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Nadia S, Rivai F, Sidin I, Pasinringi SA. What is known about patient-centered care application in post-surgical breast cancer patients? Breast Dis 2023; 42:233-243. [PMID: 37522192 DOI: 10.3233/bd-239004] [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: 08/01/2023]
Abstract
BACKGROUND Over the past two decades, patient-centered care has become internationally recognized as a dimension of high-quality health care. Recent research has shown that patient-centered care has many benefits, which are broadly categorized as patient experience and clinical and operational benefits. OBJECTIVE The study aimed at analyzing the correlation between the application of patient-centered care (PCC) and length of stay, patient satisfaction, and clinical outcome of post-surgical breast cancer patients. METHODS The study design was cross-sectional. A sample of 100 patients was determined and selected with the inclusion criteria. Data were collected using measuring tools comprising patient-centered care and patient satisfaction questionnaires as well as medical records to evaluate the length of stay and clinical outcomes. Bivariate analysis was conducted to analyze the correlation between patient-centered-care and length of stay (LOS), patient satisfaction, and the clinical outcomes of inpatients. RESULTS A correlation was found between patient-centered care (PCC) application and patient satisfaction (p = 0.005), but no correlation was observed between PCC application and length of stay (LOS) (p = 0.176) as well as clinical outcome (p = 0.128). CONCLUSIONS The application of patient-centered care can be attributed to patient satisfaction but is not correlated to length of stay and clinical outcome of post-surgical breast cancer patients. The hospital should create an accepted definition and commonly agreed set of dimensions used for the concept of operationalization and its measurement to implement PCC and improve overall patient satisfaction and clinical outcome and reduce the length of stay as expected.
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Affiliation(s)
- Shafa Nadia
- Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Fridawaty Rivai
- Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
- Hasanuddin University Hospital, Makassar, South Sulawesi, Indonesia
| | - Indahwaty Sidin
- Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
- Hasanuddin University Hospital, Makassar, South Sulawesi, Indonesia
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Fu M, Guo J, Zhang Y, Zhao Y, Zhang Y, Hou Z, Wang Z. Effect of integrated management bundle on 1-year overall survival outcomes and perioperative outcomes in super elderly patients aged 90 and over with hip fracture: non-concurrent cohort study. BMC Musculoskelet Disord 2022; 23:778. [PMID: 35971104 PMCID: PMC9377134 DOI: 10.1186/s12891-022-05720-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 07/29/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Due to concomitant factors like frailty and comorbidity, super elderly (≥90 years) patients with hip fracture differ from patients aged 65-89 years in perioperative complications and mortality. The integrated management bundle referred to bundled application of multiple clinical measures. The aim of this study was to analyze effect of integrated management bundle on 1-year overall survival and perioperative outcomes in super elderly patients with hip fracture, with multidisciplinary management group serving as the control group. METHODS In this retrospective cohort study, super elderly patients with hip fracture were included from Jan 2017 to Nov 2020. Patients were retrospectively divided to multidisciplinary management group and integrated management bundle group. The primary outcome was 1- year overall survival, and the secondary outcome was perioperative outcomes. Kaplan-Meier methods was used to compare survival probability. Multivariable Cox's modeling was used to explain the effect of integrated bundle on 1-year overall survival adjusted for confounders. The perioperative outcomes including complications and in-hospital data of two groups were compared. The multivariable logistic regression was used to explain the effect of integrated bundle on the occurrence of perioperative complications adjusted for confounders. Prognostic factors related to survival was identified by multivariable Cox's regression analysis. RESULTS Ninety-seven patients comprised multidisciplinary management group, and 83 comprised integrated management bundle group. The Kaplan-Meier plots showed that the survival probability of integrated management bundle group was significantly better than multidisciplinary management group (HR:0.435, 95%CI:0.207-0.914, P = 0.039). Multivariable analysis after adjustment for confounders showed a 42.8% lower incidence of mortality integrated management bundle group than multidisciplinary management group (HR:0.428, 95%CI:0.186-0.986, P = 0.046). Incidence of hypoproteinemia, and electrolyte disturbance in integrated management bundle group was significantly lower than multidisciplinary management group (all P < 0.05). In addition, significant reduction was observed in length of stay (P < 0.05) in integrated management bundle group. Multivariable logistic regression showed integrated management bundle was independent protective factor of hypoproteinemia, and electrolyte disturbance. mECM score ≥ 6 and ASA score > 2 were independent risk factors of overall survival (HR: 1.940, 95%CI: 1.067-3.525,P = 0.030; HR: 2.281, 95%CI: 1.113-4.678,P = 0.024). CONCLUSIONS The integrated management bundle improved 1-year overall survival and played positive effects in improving perioperative outcomes. It might be a more suitable management modality for super elderly patients with hip fracture.
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Affiliation(s)
- Mingming Fu
- Department of Geriatric Orthopedics, Third Hospital of Hebei Medical University, Hebei, 050051, Shijiazhuang, People's Republic of China
| | - Junfei Guo
- Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People's Republic of China
| | - Yaqian Zhang
- Department of Geriatric Orthopedics, Third Hospital of Hebei Medical University, Hebei, 050051, Shijiazhuang, People's Republic of China
| | - Yuqi Zhao
- Department of Geriatric Orthopedics, Third Hospital of Hebei Medical University, Hebei, 050051, Shijiazhuang, People's Republic of China
| | - Yingze Zhang
- Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People's Republic of China.,NHC Key Laboratory of Intelligent Orthopedic Equipment (The Third Hospital of Hebei Medical University), Hebei, 050051, Shijiazhuang, People's Republic of China.,Chinese Academy of Engineering, Beijing, 100088, People's Republic of China
| | - Zhiyong Hou
- Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People's Republic of China. .,NHC Key Laboratory of Intelligent Orthopedic Equipment (The Third Hospital of Hebei Medical University), Hebei, 050051, Shijiazhuang, People's Republic of China.
| | - Zhiqian Wang
- Department of Geriatric Orthopedics, Third Hospital of Hebei Medical University, Hebei, 050051, Shijiazhuang, People's Republic of China.
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Luo J, Xie N, Yang L. Observation of the Intervention Effect of Biofeedback Therapy Combined With Cluster Nursing on Perioperative Constipation in Patients With Thoracolumbar Fracture. Front Surg 2022; 9:847068. [PMID: 35321074 PMCID: PMC8934880 DOI: 10.3389/fsurg.2022.847068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 01/25/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose To discuss the intervention effect of biofeedback therapy combined with cluster nursing on perioperative constipation in patients with thoracolumbar fracture. Methods From June 2019 to June 2020, a total of 482 patients with thoracolumbar fracture who were treated by surgery in our department were selected. The random number table method was used to divide into experimental group (n = 241) and control group (n = 241). The control group was given routine constipation care, the experimental group was given biofeedback therapy combined with cluster nursing based on the control group. The constipation score, Bristol stool scale score, the short health questionnaire (SF-36) scale score, and the satisfaction of two groups were observed. Results The constipation scores of the experimental group were lower than those of the control group, while the Bristol stool scale score, SF-36 score, and satisfaction degree of the experimental group were higher than those of the control group (p < 0.05). Conclusion Biofeedback therapy combined with cluster nursing has a good intervention effect in perioperative constipation of patients with thoracolumbar fracture, which can reduce the degree of constipation, improve stool traits, improve the quality of life, and improve the satisfaction of patients.
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Affiliation(s)
- Jin Luo
- Department of Spine Surgery, Suining Central Hospital, Suining, China
| | - Nan Xie
- Nursing Department, Suining Central Hospital, Suining, China
| | - Liping Yang
- Department of Arthrosurgery, Zhuji People's Hospital of Zhejiang Province, Zhuji, China
- *Correspondence: Liping Yang
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