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Parker KJ, Mcdonagh J, Ferguson C, Hickman LD. Clinical outcomes of nurse-coordinated interventions for frail older adults discharged from hospital: A systematic review and meta-analysis. J Clin Nurs 2024. [PMID: 38951122 DOI: 10.1111/jocn.17345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 05/16/2024] [Accepted: 06/17/2024] [Indexed: 07/03/2024]
Abstract
AIM To determine the effects of nurse-coordinated interventions in improving readmissions, cumulative hospital stay, mortality, functional ability and quality of life for frail older adults discharged from hospital. DESIGN Systematic review with meta-analysis. METHODS A systematic search using key search terms of 'frailty', 'geriatric', 'hospital' and 'nurse'. Covidence was used to screen individual studies. Studies were included that addressed frail older adults, incorporated a significant nursing role in the intervention and were implemented during hospital admission with a focus on transition from hospital to home. DATA SOURCES This review searched MEDLINE (Ovid), CINAHL (EBSCO), PubMed (EBSCO), Scopus, Embase (Ovid) and Cochrane library for studies published between 2000 and September 2023. RESULTS Of 7945 abstracts screened, a total 16 randomised controlled trials were identified. The 16 randomised controlled trials had a total of 8795 participants, included in analysis. Due to the heterogeneity of the outcome measures used meta-analysis could only be completed on readmission (n = 13) and mortality (n = 9). All other remaining outcome measures were reported through narrative synthesis. A total of 59 different outcome measure assessments and tools were used between studies. Meta-analysis found statistically significant intervention effect at 1-month readmission only. No other statistically significant effects were found on any other time point or outcome. CONCLUSION Nurse-coordinated interventions have a significant effect on 1-month readmissions for frail older adults discharged from hospital. The positive effect of interventions on other health outcomes within studies were mixed and indistinct, this is attributed to the large heterogeneity between studies and outcome measures. RELEVANCE TO CLINICAL PRACTICE This review should inform policy around transitional care recommendations at local, national and international levels. Nurses, who constitute half of the global health workforce, are ideally situated to provide transitional care interventions. Nurse-coordinated models of care, which identify patient needs and facilitate the continuation of care into the community improve patient outcomes. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Review findings will be useful for key stakeholders, clinicians and researchers to learn more about the essential elements of nurse-coordinated transitional care interventions that are best targeted to meet the needs of frail older adults. IMPACT When frail older adults experience transitions in care, for example discharging from hospital to home, there is an increased risk of adverse events, such as institutionalisation, hospitalisation, disability and death. Nurse-coordinated transitional care models have shown to be a potential solution to support adults with specific chronic diseases, but there is more to be known about the effectiveness of interventions in frail older adults. This review demonstrated the positive impact of nurse-coordinated interventions in improving readmissions for up to 1 month post-discharge, helping to inform future transitional care interventions to better support the needs of frail older adults. REPORTING METHOD This systematic review was reported in accordance with the Referred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PATIENT OR PUBLIC CONTRIBUTION No Patient or Public Contribution.
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Affiliation(s)
- Kirsten J Parker
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- Centre for Chronic and Complex Care Research, Blacktown Hospital, Western Sydney Local Health District, Blacktown, New South Wales, Australia
| | - Julee Mcdonagh
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- Centre for Chronic and Complex Care Research, Blacktown Hospital, Western Sydney Local Health District, Blacktown, New South Wales, Australia
| | - Caleb Ferguson
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- Centre for Chronic and Complex Care Research, Blacktown Hospital, Western Sydney Local Health District, Blacktown, New South Wales, Australia
| | - Louise D Hickman
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
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Kweon YR, Jang KS, Back M, Lee M. Development and Psychometric Test of the Inpatients Experiences Measurement Scale (IEMS). Patient Prefer Adherence 2024; 18:1359-1372. [PMID: 38953018 PMCID: PMC11216549 DOI: 10.2147/ppa.s457746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 06/20/2024] [Indexed: 07/03/2024] Open
Abstract
Purpose In South Korea, hospitalized patients' experiences significantly impact satisfaction and treatment outcomes. This study developed and evaluated the Inpatients Experience Measurement Scale (IEMS) for its psychometric properties. Patients and Methods Participants from three hospitals were recruited using convenience sampling. Scale item generation involved patient interviews and a Delphi survey with experts. Psychometric testing used Exploratory Factor Analysis (EFA) with 150 participants and Confirmatory Factor Analysis (CFA) with 151 participants. Results A total of 301 patients participated, resulting in a 20-item scale across four factors: "Care Quality and Information Provision", "Patient Safety and Dietary Services", "Facility and Comfort Infrastructure", and "Comprehensive Patient Support Services". Rated on a 5-point Likert scale, the scale showed a high Content Validity Index (CVI) over 0.80. EFA explained 61.43% of the variance. The four-factor model was validated using CFA with favorable fit indices. The IEMS demonstrated strong convergent validity, supported by high composite reliability (CR) and average variance extracted (AVE) values. Significant correlations with the Patient Satisfaction Scale reinforced its convergent validity. Discriminant validity was confirmed, and all reliability measures exceeded the minimum threshold of 0.80. Conclusion The IEMS effectively captures inpatients' experiences, demonstrating robust reliability and validity. This scale is a valuable tool for assessing patient experiences, facilitating enhancements in patient care and satisfaction within hospital settings.
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Affiliation(s)
- Young-Ran Kweon
- Department of Nursing, Chonnam National University, Gwangju, South Korea
| | - Keum-Seong Jang
- Department of Nursing, Chonnam National University, Gwangju, South Korea
| | | | - Mikyoung Lee
- Department of Nursing, Kwangju Women’s University, Gwangju, South Korea
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Ang FJL, Cheung YB, Gandhi M, Østbye T, Malhotra C, Malhotra R, Chow CCT, Chong PH, Amin Z, Tan TSZ, Tewani K, Buang SNH, Finkelstein EA. PRECIOUS demonstrated satisfactory measurement properties for assessing the quality of care for children with serious illnesses. J Clin Epidemiol 2024; 168:111286. [PMID: 38382889 DOI: 10.1016/j.jclinepi.2024.111286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 02/12/2024] [Accepted: 02/14/2024] [Indexed: 02/23/2024]
Abstract
OBJECTIVES To determine the measurement properties of PaRental Experience with care for Children with serIOUS illnesses (PRECIOUS), a parent-reported measure of Quality of Care for seriously ill children across care settings and illness trajectories. STUDY DESIGN AND SETTING Parents self-administered baseline and 2-week follow-up surveys online. Exploratory Factor Analysis was used to determine PRECIOUS's factor structure and select items. Internal consistency was evaluated with Cronbach's α, test-retest reliability with intraclass correlation coefficients, and convergent validity with Spearman's correlations between PRECIOUS scales and subscales of Measure of Processes of Care and Quality of Children's Palliative Care Instrument. RESULTS Of 152 parents [108 (71%) mothers, 44 (29%) fathers] who completed the baseline survey, 123 (81%) completed follow-up. Exploratory Factor Analysis grouped PRECIOUS into five scales: collaborative and goal-concordant care (12 items), caregiver support and respectful care (15 items), access to financial and medical resources (five items), reducing caregiving stressors (nine items), and hospitalization-specific processes (four items). Root Mean Square Error of Approximation was 0.040 and Comparative Fit Index was 0.980. Cronbach's α ranged from 0.85 to 0.96. Intraclass correlation coefficients ranged from 0.72 to 0.86. Significant correlations with Measure of Processes of Care and Quality of Children's Palliative Care Instrument confirmed convergent validity. The original 56-item tool was reduced to 45 items. CONCLUSION PRECIOUS demonstrates satisfactory measurement properties for assessing Quality of Care for seriously ill children.
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Affiliation(s)
- Felicia Jia Ler Ang
- Programme in Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore.
| | - Yin Bun Cheung
- Programme in Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore; Center for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore; Tampere Center for Child, Adolescent and Maternal Health Research, Tampere University, Finland
| | - Mihir Gandhi
- Programme in Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore; Center for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore; Tampere Center for Child, Adolescent and Maternal Health Research, Tampere University, Finland; Biostatistics, Singapore Clinical Research Institute, Singapore, Singapore
| | - Truls Østbye
- Programme in Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore; Duke Global Health Institute, Duke University, Durham, USA
| | - Chetna Malhotra
- Programme in Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
| | - Rahul Malhotra
- Programme in Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore; Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, Singapore
| | - Cristelle Chu-Tian Chow
- Children's Complex and Home Care Services, KK Women's & Children's Hospital, Singapore, Singapore; Department of Paediatrics, KK Women's & Children's Hospital, Singapore, Singapore
| | | | - Zubair Amin
- Department of Neonatology, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore, Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Teresa Shu Zhen Tan
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore, Singapore
| | - Komal Tewani
- Women's Palliative Care Service, Perinatal Palliative Care, KK Women's & Children's Hospital, Singapore, Singapore; Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Siti Nur Hanim Buang
- Department of Paediatrics, KK Women's & Children's Hospital, Singapore, Singapore
| | - Eric Andrew Finkelstein
- Programme in Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore; Duke Department of Population Health Sciences, Duke University, Durham, USA
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Spears SDJ, Abdulle YF, Korovilas D, Torii R, Kalaskar DM, Sharma N. Neck Collar Assessment for People Living With Motor Neuron Disease: Are Current Outcome Measures Suitable? Interact J Med Res 2023; 12:e43274. [PMID: 36917160 PMCID: PMC10131796 DOI: 10.2196/43274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 03/15/2023] Open
Abstract
A majority of people living with motor neuron disease (MND) experience weakness of the neck and as a result, experience head drop. This exacerbates problems with everyday activities (eating, talking, breathing, etc). Neck collars are often used to support head drop; however, these are typically designed for prehospitalization settings to manage and brace the cervical region of the spine. As a result, it has been recorded that people living with MND often reject these collars for a variety of reasons but most notably because they are too restricting. The current standardized outcome measures (most notably restricting cervical range of motion) used for neck collars are summarized herein along with whether they are suitable for a bespoke neck collar specifically designed for people living with MND.
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Affiliation(s)
- Samuel D J Spears
- Institute of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Sciences, University College London, London, United Kingdom.,National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | - Yusuf F Abdulle
- National Hospital for Neurology and Neurosurgery, London, United Kingdom.,Department for Clinical and Movement Neurosciences, University College London, London, United Kingdom
| | | | - Ryo Torii
- Department of Mechanical Engineering, University College London, London, United Kingdom
| | - Deepak M Kalaskar
- Institute of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Sciences, University College London, London, United Kingdom
| | - Nikhil Sharma
- National Hospital for Neurology and Neurosurgery, London, United Kingdom.,Department for Clinical and Movement Neurosciences, University College London, London, United Kingdom
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Brandão A, Ribeiro L. The Impact of Patient Experience on Loyalty in the Context of Medical-Aesthetic Health Services. J Patient Exp 2023; 10:23743735231160422. [PMID: 37026115 PMCID: PMC10071194 DOI: 10.1177/23743735231160422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
The purpose of this study was to determine the antecedents and consequences of patient experience in the context of medical-aesthetic health services. A quantitative study was conducted and data was collected through online surveys. Moreover, data were provided in the field via the administration of questionnaires to patients of medical clinics. The data were analyzed according to structural equation modeling procedures. The results showed that both the relational (communication and involvement) and functional (environment, tangibles, processes, outcomes, competence, monetary cost) dimensions of care have a direct and positive impact on customer experience (CE). This study shows the prevalence of the functional dimension when compared to the relational one, which more strongly influences a patient’s CE. Moreover, CE positively impacts perceived quality, overall satisfaction, and loyalty behaviors.
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Affiliation(s)
- Amélia Brandão
- Department of Management, School of Economics and Management and Cef.up, University of Porto, Porto, Portugal
| | - Liliana Ribeiro
- School of Economics and Management, University of Porto, Porto, Portugal
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Ang FJL, Finkelstein EA, Gandhi M. Parent-Reported Experience Measures of Care for Children With Serious Illnesses: A Scoping Review. Pediatr Crit Care Med 2022; 23:e416-e423. [PMID: 35616499 DOI: 10.1097/pcc.0000000000002996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This scoping review aimed to: 1) identify parent-reported experience measures (PaREMs) for parents of children with serious illnesses from peer-reviewed literature, 2) map the types of care experience being evaluated in PaREMs, 3) identify and describe steps followed in the measure development process, including where gaps lie and how PaREMs may be improved in future efforts, and 4) help service providers choose a PaREM suitable for their service delivery setting and strategy. DATA SOURCES Relevant articles were systematically searched from PubMed, CINAHL, and Scopus EBSCOhost databases until June 10, 2021, followed by a manual reference list search of highly relevant articles. STUDY SELECTION Abstracts were screened, followed by a full-text review using predetermined inclusion and exclusion criteria. DATA EXTRACTION A standardized data extraction tool was used. DATA SYNTHESIS Sixteen PaREMs were identified. There were large variances in the development processes across measures, and most have been developed in high-income, English-speaking Western countries. Most only assess the quality of acute inpatient care. Few measures can be used by multiple service providers or chronic care, and many do not capture all relevant domains of the parent experience. CONCLUSIONS Service providers should integrate PaREMs into their settings to track and improve the quality of care. Given the multidisciplinary nature of pediatric care and the often-unpredictable disease trajectories of seriously ill children, measures that are applicable to multiple providers and varying lengths of care are essential for standardized assessment of quality of care and coordination among providers. To improve future PaREM development, researchers should follow consistent and methodologically robust steps, ideally in more diverse sociocultural and health systems contexts. Future measures should widen their scope to be applicable over the disease trajectory and to multiple service providers in a child's network of care for a comprehensive evaluation of experience.
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Affiliation(s)
- Felicia Jia Ler Ang
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Eric Andrew Finkelstein
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Mihir Gandhi
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
- Singapore Clinical Research Institute, Singapore
- Tampere Center for Child, Adolescent, and Maternal Health Research, Tampere University, Kauppi Campus, Tampere, Finland
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7
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London AE, Blackmore CC, Tufano AE, Quisenberry EJ, Plsek P. Coupling Lean and Experience-Based Design for Measuring and Incorporating Patient Emotional Experience Into the Redesign of Health Care. Qual Manag Health Care 2022; 31:184-190. [PMID: 34813582 DOI: 10.1097/qmh.0000000000000331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Incorporation of Lean into health care requires consideration of the patient and other customer experience of care as well as final health outcomes. We incorporate experience-based design (EBD) into our Lean management method to assess the experience of care, guide redesign of care processes, and assess the effectiveness of quality improvement on the care experience. Foundational to EBD is identification of "touch points," moments in the health care delivery process where a patient has a strong positive or negative emotional response that has the potential to alter the way patients feel about their overall care experience. METHODS EBD proceeds sequentially from qualitative assessment of customer experience and touch points (through observations and interviews); semiquantitatively assessing the experience across many patients (through EBD questionnaires); engaging in codesign with patients (through improvement teams and events); and reassessing the care experience after improvement (through follow-up EBD questionnaires). The use of project-specific (EBD) emotion word questionnaires enables assessment of change over time. These EBD questionnaires are developed ad hoc for each care improvement effort, to reflect the specific high emotion touch points patients identify for that care process, and therefore pose unique validity and reliability challenges. We have previously validated a set of emotion words that form the library from which questionnaire designers select the relevant emotion word choices. In addition, to assess consistency of measurement in the absence of any improvement, we performed a repeated-measures study deploying the same EBD questionnaire to different groups of patients, separated by a 60-day interval in the absence of any quality improvement work. RESULTS We apply EBD across the health care enterprise, including patients and family caregivers, as well as staff members. Examples where EBD has been incorporated into care redesign have included; outpatient care for pancreatic cancer patients; clinic visits in rheumatology; delirium care for hospital inpatients; and the orientation process for newly hired advanced practice providers. Our reliability data demonstrate that moderate differences in scores on the EBD questionnaire (up to 19 percentage points) may reflect random variability, but differences of greater magnitude reflect actual changes in the patient experience. CONCLUSIONS In summary, experience-based design has promise as a methodology to incorporate patient experience within a Lean management structure. EBD can aid with health care redesign, defining the emotional touch points that are foundational to the experience of care, enabling targeting of quality improvement efforts, and assessing change.
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Affiliation(s)
- Amy E London
- Virginia Mason Medical Center, Seattle, Washington
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Price D, Edwards M, Davies F, Cooper A, McFadzean J, Carson-Stevens A, Cooke M, Dale J, Evans BA, Harrington B, Hepburn J, Siriwardena AN, Snooks H, Edwards A. Patients’ experiences of attending emergency departments where primary care services are located: qualitative findings from patient and clinician interviews from a realist evaluation. BMC Emerg Med 2022; 22:12. [PMID: 35065616 PMCID: PMC8783419 DOI: 10.1186/s12873-021-00562-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 12/07/2021] [Indexed: 12/03/2022] Open
Abstract
Background Patient experience is an important outcome and indicator of healthcare quality, and patient reported experiences are key to improving quality of care. While patient experience in emergency departments (EDs) has been reported in research, there is limited evidence about patients’ specific experiences with primary care services located in or alongside EDs. We aim to identify theories about patient experience and acceptability of being streamed to a primary care clinician in an ED. Methods Using theories from a rapid realist review as a basis, we interviewed 24 patients and 106 staff members to generate updated theories about patient experience and acceptability of streaming to primary care services in EDs. Feedback from 56 stakeholders, including clinicians, policymakers and patient and public members, as well as observations at 13 EDs, also contributed to the development of these theories, which we present as a programme theory. Results We found that patients had no expectations or preferences for which type of clinician they were seen by, and generally found being streamed to a primary care clinician in the ED acceptable. Clinicians and patients reported that patients generally found primary care streaming acceptable if they felt their complaint was dealt with suitably, in a timely manner, and when clinicians clearly communicated the need for investigations, and how these contributed to decision-making and treatment plans. Conclusions From our findings, we have developed a programme theory to demonstrate that service providers can expect that patients will be generally satisfied with their experience of being streamed to, and seen by, primary care clinicians working in these services. Service providers should consider the potential advantages and disadvantages of implementing primary care services at their ED. If primary care services are implemented, clear communication is needed between staff and patients, and patient feedback should be sought.
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Rosebrock HY, Batterham PJ, Chen NA, McGillivray L, Rheinberger D, Torok MH, Shand FL. Nonwillingness to Return to the Emergency Department and Nonattendance of Follow-Up Care Arrangements Following an Initial Suicide-Related Presentation. CRISIS 2021; 43:442-451. [PMID: 34547919 DOI: 10.1027/0227-5910/a000812] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Background: For people experiencing a suicidal crisis the emergency department (ED) is often the only option to find help. Aims: The aims of this study were (a) to identify predictors of patients' nonwillingness to return to the ED for help with a future suicidal crisis, and (b) whether nonwillingness to return was associated with follow-up appointment nonattendance. Method: This study utilized baseline data from the RESTORE online survey, and included 911 participants who had presented to an ED for suicidal crisis in the past 18 months, across participating local health districts in the Australian Capital Territory and New South Wales. Results: Patients who reported a more negative ED experience and longer triage wait times were less willing to return. Those who were less willing to return were also less likely to attend their follow-up appointment. Limitations: Due to the cross-sectional study design, causal inferences are not possible. Additionally, the self-report measures used are susceptible to recall bias. Conclusion: Patients' experience of service at EDs is a key indicator to drive improvement of patient outcomes for individuals experiencing a suicidal crisis.
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Affiliation(s)
- Hannah Y Rosebrock
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, Australian National University, Canberra, ACT, Australia
| | - Nicola A Chen
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Lauren McGillivray
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Demee Rheinberger
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Michelle H Torok
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Fiona L Shand
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
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Vo PTN, Tran AT, Nguyen HV, Hoang MV. Evaluation of Inpatient Experience at Some Clinical Departments of Kien Giang General Hospital, Kien Giang Province, Vietnam, 2020: An Analytical Cross-Sectional Study. Health Serv Insights 2021; 14:11786329211020843. [PMID: 34211277 PMCID: PMC8216414 DOI: 10.1177/11786329211020843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 05/10/2021] [Indexed: 11/17/2022] Open
Abstract
Patient experience is being widely considered in evaluating the quality of health care services. This is a cross-sectional study with 860 inpatients hospitalized in 4 clinical departments (General Internal Medicine; Cardiology; General Surgery; Surgery, and Orthopedic Trauma) of the Kien Giang General Hospital, from April to June 2020. Data was collected through a two-part questionnaire used to evaluate the inpatient experience during hospital treatment, using the Likert scale 5 points. The patient’s experience is classified into 3 aspects (environment—facilities, healthcare staff's care, treatment information). In total, 815 participants responded to the interview (94.8%). The rates of patients having a positive experience on the environment and facilities, the care of health workers, and treatment information are 31.7%, 85.9%, and 74.2%, respectively. The patient’s positive overall experience rate is 65.5%. Factors related to the patient's overall experience are the department of treatment, residential area, age, and employment status (P < .05). Overall, the positive experience of inpatients at some clinical departments of Kien Giang General Hospital was a relatively low rate (65.5%). Specifically, healthcare staff's care is experienced at a high rate, this factor should be continuously promoted. Improving and upgrading factors in the aspects of the environment—facilities and the treatment information should be implemented if the hospital wants to improve its quality of healthcare services.
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Affiliation(s)
| | | | | | - Minh Van Hoang
- Hanoi University of Public Health, Hanoi, Vietnam.,National Institute of Health Sciences, Bach Mai Hospital (NIHS), Hanoi, Vietnam
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Zakkar MA, Meyer SB, Janes CR. Evidence and politics of patient experience in Ontario: The perspective of healthcare providers and administrators. Int J Health Plann Manage 2021; 36:1189-1206. [PMID: 33829549 DOI: 10.1002/hpm.3153] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 09/22/2020] [Accepted: 03/01/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Patient experience has a direct impact on patients' engagement in healthcare, their commitment to treatment plans, and their relationship with their healthcare providers, all of which can impact their health outcomes. The complexity of the healthcare system, the increasing health needs of the population, and the priority and knowledge differences among healthcare stakeholders impact how they conceptualize and seek to achieve the ideal patient experience and the weights that they give to different elements of this experience. AIMS This study sought to understand the perspectives of healthcare providers and administrators in Ontario regarding the factors affecting the patient experience. MATERIALS & METHODS Qualitative data were collected between April 2018 and May 2019. Twenty-one semi-structured interviews were conducted. Interviewees included physicians, nurses, optometrists, dietitians, quality managers, and policymakers. Thematic analysis was used to analyse the data, utilizing and extending a previously developed patient experience framework. RESULTS Several themes emerged in the data, and they represent two perspectives on patient experience: the biomedical perspective, which prioritizes health outcomes and gives high weights to healthcare experience factors that can be controlled by healthcare providers, while ignoring other factors, and the sociopolitical perspective, which recognizes the impacts of healthcare politics and the social context of health on patient experience in Ontario. CONCLUSION The study is timely in light of the current changes in the Ontario healthcare system and the healthcare reform started by the new government, as it sheds light on the possible negative impact of healthcare policy and politics on patient experience.
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Affiliation(s)
- Moutasem A Zakkar
- The School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Samantha B Meyer
- The School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Craig R Janes
- The School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
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Abstract
The patient experience is now globally recognized as an independent dimension of health-care quality. However, although patients, providers, health-care managers, and policy-makers agree on its importance, there is no standardized definition of the patient experience. A clear understanding of the basic concepts that make up the foundation of the patient experience is more important than a statement defining the patient experience. The fundamental nature of health care involves people taking care of other people in unique times of distress. Thus, the human experience is at the very core of understanding what the patient experience is. This article reviews a framework of the basic human experience of patients as they progress from being unique, healthy individuals to a state of experiencing both disease and health-care services. This novel framework naturally leads to a basic understanding of the patient experience as a human experience of health-care services.
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13
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Schmidt M, Uman T. Experiences of acute care by persons with mental health problems: An integrative literature review. J Psychiatr Ment Health Nurs 2020; 27:789-806. [PMID: 32083776 DOI: 10.1111/jpm.12624] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 01/27/2020] [Accepted: 02/20/2020] [Indexed: 01/31/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Understanding experiences of acute care by persons with mental health problems is vital for improving these experiences through the development of different parts of the care delivery and its facilities. Literature has extensively addressed experiences of persons with mental health problems in acute care settings. Yet, there is a paucity of studies that aggregate and organize these findings in presenting development-oriented solutions for the improvements of these experiences. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Acute care can be understood through patients' experiences of structure (such as setting, staff and resources); process (such as communication and interpersonal relations); and outcome (such as satisfaction and post-discharge well-being and health) and suggests improvements in these domains. The paper illuminates that previous literature has mainly captured negative experiences of acute care by persons with mental health problems, and suggests diverting the focus to the best practices and to seek inspiration from other fields of research. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Attending to the improvement and development of different parts of the acute care might be an important step in improving experiences of persons with mental health problems. For example, improving resource allocation systems and facilities, emphasizing professionalism in encounters with these patients and systematically assessing patient satisfaction during and after visits are important areas that require attention. ABSTRACT: Aim The provision of acute care to persons with mental health problems is challenging due to difficulties in encountering this group and the vulnerability of these persons. Understanding this group's experiences with acute care is thus an important endeavour. The purpose of this review was to critically and systematically identify and assess previous research on experiences of acute care by persons with mental health problems, guided by Donabedian's structure-process-outcome framework (Prospero ID: CRD42019116652). Method and results An integrative literature review was performed, resulting in the identification of 43 studies. The search was conducted using five electronic databases: Web of Science Core, PubMed, MEDLINE, CINAHL and PsycINFO. Discussion The review revealed that patients experienced structure components such as setting, staff and resources in a predominantly negative way. A predominately negative picture also emerged of the process components, where, for example, communication and interpersonal relations were represented by negative experiences, with limited positive experiences reported. The outcome components, related to patients' satisfaction and their well-being after discharge, were also predominantly experienced negatively. Implications for practice Using Donabedian's framework of structure, process and outcome allowed us to systematize the literature reviewed, to identify the research gaps and to suggest ways forward for the field's development.
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Affiliation(s)
- Manuela Schmidt
- Faculty of Health Science, Kristianstad University, Kristianstad, Sweden.,Department of Health Sciences, Lund University, Lund, Sweden
| | - Timur Uman
- Jönköping International Business School, Jönköping University, Jönköping, Sweden
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Beaird G, Baernholdt M, White KR. Perceptions of interdisciplinary rounding practices. J Clin Nurs 2020; 29:1141-1150. [PMID: 31889345 DOI: 10.1111/jocn.15161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 12/05/2019] [Accepted: 12/20/2019] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To explore practitioner perspectives on the facilitators, barriers and outcomes associated with interdisciplinary rounding practices (IDR). BACKGROUND Interdisciplinary rounding practices is frequently used intervention to promote collaboration and patient-centred care in hospital units. Previous research supports that having IDR in place can lead to greater perceptions of collaboration and practitioner satisfaction; however, the practice does not always lead to better outcomes for patients. For IDR to be successful, unit leadership needs a greater understanding of facilitators and barriers as perceived by team members. At both the individual and organisational levels, there is limited understanding on what influences the success of IDR. This study seeks to explore factors influencing interdisciplinary rounding and perceived outcomes by team members. DESIGN A quasi-qualitative design was used to address the aim of this study. Four open-ended questions were emailed to practitioners across fifteen units in two academic health centres. All units identified as having IDR in place. METHODS A directed content analysis of practitioner responses was used to identify key themes. The Standards for Reporting Qualitative Research checklist was consulted for reporting of the results. RESULTS A total of 141 practitioners responded to the open-ended questions. Three themes emerged from the data: (a) setting the stage; (b) the work of the team; and 3) benefits to patient care. CONCLUSIONS The study provides a nuanced perspective of facilitators, barriers and potential outcomes associated with IDR. Future research is needed to gain additional perspective on the role the organisation plays in promoting a healthy workplace environment as well as providing patient-centred care. RELEVANCE TO CLINICAL PRACTICE This study provides insight into facilitators and barriers to conducting interdisciplinary rounding practices in the inpatient setting. Results can be useful to unit leaders and staff that advocate for more collaborative and patient-centred rounding practices.
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Youssef A, Chaudhary ZK, Wiljer D, Mylopoulos M, Sockalingam S. Mapping Evidence of Patients' Experiences in Integrated Care: A Scoping Review. Gen Hosp Psychiatry 2019; 61:1-9. [PMID: 31479842 DOI: 10.1016/j.genhosppsych.2019.08.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 08/12/2019] [Accepted: 08/12/2019] [Indexed: 01/23/2023]
Abstract
OBJECTIVES Despite the established clinical and cost-effectiveness of integrated care (IC) models for patients with comorbid mental and physical illness, little is known about whether these models facilitate a better care experience from the patient's perspective. The authors conducted a scoping review of the literature to explore how IC influences patients' care experiences. METHODS MEDLINE, EMBASE, PSYC INFO CINAHL, AMED, the Cochrane Library, and grey literature were searched to identify relevant articles. Eligible studies were systematically reviewed and analyzed, using thematic analysis approach, to identify patterns, trends, and variation in patient experience within IC settings. RESULTS Search results yielded 5250 unique resources of which 21 primary studies met our eligibility criteria for analysis. Findings from this scoping review revealed variation in patients' experiences in IC settings. IC models enhanced patients' experience by creating theraputic spaces: improving patient access to care, developing collaborative relationships, and personalizing patient care to address individual needs. CONCLUSION Productive interactions with care team were key to improve patient engagement and experience of centeredness in IC settings. Successful implementation of IC demanded purposeful alignment of IC structural components and care processes to create therapeutic spaces that address patient care needs and preferences.
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Affiliation(s)
- Alaa Youssef
- Institute for Medical Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; The Wilson Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Zarah K Chaudhary
- The Wilson Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - David Wiljer
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; University Health Network Centre for Mental Health, Toronto, Ontario, Canada; The Institute for Health Policy, Management and Education, University of Toronto, Toronto, Ontario, Canada
| | - Maria Mylopoulos
- The Wilson Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Sanjeev Sockalingam
- Institute for Medical Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; The Wilson Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada; University Health Network Centre for Mental Health, Toronto, Ontario, Canada; Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.
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Abstract
Purpose
Patient experience is a complex multidimensional phenomenon that has been linked to constructs that are also complex to conceptualize, such as patient-centeredness, patient expectations and patient satisfaction. The purpose of this paper is to shed light on the different dimensions of patient experience, including those that receive inadequate attention from policymakers such as the patient’s lived experience of illness and the impact of healthcare politics. The paper proposes a simple classification for these dimensions, which differentiates between two types of dimensions: the determinants and the manifestations of patient experience.
Design/methodology/approach
This paper uses a narrative review of the literature to explore select constructs and initiatives developed for theorizing or operationalizing patient experience. Literature topics reviewed include healthcare quality, medical anthropology, health policy, healthcare system and public health.
Findings
The paper identifies five determinants for patient experience: the experience of illness, patient’s subjective influences, quality of healthcare services, health system responsiveness and the politics of healthcare. The paper identifies two manifestations of patient experience: patient satisfaction and patient engagement.
Originality/value
The paper proposes a classification scheme of the dimensions of patient experience and a concept map that links together heterogeneous constructs related to patient experience. The proposed classification and the concept map provide a holistic view of patient experience and help healthcare providers, quality managers and policymakers organize and focus their healthcare quality improvement endeavors on specific dimensions of patient experience while taking into consideration the other dimensions.
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Heinemann AW, Fatone S, LaVela SL, Slater BCS, Deutsch A, Peterson M, Soltys NT, McPherson V. Orthotists' and physical therapists' perspectives on quality of care indicators for persons with custom ankle-foot orthoses. Assist Technol 2019; 33:206-216. [PMID: 31091177 DOI: 10.1080/10400435.2019.1610814] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Purpose: To describe the priorities of orthotists and physical therapists about quality measurement themes, and the feasibility and utility of collecting data from persons using custom AFOs that could inform quality measure development.Materials and Methods: Online survey assessed respondents' perspectives and experiences. An Advisory Committee representing professional, organizational, and accreditor groups distributed survey invitations.Results: 461 orthotists and 153 physical therapists completed part or all of the survey; 60% rated 9 quality themes and 20 quality of care topics as extremely important, and 12 standard instruments as feasible and good to use for quality measurement. Patients were the preferred source of information for ease of scheduling, device weight, ease of donning and doffing, adherence to device use, beneficial effects, activity level and independence, and quality of life. Clinicians were the preferred source for material quality, device modifiability, and joint range of motion. Facility records were the preferred source for timeliness of device delivery and clinician follow-up. Respondents reported that gait speed and walking endurance were best obtained by patient performance.Conclusions: Results provide insight on the topics orthotists and physical therapists regard as priorities for defining healthcare quality for persons using custom ankle-foot orthoses and instruments for data collection.
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Affiliation(s)
- Allen W Heinemann
- Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, Illinois, USA.,Center for Rehabilitation Outcomes Research, The Shirley Ryan Ability Lab, Chicago, Illinois, USA
| | - Stefania Fatone
- Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, Illinois, USA.,Prosthetics-Orthotics Center, Northwestern University, Chicago, Illinois, USA
| | - Sherri L LaVela
- Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, Illinois, USA.,Department of Veterans Affairs, Center of Innovation for Complex Chronic Healthcare (CINCCH), Health Services Research & Development, Hines, Illinois, USA
| | - Billie C S Slater
- Minneapolis Adaptive Design and Engineering (MADE), Minneapolis VAHealth Care System, Minneapolis, Minnesota, USA
| | - Anne Deutsch
- Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, Illinois, USA.,Center for Rehabilitation Outcomes Research, The Shirley Ryan Ability Lab, Chicago, Illinois, USA.,RTI International, Chicago, Illinois, USA
| | - Michelle Peterson
- Physical Medicine and Rehabilitation Department, Polytrauma Rehabilitation Center, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
| | - Nicole T Soltys
- Center for Rehabilitation Outcomes Research, The Shirley Ryan Ability Lab, Chicago, Illinois, USA
| | - Vari McPherson
- Center for Rehabilitation Outcomes Research, The Shirley Ryan Ability Lab, Chicago, Illinois, USA
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Forestier B, Anthoine E, Reguiai Z, Fohrer C, Blanchin M. A systematic review of dimensions evaluating patient experience in chronic illness. Health Qual Life Outcomes 2019; 17:19. [PMID: 30665417 PMCID: PMC6341593 DOI: 10.1186/s12955-019-1084-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 01/07/2019] [Indexed: 12/23/2022] Open
Abstract
Background Living with a chronic disease often means experiencing chronic treatments and regular multidisciplinary monitoring as well as a profound life-changing experience which may impact all aspects of a patients life. The patient experience of chronic disease is frequently assessed by patient reported measures (PRMs) which incorporate patients perspectives to better understand how illness, treatment and care impact the entirety of a patient’s life. The purpose of this review was to collect and review different kinds of available PRM instruments validated for chronic patients, to produce an inventory of explored concepts in these questionnaires and to identify and classify all dimensions assessing chronic patients experience. Methods A systematic review of PRM instruments validated for chronic patients was conducted from three databases (Medline, the Cochrane library, and Psycinfo). Articles were selected after a double reading and questionnaires were classified according to their targeted concept. Then, all dimensions of the questionnaires were clustered into different categories. Results 107 primary validation studies of PRM questionnaires were selected. Five kinds of instruments were recorded: 1) Questionnaires assessing health related quality of life or quality of life; 2) Instruments focusing on symptoms and functional status; 3) Instruments exploring patients’ feelings and attitude about illness; 4) Questionnaires related to patients’ experience of treatment or healthcare; 5) Instruments assessing patients attitudes about treatment or healthcare. Twelve categories of dimensions were obtained from these instruments. Conclusions This review provided an overview of some of the dimensions used to explore chronic patient experience. A large PRM diversity exists and none of the reviewed and selected questionnaires covered all identified categories of dimensions of patient experience of chronic disease. Furthermore, the definition of explored concepts varies widely among researchers and complex concepts often lack a clear definition in the reviewed articles. Before attempting to measure chronic patient experience, researchers should construct appropriate instruments focusing on well-defined concepts and dimensions encompassing patient’s personal experience, attitude and adaptation to illness, treatment or healthcare. Electronic supplementary material The online version of this article (10.1186/s12955-019-1084-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bastien Forestier
- UMR U1246 SPHERE "methodS in Patient centered outcomes & HEalth REsearch", Université de Nantes, Université de Tours, INSERM, Nantes, France.,Pôle de santé publique, CHU de Nantes, Nantes, France
| | - Emmanuelle Anthoine
- UMR U1246 SPHERE "methodS in Patient centered outcomes & HEalth REsearch", Université de Nantes, Université de Tours, INSERM, Nantes, France.,Pôle de santé publique, CHU de Nantes, Nantes, France
| | - Ziad Reguiai
- Service de dermatologie, Polyclinique Courlancy, Reims, France
| | - Cécile Fohrer
- Service d'hématologie clinique, CHU de Strasbourg, Strasbourg, France
| | - Myriam Blanchin
- UMR U1246 SPHERE "methodS in Patient centered outcomes & HEalth REsearch", Université de Nantes, Université de Tours, INSERM, Nantes, France.
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Wensley C, Botti M, McKillop A, Merry AF. A framework of comfort for practice: An integrative review identifying the multiple influences on patients' experience of comfort in healthcare settings. Int J Qual Health Care 2017; 29:151-162. [PMID: 28096279 DOI: 10.1093/intqhc/mzw158] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Accepted: 12/25/2016] [Indexed: 11/12/2022] Open
Abstract
Purpose Comfort is central to patient experience but the concept of comfort is poorly defined. This review aims to develop a framework representing patients' complex perspective of comfort to inform practice and guide initiatives to improve the quality of healthcare. Data sources CINAHL, MEDLINE Complete, PsycINFO and Google Scholar (November 2016); reference lists of included publications. Study selection Qualitative and theoretical studies advancing knowledge about the concept of comfort in healthcare settings. Studies rated for methodological quality and relevance to patients' perspectives. Data extraction Data on design, methods, features of the concept of comfort, influences on patients' comfort. Data were systematically coded and categorized using Framework method. Results of data synthesis Sixty-two studies (14 theoretical and 48 qualitative) were included. Qualitative studies explored patient and staff perspectives in varying healthcare settings including hospice, emergency departments, paediatric, medical and surgical wards and residential care for the elderly. From patients' perspective, comfort is multidimensional, characterized by relief from physical discomfort and feeling positive and strengthened in one's ability to cope with the challenges of illness, injury and disability. Different factors are important to different individuals. We identified 10 areas of influence within four interrelated levels: patients' use of self-comforting strategies; family presence; staff actions and behaviours; and environmental factors. Conclusion Our data provide new insights into the nature of comfort as a highly personal and contextual experience influenced in different individuals by different factors that we have classified into a framework to guide practice and quality improvement initiatives.
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Affiliation(s)
- Cynthia Wensley
- School of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia
| | - Mari Botti
- School of Nursing and Midwifery, Deakin University, Epworth Deakin Centre for Clinical Nursing Research, 221 Burwood Highway, Burwood, VIC 3125, Australia
| | - Ann McKillop
- School of Nursing, University of Auckland, 89-91 Grafton Rd, Grafton, Auckland 1010, New Zealand
| | - Alan F Merry
- Department of Anaesthesiology, School of Medicine, University of Auckland and Specialist Anaesthetist Auckland City Hospital>, 2 Park Rd, Grafton, Auckland 1023, New Zealand
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20
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Patient experience and satisfaction with a healthcare system: connecting the dots. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2017. [DOI: 10.1080/20479700.2017.1353776] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Male L, Noble A, Atkinson J, Marson T. Measuring patient experience: a systematic review to evaluate psychometric properties of patient reported experience measures (PREMs) for emergency care service provision. Int J Qual Health Care 2017; 29:314-326. [PMID: 28339923 PMCID: PMC5890873 DOI: 10.1093/intqhc/mzx027] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 12/22/2016] [Accepted: 02/21/2017] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Knowledge about patient experience within emergency departments (EDs) allows services to develop and improve in line with patient needs. There is no standardized instrument to measure patient experience. The aim of this study is to identify patient reported experience measures (PREMs) for EDs, examine the rigour by which they were developed and their psychometric properties when judged against standard criteria. DATA SOURCES Medline, Scopus, CINAHL, PsycINFO, PubMed and Web of Science were searched from inception to May 2015. STUDY SELECTION Studies were identified using specific search terms and inclusion criteria. A total of eight articles, reporting on four PREMs, were included. DATA EXTRACTION Data on the development and performance of the four PREMs were extracted from the articles. The measures were critiqued according to quality criteria previously described by Pesudovs K, Burr JM, Harley C, et al. (The development, assessment, and selection of questionnaires. Optom Vis Sci 2007;84:663-74.). RESULTS There was significant variation in the quality of development and reporting of psychometric properties. For all four PREMs, initial development work included the ascertainment of patient experiences using qualitative interviews. However, instrument performance was poorly assessed. Validity and reliability were measured in some studies; however responsiveness, an important aspect on survey development, was not measured in any of the included studies. CONCLUSION PREMS currently available for use in the ED have uncertain validity, reliability and responsiveness. Further validation work is required to assess their acceptability to patients and their usefulness in clinical practice.
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Affiliation(s)
- Leanne Male
- University of Liverpool, Room 2.29, Clinical Sciences Centre, Aintree University Hospital, Fazakerley L9 7LJ, UK
| | - Adam Noble
- University of Liverpool, Room 2.29, Clinical Sciences Centre, Aintree University Hospital, Fazakerley L9 7LJ, UK
| | - Jessica Atkinson
- University of Liverpool, Room 2.29, Clinical Sciences Centre, Aintree University Hospital, Fazakerley L9 7LJ, UK
| | - Tony Marson
- The Walton Centre NHS Foundation Trust, Lower Lane, Liverpool L9 7LJ, UK
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Ball K, Swallow V. Patient experiences of cardiac surgery and nursing care: a narrative review. ACTA ACUST UNITED AC 2016. [DOI: 10.12968/bjca.2016.11.7.348] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Katie Ball
- Clinical Research Nurse, Central Manchester University Hospital Foundation Trust, Manchester (Formerly Staff Nurse, Cardiothoracic Critical Care at time of writing)
| | - Veronica Swallow
- Professor in Child and Family Health, School of Healthcare, University of Leeds, Leeds
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Timmins F, Mc Bennett P, Norton C. Providing compassionate care to patients waiting on Emergency Department trolleys: can we do more? Nurs Crit Care 2015; 19:114-6. [PMID: 24734848 DOI: 10.1111/nicc.12098] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Fiona Timmins
- School of Nursing and Midwifery, Trinity College Dublin, Dublin 2, Ireland.
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