems. IMPLICATIONS FOR PRACTICE Older people's perspective is an important component for quality work and might lead to improvements in the quality of oral care in STC.
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Affiliation(s)
- Maria Andersson
- Department of Health Science, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
| | - Bodil Wilde-Larsson
- Department of Health Science, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden.,Faculty of Public Health Studies, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Eva Carlsson
- Faculty of Health and Medicine, University Health Care Research Center, Örebro University, Örebro, Sweden
| | - Mona Persenius
- Department of Health Science, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
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Sandsdalen T, Høye S, Rystedt I, Grøndahl VA, Hov R, Wilde-Larsson B. The relationships between the combination of person- and organization-related conditions and patients' perceptions of palliative care quality. BMC Palliat Care 2017; 16:66. [PMID: 29212539 PMCID: PMC5719731 DOI: 10.1186/s12904-017-0240-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 11/14/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Little is known about the combination of person- and organization- related conditions and the relationships with patients' perspectives of care quality. Such a combination could contribute knowledge reflecting the complexity of clinical practice, and enhance individualized care. The aim was to investigate the relationships between the combination of person- and organization-related conditions and patients' perceptions of palliative care quality. METHODS A cross-sectional study, including 191 patients in the late palliative phase (73% response rate) admitted to hospice inpatient care (n = 72), hospice day care (n = 51), palliative units in nursing homes (n = 30) and home care (n = 38), was conducted between November 2013 and December 2014, using the instrument Quality from the Patients' Perspective specific to palliative care (QPP-PC). Data were analysed, using analysis of covariance, to explore the amount of the variance in the dependent variables (QPP-PC) that could be explained by combination of the independent variables - Person- and organization-related conditions, - while controlling for differences in covariates. RESULTS Patients scored the care received and the subjective importance as moderate to high. The combination of person- and organization - related conditions revealed that patients with a high sense of coherence, lower age (person - related conditions) and being in a ward with access to and availability of physicians (organization-related condition) might be associated with significantly higher scores for the quality of care received. Gender (women), daily contact with family and friends, and low health-related quality of life (person-related conditions) might be associated with higher scores for subjective importance of the aspects of care quality. CONCLUSION Healthcare personnel, leaders and policy makers need to pay attention to person- and organization-related conditions in order to provide person-centered palliative care of high quality. Further studies from palliative care contexts are needed to confirm the findings and to investigate additional organizational factors that might influence patients' perceptions of care quality.
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Affiliation(s)
- Tuva Sandsdalen
- Department of Health Studies, Faculty of Public Health, Inland Norway University of Applied Sciences, Post box 400, 2418 Elverum, Norway
- Department of Health Science, Faculty of Health, Science and Technology, Discipline of Nursing Science, Karlstad University, 651 88 Karlstad, Sweden
| | - Sevald Høye
- Department of Health Studies, Faculty of Public Health, Inland Norway University of Applied Sciences, Post box 400, 2418 Elverum, Norway
| | - Ingrid Rystedt
- Department of Health Science, Faculty of Health, Science and Technology, Discipline of Nursing Science, Karlstad University, 651 88 Karlstad, Sweden
| | | | - Reidun Hov
- Department of Health Studies, Faculty of Public Health, Inland Norway University of Applied Sciences, Post box 400, 2418 Elverum, Norway
| | - Bodil Wilde-Larsson
- Department of Health Studies, Faculty of Public Health, Inland Norway University of Applied Sciences, Post box 400, 2418 Elverum, Norway
- Department of Health Science, Faculty of Health, Science and Technology, Discipline of Nursing Science, Karlstad University, 651 88 Karlstad, Sweden
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Xie Z, Or C. Associations Between Waiting Times, Service Times, and Patient Satisfaction in an Endocrinology Outpatient Department: A Time Study and Questionnaire Survey. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2017; 54:46958017739527. [PMID: 29161947 PMCID: PMC5798665 DOI: 10.1177/0046958017739527] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The issue of long patient waits has attracted increasing public attention due to the negative effects of waiting on patients' satisfaction with health care. The present study examined the associations between actual waiting time, perceived acceptability of waiting time, actual service time, perceived acceptability of service time, actual visit duration, and the level of patient satisfaction with care. We conducted a cross-sectional time study and questionnaire survey of endocrinology outpatients visiting a major teaching hospital in China. Our results show that actual waiting time was negatively associated with patient satisfaction regarding several aspects of the care they received. Also, patients who were less satisfied with the sociocultural atmosphere and the identity-oriented approach to their care tended to perceive the amounts of time they spent waiting and receiving care as less acceptable. It is not always possible to prevent dissatisfaction with waiting, or to actually reduce waiting times by increasing resources such as increased staffing. However, several improvements in care services can be considered. Our suggestions include providing clearer, more transparent information to keep patients informed about the health care services that they may receive, and the health care professionals who are responsible for those services. We also suggest that care providers are encouraged to continue to show empathy and respect for patients, that patients are provided with private areas where they can talk with health professionals and no one can overhear, and that hospital staff treat the family members or friends who accompany patients in a courteous and friendly way.
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Affiliation(s)
| | - Calvin Or
- 1 The University of Hong Kong, China
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Donate-Manzanares M, Rodríguez-Almagro J, Rodríguez-Cano T, Hernández-Martínez A, Barrilero-Fernández E, Santos-Hernández G, Beato-Fernández L. Cross-cultural adaptation and validation of the psychometric properties of the Quality from the Patient's Perspective I Questionnaire translated into Spanish. Midwifery 2017; 55:75-82. [DOI: 10.1016/j.midw.2017.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 09/07/2017] [Accepted: 09/10/2017] [Indexed: 11/27/2022]
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Bornet MA, Rubli Truchard E, Rochat E, Pasquier J, Monod S. Factors associated with quality of life in elderly hospitalised patients undergoing post-acute rehabilitation: a cross-sectional analytical study in Switzerland. BMJ Open 2017; 7:e018600. [PMID: 29061633 PMCID: PMC5665247 DOI: 10.1136/bmjopen-2017-018600] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES We investigated whether biopsychosocial and spiritual factors and satisfaction with care were associated with patients' perceived quality of life. DESIGN This was a cross-sectional analytical study. SETTING Data were collected from inpatients at a postacute geriatric rehabilitation centre in a university hospital in Switzerland. PARTICIPANTS Participants aged 65 years and over were consecutively recruited from October 2014 to January 2016. Exclusion criteria included significant cognitive disorder and terminal illness. Of 227 eligible participants, complete data were collected from 167. MAIN OUTCOME MEASURES Perceived quality of life was measured using WHO Quality of Life Questionnaire-version for older people. Predictive factors were age, sex, functional status at admission, comorbidities, cognitive status, depressive symptoms, living conditions and satisfaction with care. A secondary focus was the association between spiritual needs and quality of life. RESULTS Patients undergoing geriatric rehabilitation experienced a good quality of life. Greater quality of life was significantly associated with higher functional status (rs=0.204, p=0.011), better cognitive status (rs=0.175, p=0.029) and greater satisfaction with care (rs=0.264, p=0.003). Poorer quality of life was significantly associated with comorbidities (rs=-.226, p=0.033), greater depressive symptoms (rs=-.379, p<0.001) and unmet spiritual needs (rs=-.211, p=0.049). Multivariate linear regression indicated that depressive symptoms (β=-0.961; 95% CIs -1.449 to 0.472; p<0.001) significantly predicted quality of life. CONCLUSIONS Patient perceptions of quality of life were significantly associated with depression. More research is needed to assess whether considering quality of life could improve care plan creation.
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Affiliation(s)
- Marc-Antoine Bornet
- Platform Medicine, Spirituality, Care and Society, Lausanne University Hospital Center, Lausanne, Switzerland
| | - Eve Rubli Truchard
- Service of Geriatric Medicine and Geriatric Rehabilitation, Lausanne University Hospital Center, Lausanne, Switzerland
| | - Etienne Rochat
- Platform Medicine, Spirituality, Care and Society, Lausanne University Hospital Center, Lausanne, Switzerland
| | - Jérôme Pasquier
- Institute of Social and Preventive Medicine, Lausanne University Hospital Center, Lausanne, Switzerland
| | - Stéfanie Monod
- Department of Public Health, Canton of Vaud, Lausanne, Switzerland
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Factors associated with women's perception of and satisfaction with quality of intrapartum care practices in Swaziland. Midwifery 2017; 57:32-38. [PMID: 29153982 DOI: 10.1016/j.midw.2017.10.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 10/16/2017] [Accepted: 10/17/2017] [Indexed: 11/21/2022]
Abstract
OBJECTIVE giving birth is a lifetime event, where the quality of care a woman receives has the potential to affect her or her baby both physically and emotionally either on a short-term or long-term basis. This study aimed at identifying factors associated with women's perception of and satisfaction with the quality of intrapartum care as well as their future loyalty intentions in two regional hospitals in Swaziland. METHODS this is a correlational study where data were collected from 383 women conveniently selected from two regional hospitals where they gave birth. The QPP-I, SHPC, AND WOM questionnaires were used for data collection which was done from July to September 2016. FINDINGS the results reflected that women's satisfaction with quality of intrapartum care total mean score was (M±SD = 74.17±10.1), a perceived reality of intrapartum care practices total mean score of (M±SD = 96.94±16.0), a high subjective importance total mean score (M±SD = 117.78±10.5), and above average future loyalty intension total mean score (M±SD 1.67±0.69). Factors that significantly predicted women's satisfaction with quality of intrapartum care include, perceived quality (F = 54.13, p<0.001 with 28% R2 variance), demographic variables (educational level, employment status and gestational weeks) (F = 10.66, p =<0.001, with 8% R2 variance), future loyalty intensions (F = 48.57, p<0.001with 7% R2 variance), and subjective importance (F = 44.74, p<0.001 with 1% R2 variance). CONCLUSION the study revealed that women's perceived reality of and satisfaction with the quality of intrapartum care practices was suboptimal. Improvement should be focused on evidence-based intrapartum care that is women-centered, involving the clients in decision-making and also a comprehensive childbirth education for the pregnant mothers.
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Frieberg OP, Millqvist E, Nilsson J, From I. Development and validation of the self-administered Falun health instrument (SAFHI) using data from health promoted workplaces in Sweden. Scand J Public Health 2017; 46:735-743. [PMID: 29027502 DOI: 10.1177/1403494817728668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM The aim of this study was to develop and to validate the self-administered Falun health instrument. An additional aim was to test its applicability in measuring people's lifestyles linked to health. METHODS In 2002, an instrument was constructed containing questions regarding the hazardous use of alcohol, tobacco, unhealthy diets and insufficient physical activity. A pilot study using the instrument was assessed between 2002 and 2006. In Sweden, it was further expanded and tested during the years 2004-2014 among a total of 1295 people. RESULTS Face validity was evaluated among colleagues and experts for clarity and completeness resulting in minor adjustments of some questions. With the test-retest method, the self-administered Falun health questionnaire showed a positive and high reproducibility and high compliance. Cronbach's alpha showed a high level of consistency (average 0.86). Factor analysis demonstrated the choice of questions correlated highly to the measured lifestyle. CONCLUSIONS This study showed that the self-administered Falun health questionnaire is a valid and reliable instrument, useful for detecting individuals at risk of developing diseases that are related to individual choice of lifestyle.
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Affiliation(s)
- Otto-Patrik Frieberg
- 1 Health Centre Läkarhuset Unicare, Borlänge, Sweden; Centre of Clinical Research (CKF), Dalarna, Sweden
| | - Eva Millqvist
- 2 Department of Internal Medicine/Respiratory Medicine and Allergology, University of Gothenburg, Sweden
| | - Jan Nilsson
- 3 Department of Medical Science, Sophiahemmet University, Sweden.,4 Department of Health Sciences, Karlstad University, Sweden
| | - Ingrid From
- 5 The School of Education, Health and Social Studies, Dalarna University, Sweden
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Abstract
Purpose The purpose of this paper is to explore potential differences in how nursing home residents rate care quality and to explore cluster characteristics. Design/methodology/approach A cross-sectional design was used, with one questionnaire including questions from quality from patients' perspective and Big Five personality traits, together with questions related to socio-demographic aspects and health condition. Residents ( n=103) from four Norwegian nursing homes participated (74.1 per cent response rate). Hierarchical cluster analysis identified clusters with respect to care quality perceptions. χ2 tests and one-way between-groups ANOVA were performed to characterise the clusters ( p<0.05). Findings Two clusters were identified; Cluster 1 residents (28.2 per cent) had the best care quality perceptions and Cluster 2 (67.0 per cent) had the worst perceptions. The clusters were statistically significant and characterised by personal-related conditions: gender, psychological well-being, preferences, admission, satisfaction with staying in the nursing home, emotional stability and agreeableness, and by external objective care conditions: healthcare personnel and registered nurses. Research limitations/implications Residents assessed as having no cognitive impairments were included, thus excluding the largest group. By choosing questionnaire design and structured interviews, the number able to participate may increase. Practical implications Findings may provide healthcare personnel and managers with increased knowledge on which to develop strategies to improve specific care quality perceptions. Originality/value Cluster analysis can be an effective tool for differentiating between nursing homes residents' care quality perceptions.
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Affiliation(s)
| | - Liv Berit Fagerli
- Faculty of Health and Social Sciences, Østfold University College , Halden, Norway
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Ballangrud R, Husebø SE, Aase K, Aaberg OR, Vifladt A, Berg GV, Hall-Lord ML. "Teamwork in hospitals": a quasi-experimental study protocol applying a human factors approach. BMC Nurs 2017; 16:34. [PMID: 28670201 PMCID: PMC5492228 DOI: 10.1186/s12912-017-0229-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 06/19/2017] [Indexed: 11/16/2022] Open
Abstract
Background Effective teamwork and sufficient communication are critical components essential to patient safety in today’s specialized and complex healthcare services. Team training is important for an improved efficiency in inter-professional teamwork within hospitals, however the scientific rigor of studies must be strengthen and more research is required to compare studies across samples, settings and countries. The aims of the study are to translate and validate teamwork questionnaires and investigate healthcare personnel’s perception of teamwork in hospitals (Part 1). Further to explore the impact of an inter-professional teamwork intervention in a surgical ward on structure, process and outcome (Part 2). Methods To address the aims, a descriptive, and explorative design (Part 1), and a quasi-experimental interventional design will be applied (Part 2). The study will be carried out in five different hospitals (A-E) in three hospital trusts in Norway. Frontline healthcare personnel in Hospitals A and B, from both acute and non-acute departments, will be invited to respond to three Norwegian translated teamwork questionnaires (Part 1). An inter-professional teamwork intervention in line with the TeamSTEPPS recommend Model of Change will be implemented in a surgical ward at Hospital C. All physicians, registered nurses and assistant nurses in the intervention ward and two control wards (Hospitals D and E) will be invited to to survey their perception of teamwork, team decision making, safety culture and attitude towards teamwork before intervention and after six and 12 months. Adult patients admitted to the intervention surgical unit will be invited to survey their perception of quality of care during their hospital stay before intervention and after six and 12 month. Moreover, anonymous patient registry data from local registers and data from patients’ medical records will be collected (Part 2). Discussion This study will help to understand the impact of an inter-professional teamwork intervention in a surgical ward and contribute to promote healthcare personnel’s team competences with an opportunity to achieve changes in work processes and patient safety. Trial registration Trial registration number (TRN) is ISRCTN13997367. The study was registered retrospectively with registration date 30.05.2017.
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Affiliation(s)
- Randi Ballangrud
- Department of Health Science Gjøvik, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Gjøvik, P.O. Box 191, 2802 Gjøvik, Norway
| | - Sissel Eikeland Husebø
- Department of Health Studies, Faculty of Social Sciences, University of Stavanger, P.O. Box 8600 Forus, , 4036 Stavanger, Norway.,Department of Surgery, Stavanger University Hospital, Gerd Ragna Bloch Thorsens street 8, 4011 Stavanger, Norway
| | - Karina Aase
- Department of Health Studies, Faculty of Social Sciences, University of Stavanger, P.O. Box 8600 Forus, , 4036 Stavanger, Norway
| | - Oddveig Reiersdal Aaberg
- Department of Health Science Gjøvik, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Gjøvik, P.O. Box 191, 2802 Gjøvik, Norway
| | - Anne Vifladt
- Department of Health Science Gjøvik, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Gjøvik, P.O. Box 191, 2802 Gjøvik, Norway
| | - Geir Vegard Berg
- Department of Health Science Gjøvik, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Gjøvik, P.O. Box 191, 2802 Gjøvik, Norway.,Innlandet Hospital Trust Division Lillehammer, Lillehammer, Norway
| | - Marie Louise Hall-Lord
- Department of Health Science Gjøvik, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Gjøvik, P.O. Box 191, 2802 Gjøvik, Norway.,Department of Health Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
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65
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Luhr K, Eldh AC, Nilsson U, Holmefur M. Patient preferences for patient participation: Psychometric evaluation of The 4Ps tool in patients with chronic heart or lung disorders. ACTA ACUST UNITED AC 2017. [DOI: 10.1177/2057158517713156] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Patient Preferences for Patient Participation tool (The 4Ps) was developed to aid clinical dialogue and to help patients to 1) depict, 2) prioritise, and 3) evaluate patient participation with 12 pre-set items reiterated in the three sections. An earlier qualitative evaluation of The 4Ps showed promising results. The present study is a psychometric evaluation of The 4Ps in patients with chronic heart or lung disease ( n = 108) in primary and outpatient care. Internal scale validity was evaluated using Rasch analysis, and two weeks test–retest reliability of the three sections using kappa/weighted kappa and a prevalence- and bias-adjusted kappa. The 4Ps tool was found to be reasonably valid with a varied reliability. Proposed amendments are rephrasing of two items, and modifications of the rating scale in Section 2. The 4Ps is suggested for use to increase general knowledge of patient participation, but further studies are needed with regards to its implementation.
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Affiliation(s)
- Kristina Luhr
- University Health Care Research Center, Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Ann Catrine Eldh
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
- Department of Medical and Health Sciences, Linköping University, Sweden
| | - Ulrica Nilsson
- Faculty of Medicine and Health, Örebro University, Sweden
| | - Marie Holmefur
- Faculty of Medicine and Health, Örebro University, Sweden
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66
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Ängerud KH, Boman K, Brännström M. Areas for quality improvements in heart failure care: quality of care from the family members' perspective. Scand J Caring Sci 2017; 32:346-353. [PMID: 28543624 DOI: 10.1111/scs.12468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 03/21/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND The complex needs of people with chronic heart failure (HF) place great demands on their family members, and it is important to ask family members about their perspectives on the quality of HF care. OBJECTIVE To describe family members' perceptions of quality of HF care in an outpatient setting. METHODS A cross-sectional study using a short form of the Quality from Patients' Perspective (QPP) questionnaire for data collection. The items in the questionnaire measure four dimensions of quality, and each item consists of both the perceived reality of the care and its subjective importance. The study included 57 family members of patients with severe HF in NYHA class III-IV. RESULTS Family members reported areas for quality improvements in three out of four dimensions and in dimensionless items. The lowest level of perceived reality was reported for treatment for confusion and loss of appetite. Treatment for shortness of breath, access to the apparatus and access to equipment necessary for medical care were the items with the highest subjective importance for the family members. CONCLUSION Family members identified important areas for quality improvement in the care for patients with HF in an outpatient setting. In particular, symptom alleviation, information to patients, patient participation and access to care were identified as areas for improvements. Thus, measuring quality from the family members' perspective with the QPP might be a useful additional perspective when it comes to the planning and implementation of changes in the organisation of HF care.
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Affiliation(s)
| | - Kurt Boman
- Research Unit Skellefteå, Department of Medicine, Umeå University, Umeå, Sweden.,Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Margareta Brännström
- Department of Nursing, Umeå University, Umeå, Sweden.,The Arctic Research Centre, Umeå University, Umeå, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
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67
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Andersson E, Small R. Fathers' satisfaction with two different models of antenatal care in Sweden - Findings from a quasi-experimental study. Midwifery 2017; 50:201-207. [PMID: 28475916 DOI: 10.1016/j.midw.2017.04.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 04/21/2017] [Accepted: 04/26/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Ewa Andersson
- Karolinska Institutet, Department of Women's and Children's Health, Division for Reproductive health, Retziusväg 13 A, 17177 Stockholm, Sweden.
| | - Rhonda Small
- Karolinska Institutet, Department of Women's and Children's Health, Division for Reproductive health, Retziusväg 13 A, 17177 Stockholm, Sweden; Judith Lumley Centre, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
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68
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Hägglund P, Olai L, Ståhlnacke K, Persenius M, Hägg M, Andersson M, Koistinen S, Carlsson E. Study protocol for the SOFIA project: Swallowing function, Oral health, and Food Intake in old Age: a descriptive study with a cluster randomized trial. BMC Geriatr 2017; 17:78. [PMID: 28335729 PMCID: PMC5364593 DOI: 10.1186/s12877-017-0466-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 03/16/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Extensive studies have shown that older people are negatively impacted by impaired eating and nutrition. The abilities to eat, enjoy food, and participate in social activities associated with meals are important aspects of health-related quality of life (HRQoL) and recovery after illness. This project aims to (i) describe and analyze relationships between oral health and oral HRQoL, swallowing ability, eating ability, and nutritional risk among older individuals admitted to short-term care; (ii) compare the perceptions that older individuals and staff report on care quality related to oral hygiene and eating; and (iii) study the feasibility and effects of a training program for people with impaired swallowing (i.e., dysphagia). METHODS/DESIGN This project consists of two parts, which will be performed in five Swedish counties. It will include approximately 400 older individuals and 200 healthcare professionals. Part 1 is a cross-sectional, descriptive study of older people admitted to short-term care. Subjects will be assessed by trained professionals regarding oral health status, oral HRQoL, eating and nutritional risk, and swallowing ability. Swallowing ability will be measured with a teaspoon test and a swallowing capacity test (SCT). Furthermore, subjects and staff will complete a questionnaire regarding their perceptions of care quality. Part 2 is a cluster randomized intervention trial with controls. Older participants with dysphagia (i.e., SCT <10 ml/s, measured in part 1) will be recruited consecutively to either the intervention or control group, depending on where they were admitted for short-term care. At baseline, all subjects will be assessed for oral health status, oral HRQoL, eating and nutritional risk, swallowing ability, and swallowing-related QoL. Then, the intervention group will receive 5 weeks of training with an oral screen for neuromuscular training focused on orofacial and pharyngeal muscles. After completing the intervention, and at six months post-intervention, all assessments will be repeated in both study groups. DISCUSSION The results will make important contributions to rehabilitation knowledge, including approaches for improving swallowing function, oral health, and food intake and for improving the quality of oral care for older people. TRIAL REGISTRATION This trial was retrospectively registered at ClinicalTrials.gov, on July 4, 2016, identifier: NCT02825927 .
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Affiliation(s)
- Patricia Hägglund
- Oral and Maxillofacial Radiology, Department of Odontology, Faculty of Medicine, Umeå University, SE-90187, Umeå, Sweden.
| | - Lena Olai
- School of Education, Health and Social Science, Dalarna University, Falun, Sweden.,Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Section, Uppsala University, Uppsala, Sweden
| | - Katri Ståhlnacke
- Public Dental Services, Örebro County Region, Örebro, Sweden.,Faculty of Health and Medicine, Örebro University, Örebro, Sweden
| | - Mona Persenius
- Department of Health Science, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
| | - Mary Hägg
- Speech and Swallowing Centre, Department of Otorhinolaryngology, Hudiksvall Hospital, County Council of Gävleborg, Hudiksvall, Sweden.,Centre for Research and Development, Uppsala University, Uppsala, Sweden
| | - Maria Andersson
- Department of Health Science, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
| | - Susanne Koistinen
- School of Education, Health and Social Science, Dalarna University, Falun, Sweden.,School of Health Sciences, Faculty of Health and Medicine, Örebro University, Örebro, Sweden
| | - Eva Carlsson
- University Health Care Research Center, Faculty of Health and Medicine, Örebro University, Örebro, Sweden
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Jangland E, Gunningberg L. Improving patient participation in a challenging context: a 2-year evaluation study of an implementation project. J Nurs Manag 2017; 25:266-275. [PMID: 28164406 DOI: 10.1111/jonm.12459] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2016] [Indexed: 11/29/2022]
Abstract
AIM To evaluate an implementation project on patient participation. BACKGROUND Patient participation is one of the cornerstones of person-centred care. A previous intervention study resulted in improved patient participation in a surgical department in a large university hospital in Sweden. A subsequent implementation project was guided by the PARiSH framework and included several strategies over 2 years. METHOD Patients (n = 198) in five units completed a questionnaire and nurse managers (n = 5) were interviewed. RESULTS Although the long-term implementation project did not improve patient participation in the units, the nurse managers described a changing culture in which staff grew to accept patients' involvement in their own care. Several barriers to change and sustainability were acknowledged. CONCLUSIONS Improving patient participation in a busy environment is challenging. The framework was useful in the different steps of the project. In the future, the interrelationship of the core elements needs to be analysed in an ongoing and deeper way to allow both prediction and prevention of barriers to improvement. IMPLICATIONS FOR NURSING MANAGEMENT A dedicated leadership together with skilled facilitators should encourage and support staff to reflect on their attitudes and ways of working to increase person-centred care.
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Affiliation(s)
- Eva Jangland
- Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden.,Department of Surgery, Uppsala University Hospital, Uppsala, Sweden
| | - Lena Gunningberg
- Department of Public Health and Caring Sciences, Uppsala University Hospital, Uppsala, Sweden.,Quality Department, Uppsala University Hospital, Uppsala, Sweden
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Ängerud KH, Boman K, Ekman I, Brännström M. Areas for quality improvements in heart failure care: quality of care from the patient's perspective. Scand J Caring Sci 2016; 31:830-838. [DOI: 10.1111/scs.12404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 10/05/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Karin H. Ängerud
- Department of Nursing; Umeå University; Umeå Sweden
- The Arctic Research Centre; Umeå University; Umeå Sweden
| | - Kurt Boman
- Research Unit Skellefteå; Department of Medicine; Umeå University; Umeå Sweden
- Department of Public Health and Clinical Medicine; Umeå University; Umeå Sweden
| | - Inger Ekman
- Institute of Health and Care Sciences; University of Gothenburg; Gothenburg Sweden
- Centre for Person-Centred Care; University of Gothenburg (GPCC); Gothenburg Sweden
| | - Margareta Brännström
- Department of Nursing; Umeå University; Umeå Sweden
- The Arctic Research Centre; Umeå University; Umeå Sweden
- Centre for Person-Centred Care; University of Gothenburg (GPCC); Gothenburg Sweden
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71
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Malfait S, Eeckloo K, Lust E, Van Biesen W, Van Hecke A. Feasibility, appropriateness, meaningfulness and effectiveness of patient participation at bedside shift reporting: mixed-method research protocol. J Adv Nurs 2016; 73:482-494. [DOI: 10.1111/jan.13154] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Simon Malfait
- Ghent University Hospital; Belgium
- Faculty of Medicine and Health Sciences; Department of Public Health, UCVV; Ghent University; Belgium
| | - Kristof Eeckloo
- Ghent University Hospital; Belgium
- Faculty of Medicine and Health Sciences; Department of Public Health, UCVV; Ghent University; Belgium
| | - Elisa Lust
- Faculty of Medicine and Health Sciences; Department of Public Health, UCVV; Ghent University; Belgium
| | - Wim Van Biesen
- Ghent University Hospital; Belgium
- Faculty of Medicine and Health Sciences; Department of Internal Medicine; Ghent University; Belgium
| | - Ann Van Hecke
- Ghent University Hospital; Belgium
- Faculty of Medicine and Health Sciences; Department of Public Health, UCVV; Ghent University; Belgium
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Sandsdalen T, Grøndahl VA, Hov R, Høye S, Rystedt I, Wilde-Larsson B. Patients' perceptions of palliative care quality in hospice inpatient care, hospice day care, palliative units in nursing homes, and home care: a cross-sectional study. BMC Palliat Care 2016; 15:79. [PMID: 27553776 PMCID: PMC4995801 DOI: 10.1186/s12904-016-0152-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 08/15/2016] [Indexed: 12/25/2022] Open
Abstract
Background Patients’ perceptions of care quality within and across settings are important for the further development of palliative care. The aim was to investigate patients’ perceptions of palliative care quality within settings, including perceptions of care received and their subjective importance, and contrast palliative care quality across settings. Method A cross-sectional study including 191 patients in late palliative phase (73 % response rate) admitted to hospice inpatient care, hospice day care, palliative units in nursing homes, and home care was conducted, using the Quality from the Patients’ Perspective instrument-palliative care (QPP-PC). QPP-PC comprises four dimensions and 12 factors; “medical–technical competence” (MT) (2 factors), “physical–technical conditions” (PT) (one factor), “identity–orientation approach” (ID) (4 factors), “sociocultural atmosphere” (SC) (5 factors), and three single items (S); medical care, personal hygiene and atmosphere. Data were analysed using paired-samples t-test and analysis of covariance while controlling for differences in patient characteristics. Results Patients’ perceptions of care received within settings showed high scores for the factors and single items “honesty” (ID) and “atmosphere” (S) in all settings and low scores for “exhaustion” (MT) in three out of four settings. Patients’ perceptions of importance scored high for “medical care” (S), “honesty” (ID), “respect and empathy” (ID) and “atmosphere” (S) in all settings. No aspects of care scored low in all settings. Importance scored higher than perceptions of care received, in particular for receiving information. Patients’ perceptions of care across settings differed, with highest scores in hospice inpatient care for the dimensions; ID, SC, and “medical care” (S), the SC and “atmosphere” (S) for hospice day care, and “medical care” (S) for palliative units in nursing homes. There were no differences in subjective importance across settings. Conclusion Strengths of services related to identity–orientation approach and a pleasant and safe atmosphere. Key areas for improvement related to receiving information. Perceptions of subjective importance did not differ across settings, but perceptions of care received scored higher in more care areas for hospice inpatient care, than in other settings. Further studies are needed to support these findings, to investigate why perceptions of care differ across settings and to highlight what can be learned from settings receiving high scores.
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Affiliation(s)
- Tuva Sandsdalen
- Department of Health Studies, Faculty of Public Health, Hedmark University of Applied Sciences, Postbox 400, 2418, Elverum, Norway. .,Department of Health Science, Faculty of Health, Science and Technology, Discipline of Nursing Science, Karlstad University, 651 88, Karlstad, Sweden.
| | | | - Reidun Hov
- Department of Health Studies, Faculty of Public Health, Hedmark University of Applied Sciences, Postbox 400, 2418, Elverum, Norway
| | - Sevald Høye
- Department of Health Studies, Faculty of Public Health, Hedmark University of Applied Sciences, Postbox 400, 2418, Elverum, Norway
| | - Ingrid Rystedt
- Department of Health Science, Faculty of Health, Science and Technology, Discipline of Nursing Science, Karlstad University, 651 88, Karlstad, Sweden
| | - Bodil Wilde-Larsson
- Department of Health Studies, Faculty of Public Health, Hedmark University of Applied Sciences, Postbox 400, 2418, Elverum, Norway.,Department of Health Science, Faculty of Health, Science and Technology, Discipline of Nursing Science, Karlstad University, 651 88, Karlstad, Sweden
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73
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Eldh AC, Ekman I, Ehnfors M. Conditions for Patient Participation and Non-Participation in Health Care. Nurs Ethics 2016; 13:503-14. [PMID: 16961114 DOI: 10.1191/0969733006nej898oa] [Citation(s) in RCA: 123] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This study explored patients' experiences of participation and non-participation in their health care. A questionnaire-based survey method was used. Content analysis showed that conditions for patient participation occurred when information was provided not by using standard procedures but based on individual needs and accompanied by explanations, when the patient was regarded as an individual, when the patient's knowledge was recognized by staff, and when the patient made decisions based on knowledge and needs, or performed self-care. Thus, to provide conditions for true patient participation, professionals need to recognize each patient's unique knowledge and respect the individual's description of his or her situation rather than just inviting the person to participate in decision making.
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74
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Husebø SE, Olsen ØE. Impact of clinical leadership in teams' course on quality, efficiency, responsiveness and trust in the emergency department: study protocol of a trailing research study. BMJ Open 2016; 6:e011899. [PMID: 27515758 PMCID: PMC4985869 DOI: 10.1136/bmjopen-2016-011899] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Clinical leadership has long been recognised as critical for optimising patient safety, quality of care and interprofessional teamwork in busy and stressful healthcare settings. There is a need to compensate for the absence of the conventional mentor-to-apprentice transfer of clinical leadership knowledge and skills. While young doctors and nurses are increasingly proficient in medical, surgical and technical skills, their training in, and knowledge of clinical leadership skills, is not adequate to meet the demands for these non-technical skills in the emergency department. Thus, the purpose of the paper is to present and discuss the study protocol of clinical leadership in a course for teams that aims to improve quality, efficiency, responsiveness of healthcare services and collegial trust in the emergency department. METHODS AND ANALYSIS The study employs a trailing research design using multiple quantitative and qualitative methods in the summative (pretest and post-test) and formative evaluation. Quantitative data have been collected from a patient questionnaire, the emergency departments' database and by the observation of team performance. Qualitative data have been collected by shadowing healthcare professionals and through focus group interviews. To ensure trustworthiness in the data analysis, we will apply member checks and analyst triangulation, in addition to providing contextual and sample description to allow for evaluation of transferability of our results to other contexts and groups. ETHICS AND DISSEMINATION The study is approved by the ethics committee of the western part of Norway and the hospital. The study is based on voluntary participation and informed written consent. Informants can withdraw at any point in time. The results will be disseminated at research conferences, peer review journals and through public presentations to people outside the scientific community.
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Affiliation(s)
- Sissel Eikeland Husebø
- Department of Health Studies, Faculty of Social Science, University of Stavanger, Stavanger, Norway
- Department of Surgery, Stavanger University Hospital, Stavanger, Norway
| | - Øystein Evjen Olsen
- Emergency Department, Stavanger University Hospital, Stavanger, Norway
- Global Health Priorities Research Group, Department of Global Public Health and Primary Care, Center for International Health, University of Bergen, Bergen, Norway
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Beattie M, Shepherd A, Lauder W, Atherton I, Cowie J, Murphy DJ. Development and preliminary psychometric properties of the Care Experience Feedback Improvement Tool (CEFIT). BMJ Open 2016; 6:e010101. [PMID: 27301482 PMCID: PMC4916633 DOI: 10.1136/bmjopen-2015-010101] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 04/07/2016] [Accepted: 04/26/2016] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE To develop a structurally valid and reliable, yet brief measure of patient experience of hospital quality of care, the Care Experience Feedback Improvement Tool (CEFIT). Also, to examine aspects of utility of CEFIT. BACKGROUND Measuring quality improvement at the clinical interface has become a necessary component of healthcare measurement and improvement plans, but the effectiveness of measuring such complexity is dependent on the purpose and utility of the instrument used. METHODS CEFIT was designed from a theoretical model, derived from the literature and a content validity index (CVI) procedure. A telephone population surveyed 802 eligible participants (healthcare experience within the previous 12 months) to complete CEFIT. Internal consistency reliability was tested using Cronbach's α. Principal component analysis was conducted to examine the factor structure and determine structural validity. Quality criteria were applied to judge aspects of utility. RESULTS CVI found a statistically significant proportion of agreement between patient and practitioner experts for CEFIT construction. 802 eligible participants answered the CEFIT questions. Cronbach's α coefficient for internal consistency indicated high reliability (0.78). Interitem (question) total correlations (0.28-0.73) were used to establish the final instrument. Principal component analysis identified one factor accounting for 57.3% variance. Quality critique rated CEFIT as fair for content validity, excellent for structural validity, good for cost, poor for acceptability and good for educational impact. CONCLUSIONS CEFIT offers a brief yet structurally sound measure of patient experience of quality of care. The briefness of the 5-item instrument arguably offers high utility in practice. Further studies are needed to explore the utility of CEFIT to provide a robust basis for feedback to local clinical teams and drive quality improvement in the provision of care experience for patients. Further development of aspects of utility is also required.
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Affiliation(s)
- Michelle Beattie
- School of Health Sciences, University of Stirling, Centre for Health Science, Inverness, UK
| | - Ashley Shepherd
- School of Health Sciences, University of Stirling, Stirling, UK
| | - William Lauder
- College of Nursing, University of South Florida, South Florida, Florida, USA
| | - Iain Atherton
- School of Nursing, Midwifery and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Julie Cowie
- School of Health Sciences, University of Stirling, Stirling, UK
| | - Douglas J Murphy
- Quality, Safety and Informatics Research Group, University of Dundee, Dundee, UK
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76
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Samsson KS, Bernhardsson S, Larsson MEH. Perceived quality of physiotherapist-led orthopaedic triage compared with standard practice in primary care: a randomised controlled trial. BMC Musculoskelet Disord 2016; 17:257. [PMID: 27286829 PMCID: PMC4901501 DOI: 10.1186/s12891-016-1112-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 06/02/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physiotherapist-led orthopaedic triage, where physiotherapists diagnose and determine management plans, aims to enhance effectiveness and provide the best care. However, scientific evidence for the effectiveness of this model of care remains limited, and there are few studies reporting on patients' perceptions of the care provided. The purpose of this study was to evaluate patients' perceived quality of care in a physiotherapist-led orthopaedic triage in primary care, compared with standard practice. METHODS In a randomised controlled trial, patients of working age referred for orthopaedic consultation at a primary healthcare clinic in Sweden received either physiotherapist-led triage (n = 102) or standard practice (orthopaedic surgeon assessment) (n = 101). Neither subjects nor clinicians were blinded. The questionnaire Quality from the Patient's Perspective (QPP) was used to evaluate perceived quality of care focusing on the caregivers' medical-technical competence and identity-orientated approach. Also, to what extent patients' expectations were met, and their intention to follow advice was evaluated. RESULTS For this study, 163 patients (80 %) were analysed (physiotherapist-led triage (n = 83), standard practice (n = 80)). Participants perceived significantly higher quality of care with the triage than with the standard practice in regards to receiving best possible examination and treatment (medical-technical competence) (p < 0.001). This was also found in regards to receiving information about examination and treatment (p < 0.001), results (p < 0.001), and self-care (p < 0.001), the caregiver's understanding (p < 0.001), respect (p < 0.001) and commitment (p < 0.001) as well as the opportunity to participate in decision-making (p = 0.01) (identity-orientated approach). Participants in the physiotherapist-led triage group reported to a significantly higher extent that their expectations of the treatment were met (p < 0.001), as well as the intent to follow the advice and instructions received (p = 0.019). CONCLUSIONS This paper reports on patients' perceptions of quality of care in a physiotherapist-led orthopaedic triage compared with standard practice. Patients in both groups reported that they perceived good quality of care, with the patients in the physiotherapist-led triage reporting significantly higher perceived quality of care than those in the standard practice group. This model of care seems to meet patients' expectations and result in a greater intention to follow advice and instructions for self-management. Our findings are in line with existing literature that this model of care provides an opportunity to shape patient-centered care that can improve access and offer care on the most appropriate level, with maintained good quality of care. TRIAL REGISTRATION Clinical Trials NCT02265172 . Registered 10 June 2014.
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Affiliation(s)
- Karin S Samsson
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Box 430, 405 30, Gothenburg, Sweden. .,Närhälsan Tjörn Rehabilitation Clinic, Primary Health Care, Region Västra Götaland, Syster Ebbas väg 1, 471 94, Kållekärr, Sweden.
| | - Susanne Bernhardsson
- Närhalsan Research and Development Primary Health Care, Region Västra Götaland, Kungsgatan 12, 6th floor, 411 18, Gothenburg, Sweden
| | - Maria E H Larsson
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Box 430, 405 30, Gothenburg, Sweden.,Närhalsan Research and Development Primary Health Care, Region Västra Götaland, Kungsgatan 12, 6th floor, 411 18, Gothenburg, Sweden
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Kabatooro A, Ndoboli F, Namatovu J. Patient satisfaction with medical consultations among adults attending Mulago hospital assessment centre. S Afr Fam Pract (2004) 2016; 58:87-93. [PMID: 28480060 PMCID: PMC5417694 DOI: 10.1080/20786190.2016.1177977] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background Patient satisfaction is known to positively influence patients’ compliance with medical advice. In Africa, and specifically Uganda, this interaction has rarely been put to scientific inquiry. This study aimed to determine the level of patient satisfaction and identify factors influencing satisfaction with medical consultations among adults attending Mulago Assessment Centre. Methods This was a quantitative descriptive cross-sectional study where 384 respondents were interviewed using a structured questionnaire adapted from the Medical Interview Satisfaction Scale (MISS-21) with a four-point Likert scale. Patient satisfaction was measured using four dimensions namely: information provision, clinicians’ communication skills, perceived consulting time and patient’s confidence in the clinician. Respondents’ mean scores were categorised as satisfied or dissatisfied. Multivariate linear regression analysis assessed the effect of independent variables on the regression factor score of the dependent variable. Significance level was set at p < 0.05. Final data analysis was done using STATA version 11.0. Results Of the sample, 53.9% were satisfied with the medical consultation. Patients’ average scores showed lowest satisfaction for information provision (2.7 points) compared with communication skills (3.22 points), patient confidence in the clinicians (3.22 points) and consultation time (3.05 points). Being older, employed, living further away from the health centre and frequently visiting the centre were positively associated with patient satisfaction. Conclusions Patient satisfaction was largely affected by interpersonal factors. This highlights the need for training of clinicians on the importance of adequate information provision, good communication skills and technical competences like thorough examination of patients and relieving worries about illness during the consultation.
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Affiliation(s)
- Angella Kabatooro
- Department of Family Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Fred Ndoboli
- Department of Family Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Jane Namatovu
- Department of Family Medicine, Makerere University College of Health Sciences, Kampala, Uganda
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Skundberg-Kletthagen H, Hall-Lord ML, Hedelin B, Wangensteen S. Relatives of Inpatients Suffering from Severe Depression: Their Burden and Encounters with the Psychiatric Health Services. Issues Ment Health Nurs 2016; 37:293-8. [PMID: 27058574 DOI: 10.3109/01612840.2016.1145309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The aim was to investigate relatives of inpatients with severe depression - their perceptions of encountering psychiatric specialist health services and their degree of burden. Sixty-eight relatives recruited via hospital wards and community specialist health centers responded to a questionnaire, with questions from the Quality from the Patients Perspective modified to relatives and the Burden Assessment Scale. Relatives recruited via community specialist health centers perceived less received information and support than those recruited via hospital wards. Higher burden was reported among relatives receiving less information and support than they needed from the psychiatric specialist health services. Healthcare professionals are recommended to give relatives the information and support according to their needs.
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Affiliation(s)
- Hege Skundberg-Kletthagen
- a Karlstad University , Department of Health Sciences , Karlstad , Sweden.,b Norwegian University of Science and Technology , Department of Nursing , Gjøvik , Norway
| | - Marie Louise Hall-Lord
- a Karlstad University , Department of Health Sciences , Karlstad , Sweden.,b Norwegian University of Science and Technology , Department of Nursing , Gjøvik , Norway
| | - Birgitta Hedelin
- b Norwegian University of Science and Technology , Department of Nursing , Gjøvik , Norway
| | - Sigrid Wangensteen
- b Norwegian University of Science and Technology , Department of Nursing , Gjøvik , Norway
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79
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Kolovos P, Kaitelidou D, Lemonidou C, Sachlas A, Sourtzi P. Patients’ perceptions and preferences of participation in nursing care. J Res Nurs 2016. [DOI: 10.1177/1744987116633498] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The aim of this study was to investigate patients’ perceptions and preferences of their participation in nursing care during hospitalisation in Greece. The sample consisted of medical and surgical patients ( n = 300). A questionnaire was developed to measure patients’ perception of participation, including an open question and the control preference scale. Descriptive and inferential statistics were used for quantitative data analysis and content analysis for qualitative data. Participation was described as ‘information receiving and responsibility’ and ‘ability to influence’. One-third of the respondents preferred a collaborative role with the nurses, while 77.2% rationalised patient participation with the themes ‘strengthening patient’s role’, ‘improve hospitalisation’ and ‘collaborative relationship’. The meaning of participation seems to support shared information, patient responsibility and motivation during nursing care. Patients were aware of the positive effects of their involvement in care and were willing to assume, at least to some extent, an active role in their own care. Changes in nursing care organisation, nurses’ communication skills and additional educational strategies need to be developed and implemented in clinical practice to optimise patient participation.
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Affiliation(s)
- Petros Kolovos
- Teaching Staff, Department of Nursing, University of Peloponnese, Greece
| | - Daphne Kaitelidou
- Assistant Professor, Faculty of Nursing, National and Kapodistrian University of Athens, Greece
| | - Chrysoula Lemonidou
- Professor, Faculty of Nursing, National and Kapodistrian University of Athens, Greece
| | | | - Panayota Sourtzi
- Professor, Faculty of Nursing, National and Kapodistrian University of Athens, Greece
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Galle A, Van Parys AS, Roelens K, Keygnaert I. Expectations and satisfaction with antenatal care among pregnant women with a focus on vulnerable groups: a descriptive study in Ghent. BMC WOMENS HEALTH 2015; 15:112. [PMID: 26627054 PMCID: PMC4667492 DOI: 10.1186/s12905-015-0266-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 11/18/2015] [Indexed: 11/26/2022]
Abstract
Background Previous studies demonstrate that people’s satisfaction with healthcare influences their further use of that healthcare system. Satisfied patients are more likely to take part in the decision making process and to complete treatment. One of the important determinants of satisfaction is the fulfillment of expectations. This study aims to analyse both expectations and satisfaction with antenatal care among pregnant women, with a particular focus on vulnerable groups. Methods A quantitative descriptive study was conducted in 155 women seeking antenatal care at the University Hospital of Ghent (Belgium), of whom 139 completed the questionnaire. The statistical program SPSS-21 was used for data analysis. Results Women had high expectations relating to continuity of care and women-centered care, while expectations regarding availability of other services and complete care were low. We observed significantly lower expectations among women without higher education, with low income, younger than 26 years and women who reported intimate partner violence. General satisfaction with antenatal care was high. Women were satisfied with their relationship with the healthcare worker, however ; they evaluated the information received during the consultation and the organizational aspects of antenatal care as less satisfactory. Conclusions In order to improve satisfaction with antenatal care, organizational aspects of antenatal care (e.g. reducing waiting times and increasing accessibility) need to be improved. In addition, women would appreciate a better provision of information during consultation. More research is needed for an in-depth understanding of the determinants of satisfaction and the relationship with low socio economic status (SES). Electronic supplementary material The online version of this article (doi:10.1186/s12905-015-0266-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anna Galle
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, International Centre for Reproductive Health, Ghent University, De Pintelaan 185, UZP 114, 9000, Ghent, Belgium.
| | - An-Sofie Van Parys
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, International Centre for Reproductive Health, Ghent University, De Pintelaan 185, UZP 114, 9000, Ghent, Belgium.
| | - Kristien Roelens
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, International Centre for Reproductive Health, Ghent University, De Pintelaan 185, UZP 114, 9000, Ghent, Belgium.
| | - Ines Keygnaert
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, International Centre for Reproductive Health, Ghent University, De Pintelaan 185, UZP 114, 9000, Ghent, Belgium.
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Sandsdalen T, Rystedt I, Grøndahl VA, Hov R, Høye S, Wilde-Larsson B. Patients' perceptions of palliative care: adaptation of the Quality from the Patient's Perspective instrument for use in palliative care, and description of patients' perceptions of care received. BMC Palliat Care 2015; 14:54. [PMID: 26525048 PMCID: PMC4630886 DOI: 10.1186/s12904-015-0049-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 10/16/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Instruments specific to palliative care tend to measure care quality from relative perspectives or have insufficient theoretical foundation. The instrument Quality from the Patient's Perspective (QPP) is based on a model for care quality derived from patients' perceptions of care, although it has not been psychometrically evaluated for use in palliative care. The aim of this study was to adapt the QPP for use in palliative care contexts, and to describe patients' perceptions of the care quality in terms of the subjective importance of the care aspects and the perceptions of the care received. METHOD A cross-sectional study was conducted between November 2013 and December 2014 which included 191 patients (73% response rate) in late palliative phase at hospice inpatient units, hospice day-care units, wards in nursing homes that specialized in palliative care and homecare districts, all in Norway. An explorative factor analysis using principal component analysis, including data from 184 patients, was performed for psychometric evaluation. Internal consistency was assessed by Cronbach's alpha and paired t-tests were used to describe patients' perceptions of their care. RESULTS The QPP instrument was adapted for palliative care in four steps: (1) selecting items from the QPP, (2) modifying items and (3) constructing new items to the palliative care setting, and (4) a pilot evaluation. QPP instrument specific to palliative care (QPP-PC) consists of 51 items and 12 factors with an eigenvalue ≥1.0, and showed a stable factor solution that explained 68.25% of the total variance. The reliability coefficients were acceptable for most factors (0.79-0.96). Patients scored most aspects of care related to both subjective importance and actual care received as high. Areas for improvement were symptom relief, participation, continuity, and planning and cooperation. CONCLUSION The QPP-PC is based on a theoretical model of quality of care, and has its roots in patients' perspectives. The instrument was developed and psychometrically evaluated in a sample of Norwegian patients with various diagnoses receiving palliative care in different care contexts. The evaluation of the QPP-PC shows promising results, although it needs to be further validated and tested in other contexts and countries.
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Affiliation(s)
- Tuva Sandsdalen
- Department of Health Studies, Faculty of Public Health, Hedmark University College, Postbox 400, 2418, Elverum, Norway. .,Department of Health Science, Faculty of Health, Science and Technology, Discipline of Nursing Science, Karlstad University, 651 88, Karlstad, Sweden.
| | - Ingrid Rystedt
- Department of Health Science, Faculty of Health, Science and Technology, Discipline of Nursing Science, Karlstad University, 651 88, Karlstad, Sweden.
| | | | - Reidun Hov
- Department of Health Studies, Faculty of Public Health, Hedmark University College, Postbox 400, 2418, Elverum, Norway.
| | - Sevald Høye
- Department of Health Studies, Faculty of Public Health, Hedmark University College, Postbox 400, 2418, Elverum, Norway.
| | - Bodil Wilde-Larsson
- Department of Health Studies, Faculty of Public Health, Hedmark University College, Postbox 400, 2418, Elverum, Norway. .,Department of Health Science, Faculty of Health, Science and Technology, Discipline of Nursing Science, Karlstad University, 651 88, Karlstad, Sweden.
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From I, Wilde-Larsson B, Nordström G, Johansson I. Formal caregivers' perceptions of quality of care for older people: associating factors. BMC Res Notes 2015; 8:623. [PMID: 26517989 PMCID: PMC4627617 DOI: 10.1186/s13104-015-1597-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 10/19/2015] [Indexed: 11/22/2022] Open
Abstract
Background Despite the growing number of studies concerning quality of care for older people, there is a lack of studies depicting factors associated with good quality of care from the formal caregivers’ perspective. The aim was to describe formal caregivers’ perceptions of quality of care for older people in the community and explore factors associated
with these perceptions. In total, 70 nursing assistants, 163 enrolled nurses and 198 registered nurses from 14 communities in central Sweden participated in the study. They filled out the following questionnaires: a modified version of Quality from the Patient’s Perspective, Creative Climate Questionnaire, Stress of Conscience Questionnaire, items regarding education and competence, Health Index and Sense of coherence questionnaire. The overall response rate was 57 % (n = 431). Results In the perceived reality of quality of care respondents assessed the highest mean value in the dimension medical-technical competence and physical technical conditions and lower values in the dimensions; identity-oriented approach, socio-cultural atmosphere and in the context specific dimension. The caregivers estimated their competence and health rather high, had lower average values in sense of coherence and organizational climate and low values in stress of conscience. Conclusions The PR of quality of care were estimated higher among NA/ENs compared to RNs. Occupation, organizational climate and stress of conscience were factors associated with quality of care that explained 42 % of the variance. Competence, general health and sense of coherence were not significantly associated to quality of care. The mentioned factors explaining quality of care might be intertwined and showed that formal caregivers’ working conditions are of great importance for quality of care.
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Affiliation(s)
- Ingrid From
- School of Health and Social Studies, Dalarna University, 791 88, Falun, Sweden. .,Department of Health Sciences, Faculty of Health Science and Technology, Karlstad University, Karlstad, Sweden.
| | - Bodil Wilde-Larsson
- Department of Health Sciences, Faculty of Health Science and Technology, Karlstad University, Karlstad, Sweden. .,Department of Nursing and Mental Health, Department of Nursing, Faculty of Public Health, Hedmark University College, Elverum, Norway.
| | - Gun Nordström
- Department of Health Sciences, Faculty of Health Science and Technology, Karlstad University, Karlstad, Sweden. .,Department of Nursing and Mental Health, Department of Nursing, Faculty of Public Health, Hedmark University College, Elverum, Norway.
| | - Inger Johansson
- Department of Health Sciences, Faculty of Health Science and Technology, Karlstad University, Karlstad, Sweden. .,Department of Nursing, Gjövik University College, Gjövik, Norway.
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Kirchhoff JW, Grøndahl VA, Andersen KL. Betydningen av sosiale nettverk og kvalitet på pleien for opplevelse av ensomhet blant brukere av hjemmesykepleie. ACTA ACUST UNITED AC 2015. [DOI: 10.18261/issn1892-2686-2015-03-04] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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84
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Petersen GS, Knudsen JL, Vinter MM. Cancer patients' preferences of care within hospitals: a systematic literature review. Int J Qual Health Care 2015; 27:384-95. [PMID: 26265160 DOI: 10.1093/intqhc/mzv059] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2015] [Indexed: 11/14/2022] Open
Abstract
PURPOSE Knowledge about cancer patients' preferences in health care is important because it enables care to be patient centered. However, the literature does not provide an overview. The aim of this study was to identify the dimensions of hospital-based cancer care that patients evaluate the most important using Patient-rated importance as a method. DATA SOURCE PubMed was searched in 2013/2014. STUDY SELECTION Studies were identified, if they were in accordance with specific search terms and focused on hospital-based cancer care. Totally, 11 studies were found. DATA EXTRACTION The 11 studies comprised a total of 598 items. Of these, 592 items were categorized into 19 care dimensions. The highest rated quartile of items was identified as care elements patients evaluated to be the most important. Identification of the most important dimensions was done by calculating the percentages of items within each dimension that were within the highest quartile. RESULTS OF DATA SYNTHESIS The 11 studies varied a lot in regard to aim and patient characteristics. The three most important dimensions were as follows: Rapid diagnosis and treatment; High professional standard; and Information about treatment and side(effects)/consequences. Within four dimensions, Psychosocial support, Physical facilities, Waiting time and Transparency in care, no items were within the highest quartile. CONCLUSION Patient-rated importance was a useful method in identifying the care patients preferred. Due to a limited number of studies and great diversity within studies evaluated, interpretation of results should be cautious. However, it seems that cancer patients treated in hospitals with a curative intent find treatment-related information, professional standard and short delay of diagnosis and treatment most important.
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Affiliation(s)
| | - Janne Lehmann Knudsen
- Danish Cancer Society, Documentation & Quality, Strandboulevarden 49, Copenhagen DK-2100, Denmark
| | - Mette Marianne Vinter
- Danish Cancer Society, Documentation & Quality, Strandboulevarden 49, Copenhagen DK-2100, Denmark
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85
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Beattie M, Murphy DJ, Atherton I, Lauder W. Instruments to measure patient experience of healthcare quality in hospitals: a systematic review. Syst Rev 2015; 4:97. [PMID: 26202326 PMCID: PMC4511995 DOI: 10.1186/s13643-015-0089-0] [Citation(s) in RCA: 201] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 07/08/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Improving and sustaining the quality of hospital care is an international challenge. Patient experience data can be used to target improvement and research. However, the use of patient experience data has been hindered by confusion over multiple instruments (questionnaires) with unknown psychometric testing and utility. METHODS We conducted a systematic review and utility critique of questionnaires to measure patient experience of healthcare quality in hospitals. Databases (Medical Literature Analysis and Retrieval System (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psychological Information (PsychINFO) and Web of Knowledge until end of November 2013) and grey literature were scrutinised. Inclusion criteria were applied to all records with a 10 % sample independently checked. Critique included (1) application of COSMIN checklists to assess the quality of each psychometric study, (2) critique of psychometric results of each study using Terwee et al. criteria and (3) development and critique of additional aspects of utility for each instrument. Two independent reviewers completed each critique. Synthesis included combining findings in a utility matrix. RESULTS We obtained 1157 records. Of these, 26 papers measuring patient experience of hospital quality of care were identified examining 11 international instruments. We found evidence of extensive theoretical/development work. The quality of methods and results was variable but mostly of a high standard. Additional aspects of utility found that (1) cost efficiency was mostly poor, due to the resource necessary to obtain reliable samples; (2) acceptability of most instruments was good and (3) educational impact was variable, with evidence on the ease of use, for approximately half of the questionnaires. CONCLUSIONS Selecting the right patient experience instrument depends on a balanced consideration of aspects of utility, aided by the matrix. Data required for high stakes purposes requires a high degree of reliability and validity, while those used for quality improvement may tolerate lower levels of reliability in favour of other aspects of utility (educational impact, cost and acceptability). SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42013006754.
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Affiliation(s)
- Michelle Beattie
- School of Health Sciences, Centre for Health Science, University of Stirling, Highland Campus, Old Perth Rd, Inverness, IV2 3JH, UK.
| | - Douglas J Murphy
- Quality, Safety and Informatics Research Group, University of Dundee, Dundee, UK.
| | - Iain Atherton
- School of Nursing, Midwifery and Social Care, Edinburgh Napier University, Edinburgh, UK.
| | - William Lauder
- School of Health Sciences, University of Stirling, Stirling, UK.
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Hildingsson I. Women's birth expectations, are they fulfilled? Findings from a longitudinal Swedish cohort study. Women Birth 2015; 28:e7-13. [DOI: 10.1016/j.wombi.2015.01.011] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 12/28/2014] [Accepted: 01/31/2015] [Indexed: 11/28/2022]
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Abstract
PURPOSE The purpose of this paper is to describe instruments used for quality assessment in acute care. Quality care assessment is essential for improving care delivery. Quality instruments can be used to evaluate nurse and patient perspectives in multi-professional care. Therefore, valid and reliable measurement instruments are vital. DESIGN/METHODOLOGY/APPROACH A literature search identified several instruments that measure quality from a nurse and patient perspectives. The questionnaires were appraised in several steps with specific criteria: psychometric properties, underlying construct or test theory, study context, sample characteristics and target population. FINDINGS Overall, 14 instruments were evaluated, but only eight questionnaires represented nurse and patient views regarding quality. Instruments showed several disparities in their theoretical foundations and their psychometric properties. Two instruments did not provide validity data and one questionnaire did not report reliability data. PRACTICAL IMPLICATIONS To inform healthcare managers about acute care quality, the authors demonstrated the need for more valid and reliable measurements by using the Guidelines for Critiquing Instrument Development and Validation Reports to evaluate quality care instruments' psychometric properties. ORIGINALITY/VALUE There is a long tradition in quality care evaluations using questionnaires. Only a few instruments can be recommended for practical use.
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Affiliation(s)
- Manela Glarcher
- Department of Nursing Science and Gerontology, UMIT the Health and Life Sciences University, Hall in Tirol, Austria
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Wong ELY, Coulter A, Hewitson P, Cheung AWL, Yam CHK, Lui SF, Tam WWS, Yeoh EK. Patient experience and satisfaction with inpatient service: development of short form survey instrument measuring the core aspect of inpatient experience. PLoS One 2015; 10:e0122299. [PMID: 25860775 PMCID: PMC4393260 DOI: 10.1371/journal.pone.0122299] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 02/19/2015] [Indexed: 11/18/2022] Open
Abstract
Patient experience reflects quality of care from the patients' perspective; therefore, patients' experiences are important data in the evaluation of the quality of health services. The development of an abbreviated, reliable and valid instrument for measuring inpatients' experience would reflect the key aspect of inpatient care from patients' perspective as well as facilitate quality improvement by cultivating patient engagement and allow the trends in patient satisfaction and experience to be measured regularly. The study developed a short-form inpatient instrument and tested its ability to capture a core set of inpatients' experiences. The Hong Kong Inpatient Experience Questionnaire (HKIEQ) was established in 2010; it is an adaptation of the General Inpatient Questionnaire of the Care Quality Commission created by the Picker Institute in United Kingdom. This study used a consensus conference and a cross-sectional validation survey to create and validate a short-form of the Hong Kong Inpatient Experience Questionnaire (SF-HKIEQ). The short-form, the SF-HKIEQ, consisted of 18 items derived from the HKIEQ. The 18 items mainly covered relational aspects of care under four dimensions of the patient's journey: hospital staff, patient care and treatment, information on leaving the hospital, and overall impression. The SF-HKIEQ had a high degree of face validity, construct validity and internal reliability. The validated SF-HKIEQ reflects the relevant core aspects of inpatients' experience in a hospital setting. It provides a quick reference tool for quality improvement purposes and a platform that allows both healthcare staff and patients to monitor the quality of hospital care over time.
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Affiliation(s)
- Eliza L Y Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Angela Coulter
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Paul Hewitson
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Annie W L Cheung
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Carrie H K Yam
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Siu Fai Lui
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Wilson W S Tam
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Eng-Kiong Yeoh
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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89
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Forsberg A, Vikman I, Wälivaara BM, Engström Å. Patients' Perceptions of Quality of Care During the Perioperative Procedure. J Perianesth Nurs 2015. [PMID: 26210559 DOI: 10.1016/j.jopan.2014.05.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe patients' perceptions of quality of care during the perioperative period and to identify areas for quality improvement. DESIGN A cross-sectional descriptive survey design was used. METHODS The data were collected (N = 170) using a questionnaire for perioperative care. The methods were descriptive statistics, reported as percentages, and a manifest content analysis of the free text. FINDING The areas identified for improvement were information and participation. The participants lacked knowledge, preferred to hand over decision making to the hospital staff, and indicated that having personalized information about the surgery and perioperative period was important. However, too detailed information before surgery could cause increased anxiety. CONCLUSIONS This study indicates that participation and information needs in perioperative settings seem to be situation specific. In addition, these needs seem to be personal and surgery specific. Further studies are required to clarify the differences in the satisfaction and quality of care between groups of patients in the perioperative context.
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90
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Wallin Lundell I, Öhman SG, Sundström Poromaa I, Högberg U, Sydsjö G, Skoog Svanberg A. How women perceive abortion care: A study focusing on healthy women and those with mental and posttraumatic stress. EUR J CONTRACEP REPR 2015; 20:211-22. [PMID: 25666812 DOI: 10.3109/13625187.2014.1002032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objectives To identify perceived deficiencies in the quality of abortion care among healthy women and those with mental stress. Methods This multi-centre cohort study included six obstetrics and gynaecology departments in Sweden. Posttraumatic stress (PTSD/PTSS) was assessed using the Screen Questionnaire-Posttraumatic Stress Disorder; anxiety and depressive symptoms, using the Hospital Anxiety Depression Scale; and abortion quality perceptions, using a modified version of the Quality from the Patient's Perspective questionnaire. Pain during medical abortion was assessed in a subsample using a visual analogue scale. Results Overall, 16% of the participants assessed the abortion care as being deficient, and 22% experienced intense pain during medical abortion. Women with PTSD/PTSS more often perceived the abortion care as deficient overall and differed from healthy women in reports of deficiencies in support, respectful treatment, opportunities for privacy and rest, and availability of support from a significant person during the procedure. There was a marginally significant difference between PTSD/PTSS and the comparison group for insufficient pain alleviation. Conclusions Women with PTSD/PTSS perceived abortion care to be deficient more often than did healthy women. These women do require extra support, relatively simple efforts to provide adequate pain alleviation, support and privacy during abortion may improve abortion care.
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Affiliation(s)
- Inger Wallin Lundell
- * Department of Women's and Children's Health, Uppsala University , Uppsala , Sweden
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91
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Tavakol Olofsson P, Aspelin P, Bergstrand L, Blomqvist L. Patients' experience of outsourcing and care related to magnetic resonance examinations. Ups J Med Sci 2014; 119:343-9. [PMID: 25142133 PMCID: PMC4248075 DOI: 10.3109/03009734.2014.951133] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 07/29/2014] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Outsourcing radiological examinations from public university hospitals affects the patient, who has to attend a different clinic or hospital for the radiological examination. We currently have a limited understanding of how patients view outsourcing and their care related to MR examinations. AIM To examine the experiences of patients who are sent to private radiology units when their referrals for MR examinations are outsourced from a university hospital, as well as to explore factors which influence patient satisfaction regarding the quality of care related to the MR examination. METHODS A group of patients (n = 160) referred for MR examinations and either examined at a university hospital or at an external private unit were interviewed. The interview was designed as a verbal questionnaire. Data were analyzed using Student's t test, analysis of variance (ANOVA), and Pearson's correlation. RESULTS Sixty-nine percent of the patients could neither choose nor influence the location at which they were examined. For those who could, aspects that influenced the patient's choice of radiology department were: short waiting time 79% (127/160), ease of traveling to the radiology department 68% (110/160), and short distance to their home or work 58% (93/160). For 40% (60/160) of the patients, a short time in the waiting room was related to a positive experience of the MR examination. CONCLUSION If patients were informed about outsourcing and could also choose where to have their examination, key factors contributing to patient satisfaction could be met even when MR examinations are outsourced.
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Affiliation(s)
- Parvin Tavakol Olofsson
- Department of Clinical Science, Intervention and Technology at Karolinska Institutet, Division of Medical Imaging and Technology, Stockholm, Sweden
| | - Peter Aspelin
- Department of Clinical Science, Intervention and Technology at Karolinska Institutet, Division of Medical Imaging and Technology, Stockholm, Sweden
| | | | - Lennart Blomqvist
- Department of Radiology, Karolinska University Hospital in Solna, Stockholm, Sweden
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92
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Holter H, Sandin-Bojö AK, Gejervall AL, Wikland M, Wilde-Larsson B, Bergh C. Patient-centred quality of care in an IVF programme evaluated by men and women. Hum Reprod 2014; 29:2695-703. [PMID: 25316450 DOI: 10.1093/humrep/deu254] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
STUDY QUESTION Do men and women value the same aspects of quality of care during IVF treatment when measuring rates of importance by the validated instrument, quality from the patient's perspective of in vitro fertilization (QPP-IVF)? SUMMARY ANSWER Women valued most aspects of care as significantly more important than their partner although men and women evaluated the importance of the different care factors in a similar pattern. WHAT IS KNOWN ALREADY A few validated tools measuring patient-centred quality of care during IVF have been developed. Few studies of gender differences concerning experiences of patient-centred quality of care have been reported in the literature to date. STUDY DESIGN, SIZE AND DURATION A two-centre study was conducted between September 2011 and May 2012. Heterosexual couples (n = 497) undergoing IVF were invited to complete a questionnaire before receiving the result of the pregnancy test. PARTICIPANTS/MATERIALS, SETTING, METHODS In all, 363 women and 292 men evaluated quality of care by answering the QPP-IVF questionnaire. The measurements consisted of two kinds of evaluations: the rating of the importance of various aspects of treatment (subjective importance) and the rating of perceived quality of care (perceived reality). Comparisons between men and women on importance ratings and perceived reality ratings were performed both on factor (subscale) and single item levels by intra-couple analyses and corrected for age. A stepwise multiple logistic regression analysis was performed in order to select baseline variables independently predicting evaluation at factor level. MAIN RESULTS AND THE ROLE OF CHANCE The response rate was 67.5%, with 363 women (74.2%) and 292 men (60.6%) completing the study. Both the woman and man responded in 251 couples. Women rated the different care aspects as significantly more important than their partner in all factors except the factor, 'Responsibility/continuity'. Both genders gave the factors, 'Medical care' and 'Information after treatment', the highest scores. At item level women rated the majority of items as significantly more important than men. Perceived reality for the majority of factors and items was similarly rated by men and women in the couples. For women, receiving embryo transfer, short duration of infertility, IVF as a method and number of previous cycles were independently correlated to the highest score of importance of certain factors. LIMITATIONS, REASON FOR CAUTION The lower response rate of men compared with women (60.6 versus 74.2%, respectively) might have influenced the results through selection bias. Only patients who had adequate fluency in the Swedish language participated. WIDER IMPLICATIONS OF THE FINDINGS This study is an important contribution in comparing the needs of men and women undergoing IVF treatments. The QPP-IVF instrument is a suitable instrument for revealing important care aspects identified by both men and women and a useful tool for stimulating patient-centred quality improvements within and between clinics. STUDY FUNDING/COMPETING INTEREST The study was supported by the LUA/ALF agreement at Sahlgrenska University Hospital, Gothenburg, Sweden, and by Hjalmar Svensson's Research Foundation. None of the authors declared any conflict of interests.
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Affiliation(s)
- Herborg Holter
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg SE-413 45, Sweden
| | - Ann-Kristin Sandin-Bojö
- Department of Health Sciences, Nursing Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad SE 651 88, Sweden
| | - Ann-Louise Gejervall
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg SE-413 45, Sweden
| | - Matts Wikland
- Fertility Centre Scandinavia, Box 5418, Gothenburg SE-40229, Sweden
| | - Bodil Wilde-Larsson
- Department of Health Sciences, Nursing Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad SE 651 88, Sweden
| | - Christina Bergh
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg SE-413 45, Sweden
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93
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Abstract
Purpose
– The purpose of this paper is to evaluate an organizationally oriented, patient-focused care (PFC) model's effects on care quality and work climate.
Design/methodology/approach
– The study has a before-after (PFC implementation) design. The sample included 1,474 patients and 458 healthcare providers in six participating wards before and after PFC implementation, plus five additional randomly chosen wards, which only featured in the post-assessment.
Findings
– No pre-post differences were found regarding care perceptions or provider work climate evaluations. Statistically significant improvements were noted among provider care evaluations. Using aggregate-level ward data, multiple regression analyses showed that high adherence to PFC principles and a positive work climate contributed significantly to variance among care quality ratings.
Research limitations/implications
– Among healthcare providers, questions related to specific PFC aspects during evenings, nights and weekends had to be dropped owing to a low response rate.
Practical implications
– An important requirement for both practice and research is to tailor PFC to various health and social care contexts.
Originality/value
– The study is large-scale before-after PFC model review, where patient and provider data were collected using well-established measurements.
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Eldh AC, Luhr K, Ehnfors M. The development and initial validation of a clinical tool for patients' preferences on patient participation--The 4Ps. Health Expect 2014; 18:2522-35. [PMID: 24938672 DOI: 10.1111/hex.12221] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2014] [Indexed: 12/15/2022] Open
Abstract
AIMS To report on the development and initial testing of a clinical tool, The Patient Preferences for Patient Participation tool (The 4Ps), which will allow patients to depict, prioritize, and evaluate their participation in health care. BACKGROUND While patient participation is vital for high quality health care, a common definition incorporating all stakeholders' experience is pending. In order to support participation in health care, a tool for determining patients' preferences on participation is proposed, including opportunities to evaluate participation while considering patient preferences. METHODS Exploratory mixed methods studies informed the development of the tool, and descriptive design guided its initial testing. The 4Ps tool was tested with 21 Swedish researcher experts (REs) and patient experts (PEs) with experience of patient participation. Individual Think Aloud interviews were employed to capture experiences of content, response process, and acceptability. RESULTS 'The 4Ps' included three sections for the patient to depict, prioritize, and evaluate participation using 12 items corresponding to 'Having Dialogue', 'Sharing Knowledge', 'Planning', and 'Managing Self-care'. The REs and PEs considered 'The 4Ps' comprehensible, and that all items corresponded to the concept of patient participation. The tool was perceived to facilitate patient participation whilst requiring amendments to content and layout. CONCLUSIONS A tool like The 4Ps provides opportunities for patients to depict participation, and thus supports communication and collaboration. Further patient evaluation is needed to understand the conditions for patient participation. While The 4Ps is promising, revision and testing in clinical practice is required.
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Affiliation(s)
- Ann Catrine Eldh
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Kristina Luhr
- School of Health and Medical Sciences, Örebro University, Örebro, Sweden.,Family Medicine Research Centre, Örebro County Council, Örebro, Sweden
| | - Margareta Ehnfors
- School of Health and Medical Sciences, Örebro University, Örebro, Sweden
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95
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Holter H, Sandin-Bojö AK, Gejervall AL, Wikland M, Wilde-Larsson B, Bergh C. Quality of care in an IVF programme from a patient's perspective: development of a validated instrument. Hum Reprod 2013; 29:534-47. [PMID: 24287821 DOI: 10.1093/humrep/det421] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Is it possible to develop a trustworthy instrument to evaluate the patient's perspective on fertility care and to document fully all methodological steps, including validation? SUMMARY ANSWER A validated instrument has been developed for both women and men undergoing assisted reproduction to monitor the quality of care on a regular basis, similar to live birth rates and other effectiveness data. WHAT IS KNOWN ALREADY?: Within fertility care, several instruments have been developed, but many have significant methodological problems and few have been validated. Most instruments focus exclusively on women and no questionnaires have been directed at women and men separately. STUDY DESIGN, SIZE AND DURATION The questionnaire specific to IVF treatments (QPP-IVF) is based on the theoretical foundation of the validated general instrument, quality of care from patients perspective (QPP), for both women and men. The QPP-IVF was developed and validated by quantitative methods. A two-centre study ran between September 2011 and May 2012. PARTICIPANTS/MATERIALS, SETTING, METHODS In all, 655 women and men participated. The measurements consisted of two kinds of evaluations: the rating of perceived reality of care and the rating of the subjective importance of various aspects of treatment. The questionnaire consisted of 43 items for women and 42 items for men. An exploratory factor analysis was performed for women for all items of subjective importance. Eigenvalue, explained variance and factor loading are given for each factor. Internal consistency of subscales was assessed by Cronbach's alpha, item discriminant validity and percentage scaling success. For external validity, a correlation with fertility quality of life (FertiQoL) was performed and for reliability, a test-retest analysis was carried out. Sensitivity analyses were performed by known-group analyses. All significance tests were two sided and conducted at the 5% significance level. MAIN RESULTS AND THE ROLE OF CHANCE The QPP-IVF instrument, divided into four dimensions, seemed a valid and reliable way of measuring the quality of care from a patient's perspective, for both women and men. The item-scaling test confirmed 10 underlying factors, with scaling success in all subscales and Cronbach's alpha >0.70 for women in almost all subscales. It was somewhat lower for men but still acceptable. The external validity was acceptable, with significant correlation between QPP-IVF and FertiQoL. The test-retest analysis confirmed that QPP-IVF was a stable instrument, with intra-class correlation coefficients from 0.74 to 0.89 for women. Sensitivity analyses indicated a sensitive instrument. LIMITATIONS, REASON FOR CAUTION The response rate to the questionnaire was 67.5%. Although considered acceptable in questionnaire studies, this response level might introduce a certain risk of selection bias. The questionnaire was developed and validated only in Sweden. WIDER IMPLICATIONS OF THE FINDINGS The QPP-IVF may be of use for purposes of quality improvement and national comparisons. Future studies should focus on establishing the QPP-IVF as a valuable instrument for measuring the quality of care outside Sweden. STUDY FUNDING/COMPETING INTEREST The study was supported by the LUA/ALF agreement at Sahlgrenska University Hospital, Gothenburg, Sweden and by Hjalmar Svensson's Research Foundation. None of the authors declared any conflict of interests.
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Affiliation(s)
- Herborg Holter
- Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Reproductive Medicine, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
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Samsson K, Larsson MEH. Physiotherapy screening of patients referred for orthopaedic consultation in primary healthcare - a randomised controlled trial. ACTA ACUST UNITED AC 2013; 19:386-91. [PMID: 24246908 DOI: 10.1016/j.math.2013.10.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Revised: 10/14/2013] [Accepted: 10/18/2013] [Indexed: 10/26/2022]
Abstract
A large proportion of patients who consult primary healthcare for musculoskeletal pain are referred for orthopaedic consultation, but only a small number of these patients are appropriate for orthopaedic intervention. Experienced physiotherapists have the appropriate knowledge to manage musculoskeletal disorders. The primary aim of this randomised study was therefore to evaluate a screening by a physiotherapist of patients referred for orthopaedic consultation compared to standard practice in primary care. Patients referred for orthopaedic consultation (n=203) were randomised to physiotherapy screening or standard practice. Selection accuracy for orthopaedic intervention and other referrals were analysed with proportion analysis. Patient views of the quality of care were analysed with Mann-Whitney U-test, waiting time with Independent t-test. There was higher selection accuracy for orthopaedic intervention in the physiotherapy screening group (p=0.002). A smaller proportion of patients in the screening group were referred back to their general practitioner (GP) (p<0.001) and a larger proportion to the physiotherapy clinic (p<0.001) compared to standard practice. The proportion of patients referred for further investigations was significantly lower in the physiotherapy screening group (p<0.039). Waiting time was shorter in the screening group (p<0.001). A large proportion of the patients reported no hesitation to attend the clinic for future care, no difference between the groups (p<0.95). The findings in this study suggest that an experienced physiotherapist effectively can screen patients referred for orthopaedic consultation in primary healthcare.
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Affiliation(s)
- Karin Samsson
- Närhälsan Physiotherapy Clinic Tjörn, Primary Health Care, Region Västra Götaland, Sweden; The Sahlgrenska Academy at Gothenburg University, Institute of Neuroscience and Physiology, Physiotherapy, Gothenburg, Sweden.
| | - Maria E H Larsson
- Narhalsan Research and Development, Primary Health Care, Region Västra Götaland, Sweden; The Sahlgrenska Academy at Gothenburg University, Institute of Neuroscience and Physiology, Physiotherapy, Gothenburg, Sweden
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97
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Andersson E, Christensson K, Hildingsson I. Mothers’ satisfaction with group antenatal care versus individual antenatal care – A clinical trial. SEXUAL & REPRODUCTIVE HEALTHCARE 2013; 4:113-20. [DOI: 10.1016/j.srhc.2013.08.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 07/07/2013] [Accepted: 08/12/2013] [Indexed: 10/26/2022]
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98
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Josse-Eklund A, Wilde-Larsson B, Petzäll K, Sandin-Bojö AK. Individual and organisational factors influencing registered nurses’ attitudes towards patient advocacy in Swedish community health care of elders. Scand J Caring Sci 2013; 28:486-95. [DOI: 10.1111/scs.12073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 07/27/2013] [Indexed: 11/28/2022]
Affiliation(s)
| | - Bodil Wilde-Larsson
- Department of Health Sciences; Karlstad University; Karlstad Sweden
- Department of Public Health; Hedmark University College; Elverum Norway
| | - Kerstin Petzäll
- Department of Health Sciences; Karlstad University; Karlstad Sweden
- Department of Nursing; Gjøvik University College; Gjøvik Norway
| | - Ann-Kristin Sandin-Bojö
- Department of Health Sciences; Karlstad University; Karlstad Sweden
- The Womens department; The County Council of Värmland; Karlstad Sweden
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99
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Sawyer A, Ayers S, Abbott J, Gyte G, Rabe H, Duley L. Measures of satisfaction with care during labour and birth: a comparative review. BMC Pregnancy Childbirth 2013; 13:108. [PMID: 23656701 PMCID: PMC3659073 DOI: 10.1186/1471-2393-13-108] [Citation(s) in RCA: 131] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 05/02/2013] [Indexed: 12/17/2022] Open
Abstract
Background Satisfaction is the one of the most frequently reported outcome measures for quality of care. Assessment of satisfaction with maternity services is crucial, and psychometrically sound measures are needed if this is to inform health practices. This paper comparatively reviews current measures of satisfaction with care during labour and birth. Methods A review of the literature was conducted. Studies were located through computerised databases and hand searching references of identified articles and reviews. Inclusion criteria were that the questionnaire was a multi-item scale of satisfaction with care during labour and birth, and some form of psychometric information (either information about questionnaire construction, or reliability, or validity) had to be reported. Results Nine questionnaires of satisfaction with care during labour and birth were identified. Instruments varied in psychometric properties and dimensions. Most described questionnaire construction and tested some form of reliability and validity. Measures were generally not based on the main theoretical models of satisfaction and varied in scope and application to different types of samples (e.g. satisfaction following caesarean section). For an in-depth measure of satisfaction with intrapartum care, the Intrapartal-Specific Quality from the Patient’s Perspective questionnaire (QPP-I) is recommended. Brief measures with good reliability and validity are provided by the Six Simple Questions (SSQ) or Perceptions of Care Adjective Checklist (PCACL-R). Conclusions Despite the interest in measures of satisfaction there are only a small number of validated measures of satisfaction with care during labour and birth. It is important that brief, reliable and valid measures are available for use in general and specific populations in order to assist research and inform practice.
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Affiliation(s)
- Alexandra Sawyer
- School of Health Sciences, City University London, 20 Bartholomew Close, London, UK
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100
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Women's satisfaction with antenatal care: Comparing women in Sweden and Australia. Women Birth 2013; 26:e9-e14. [DOI: 10.1016/j.wombi.2012.06.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 06/22/2012] [Indexed: 11/20/2022]
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