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Ahmadi H, Mirza Aghazadeh Attari A, Ajoudani F, Lotfi M. Family-based education and follow-up program for patients with burns: A mixed assessment study. Burns 2024; 50:1671-1681. [PMID: 38604826 DOI: 10.1016/j.burns.2024.03.029] [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: 11/07/2023] [Revised: 03/10/2024] [Accepted: 03/31/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Burn injuries are a major cause of morbidity and mortality worldwide, affecting not only the patients but also their families. Family-based education and follow-up program are interventions that aim to improve the quality of life and psychosocial outcomes of patients with burns and their families. However, we find a lack of evidence on the effectiveness and feasibility of these programs in different settings and populations. This study aimed to evaluate the features of the family-based education and follow-up program (FBEFP), a pilot project that was developed and implemented at the Tabriz Sina Teaching Hospital in 2020 to improve its burn care system. DESIGN A mixed-methods approach was used to collect and analyze both quantitative and qualitative data from various sources, such as, questionnaires, medical records, interviews and observation notes, to assess the content, process, and outcome of the program. The study followed the three steps of the CDC's framework for program evaluation: describing the program, measuring its effectiveness, and providing recommendations for improvement. RESULTS The results of this study revealed the positive impacts of the FBEFP on the patients' physical, psychological, and social outcomes and quality of life. 4.8% of the people in the follow-up group were re-admitted, while this amount was 7.2% in the group without follow-up. Although the number of readmissions was less in the non-follow-up group, statistically no significant difference was observed between the two ratios before and after follow-up. In order to evaluate satisfaction rates, In the follow-up group, 72 patients and in the non-follow-up group, 38 patients were reached. After converting these data to normal distribution, using t-tests, it was determined that the difference between the two studied groups was highly significant. In other words, the follow-up process had favorable results on satisfaction of the studied people. However, the study also identified some challenges and barriers in implementing the program, such as lack of resources, staff training, and family involvement. CONCLUSION FBEFP is a promising intervention that enhances the well-being of patients with burns and their families. However, more evidence is needed to support its effectiveness and feasibility in different contexts and populations. The study also provided valuable insights into the benefits and challenges of implementing a Family-Based Education and Follow-up Program for patients with burns in a low-resource setting. The study contributed to the development of guidelines and recommendations for future research and practice in this field.
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Affiliation(s)
- Homa Ahmadi
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Fardin Ajoudani
- School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
| | - Mojgan Lotfi
- School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
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Jonasson LL, Bångsbo A, Billhult A, Wolmesjö M. Older adults' experiences of participation in daily activities in Swedish assisted living. BMC Geriatr 2023; 23:762. [PMID: 37990295 PMCID: PMC10662507 DOI: 10.1186/s12877-023-04484-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 11/14/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND According to Swedish law, older adults in Sweden should be able to live a good, safe, and independent life with social and healthcare provided, based on their individual needs. In assisted living in Swedish eldercare the environment affects the older adults' ability to participate in decision-making and strengthens their ability to feel meaningfulness. The ability of staff working in social and healthcare to invite older adults to participate varies. It is important to examine how older adults perceive their situation, as caregivers in eldercare tend to focus on routine work and experience difficulties in meeting the individual needs of older adults. The aim of this study was to explore how older adults in assisted living experienced participation in daily activities. METHODS A qualitative interview study was conducted in two municipalities in the western part of Sweden. An exploratory and inductive design was used. Individual interviews were conducted with 11 older adults living in two different assisted living facilities. The data were analysed using thematic analysis. RESULTS The interviews resulted in three themes: Being involved, Sense of well-being, and Influenced by the context. The older adults' experiences of participation were interpreted as feelings of being involved in daily life activities, and how they felt involved in their own care and nursing. Participation created prerequisites for well-being. Sense of well-being could be related to feelings of security and social community. The organisation and work environment of the healthcare staff had a great impact on their ability to increase the participation of the older adults. The older adults were aware of the everyday work situation of the providers of social and healthcare and were Influenced by the context. DISCUSSION/CONCLUSION Important conditions for a good quality of life and participation for the older adults are to be treated with respect, receive information, and be able to choose. The older adults expressed several good ideas for improvements and a willingness to be involved in the development of the organisation at different levels. It is essential to invite older adults in assisted living to participate in the design of care and nursing.
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Affiliation(s)
- Lise-Lotte Jonasson
- Department of Nursing Science, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
| | - Angela Bångsbo
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Annika Billhult
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Maria Wolmesjö
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
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Elliott A, Gibson S. Exploring stakeholder experiences of dietetic service and care delivery: A systematic qualitative review. J Hum Nutr Diet 2023; 36:288-310. [PMID: 35833488 PMCID: PMC10087390 DOI: 10.1111/jhn.13063] [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: 03/23/2022] [Accepted: 06/01/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND There is limited understanding of patients' and healthcare professionals' perceptions and experiences of receiving and delivering dietetic care, respectively. This systematic review of the literature used qualitative synthesis to explore the perceptions and experiences of multiple stakeholders involved in the delivery of nutrition care and dietetic service. METHODS MEDLINE, Embase, CINAHL, Cochrane Library, Scopus, ISI Web of Science, PsycINFO and ProQuest were systematically searched. Study characteristics and perceptions of stakeholders regarding nutrition care services were extracted. Qualitative synthesis was employed and thematic analysis conducted. RESULTS Five themes were identified from 44 studies related to stakeholders' perceptions of dietetic services. Studies included quantitative, qualitative and mixed methods involving patients, families, dietitians and other healthcare professionals. The themes were (1) patients desiring a personalised approach to nutrition care; (2) accessing dietetic service; (3) perceived impact of nutrition care on the patient; (4) relationships between stakeholders; and (5) beliefs about nutrition expertise. Two themes were specific to patients; these were the desire for individualised care and the impact of nutrition care. Within each theme perceptions varied with patients' views often contrasting with those of dietetic service providers. CONCLUSIONS Experiences of dietetic service do not always meet stakeholder expectations which impacts on patient engagement. Seeking stakeholder input is imperative to design dietetic services that engage patients in positive and supportive clinical partnerships.
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Affiliation(s)
- Andrea Elliott
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Notting Hill, Victoria, Australia
| | - Simone Gibson
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Notting Hill, Victoria, Australia
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4
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Yan M, Zhi M, Xu Y, Hu L, Liu Y. Inpatient Satisfaction with Nursing Care and Its Impact Factors in Chinese Tertiary Hospitals: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16523. [PMID: 36554403 PMCID: PMC9778790 DOI: 10.3390/ijerph192416523] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/29/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
AIMS To evaluate the level of patient satisfaction with nursing care in China's major tertiary hospitals, and to explore patient and hospital level factors associated with patient satisfaction, in order to provide policy implications for the evaluation and improvement of nursing care, toward a patient-centered healthcare system. BACKGROUND Patient satisfaction with nursing care has been designated as a key measure of the quality of nursing care and is one of the main focuses of the current healthcare improvement campaign in China. METHODS We participated in the 2021 China National Patient Survey and designed and administered a survey instrument with five domains, to evaluate patient satisfaction with nursing care among 24,971 inpatients from 143 tertiary hospitals across 31 provinces in China. Descriptive analysis and binary logistic regressions were utilized to assess the level of satisfaction and identify key factors related to nursing satisfaction. RESULTS The overall satisfaction level is high, but satisfaction with health guidance is relatively low. Patients' sociodemographic characteristics, including age, income, and education, are significantly associated with their satisfaction. Hospital characteristics, such as geographic location, type, and nurse-to-doctor ratio, significantly impact inpatient satisfaction with nursing care. Patients of hospitals in the eastern region, general hospitals, and hospitals with higher nurse-to-doctor ratios are more satisfied with nursing care. CONCLUSION More attention should be paid to equitably allocating healthcare resources among different regions, improving the management and competence of non-general hospitals, and strengthening the recruitment and retention of the nursing workforce. Moreover, patient characteristics should be considered when evaluating patient satisfaction across hospitals. Patient and Public Contribution: These findings will help us better understand patients' satisfaction regarding nursing care in Chinese tertiary hospitals and develop targeted interventions, to establish a patient-centered healthcare system.
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Affiliation(s)
| | | | | | - Linlin Hu
- Correspondence: (L.H.); (Y.L.); Tel.: +86-13661229049 (L.H.); +86-13522592907 (Y.L.)
| | - Yuanli Liu
- Correspondence: (L.H.); (Y.L.); Tel.: +86-13661229049 (L.H.); +86-13522592907 (Y.L.)
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5
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Kynoch K, Ameen M, Ramis MA, Khalil H. Use of Patient-Reported Data within the Acute Healthcare Context: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11160. [PMID: 36141433 PMCID: PMC9517657 DOI: 10.3390/ijerph191811160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/24/2022] [Accepted: 09/01/2022] [Indexed: 06/16/2023]
Abstract
Patient-reported outcome measures (PROMs), patient-reported experience measures (PREMs) and patient satisfaction surveys provide important information on how care can be improved. However, data collection does not always translate to changes in practice or service delivery. This scoping review aimed to collect, map and report on the use of collected patient-reported data used within acute healthcare contexts for improvement to care or processes. Using JBI methods, an extensive search was undertaken of multiple health databases and trial registries for published and unpublished studies. The concepts of interest included the types and characteristics of published patient experience and PROMs research, with a specific focus on the ways in which data have been applied to clinical practice. Barriers and facilitators to the use of collected data were also explored. From 4057 records, 86 papers were included. Most research was undertaken in North America, Canada or the UK. The Hospital Consumer Assessment of Healthcare Providers and Systems tool (HCAHPS) was used most frequently for measuring patient satisfaction. Where reported, data were applied to improve patient-centred care and utilization of health resources. Gaps in the use of patient data within hospital services are noticeable. Engaging management and improving staff capability are needed to overcome barriers to implementation.
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Affiliation(s)
- Kathryn Kynoch
- Mater Health and Queensland Centre for Evidence Based Nursing and Midwifery, A JBI Centre of Excellence, Brisbane 4006, Australia
| | - Mary Ameen
- Faculty of Medicine, Nursing and Health Sciences, Monash Rural Health Churchill, Monash University, Churchill 3842, Australia
| | - Mary-Anne Ramis
- Mater Health and Queensland Centre for Evidence Based Nursing and Midwifery, A JBI Centre of Excellence, Brisbane 4006, Australia
| | - Hanan Khalil
- School of Psychology and Public Health, La Trobe University, Melbourne 3086, Australia
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Perception of the image of the nursing profession and its relationship with quality of care. BMC Nurs 2022; 21:57. [PMID: 35272645 PMCID: PMC8908293 DOI: 10.1186/s12912-022-00830-4] [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: 10/18/2021] [Accepted: 02/19/2022] [Indexed: 12/02/2022] Open
Abstract
Background Good quality of care (QOC) is related to high recovery rates, fewer mistakes, and better outcomes in general. The perception of the nursing profession (NP) among nurses has many social and professional implications, and it is important to understand the implications regarding their QOC. The aim of the study was to examine whether there is a relationship between the self-image of nursing and the nurses’ QOC, and whether men and women differ in their nursing image (NI). Methods A cross-sectional study applied among nursing teams employed in various inpatient wards: An online questionnaire was distributed and included (1) Sociodemographic details; (2) Image of the nursing profession; and (3) Nurses’ perception of their nursing care quality. Results The results show a significant positive relationship between the NI perception among nurses and their perceptions of the QOC they provide. No sex differences were found between male and female nurses. Conclusion This study highlights the correlation between the NP’s self-image and self-reported QOC. Health policy makers should build national programs that improve the image of nursing among nursing teams, and create an empowering and positive working environment, which would most probably improve the quality of nursing care.
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VITALE E, CANONICO A, FERRAMOSCA FM, LUPO R, GUGLIELMI V. Can the quality perceived by the surgical patients vary before and after the surgical intervention? An observational descriptive study. Chirurgia (Bucur) 2022. [DOI: 10.23736/s0394-9508.21.05248-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Al-Jabri FYM, Turunen H, Kvist T. Patients' Perceptions of Healthcare Quality at Hospitals Measured by the Revised Humane Caring Scale. J Patient Exp 2021; 8:23743735211065265. [PMID: 34926803 PMCID: PMC8674720 DOI: 10.1177/23743735211065265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The patients’ perceptions are central to quality improvement of the healthcare
system worldwide. This study aimed to examine patients’ perceptions of quality
care and investigate the demographic factors related to the overall patients’
perceptions. The Revised Humane Caring Scale was distributed to 367 adult
patients who were admitted at medical, surgical, and obstetrics and gynecology
departments in 2 tertiary hospitals in Oman. Overall patients’ perceptions of
quality of care were high, with professionalism being rated the highest, and
cognition of physical needs and human resources rated the lowest. Significant
differences in patients’ perceptions between hospitals as well as in the
subscales of interdisciplinary collaboration and outcome variables, between
planned- and emergency-admitted patients were found. The linear regression
analysis indicated a relationship between gender and overall quality care where
male patients reported higher satisfaction compared to counterparts. This study
suggested the need to improve the cognition of physical needs (food quality and
environmental sanitation) and human resources (staff to patient ratio) as well
as pay attention to the individual patients’ needs especially for
emergency-admitted patients.
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Affiliation(s)
| | - Hannele Turunen
- Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland
| | - Tarja Kvist
- University of Eastern Finland, Kuopio, Finland
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Holm A, Lindgren H, Bläckberg M, Augutis M, Jakobsson P, Tell M, Wallinder J, Lundström KJ, Styrke J. Patients' perspective on prostatic artery embolization: A qualitative study. SAGE Open Med 2021; 9:20503121211000908. [PMID: 33786178 PMCID: PMC7958185 DOI: 10.1177/20503121211000908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 02/12/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives The aim was to describe the patients' experience of undergoing prostatic artery embolization. Methods A retrospective qualitative interview study was undertaken with 15 patients of mean age 73 years who had undergone prostatic artery embolization with a median duration of 210 min at two medium sized hospitals in Sweden. The reasons for conducting prostatic artery embolization were clean intermittent catheterization (n = 4), lower urinary tract symptoms (n = 10) or haematuria (n = 1). Data were collected through individual, semi-structured telephone interviews 1-12 months after treatment and analysed using qualitative content analysis. Results Four categories with sub-categories were formulated to describe the results: a diverse experience; ability to control the situation; resumption of everyday activities and range of opinions regarding efficacy of outcomes. Overall, the patients described the procedure as painless, easy and interesting and reported that while the procedure can be stressful, a calm atmosphere contributed to achieving a good experience. Limitations on access to reliable information before, during and after the procedure were highlighted as a major issue. Practical ideas for improving patient comfort during the procedure were suggested. Improved communications between treatment staff and patients were also highlighted. Most patients could resume everyday activities, some felt tired and bruising caused unnecessary worry for a few. Regarding functional outcome, some patients described substantial improvement in urine flow while others were satisfied with regaining undisturbed night sleep. Those with less effect were considering transurethral resection of the prostate as a future option. Self-enrolment to the treatment and long median operation time may have influenced the results. Conclusions From the patients' perspective, prostatic artery embolization is a well-tolerated method for treating benign prostate hyperplacia.
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Affiliation(s)
- Alexander Holm
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden
| | - Hans Lindgren
- Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden.,Department of Interventional Radiology and Surgery, Helsingborg Hospital, Helsingborg, Sweden
| | - Mats Bläckberg
- Department of Urology, Helsingborg Hospital, Helsingborg, Sweden
| | - Marika Augutis
- Department of Research and Development, Sundsvalls Hospital, Sundsvall, Sweden
| | - Peter Jakobsson
- Department of Radiology, Östersunds Hospital, Östersund, Sweden
| | - Mattias Tell
- Department of Surgery, Sundsvalls Hospital, Sundsvall, Sweden
| | - Jonas Wallinder
- Department of Surgery, Sundsvalls Hospital, Sundsvall, Sweden
| | - Karl-Johan Lundström
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden
| | - Johan Styrke
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden
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Ogunlade AA, Ayandiran EO, Oyediran OO, Oyelade OO, Olaogun AAE. Quality of emergency nursing care in two tertiary healthcare settings in a developing Sub-Saharan African Country. Afr J Emerg Med 2020; 10:S73-S77. [PMID: 33318906 PMCID: PMC7723905 DOI: 10.1016/j.afjem.2020.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 04/17/2020] [Accepted: 05/20/2020] [Indexed: 11/24/2022] Open
Abstract
Introduction The quality of care received by patients during the first few hours following an accident and/or acute life-threatening conditions can significantly affect the overall outcome of treatment. This study, therefore, assessed the quality of emergency nursing care in two tertiary healthcare settings in a developing Sub-Saharan African Country. Methods The study was conducted in two renowned tertiary hospitals in Southwest Nigeria. Four hundred and twenty-eight patients selected by purposive sampling technique from the two hospitals formed the sample. The Donabedian three-pronged approach of structure, process and outcome domains was employed for data collection. Two instruments; an adapted validated structured questionnaire and an observation checklist were used for data collection and data collected were analysed with the aid of Statistical Package for Social Sciences (SPSS 24) using mainly descriptive statistics such as frequency counts and percentages. Results Results showed that a majority (62.6%) rated the quality of emergency nursing care as high though observation revealed glaring differences in the structure, process and outcome domains of quality in selected hospitals. Discussion/Conclusion The study, therefore, concluded that while the quality of emergency nursing care in the selected hospitals can be described in general as average, a lot still needs to be done to address the identified deficiencies in emergency nursing care.
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Affiliation(s)
- Alade A Ogunlade
- Department of Nursing Science, Faculty of Basic Medical Sciences, Edo University Iyamho, Edo State, Nigeria
- Corresponding author.
| | - Emmanuel O Ayandiran
- Department of Nursing Science, Faculty of Basic Medical Sciences, Obafemi Awolowo, University, Ile-Ife, Nigeria
| | - Olufemi O Oyediran
- Department of Nursing Science, Faculty of Basic Medical Sciences, Obafemi Awolowo, University, Ile-Ife, Nigeria
| | - Oyeyemi O Oyelade
- Department of Nursing Science, Faculty of Basic Medical Sciences, Obafemi Awolowo, University, Ile-Ife, Nigeria
| | - Adenike AE Olaogun
- Department of Nursing Science, Faculty of Basic Medical Sciences, Obafemi Awolowo, University, Ile-Ife, Nigeria
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Kim SM, Kim T, Cha WC, Lee JH, Kwon IH, Choi Y, Kim JS. User Experience of Mobile Personal Health Records for the Emergency Department: Mixed Methods Study. JMIR Mhealth Uhealth 2020; 8:e24326. [PMID: 33320102 PMCID: PMC7772069 DOI: 10.2196/24326] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/22/2020] [Accepted: 11/03/2020] [Indexed: 11/25/2022] Open
Abstract
Background Personal health records (PHRs) can be useful in the emergency department, as they provide patient information in an accurate and timely manner and enable it to be used actively. This has an effect on patients’ health outcomes and patient experience. Despite the importance of PHRs in emergencies, there are only a few studies related to PHRs in emergencies that evaluate patient experience. Objective This study aims to introduce the novel mobile PHR (mPHR) platform to emergency environments and assess user experience. Methods The study was conducted from October 2019 to November 2019. In total, 1000 patients or carers in the emergency departments of 3 hospitals were provided an application-based service called FirstER, which was developed to collect and utilize medical information for patients in the emergency department. This study was performed as a mixed methods study. After using FirstER, we investigated its usability and conducted a survey on the experience of obtaining medical information with a legacy system and with FirstER. Additionally, we interviewed 24 patients to gain insight into their experiences regarding medical information using FirstER. For the quantitative analysis, the survey results were analyzed using descriptive statistics (mean and standard deviation). For the qualitative analysis, we determined the keywords and their frequencies from each survey question and interview question. Results In total, 1000 participants, consisting of both patients and carers, were recruited in this study. Their mean age was 41.4 (SD 13.3) years. We ascertained participants’ satisfaction with FirstER and their mPHR needs through a survey and an in-depth interview. With the current system, participants were not well aware of their health conditions and medical information, and they were passive in the use of their medical information and treatment. However, they wanted their medical information for several reasons, such as information sharing and managing their health conditions. FirstER provided participants with their needed information and an easy way to access it. The mean System Usability Scale (SUS) value was 67.1 (SD 13.8), which was considered very near to acceptable. Conclusions This study is the first to implement mPHRs in the emergency department of large tertiary hospitals in the Republic of Korea. FirstER was found to enhance user experience in emergencies, as it provided necessary medical information and proper user experience. Moreover, the average SUS was 67.1, which means that participants found FirstER to be very near to acceptable. This is very encouraging in that FirstER was developed within a very short time, and it was a pilot study. Trial Registration Clinicaltrials.gov NCT04180618; https://clinicaltrials.gov/ct2/show/NCT04180618
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Affiliation(s)
- Su Min Kim
- Department of Digital Health, Samsung Advanced Institute for Health Science & Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Taerim Kim
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Won Chul Cha
- Department of Digital Health, Samsung Advanced Institute for Health Science & Technology, Sungkyunkwan University, Seoul, Republic of Korea.,Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Health Information and Strategy Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Jae-Ho Lee
- Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.,Department of Information Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - In Ho Kwon
- Department of Emergency Medicine, Dong-a University Hospital, Busan, Republic of Korea.,Department of Emergency Medicine, Dong-a University College of Medicine, Busan, Republic of Korea
| | - Yuri Choi
- Department of Emergency Medicine, Dong-a University Hospital, Busan, Republic of Korea.,Department of Emergency Medicine, Dong-a University College of Medicine, Busan, Republic of Korea
| | - June-Sung Kim
- Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Bagnasco A, Zanini M, Dasso N, Rossi S, Timmins F, Galanti MC, Aleo G, Catania G, Sasso L. Dignity, privacy, respect and choice-A scoping review of measurement of these concepts within acute healthcare practice. J Clin Nurs 2020; 29:1832-1857. [PMID: 32220088 DOI: 10.1111/jocn.15245] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 01/23/2020] [Accepted: 03/12/2020] [Indexed: 12/16/2022]
Abstract
AIMS AND OBJECTIVES To synthesise and review literature related to instruments that measure psychosocial aspects of fundamental care in acute hospital care settings. BACKGROUND Psychosocial aspects of care often receive less priority in terms of care provision in acute care environments. At the same time, if these elements are overlooked, there may be consequences. Despite the availability of many instruments designed to measure specific aspects of care, these concepts are often not studied within the broader context of fundamentals of care, but rather coexist as isolated explorations of specific subelements. DESIGN A scoping review was conducted, based on Arksey & O'Malley's (2005) methodological framework and following the PRISMA checklist. METHODS Using the five recommended steps-identifying the research question; identifying relevant studies; study selection; charting the data; and summarising and reporting the results-three databases were searched: MEDLINE/PubMed, CINAHL and EMBASE, in February 2019. RESULTS Following independent screening by two of the authors, 48 papers were included. From these 48 papers, 33 instruments were identified. Only five of these tools thoroughly assessed psychosocial aspects elements of care (dignity, respect, privacy and patients' choice) through dedicated items. CONCLUSIONS This review provides nurses with a synthesis of 33 instruments that assess the psychosocial aspects of care. This provides an important resource to guide measurement of dignity, respect, privacy and patients' choice. The findings also provide guidance to future research in this field. RELEVANCE TO CLINICAL PRACTICE This paper reviews and synthesises these instruments to provide a resource to nurses to inform their decisions and practice around measurement and evaluation of these key aspects of care. This provides a useful guide to measure and monitor the improvement of fundamental care delivery in practice and points to strengths and weaknesses of the instruments concerned.
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Affiliation(s)
| | - Milko Zanini
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Nicoletta Dasso
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Silvia Rossi
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Fiona Timmins
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | | | - Giuseppe Aleo
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Gianluca Catania
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Loredana Sasso
- Department of Health Sciences, University of Genoa, Genoa, Italy
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13
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Kruszecka-Krówka A, Smoleń E, Cepuch G, Piskorz-Ogórek K, Perek M, Gniadek A. Determinants of Parental Satisfaction with Nursing Care in Paediatric Wards-A Preliminary Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101774. [PMID: 31137478 PMCID: PMC6572998 DOI: 10.3390/ijerph16101774] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 05/15/2019] [Accepted: 05/17/2019] [Indexed: 12/28/2022]
Abstract
Background: The quality of medical services for a child and their parents are tantamount to a sense of satisfaction with care. Purpose: The assessment of determinants of parental satisfaction with nursing care in paediatric wards. Methods: The study covered 336 parents of children hospitalised in paediatric departments and was based on the “EMPHATIC” questionnaire, standardized and adapted to Polish conditions. Results: The mean score of the overall parental satisfaction was high, amounting to 4.19 points. The lower level of satisfaction with nursing care was reported in parents of children under the age of 6 years, admitted in an emergency mode with a diagnosed post-trauma condition and those with higher education. The duration of hospitalisation, sex and age of parents did not have an influence on the satisfaction with care. Conclusions: The age of the child, admission mode and education of respondents are determinants of parental satisfaction with nursing care.
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Affiliation(s)
- Agnieszka Kruszecka-Krówka
- Department of Clinical Nursing, Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, 31-501 Kraków, Poland.
| | - Ewa Smoleń
- Chair and Department of Management in Nursing, Faculty of Health Sciences, Medical University of Lublin, 20-059 Lublin, Poland.
| | - Grażyna Cepuch
- Department of Clinical Nursing, Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, 31-501 Kraków, Poland.
| | - Krystyna Piskorz-Ogórek
- Nursing Department Faculty of Health Sciences, University of Warmia and Mazury, 10-719 Olsztyn, Poland.
| | - Mieczysława Perek
- Department of Clinical Nursing, Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, 31-501 Kraków, Poland.
| | - Agnieszka Gniadek
- Department of Nursing Management and Epidemiological Nursing, Faculty of Health Sciences, Jagiellonian University Medical College, 30-501 Kraków, Poland.
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14
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Schultz H, Schultz Larsen T, Möller S, Qvist N. The Effect of Patient-Controlled Oral Analgesia for Acute Abdominal Pain after Discharge. Pain Manag Nurs 2019; 20:352-357. [PMID: 31103520 DOI: 10.1016/j.pmn.2019.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 02/02/2019] [Accepted: 02/02/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND During hospitalization, patients who were admitted with acute abdominal pain must be prepared to care for themselves at home after discharge to continue established treatment, promote recovery, and avoid readmission. AIMS Our aim was to investigate the quality of pain management after discharge, when patient-controlled oral analgesia was compared with standard care for patients admitted to hospital with acute abdominal pain. The primary outcome measures were pain intensity and patient perception of care. The secondary outcome measures were pain interference with activity, affective experiences, side effects, and use of analgesics. DESIGN A questionnaire study measuring the effect of an intervention on patient-controlled oral analgesics. SETTINGS An emergency department and a surgical department in Denmark. PARTICIPANTS Patients admitted to hospital with acute abdominal pain. METHODS A pre- and postintervention study was conducted in an emergency department and a surgical department with three subunits. Data were collected using a Danish modified Revised American Pain Society Patient Outcome Questionnaire with five subscales (scale 0-10) completed in weeks 1 and 4 after discharge. RESULTS In total, 117 patients were included. The median scores at week 1 and week 4 in the control and intervention groups were, respectively, 2/1 and 1/0 on the pain subscale (p = .11/.16), 3/0 and 3/0 on the activity subscale (p = .19/.80), 1/0 and 0/0 on the emotional subscale (p = .02/.72), 1/0 and 1/0 on the side effect subscale (p = .95/.99), and 8/5 and 7/7 on the patient perception subscale (p = .35/.49). There was no significant difference in the use of analgesics at week 1. CONCLUSIONS Patient-controlled oral analgesia during the hospital stay did not improve the quality of pain management after discharge.
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Affiliation(s)
- Helen Schultz
- Surgical Department, Odense University Hospital, Odense, Denmark; Institute of Clinical Research, University of Southern Denmark, Odense, Denmark; OPEN (Odense Patient Data Explorative Network), Odense University Hospital, Odense, Denmark.
| | | | - Sören Möller
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark; OPEN (Odense Patient Data Explorative Network), Odense University Hospital, Odense, Denmark
| | - Niels Qvist
- Surgical Department, Odense University Hospital, Odense, Denmark; Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
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15
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Gröndahl W, Muurinen H, Katajisto J, Suhonen R, Leino-Kilpi H. Perceived quality of nursing care and patient education: a cross-sectional study of hospitalised surgical patients in Finland. BMJ Open 2019; 9:e023108. [PMID: 30948561 PMCID: PMC6500100 DOI: 10.1136/bmjopen-2018-023108] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 02/11/2019] [Accepted: 02/12/2019] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES This study aims to analyse the relationship between patient education and the quality of surgical nursing care as perceived by patients. The background of the study lies in the importance of a patient-centred approach for both patient education and quality evaluation. DESIGN This was a cross-sectional descriptive correlational study with surgical patients. SETTING Data were collected in 2013 in one hospital district in Finland. PARTICIPANTS 480 hospitalised surgical patients. METHODS The data were collected using two structured instruments: one measuring the perceived quality of nursing care experienced by patients (Good Nursing Care Scale) and one measuring the received knowledge of hospital patients (RKhp). Data were analysed statistically using descriptive and inferential statistics to describe the sample and study variables. Pearson's correlation coefficients were used to analyse the association between the scales. RESULTS Surgical hospital patients evaluated the level of the quality of nursing care as high; this was especially true with reference to the environment and staff characteristics, but not to collaboration with family members. Most (85%) of the patients had received sufficient knowledge preoperatively and they were familiar with the proceeding of their care and treatment after discharge; in particular, they had received bio-physiological knowledge, consisting of knowledge of the disease, symptoms and the physiological elements of care. The positive correlation between the perceived quality of surgical nursing care and received knowledge was strong, suggesting a positive relationship between patient education and improvement of the quality of nursing care. CONCLUSIONS Based on the results, the quality of nursing care and patient education are interconnected. Thus, by improving patient education, the quality of nursing care can also be improved. It is particularly important to improve collaboration with family members and patients' own management strategies as well as the multidimensionality of educational knowledge.
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Affiliation(s)
- Weronica Gröndahl
- Digestive and Urology Clinic, Turku University Hospital, Turku, Finland
| | - Hanna Muurinen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Jouko Katajisto
- Department of Mathematics and Statistics, University of Turku, Turku, Finland
| | - Riitta Suhonen
- Department of Nursing Science, University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
- City of Turku, Welfare Division, Turku, Finland
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
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16
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Karaca A, Durna Z. Patient satisfaction with the quality of nursing care. Nurs Open 2019; 6:535-545. [PMID: 30918704 PMCID: PMC6419107 DOI: 10.1002/nop2.237] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 11/03/2018] [Accepted: 12/03/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate patients' satisfaction with the quality of nursing care and examine associated factors. DESIGN A cross-sectional, descriptive survey study. METHODS The sample was composed of 635 patients discharged from a private hospital. Data were collected using "Patient Satisfaction with Nursing Care Quality Questionnaire" with a total of 19 items, and a questionnaire designed to record socio-demographic characteristics and medical histories between January 1-May 31, 2015. RESULTS Patients were more satisfied with the "Concern and Caring by Nurses" and less satisfied with the "Information You Were Given." Patients (63.9%) described nursing care offered during hospitalization as excellent. Patients who were 18-35 years old, married, college or university graduates, treated at the surgery and obstetrics-gynaecology units, and patients who stated their health as excellent and hospitalized once or at least five times were more satisfied with the nursing care. According to this study, the nurses needed to show greater amount of interest to the information-giving process.
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Affiliation(s)
- Anita Karaca
- Florence Nightingale Hospital School of NursingIstanbul Bilim UniversityIstanbulTurkey
| | - Zehra Durna
- Florence Nightingale Hospital School of NursingIstanbul Bilim UniversityIstanbulTurkey
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17
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Rantala A, Behm L, Rosén H. Quality Is in the Eye of the Beholder-A Focus Group Study from the Perspective of Ambulance Clinicians, Physicians, and Managers. Healthcare (Basel) 2019; 7:E41. [PMID: 30871138 PMCID: PMC6473421 DOI: 10.3390/healthcare7010041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 02/27/2019] [Accepted: 03/08/2019] [Indexed: 11/16/2022] Open
Abstract
Quality within all areas of healthcare should be systemically monitored and ensured. However, the definition of quality is complex and diverse. In the ambulance service (AS), quality has traditionally been defined as response time, but this measurement eliminates the possibility of addressing other characteristics of quality, such as the care provided. This study aimed to explore what constitutes quality in the context of the ambulance service as experienced by ambulance clinicians, physicians, and managers. A focus group study was conducted with 18 participants. The three focus groups were analyzed with the focus group method developed by Kreuger and Casey. The participants highlighted patient involvement, information and care, as well as adherence to policies, regulations, and their own standards as representing quality in the AS. This study demonstrates that quality is in the eye of the beholder. As quality seems to be viewed similarly by patients and ambulance clinicians, physicians, and managers, stakeholders should aim for a paradigm shift where patients' experience of the care is just as important as various time measures.
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Affiliation(s)
- Andreas Rantala
- Department of Health Sciences, Lund University, SE-221 00 Lund, Sweden.
- Emergency Department, Helsingborg General Hospital, SE-205 01 Helsingborg, Sweden.
- Centre of Interprofessional Cooperation within Emergency Care (CICE), Linneaus University, SE-251 95 Växjö, Sweden.
| | - Lina Behm
- Department of Health Sciences, Lund University, SE-221 00 Lund, Sweden.
- Department of Health Sciences, Kristianstad University, SE-291 88 Kristianstad, Sweden.
| | - Helena Rosén
- Department of Health Sciences, Lund University, SE-221 00 Lund, Sweden.
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18
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Lin C, Cohen E, Livingston PM, Mohebbi M, Botti M. Achievement of patients' preferences for participation in oncological symptom management and its association with perceived quality of care. Patient Prefer Adherence 2019; 13:83-90. [PMID: 30643393 PMCID: PMC6318712 DOI: 10.2147/ppa.s184373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The subjectivity of symptom experience and the recognized role of patients in symptom management highlight the need to understand cancer patients' participation in symptom management and to identify the associations between patient participation and quality of care. However, research on patient participation has focused mostly on general healthcare activities, rather than symptom management, especially in cancer-care settings. This study aimed to compare the congruence between cancer patients' preference for and actual perceived experience of participation in symptom management and identify the relationships between preferred and actual patient participation and perceived quality of care. METHODS This was a cross-sectional study. Patient preference and actual experience of participation in symptom management were evaluated with the modified Control Preference Scale among patients recruited from a specialized cancer hospital in China. Patients' perception of quality of care was assessed with the short-form Quality from the Patient's Perspective questionnaire. RESULTS A total of 162 patients were recruited. Their mean age was 47.5±12.2 years, and 51.9% were females. Patients' perceived actual level of participation in symptom management substantially agreed with their preference (weighted κ-coefficient 0.61, 95% CI 0.45-0.77). There was no significant difference between patients' perception of care quality and level of preference for participation (F=0.35, P=0.722) or actual experience of participation (F=0.76, P=0.519). Higher perceptions of quality of care were found among patients whose preferred roles were achieved (P=0.007) or surpassed (P=0.045). CONCLUSION This study identified substantial agreement between patients' preferred and actual participation, given the generally passive preference. The findings indicated that supporting patients to achieve their preferred level of participation may be more important than focusing activities on encouraging increased desire to participate for the purpose of care-quality improvement.
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Affiliation(s)
- Cen Lin
- School of Nursing, Fudan University, Shanghai, China,
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, VIC, Australia,
| | - Emma Cohen
- Olivia Newton-John Cancer and Wellness Centre, Austin Health, Melbourne, VIC, Australia
| | - Patricia M Livingston
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, VIC, Australia,
| | - Mohammadreza Mohebbi
- Biostatistics Unit, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Mari Botti
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, VIC, Australia,
- Deakin Centre for Quality and Safety Research - Epworth HealthCare Partnership, Melbourne, VIC, Australia
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19
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Paukkonen L, Kankkunen P, Kreuter M, Pietilä AM. Patients’ perceptions of participation: Pilot validation study of the FI-PPRQ questionnaire in Finnish primary healthcare settings. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/2057158518815992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Patient participation is is a highly valued goal within healthcare. The aim of this study was to assess the validity of a Finnish version of the Participation in Rehabilitation Questionnaire (FI-PPRQ) developed to measure patients’ perceptions of the importance and their experience of participation in care. The original PPRQ was translated from Swedish into Finnish, then subjected to psychometric pilot testing using data acquired in a cross-sectional survey with a sample of adult patients in eight primary healthcare units (n = 88). The importance and experience ratings were evaluated separately, by calculating distributions of item and scale scores, Cronbach’s alpha coefficients, and correlations between items and scales. In addition, experience ratings were subjected to exploratory factor and multi-trait scaling analyses. The results of this study support the validity and reliability of the instrument for use in clinical settings to provide information about patient participation. However, further studies are needed with more varied settings.
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Affiliation(s)
- Leila Paukkonen
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Päivi Kankkunen
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Margareta Kreuter
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Sweden
| | - Anna-Maija Pietilä
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Social and Healthcare Services, Kuopio, Finland
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20
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Langegård U, Ahlberg K, Fransson P, Johansson B, Sjövall K, Bjork-Eriksson T, Ohlsson-Nevo E. Evaluation of quality of care in relation to health-related quality of life of patients diagnosed with brain tumor: a novel clinic for proton beam therapy. Support Care Cancer 2018; 27:2679-2691. [PMID: 30484013 PMCID: PMC6541566 DOI: 10.1007/s00520-018-4557-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 11/15/2018] [Indexed: 12/31/2022]
Abstract
Purpose Patients with brain tumors constitute a vulnerable group, and it is important that they receive the highest quality of care (QoC). The study aim was to describe the perceptions of QoC and its association with health-related quality of life in brain tumor patients undergoing proton beam therapy in a newly established clinic. Method Data were collected at the start of treatment and after 3 and 6 weeks. Adult patients (≥ 18 years old) with brain tumors (n = 186) completed two self-administered questionnaires: a modified Quality from the Patients’ Perspective, which measures perceived reality and subjective importance of care, and the EORTC QLQ-C30. Data were analyzed using parametric and non-parametric statistical tests. Results The perceived QoC was highest for treatment information and lowest for dietician and smoking information, whereas interaction with doctors and nurses was rated as the most important aspect of quality of care. Subjective importance ratings were significantly higher than perceived reality ratings for 60% of items. A better global health was moderately correlated with a higher perceived support for fatigue. Conclusions A need for quality improvement was identified for several aspects of patient care. Greater symptom distress during the treatment period led to greater perceived importance of symptom support. Ensuring QoC is complex and collaboration with other health care professionals is essential. Relevance to clinical practice The clinic could improve QoC regarding information about possible symptoms, adjust care according to patient perceptions of importance, and involve patients in care decisions. Electronic supplementary material The online version of this article (10.1007/s00520-018-4557-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ulrica Langegård
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens backe, Box 457, 405 30, Göteborg, Sweden.
| | - Karin Ahlberg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens backe, Box 457, 405 30, Göteborg, Sweden
| | - Per Fransson
- Department of Nursing, Umeå University, Umeå, Sweden.,Cancercentrum, Norrlands University Hospital, Umeå, Sweden
| | - Birgitta Johansson
- Experimental Oncology, Department of Immunology, Genetics and Pathology, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| | - Katarina Sjövall
- Department of Oncology, Skane University Hospital, Scania, Sweden.,Department of Oncology, Lund University, Lund, Sweden
| | - Thomas Bjork-Eriksson
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,The Skandion Clinic, Uppsala, Sweden.,Regional Cancer Center West, Gothenburg, Sweden
| | - Emma Ohlsson-Nevo
- University Healthcare Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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21
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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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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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Jardien-Baboo S, van Rooyen D, Ricks E, Jordan P. Perceptions of patient-centred care at public hospitals in Nelson Mandela Bay. Health SA 2016. [DOI: 10.1016/j.hsag.2016.05.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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24
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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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25
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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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Schoeps LN, Tallberg AB, Gunningberg L. Patients' knowledge of and participation in preventing pressure ulcers- an intervention study. Int Wound J 2016; 14:344-348. [PMID: 27112492 DOI: 10.1111/iwj.12606] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 03/15/2016] [Accepted: 03/29/2016] [Indexed: 11/27/2022] Open
Abstract
The aim of this study was to evaluate a patient information pamphlet on pressure ulcer (PU) prevention using a descriptive, comparative pre- and post-test study design. The patient information pamphlet 'How can you help to stop pressure ulcers?' developed by the European PU Advisory Panel in 2012 was implemented in two surgical wards in a university hospital. A total of 61 patients answered pre- and post-test questionnaires. Patients assessed their knowledge of the risks, causes and ways to prevent PUs significantly higher after the intervention than before. Twenty-eight patients (46%) reported that they had participated in PU prevention during the last 24 hours. The patients assessed the content of the PU pamphlet as useful, its language as quite easy to understand and its layout as good. Patients with a PU pamphlet during their hospital stay were more knowledgeable about and more active in their own care. It is important that nurses invite patients to be active partners in preventing PUs but also that they identify patients who need to have a more passive role. The PU pamphlet could be updated to increase its comprehensibility, meaningfulness and manageability for patients.
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Affiliation(s)
- Lena N Schoeps
- Department of Public Health and Caring Sciences, Uppsala University and Uppsala University Hospital, Uppsala, Sweden
| | - Anna-Britta Tallberg
- Department of Public Health and Caring Sciences, Uppsala University and Uppsala University Hospital, Uppsala, Sweden
| | - Lena Gunningberg
- Department of Public Health and Caring Sciences, Uppsala University and Uppsala University Hospital, Uppsala, Sweden
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Kim K, Han Y, Kim JS. Nurses’ and patients’ perceptions of privacy protection behaviours and information provision. Nurs Ethics 2016; 24:598-611. [DOI: 10.1177/0969733015622059] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: With increased attention to patient privacy and autonomy, privacy protection and information provision for patients are becoming increasingly important. Objectives: The aim of this study was to identify and analyse nurses’ and patients’ perceptions of the importance and performance of protecting patients’ privacy and providing them with relevant information. Research design: This study is a descriptive cross-sectional investigation. Participants and research context: Participants were 168 patients hospitalised in medical and surgical wards and 176 nurses who cared for them. Ethical consideration: This study was approved by the Chung-Ang University Bioethics Committee, and informed written consent was collected from all participants. Findings: Nurses’ recognition of the importance of protecting patients’ privacy and providing adequate information was higher compared to their actual performance, and the nurses’ level of performance was higher in comparison with the patients’ recognition of its importance. Discussion: Although a holistic approach to patient privacy protection and information provision is needed, the medical field has not embraced this model of care. Conclusions: These findings provide empirical data to create an ethical environment for the future, as considerable attention has been devoted to patients’ rights and medical institutions’ liability for providing explanations to patients.
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Affiliation(s)
| | - Yonghee Han
- Hallym Polytechnic University, Republic of Korea
| | - Ji-su Kim
- Chung-Ang University, Republic of Korea
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Snyder H, Engström J. The antecedents, forms and consequences of patient involvement: A narrative review of the literature. Int J Nurs Stud 2016; 53:351-78. [DOI: 10.1016/j.ijnurstu.2015.09.008] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 09/01/2015] [Accepted: 09/09/2015] [Indexed: 12/19/2022]
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Dyrstad DN, Testad I, Storm M. Older patients' participation in hospital admissions through the emergency department: an interview study of healthcare professionals. BMC Health Serv Res 2015; 15:475. [PMID: 26486306 PMCID: PMC4617984 DOI: 10.1186/s12913-015-1136-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 10/09/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Patient participation is an important aspect of healthcare quality and may be one way to improve the quality of transitional care for older patients. Research reveals minimal awareness about patient participation in hospital admissions. Hospital admissions require attention to individuals' specific needs beyond patient frailty, and to involve patients and their families in shared decision-making. The aim of this study was to identify factors influencing patient participation by exploring healthcare professionals' views on patient participation during the hospital admission of older patients through the emergency department (ED). METHODS The study used a qualitative and descriptive design with face-to-face interviews. A total of 27 interviews were conducted with 15 healthcare professionals from one hospital and 12 from another. The data were analyzed using systematic text condensation. RESULTS Healthcare professionals thought that patient participation in hospital admissions was influenced by five main factors: 1) routine treatment and care during hospital admission, and in particular certain procedures such as medical examinations; 2) the frail and thankful older patients, and the overall picture of their medical needs; 3) hospital resources, such as available staff and beds; 4) healthcare professionals' attitude towards finding out about older patients' experiences; and 5) the presence of a supportive and demanding next of kin acting as an advocate for the patient. CONCLUSIONS Patient participation in hospital admissions of older patients is dependent on the way the service is organized, the patients' condition, hospital resources, healthcare professionals' attitudes, and support from patients' next of kin. Some of the participants had high expectations of themselves and actively involved patients, but others did not find patient participation relevant in the emergency department. Some used crowded wards as a reason not to engage older patients in their own care.
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Affiliation(s)
- Dagrunn Nåden Dyrstad
- Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway.
- Department of Anaesthesiology and Intensive Care, Stavanger University Hospital, Stavanger, Norway.
| | - Ingelin Testad
- Centre for Age-Related Medicine, SESAM, Stavanger University Hospital, Stavanger, Norway.
| | - Marianne Storm
- Department of Health Studies, Faculty of Social Sciences, University of Stavanger, Stavanger, 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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King KE. Patient Satisfaction in a One-Stop Haematuria clinic and Urology Outpatients: A Comparison of Clinics. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2015. [DOI: 10.1111/ijun.12086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Kathryn E. King
- Centre for Behavioural Medicine, Department of Practice and Policy; UCL School of Pharmacy; London UK
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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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Kalaitzidis E. Patients' decision-making experiences in the acute healthcare setting--a case study. Scand J Caring Sci 2015; 30:83-90. [PMID: 25857486 DOI: 10.1111/scs.12224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 02/08/2015] [Indexed: 12/01/2022]
Abstract
BACKGROUND The transition from being an ordinary citizen to a hospitalised patient can be a daunting experience particularly for the uninitiated and inexperienced. Patients are likely to have questions such as 'where do I go?', 'what should I do?', 'when?' and 'who should I ask?' The process for making practical moment-to-moment decisions is often complex and fraught with difficulties. Identifying critical points in the hospitalisation experience may provide insights into the quality of hospital management systems and professional practices from a patient perspective. OBJECTIVE This study aimed to identify institutional practices and structures in the context of acute healthcare settings which impact on patient moment-to-moment decision-making experiences. METHOD A case study approach was used as the exploratory methodology, and interviews were conducted with three former adult inpatients. In order to gain an understanding of each participant's experiences, data collecting strategies used in this research were a semistructured interview and document analysis of information documents, such as hospital supplied pamphlets, provided to the researcher by the participants. RESULTS The study identified five major themes. Identified as being critical to the participants were information sharing by healthcare professionals, professional advice and professional role identification. Less so were environment and everyday life. Associated with these themes were the participant's common experience of being confined in unfamiliar surroundings, adjusting to institutional routines and of being heavily dependent on others. CONCLUSION Findings indicate that patient moment-to-moment decision-making may be informed and enhanced in several areas: relevant and timely information sharing, varying the dress code between the different professions, reducing conflicting professional advice, clear signage around the hospital, and flexible visiting hours, telephones and clocks in patient rooms.
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Affiliation(s)
- Evdokia Kalaitzidis
- School of Nursing and Midwifery, Flinders University, Bedford Park, Adelaide, SA, Australia
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Leo Swenne C, Cederholm K, Gustafsson M, Arakelian E. Postoperative health and patients' experiences of efficiency and quality of care after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, two to six months after surgery. Eur J Oncol Nurs 2015; 19:191-7. [PMID: 25667124 DOI: 10.1016/j.ejon.2014.05.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 05/11/2014] [Accepted: 05/20/2014] [Indexed: 11/17/2022]
Abstract
PURPOSE To study post-discharge health after Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC), and to analyse patients' experiences of in-hospital efficiency and quality of care. METHODS In-depth individual telephone interviews using an interview guide with open-ended questions were performed with 19 patients with peritoneal carcinomatosis between April and October, 2012. Data were analysed with systematic text condensation. RESULTS Four themes were identified: 1) Coming home was an essential step in the recovery process and the focus was on getting well physically despite mental stress, uncertainty about the medical rehabilitation plan and the future. 2) Health was affected negatively by postoperative chemotherapy and its side effects. 3) Stoma - a necessary evil affecting the patient's social life. 4) Quality of care and efficiency were defined in patient-centred terms and inter-personal care from the patient's perspectives on micro level. Despite all, 32% of the patients described being fully recovered and had started to study or work two months after surgery. CONCLUSIONS The study gives insights into some real-life experiences described by patients. The study results can be used to prepare written information, to design a postoperative rehabilitation plan for future patients with Peritoneal Carcinomatosis (PC) and to create a home-page through which patients can receive support from both health care professionals and other fellow patients.
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Affiliation(s)
- Christine Leo Swenne
- Department of Public Health and Caring Sciences, Uppsala University, Box 564, 751 22 Uppsala, Sweden.
| | - Karin Cederholm
- Department of Surgical Sciences, Uppsala University, Uppsala University Hospital, Entrance 70, 1st Floor, Sweden.
| | - Maria Gustafsson
- Department of Surgical Sciences, Uppsala University, Uppsala University Hospital, Entrance 70, 1st Floor, Sweden.
| | - Erebouni Arakelian
- Department of Public Health and Caring Sciences, Uppsala University, Box 564, 751 22 Uppsala, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala University Hospital, Entrance 70, 1st Floor, Sweden.
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Chan HS, Chu HY, Yen H, Chou LN. Effects of a Care Workshop on Caring Behaviors as Measured by Patients and Patient Satisfaction. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/ojn.2015.52010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Schultz H, Qvist N, Mogensen CB, Pedersen BD. Perspectives of patients with acute abdominal pain in an emergency department observation unit and a surgical assessment unit: a prospective comparative study. J Clin Nurs 2014; 23:3218-3229. [PMID: 25453126 DOI: 10.1111/jocn.12570] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2024]
Abstract
AIMS AND OBJECTIVES To investigate the patient perspective when admitted with acute abdominal pain to an emergency department observation unit compared with the perspective when admitted to a surgical assessment unit. BACKGROUND An increase in emergency department observation units has led to more short-term admissions and has changed the patient journey from admission to specialised wards staffed by specialist nurses to stays in units staffed by emergency nurses. DESIGN A comparative field study. METHODS The study included 21 patients. Participant observation and qualitative interviews were performed, and the analyses were phenomenological-hermeneutic. RESULTS Emergency department observation unit patients had extensive interaction with health professionals, which could create distrust. Surgical assessment unit patients experienced lack of interaction with nurses, also creating distrust. Emergency department observation unit patients had more encounters with fellow patients than the surgical assessment unit patients did, which was beneficial when needing assistance, but disturbing when needing rest. The limited contact with other patients in the surgical assessment unit revealed the opposite effect. In both units, there was nonpersonalised care, making it difficult for patients to make informed decisions. CONCLUSION The multibedded rooms in the emergency department observation unit had a positive influence on patient–nurse interaction, but a negative influence on privacy; the opposite was found in the surgical assessment unit with its rooms with fewer beds. The extensive professional–patient interactions in the emergency department observation unit created distrust. The limited professional–patient interaction in the surgical assessment unit did the same. That the emergency department observation unit was staffed by emergency nurses seemed to have a positive influence on the length of patient–nurse interactions, while the surgical assessment unit staffed by specialist nurses seemed to have the opposite effect. There was lack of information and personalised care in both units. RELEVANCE TO CLINICAL PRACTICE Units receiving acute patients need to provide personalised care and information about how the unit functions and about care and treatment to improve the patients' ability to make decisions during admission.
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Mohammed K, Nolan MB, Rajjo T, Shah ND, Prokop LJ, Varkey P, Murad MH. Creating a Patient-Centered Health Care Delivery System: A Systematic Review of Health Care Quality From the Patient Perspective. Am J Med Qual 2014; 31:12-21. [PMID: 25082873 DOI: 10.1177/1062860614545124] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Patient experience is one of key domains of value-based purchasing that can serve as a measure of quality and be used to improve the delivery of health services. The aims of this study are to explore patient perceptions of quality of health care and to understand how perceptions may differ by settings and condition. A systematic review of multiple databases was conducted for studies targeting patient perceptions of quality of care. Two reviewers screened and extracted data independently. Data synthesis was performed following a meta-narrative approach. A total of 36 studies were included that identified 10 quality dimensions perceived by patients: communication, access, shared decision making, provider knowledge and skills, physical environment, patient education, electronic medical record, pain control, discharge process, and preventive services. These dimensions can be used in planning and evaluating health care delivery. Future research should evaluate the effect of interventions targeting patient experience on patient outcomes.
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Affiliation(s)
| | | | - Tamim Rajjo
- Mercy Family Medicine Residency Program, Toledo, OH
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Schultz H, Qvist N, Mogensen CB, Pedersen BD. Discharge from an emergency department observation unit and a surgical assessment unit: experiences of patients with acute abdominal pain. J Clin Nurs 2014; 23:2779-89. [PMID: 24547898 DOI: 10.1111/jocn.12527] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Helen Schultz
- Research Unit of Nursing; Institute of Clinical Research; University of Southern Denmark; Odense M Denmark
| | - Niels Qvist
- Surgical Department A; Odense University Hospital; Odense C Denmark
| | | | - Birthe D Pedersen
- Research Unit of Nursing; Institute of Clinical Research; University of Southern Denmark; Odense M Denmark
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Stutzki R, Weber M, Reiter-Theil S. Finding their voices again: a media project offers a floor for vulnerable patients, clients and the socially deprived. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2013; 16:739-750. [PMID: 23404541 PMCID: PMC3832779 DOI: 10.1007/s11019-013-9468-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
'DU bist Radio' (DBR) is an award winning [DBR has been awarded with the "Catholic Media Award of the German Bishops Conference, Prädikat WERTvoll" (2011), the Suisse "Media Prize Aargau/Solothurn" (2010), the German "Alternative Media Award" (2009) and was nominated for the "Prix Europa" (2009)] monthly radio format that goes on air on three Swiss radio stations. The purpose of this program which was first broadcast in 2009 is the development of a new media format which--without applying any journalistic (or other) filter and influence--conveys authenticity of expression amongst society's most vulnerable fellow citizens such as patients, clients and the socially deprived. So-called marginal groups are encouraged to speak for themselves, as a possible paradigm case for encouraging the inclusion of patients' and relatives' "unfiltered" voices in general and in clinical ethics as well. Before handing over the microphone to the groups in focus, a team of journalists, educated in medical ethics, over a period of 4 days, teaches them on-site radio skills and craft. Once this task is completed and the actual production of the broadcast begins, the media crew does not exert any influence whatsoever on the content of the 1-h program. Thus, the final product is solely created and accounted for by the media-inexperienced participants, leading to unforeseen and often surprising results. It is discussed that the DBR approach of fostering authenticity of expression can serve as an enhancement to today's respect and autonomy oriented field of medical ethics.
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Affiliation(s)
- Ralf Stutzki
- Clinical Ethics, University Hospital Basel/Psychiatric Hospitals of the University Basel, IBMB, University of Basel, Schanzenstrasse 13, 4056, Basel, Switzerland,
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Ingravallo F, Gilmore E, Vignatelli L, Dormi A, Carosielli G, Lanni L, Taddia P. Factors associated with nurses’ opinions and practices regarding information and consent. Nurs Ethics 2013; 21:299-313. [PMID: 24036667 DOI: 10.1177/0969733013495225] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This cross-sectional survey aimed to investigate nurses’ opinions and practices regarding information and consent in the context of a large Italian teaching hospital and to explore potential influences of gender, age, university education, length of professional experience, and care setting. A questionnaire was administered to 282 nurses from six different care settings (Emergency Room, Emergency Medicine, Surgery, Hematology–Oncology, Geriatrics, and Internal Medicine). Overall, 84% (n = 237) of nurses returned the questionnaire (men: 24%; mean age: 36.2 ± 8 years; university degree: 35%; mean length of professional experience: 12 ± 8.2 years). Most respondents regularly informed patients about medications and nursing procedures and asked for consent prior to invasive procedures, but some provided information to relatives instead of patients. Lack of time or opportunity was the main difficulty in informing patients. The work setting was the foremost factor significantly associated with participants’ opinions and practices. Further investigations are needed to confirm these findings in similar and other care settings.
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Vicente V, Castren M, Sjöstrand F, Sundström BW. Elderly patients' participation in emergency medical services when offered an alternative care pathway. Int J Qual Stud Health Well-being 2013; 8:20014. [PMID: 23445898 PMCID: PMC3584033 DOI: 10.3402/qhw.v8i0.20014] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/05/2013] [Indexed: 11/14/2022] Open
Abstract
As organizational changes in the healthcare system are in progress, to enhance care quality and reduce costs, it is important to investigate how these changes affect elderly patients' experiences and their rights to participate in the choice of healthcare. The aim of this study is to describe elderly patients' lived experience of participating in the choice of healthcare when being offered an alternative care pathway by the emergency medical services, when the individual patient's medical needs made this choice possible. This study was carried out from the perspective of caring science, and a phenomenological approach was applied, where data were analysed for meaning. Data consist of 11 semi-structured interviews with elderly patients who chose a healthcare pathway to a community-based hospital when they were offered an alternative level of healthcare. The findings show that the essence of the phenomenon is described as "There was a ray of hope about a caring encounter and about being treated like a unique human being". Five meaningful constituents emerged in the descriptions: endurable waiting, speedy transference, a concerned encounter, trust in competence, and a choice based on memories of suffering from care. The conclusion is that patient participation in the choice of a healthcare alternative instead of the emergency department is an opportunity of avoiding suffering from care and being objectified.
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Affiliation(s)
- Veronica Vicente
- Section of Emergency Medicine, Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
| | - Maaret Castren
- Section of Emergency Medicine, Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
| | - Fredrik Sjöstrand
- Section of Emergency Medicine, Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
| | - Birgitta Wireklint Sundström
- School of Health Sciences, Research Centre PreHospen, The Prehospital Research Centre of Western Sweden, University of Borås, Borås, Sweden
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Jangland E, Carlsson M, Lundgren E, Gunningberg L. The impact of an intervention to improve patient participation in a surgical care unit: a quasi-experimental study. Int J Nurs Stud 2011; 49:528-38. [PMID: 22104043 DOI: 10.1016/j.ijnurstu.2011.10.024] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Revised: 09/14/2011] [Accepted: 10/26/2011] [Indexed: 10/15/2022]
Abstract
BACKGROUND Organizational changes in surgical care are requiring patients to become more responsible for their own care, both before and after surgery, and also during recovery. Involving patients in their care is vital to improving quality of care and patient safety. OBJECTIVE The aim of this study was to investigate the impact of the 'Tell-us' card on patients' perceptions of quality of care, with a specific focus on patient participation. Another aim was to evaluate the use of the Tell-us card from the patients' perspective. DESIGN A quasi-experimental design with an intervention group and control groups was used. The patient's self-written Tell-us card was introduced as the intervention. SETTING The study was conducted in two surgical care units at a Swedish university hospital. PARTICIPANTS A consecutive sample of patients admitted from the waiting list and from the emergency department was included (n=310). The inclusion criteria were surgical patients with a hospital stay of at least one day. Patients who were younger than 18 years, not able to speak or write in Swedish, or unable or unwilling to give informed consent to participate were excluded. METHODS Quality of care was assessed using the questionnaire 'Quality from the Patient's Perspective'. The patients included in the intervention group were asked to write what was most important for them during the day or just before discharge on patient-written Tell-us cards. RESULTS The use of the Tell-us card resulted in significant improvements (5 out of 17 items) in patients' abilities to participate in decisions about their nursing and medical care. The patients found the Tell-us card more useful in their interaction with registered nurses and assistant nurses than with physicians. CONCLUSIONS The use of the Tell-us card improved patients' participation in some areas of nursing and medical care in the surgical care units. The Tell-us card is an uncomplicated and inexpensive tool that could be an important step towards improved patient participation in the surgical care unit. More research is needed to evaluate the use of the Tell-us card in different hospital units and over a longer period of time.
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Affiliation(s)
- Eva Jangland
- Department of Surgical Sciences, Uppsala University, Entrance 70, SE-751 85 Uppsala, Sweden.
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Grøndahl VA, Karlsson I, Hall-Lord ML, Appelgren J, Wilde-Larsson B. Quality of care from patients' perspective: impact of the combination of person-related and external objective care conditions. J Clin Nurs 2011; 20:2540-51. [PMID: 21749512 DOI: 10.1111/j.1365-2702.2011.03810.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIMS AND OBJECTIVES To describe patients' perceptions of quality of care and to explore combinations of person-related and external objective care conditions as potential predictors of these perceptions. BACKGROUND Several studies have examined various single factors of person-related and external objective care conditions in relation to quality of care. None of these has included the effect of over-occupancy on patients' perception of quality of care. Furthermore, little is known about how combinations of different factors are related to each other and to the perception of quality of care using multivariate analysis. DESIGN A cross-sectional design. METHOD A total of 528 patients (83·7%) from 12 medical, surgical or medical-surgical wards in five hospitals in Norway participated. Perceptions of quality of care and person-related conditions were measured with the 'Quality from Patient's Perspective' instrument. Data on external objective care conditions was collected from ward statistics provided by head nurses. Multivariate general linear modelling was used (p < 0·05). RESULTS The combination of person-related and external objective care conditions revealed five factors that predict patients' perception of quality of care. Three of these are person-related conditions: sex, age and self-reported psychological well-being and two of them are external objective care conditions: RNs (headcount) on the wards and frequency of over-occupancy. These five factors explained 55% of the model. Patients rated the quality of care high. CONCLUSIONS Sex, age, psychological well-being, frequency of over-occupancy and the number of RNs are important factors that must be emphasised if patients are to perceive the quality of care as high. Relevance to clinical practice. Head nurses and healthcare authorities must continually prepare the wards for over-occupancy and they must consider the number of RNs working on the wards.
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Wadensten B, Fröjd C, Swenne CL, Gordh T, Gunningberg L. Why is pain still not being assessed adequately? Results of a pain prevalence study in a university hospital in Sweden. J Clin Nurs 2011; 20:624-34. [PMID: 21320191 DOI: 10.1111/j.1365-2702.2010.03482.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to investigate the prevalence of pain and pain assessment among inpatients in a university hospital. BACKGROUND Pain management could be considered an indicator of quality of care. Few studies report on prevalence measures including all inpatients. DESIGN Quantitative and explorative. METHOD Survey. RESULTS Of the inpatients at the hospital who answered the survey, 494 (65%) reported having experienced pain during the preceding 24 hours. Of the patients who reported having experienced pain during the preceding 24 hours, 81% rated their pain >3 and 42.1% rated their pain >7. Of the patients who reported having experienced pain during the preceding 24 hours, 38.7% had been asked to self-assess their pain using a Numeric Rating Scale (NRS); 29.6% of the patients were completely satisfied, and 11.5% were not at all satisfied with their participation in pain management. CONCLUSIONS The result showed that too many patients are still suffering from pain and that the NRS is not used to the extent it should be. Efforts to overcome under-implementation of pain assessment are required, particularly on wards where pain is not obvious, e.g., wards that do not deal with surgery patients. Work to improve pain management must be carried out through collaboration across professional groups. RELEVANCE TO CLINICAL PRACTICE Using a pain assessment tool such as the NRS could help patients express their pain and improve communication between nurses and patients in relation to pain as well as allow patients to participate in their own care. Carrying out prevalence pain measures similar to those used here could be helpful in performing quality improvement work in the area of pain management.
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Affiliation(s)
- Barbro Wadensten
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
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