Patient satisfaction and quality of life following laparoscopic Nissen fundoplication

Dynamics of quality of life improvement after floppy Nissen fundoplication for gastroesophageal reflux disease

Introduction

Gastroesophageal reflux disease (GERD) has a negative impact on global quality of life (QOL) of patients. In patients affected by GERD, laparoscopic Nissen fundoplication is one of the most commonly performed laparoscopic procedures worldwide.

Aim

To prospectively analyze the dynamics of QOL as well as severity of pain in patients with GERD, before and after laparoscopic floppy Nissen fundoplication.

Material and methods

The study involved 104 consecutive patients operated on for GERD in whom laparoscopic floppy Nissen fundoplication was performed. QOL was assessed before surgery and 1, 3, 6, 12 and 24 months after. The following instruments were used: FACIT-G, FACIT-TS-G, GIQLI, GERD symptom scale.

Results

It was found that symptom relief and quality of life improvement presented different dynamics in the postoperative course. Observations revealed relief of symptoms 1 month after surgery and improvement in QOL related to the gastrointestinal tract and pain 3 months after surgery. Global QOL increased significantly as late as 12 months after surgery.

Conclusions

Gastroesophageal reflux disease is a chronic disease of long duration, leading to impairment of quality of life. Patients, apart from typical symptoms of GERD, suffer from pain of significant severity. QOL improves significantly after surgery. Surgical treatment results in relief of GERD symptoms, which leads to gradual improvement of QOL.

Mothers' satisfaction with two systems of providing care to their hospitalized children

Background:

Despite the paramount importance of the patient’s satisfaction, there are limited data on mothers’ satisfaction with the nursing care provided to their children in Iranian clinical settings.

Objectives:

This study aimed to evaluate mothers’ satisfaction with two systems of providing care to their hospitalized children.

Patients and Methods:

This research was a two-group quasi-experimental study. Primarily, the basics of the case method and the functional care delivery systems were educated to the practicing nurses of the study setting. Each system was implemented independently. After the implementation of each system, 200 mothers whose children were hospitalized in the pediatric care ward of Shahid Beheshti Hospital, Kashan, Iran, were invited to respond to the 28 -item Pediatric Family Satisfaction Questionnaire. Study data were analyzed by SPSS v. 16.0.

Results:

Results were indicative of mothers’ satisfaction with medical care delivered by case method as 13.2 ± 5.2 and by functional method as 13.17 ± 5.56. Also, no significant difference was seen between two groups (P = 0.4). Mothers’ satisfaction with nursing care delivered by case method was 17.7 ± 4.43 and by functional method was 13.33 ± 5.69 and there was a significant difference between two groups (P = 0.004). Mothers’ satisfaction with accommodations by case method was 16.78 ± 4.07 and by functional method was 17.9 ± 6.67 with a significant difference between two groups (P = 0.06).

Conclusions:

Improving the quality of care is associated with higher patient’s satisfaction. Accordingly, developing and implementing programs for improving nurses’ communication and clinical skills can improve both care quality and patient outcomes.