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Karaferis DC, Niakas DA, Balaska D, Flokou A. Valuing Outpatients' Perspective on Primary Health Care Services in Greece: A Cross-Sectional Survey on Satisfaction and Personal-Centered Care. Healthcare (Basel) 2024; 12:1427. [PMID: 39057571 PMCID: PMC11276435 DOI: 10.3390/healthcare12141427] [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: 06/17/2024] [Revised: 07/10/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
INTRODUCTION The aims of the study were to identify and analyze the determinants associated with outpatient satisfaction in Greek primary care. This is because there is a general consensus that primary care is the linchpin of effective person-centered care delivery. METHODS A cross-sectional survey was conducted with 1012 patients' exit interviews; sociodemographic variables were included in the questionnaire to obtain data on the satisfaction of primary care users with 20 public primary healthcare centers in Athens between June 2019 and April 2021. Statistical analysis was applied to 55 items and eight dimensions of patient satisfaction, namely, arrival and admission, waiting before the appointment, cleanliness of toilets, medical examination and behavior of physician, behavior of nursing staff, laboratories, departure, and contribution of the PHCs. Descriptive analyses and multiple linear regression were used to analyze the factors influencing patient satisfaction through coefficients (β) with 95% confidence intervals and associated tests of statistical significance. RESULTS Τwo-thirds (74.21%) of this survey's participants ranged from 45 to 74 years of age. More than half of the participants were women (62.15%). The most common reasons for visits were pathological (26.48%), followed by cardiological conditions (9.78%), orthopedics (9.49%), gynecologic conditions (8.70%), and ophthalmologic problems (7.31%). In the center of satisfaction with primary care was the medical care and the behavior of the physician (β = 0.427; p < 0.01), followed by the time during appointment (β = 0.390; p < 0.01). Dimensions like "accessibility and availability, 2.19/5"; "waiting times, 2.89/5"; "infrastructure of facilities (2.04/5) and cleanliness of them, (2/5)"; "laboratories, 2.99/5" and "bureaucracy in the departure, 2.29/5" were crucial for the trust and satisfaction of patients. Overall satisfaction was rated at a moderate level (2.62 ± 0.18) while person-centered care was rated as weak (2.49 ± 0.28). CONCLUSIONS Greece is recommended to increase the sensitivity of the use of the primary health care system by patients as a first contact, continuous, comprehensive, and effective patient- and family-focused care.
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Affiliation(s)
| | - Dimitris A. Niakas
- Department of Health Economics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Dimitra Balaska
- Department of Business Administration, University of West Attica, 12241 Athens, Greece
| | - Angeliki Flokou
- School of Social Sciences, Hellenic Open University, 26335 Patra, Greece
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Tinner EME, Dogan O, Boesing M, Roser K, Michel G, Minder AE, Maier S, Bayha M, Affolter H, Baumgartner C, Meienberg F, Kuehni C, Rössler J, Wertli MM, Leuppi JD. Characteristics and feedback of adult survivors of childhood cancer seen in Swiss comprehensive follow-up clinics led by general internists: a prospective cohort study. BMJ Open 2024; 14:e081823. [PMID: 38991689 DOI: 10.1136/bmjopen-2023-081823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/13/2024] Open
Abstract
OBJECTIVES In our study, we aimed to characterise adult childhood cancer survivors (ACCS), assess their health issues, gauge health-related quality of life (HRQOL) and evaluate visit satisfaction. DESIGN Prospective cohort study using data from clinical visits and questionnaires. SETTING Interdisciplinary follow-up programme for ACCS based on the long-term follow-up (LTFU) guidelines of the Children's Oncology Group and overseen by internists in two Swiss hospitals. PARTICIPANTS ACCS attending our LTFU clinics between April 2017 and January 2022 were eligible. INTERVENTIONS We documented medical history, current health status and assessed HRQOL using Short Form-36 V.2, comparing it with Swiss general population (SGP) norms (T mean=50, SD=10; age stratified). 3 months post visit, a feedback questionnaire was distributed. MAIN RESULTS Among 102 ACCS (mean age: 32 years (range: 18-62 years), 68% women), 43 had no prior follow-up (36 ACCS>28 years, 7 ACCS≤28 years). A notable 94% had health issues, affecting an average of 6.1 (SD=3.3) organ systems. HRQOL was lower in ACCS>28 years than the SGP>28 years (physical: 44.8 (SD=11.65) vs 49.3 (SD=10.29), p=0.016; mental: 44.4 (SD=13.78) vs 50.53 (SD=9.92), p=0.004). Older ACCS (>28 years) reported inferior physical (44.8 vs 50.1 (SD=9.30), p=0.017) and mental HRQOL (44.4 vs 50.3 (SD=7.20), p=0.009) than younger ACCS. The majority of respondents reported high levels of satisfaction with the consultation, exceeding 90%. CONCLUSION ACCS attending LTFU clinics face diverse health issues impacting multiple organ systems and exhibit lower HRQOL compared with the SGP. Thus, internist-led LTFU clinics are crucial for optimising follow-up care.
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Affiliation(s)
- Eva Maria Eugenia Tinner
- University Institute of Internal Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
- Paediatric Haematology/Oncology, Department of Pediatrics, Inselspital-University Hospital Bern, Bern, Switzerland
| | - Oezcan Dogan
- University Institute of Internal Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Maria Boesing
- University Institute of Internal Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
- Medical Faculty, University of Basel, Basel, Basel-Stadt, Switzerland
| | - Katharina Roser
- Faculty of Health Sciences and Medicine, University of Lucerne, Luzern, Switzerland
| | - Gisela Michel
- Faculty of Health Sciences and Medicine, University of Lucerne, Luzern, Switzerland
| | - Anna-Elisabeth Minder
- University Institute of Internal Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
- Divison of Endocrinology, Diabetology and Porphyria, Municipal Hospital Triemli, Zurich, Switzerland
| | - Sabrina Maier
- University Institute of Internal Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Marinela Bayha
- University Institute of Internal Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
- Paediatric Haematology/Oncology, Department of Pediatrics, Inselspital-University Hospital Bern, Bern, Switzerland
| | - Helene Affolter
- Department of General Internal Medicine, University of Bern, Bern, Switzerland
| | | | - Fabian Meienberg
- University Institute of Internal Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Claudia Kuehni
- Childhood Cancer Research Group, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Jochen Rössler
- Paediatric Haematology/Oncology, Department of Pediatrics, Inselspital-University Hospital Bern, Bern, Switzerland
| | - Maria M Wertli
- Department of General Internal Medicine, University of Bern, Bern, Switzerland
- Department of General Internal Medicine, Cantonal Hospital Baden, Baden, Aargau, Switzerland
| | - Jörg D Leuppi
- University Institute of Internal Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
- Medical Faculty, University of Basel, Basel, Basel-Stadt, Switzerland
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Siddiqi A, Monton O, Woods A, Masroor T, Fuller S, Owczarzak J, Yenokyan G, Cooper LA, Freund KM, Smith TJ, Kutner JS, Colborn KL, Joyner R, Elk R, Johnston FM. Dissemination and Implementation of a Community Health Worker Intervention for Disparities in Palliative Care (DeCIDE PC): a study protocol for a hybrid type 1 randomized controlled trial. BMC Palliat Care 2023; 22:139. [PMID: 37718442 PMCID: PMC10506196 DOI: 10.1186/s12904-023-01250-0] [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: 08/09/2023] [Accepted: 08/24/2023] [Indexed: 09/19/2023] Open
Abstract
BACKGROUND There are persistent racial and ethnic health disparities in end-of-life health outcomes in the United States. African American patients are less likely than White patients to access palliative care, enroll in hospice care, have documented goals of care discussions with their healthcare providers, receive adequate symptom control, or die at home. We developed Community Health Worker Intervention for Disparities in Palliative Care (DeCIDE PC) to address these disparities. DeCIDE PC is an integrated community health worker (CHW) palliative care intervention that uses community health workers (CHWs) as care team members to enhance the receipt of palliative care for African Americans with advanced cancer. The overall objectives of this study are to (1) assess the effectiveness of the DeCIDE PC intervention in improving palliative care outcomes amongst African American patients with advanced solid organ malignancy and their informal caregivers, and (2) develop generalizable knowledge on how contextual factors influence implementation to facilitate dissemination, uptake, and sustainability of the intervention. METHODS We will conduct a multicenter, randomized, assessor-blind, parallel-group, pragmatic, hybrid type 1 effectiveness-implementation trial at three cancer centers across the United States. The DeCIDE PC intervention will be delivered over 6 months with CHW support tailored to the individual needs of the patient and caregiver. The primary outcome will be advance care planning. The treatment effect will be modeled using logistic regression. The secondary outcomes are quality of life, quality of communication, hospice care utilization, and patient symptoms. DISCUSSION We expect the DeCIDE PC intervention to improve integration of palliative care, reduce multilevel barriers to care, enhance clinic and patient linkage to resources, and ultimately improve palliative care outcomes for African American patients with advanced cancer. If found to be effective, the DeCIDE PC intervention may be a transformative model with the potential to guide large-scale adoption of promising strategies to improve palliative care use and decrease disparities in end-of-life care for African American patients with advanced cancer in the United States. TRIAL REGISTRATION Registered on ClinicalTrials.gov (NCT05407844). First posted on June 7, 2022.
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Affiliation(s)
- Amn Siddiqi
- Department of Surgery, Johns Hopkins University School of Medicine, 600 N Wolfe Street, Baltimore, MD, 21287, USA
| | - Olivia Monton
- Department of Surgery, Johns Hopkins University School of Medicine, 600 N Wolfe Street, Baltimore, MD, 21287, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA
| | - Alison Woods
- Department of Surgery, Johns Hopkins University School of Medicine, 600 N Wolfe Street, Baltimore, MD, 21287, USA
| | - Taleaa Masroor
- Department of Surgery, Johns Hopkins University School of Medicine, 600 N Wolfe Street, Baltimore, MD, 21287, USA
| | - Shannon Fuller
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD, 21205, USA
| | - Jill Owczarzak
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD, 21205, USA
| | - Gayane Yenokyan
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA
| | - Lisa A Cooper
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD, 21205, USA
- Johns Hopkins University School of Nursing, 525 N Wolfe Street, Baltimore, MD, 21205, USA
- Department of Medicine, Johns Hopkins University School of Medicine, 2024 East Monument Street, Suite 2-515, Baltimore, MD, 21287, USA
| | - Karen M Freund
- Department of Medicine, Tufts University School of Medicine, 800 Washington Street, Boston, MA, 02111, USA
| | - Thomas J Smith
- Department of Medicine, Johns Hopkins University School of Medicine, 600 N Wolfe Street, Baltimore, MD, 21287, USA
| | - Jean S Kutner
- Department of Medicine, University of Colorado School of Medicine, 12401 E 17th Ave, Aurora, CO, 80045, USA
| | - Kathryn L Colborn
- Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, 13001 E 17th Place, Aurora, CO, 80045, USA
| | - Robert Joyner
- Richard A. Henson Research Institute, TidalHealth Peninsula Regional, 100 East Carroll Street, Salisbury, MD, 21801, USA
| | - Ronit Elk
- Department of Medicine, University of Alabama at Birmingham, 933 19th Street S, Birmingham, AL, 35205, USA
| | - Fabian M Johnston
- Division of Surgical Oncology, Department of Surgery, Johns Hopkins University, 600 N Wolfe Street, Blalock 606, Baltimore, MD, 21287, USA.
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Samant R, Cisa-Paré E, Balchin K, Renaud J, Bunch L, Wheatley-Price P, McNeil A, Murray S, Meng J. Assessment of Patient Satisfaction Among Cancer Patients Undergoing Radiotherapy. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1296-1303. [PMID: 33432468 PMCID: PMC9550720 DOI: 10.1007/s13187-020-01950-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/21/2020] [Indexed: 06/12/2023]
Abstract
The patient-provider relationship is a key driver of patient satisfaction as it relates to overall healthcare experience. We surveyed patients undergoing radiation therapy to determine what they consider to be the most valued qualities in their interactions with the healthcare team. An ethics-approved 35-item patient satisfaction survey was developed in-house to gain insights on patients' perception of their relationship with the healthcare team throughout their cancer journey. There were 199 completed survey, median age 68 years, 54% women and 45% men. Almost all (95%) "agreed" or "strongly agreed" that their physicians had been sensitive and compassionate. Over 90% felt that they received adequate explanations about their treatment, and had their questions answered. The vast majority (93%) felt included in the decision-making process. Patients reported the 5 most highly rated qualities among their healthcare providers (HCPs) as knowledge, kindness, honesty, good communication, and a cheerful attitude. Overall satisfaction was high but areas for improvement were identified including being offered future appointments for further discussion, more information about clinical trials, other treatments, and community resources. Patients noted their HCPs tended to focus on the physical and emotional needs of patients, but spiritual and cultural needs were rarely addressed. Patients receiving radiotherapy reported high rates of satisfaction across many aspects of their care. These findings also reinforce the different aspects of holistic care that can be improved, and serve as a reminder to clinicians that patients perceive their role as more than just that of a medical expert.
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Affiliation(s)
- R Samant
- The Ottawa Hospital Cancer Centre, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada.
| | - E Cisa-Paré
- The Ottawa Hospital Cancer Centre, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada
| | - K Balchin
- The Ottawa Hospital Cancer Centre, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada
| | - J Renaud
- The Ottawa Hospital Cancer Centre, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada
| | - L Bunch
- The Ottawa Hospital Cancer Centre, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada
| | - P Wheatley-Price
- The Ottawa Hospital Cancer Centre, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada
| | - A McNeil
- The Ottawa Hospital Cancer Centre, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada
| | - S Murray
- The Ottawa Hospital Cancer Centre, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada
| | - J Meng
- The Ottawa Hospital Cancer Centre, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada
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Li S, Wang K. Sharing Online Health Information With Physicians: Understanding the Associations Among Patient Characteristics, Directness of Sharing, and Physician-Patient Relationship. Front Psychol 2022; 13:839723. [PMID: 35432074 PMCID: PMC9005643 DOI: 10.3389/fpsyg.2022.839723] [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: 12/20/2021] [Accepted: 02/17/2022] [Indexed: 11/18/2022] Open
Abstract
Patients increasingly share online health information with their physicians. However, few studies have investigated factors that may facilitate or inhibit such sharing and subsequent impact on physician-patient relationship. This study conducted a cross-sectional survey among 818 Chinese patients to examine if two patient characteristics -communication apprehension and eHealth literacy- influence their ways of sharing online health information with physicians and subsequently impact physician-patient relationship. The results showed that a majority of surveyed participants searched health information online, and about half of them used such information during their doctor visits. Less apprehensive patients tend to share the information with their physicians more directly, which can positively affect perceived physician reactions and patient satisfaction. eHealth literacy, however, is not found to be associated with patients’ sharing of online information with physicians. This study underscores the importance of identifying patient characteristic’s role in patient-physician interaction.
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Affiliation(s)
- Siyue Li
- College of Media and International Culture, Zhejiang University, Hangzhou, China
| | - Kexin Wang
- College of Media and International Culture, Zhejiang University, Hangzhou, China
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Measuring communication quality in the Neonatal Intensive Care Unit. Pediatr Res 2022; 91:816-819. [PMID: 33854213 PMCID: PMC9000989 DOI: 10.1038/s41390-021-01522-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND High quality communication between providers and parents of seriously ill neonatal patients is vital and yet poorly understood. Feudtner summarized five challenges and seven priorities to the study and advancement of pediatric palliative care. Improvement of communication is a priority, while lack of specification and measurement of outcomes relevant to the pediatric population remains a challenge. Specifically, measurement of communication quality in pediatrics, and especially neonatology, is problematic. METHODS We conducted a focused review of this topic which we hope will serve to support further research. We reviewed the current literature in Pubmed and searched the Palliative Care Research Cooperative (PCRC) instrument library. RESULTS We found five validated instruments which met our criteria, relied on patient or surrogate report, and were developed to measure quality of communication and/or satisfaction with communication with adult patients or their surrogates. Our Pubmed search yielded 249 unique results, only two of which met our inclusion criteria. CONCLUSION We conclude that development and exhaustive testing of a validated, comprehensive measure of communication quality for the neonatal population is needed. Without such a measure, it will be difficult to advance the field and achieve high quality prognostic communication for the parents of seriously ill babies. IMPACT Measurement of communication quality in pediatrics, and especially neonatology, is problematic, understudied, and yet critical to the advancement of the field. There has not been an overview of existing measures of communication quality in the NICU published, nor has there been a comprehensive discussion of this important topic. Our paper provides such an overview and initiates such a discussion. We present a narrative review of existing measures of communication quality in the NICU in order to highlight the need for further study.
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Wadasadawala T, Mangaj A, Mokal S, Pathak R, Sarin R, Gaikar M, Nair N, Bajpai J, Joshi S, Gulia S. Measuring Satisfaction in Breast Cancer Patients Receiving Ambulatory Care: A Validation Study. Indian J Med Paediatr Oncol 2021. [DOI: 10.1055/s-0041-1735601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Abstract
Introduction Patient satisfaction constitutes a vital service quality indicator. It provides a measure of the gap in health-care requirements and patients' expectations.
Objective The aim of this study was to perform linguistic validation of the questionnaire assessing satisfaction with outpatient care.
Materials and Methods A tool for measuring patient satisfaction was developed and validated at our institute in the English language. This tool was translated into Hindi and Marathi. Subsequently, 339 patients diagnosed with breast cancer consulting in the outpatient department from the different parts of India and having diverse linguistic and socioeconomic backgrounds were enrolled. Patients were asked to complete the satisfaction tool after consultation at a single point of time in a prospective manner.
Results All patients completed the questionnaire. The questionnaire was filled by 120, 116, and 103 patients in Hindi, Marathi, and English, respectively. Both convergent validity and discriminant validity were supported as the correlation coefficient was >0.4 for all items within a scale and <0.7 between different scales. Factor analysis was valid for all except for open-end questions. The internal consistency was >0.9 for all the questions. The mean overall satisfaction score was 88.35 (standard deviation: 19.63). Patients were satisfied in all the aspects of the consultation process, including appointment scheduling, assistant medical staff and faculty, and treating physician. However, some expressed dissatisfaction toward long-waiting times.
Conclusion The translated tool is reliable and valid and effectively measures the satisfaction of patients receiving ambulatory care.
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Affiliation(s)
- Tabassum Wadasadawala
- Department of Radiation Oncology, ACTREC, Tata Memorial Centre, Homi Bhabha National Institute, Navi Mumbai, Maharashtra, India
| | - Akshay Mangaj
- Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Smruti Mokal
- Department of Clinical Research, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Rima Pathak
- Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Rajiv Sarin
- Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Mithila Gaikar
- Department of Clinical Research, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Nita Nair
- Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Jyoti Bajpai
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Shalaka Joshi
- Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Seema Gulia
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
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Costa AM, Marchiò M, Bruni G, Bernabei SM, Cavalieri S, Bondi M, Biagini G. Evaluation of E-Health Applications for Paediatric Patients with Refractory Epilepsy and Maintained on Ketogenic Diet. Nutrients 2021; 13:1240. [PMID: 33918854 PMCID: PMC8069190 DOI: 10.3390/nu13041240] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/07/2021] [Accepted: 04/07/2021] [Indexed: 12/12/2022] Open
Abstract
E-health technologies improve healthcare quality and disease management. The aim of this study was to develop a ketogenic diet management app as well as a website about this dietary treatment and to evaluate the benefits of giving caregivers access to various web materials designed for paediatric patients with refractory epilepsy. Forty families participated in the questionnaire survey, from January 2016 to March 2016. All caregivers were exposed to paper-based materials about the ketogenic diet, whereas only 22 received the app, called KetApp, and videos produced by dieticians. Caregivers with free access to web materials were more satisfied than the others with the informative material provided by the centre (p ≤ 0.001, Mann-Whitney test). Indeed, they showed a better attitude towards treatment, and they became more aware of dietary management in comparison to the control group (p ≤ 0.001). Moreover, caregivers provided with web materials were stimulated to pursue the treatment (p = 0.002) and to introduce it to their children and other people (p = 0.001). Additionally, caregivers supplied with web materials were more willing to help other families in choosing the ketogenic diet (p = 0.004). Overall, these findings indicate that web materials are beneficial for caregivers of paediatric patients with refractory epilepsy in our centres. Thus, the use of e-health applications could be a promising tool in the daily aspects of ketogenic diet management, and it is especially of value in the attempt to start or maintain the diet during the ongoing COVID-19 pandemic crisis.
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Affiliation(s)
- Anna-Maria Costa
- Laboratory of Experimental Epileptology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (A.-M.C.); (G.B.)
| | - Maddalena Marchiò
- Laboratory of Experimental Epileptology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (A.-M.C.); (G.B.)
| | - Giulia Bruni
- AOU Meyer Hospital Florence, 50139 Florence, Italy;
| | - Silvia Maria Bernabei
- Department of Paediatric Specialties and Liver, Kidney Transplant, UO Nutritional Rehabilitation, “Bambino Gesù” Children’s Hospital, 00165 Rome, Italy;
| | - Silvia Cavalieri
- Department of Foreign Languages and Literatures, University of Verona, 37129 Verona, Italy;
| | - Marina Bondi
- Department of Studies on Language and Culture, University of Modena and Reggio Emilia, 41121 Modena, Italy;
| | - Giuseppe Biagini
- Laboratory of Experimental Epileptology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy; (A.-M.C.); (G.B.)
- Centre for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, 41125 Modena, Italy
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Hasson SP, Waissengrin B, Shachar E, Hodruj M, Fayngor R, Brezis M, Nikolaevski-Berlin A, Pelles S, Safra T, Geva R, Wolf I. Rapid Implementation of Telemedicine During the COVID-19 Pandemic: Perspectives and Preferences of Patients with Cancer. Oncologist 2021; 26:e679-e685. [PMID: 33453121 PMCID: PMC8013179 DOI: 10.1002/onco.13676] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 12/18/2020] [Indexed: 12/24/2022] Open
Abstract
Introduction The use of telemedicine in oncology practice is rapidly expanding and is considered safe and cost effective. However, the implications of telemedicine on patient‐physician interaction, patient satisfaction, and absence of the personal touch have not been studied to date. Following the spread of COVID‐19, telemedicine services were rapidly incorporated at the Oncology Division of Tel Aviv Medical Center. We aimed to evaluate patients' perspectives and preferences regarding telemedicine and to assess whether this virtual communication platform affects the patient‐physician relationship. Methods Between March 2020 and May 2020, adult cancer patients who conducted at least one successful telemedicine meeting were interviewed by trained medical personnel. The interview was based on validated patient satisfaction questionnaires and focused on patient‐physician interaction in relation to the last in‐patient visit. Results Of 236 patients, 172 (74%) patients agreed to participate. The study population comprised mainly patients with gastrointestinal malignancies (n = 79, 46%) with a median age of 63 years (range 21–88). The majority of patients were male (n = 93, 54%). Eighty‐nine (51.7%) patients were receiving active oncologic treatment, and 58 (33.7%) were under routine surveillance following completion of active therapy. Almost all had a sense of secured privacy (n = 171, 96%), the majority of patients affirmed that their concerns were met (n = 166, 93%) and perceived that eye contact with the treating physician was perceived (n = 156, 87%). Only a minority felt that the absence of physical clinic visits harmed their treatment (n = 36, 20%). Most patients (n = 146, 84.9%) wished to continue telemedicine services. A multivariate analysis revealed that higher satisfaction and visits for routine surveillance were both predictors of willingness to continue future telemedicine meetings over physical encounters (odds ratio [OR] = 2.41, p = .01; OR = 3.34, p = .03, respectively). Conclusion Telemedicine is perceived as safe and effective, and patients did not feel that it compromised medical care or the patient‐physician relationship. Integration of telemedicine is ideal for patients under surveillance after completion of active oncologic treatment. Physician communication skills workshops are warranted with implementing this platform. Implications for Practice During the COVID‐19 pandemic, telemedicine was rapidly implemented worldwide to facilitate continuity of quality care and treatment. Despite many potential setbacks, telemedicine has become a useful and safe tool for oncology practitioners to care for their patients. The use of telemedicine regarding patients' perspectives, emotions, and patient‐physician communication in daily oncology practice has not been studied to date. This study demonstrated telemedicine is perceived as safe and effective and does not compromise medical care or the patient‐physician relationship. Its use is ideal for surveillance after completion of active oncologic treatment. Physician communication skills workshops are warranted with implementing this platform. The use of telemedicine in oncology practice is rapidly expanding; however, the implications for patient‐physician interaction and patient satisfaction have not been well studied. This article evaluates patients' perspectives and preferences regarding telemedicine and whether a virtual communication platform affects the patient‐physician relationship.
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Affiliation(s)
- Shira Peleg Hasson
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Barliz Waissengrin
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Eliya Shachar
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Marah Hodruj
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rochelle Fayngor
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Mirika Brezis
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | | | - Sharon Pelles
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Tamar Safra
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ravit Geva
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ido Wolf
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Imtithal Adnan F, Noor NM, Mat Junoh NA. Associated factors of labor satisfaction and predictor of postnatal satisfaction in the north-east of Peninsular Malaysia. PLoS One 2020; 15:e0238310. [PMID: 32857816 PMCID: PMC7455019 DOI: 10.1371/journal.pone.0238310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 08/03/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Identifying the factors contributing to maternal satisfaction is a proxy measure to improve the quality of care. It evaluates the health service provision by understanding maternal perceptions and expectations and promoting adherence to health services. This study aimed to identify the sociodemographic, obstetric, and medical factors contributing to labor satisfaction among postpartum women and examine the association between labor and postnatal satisfaction. METHODOLOGY A cross-sectional study using systematic random sampling in a ratio of 1:5 based on the delivery list in a labor room in a tertiary hospital was applied. Information was obtained from medical records for sociodemographic characteristics and obstetric and medical histories. Face-to-face interviews were performed to obtain responses for Malay versions of the Women's Views of Birth Labour Satisfaction Questionnaire and the Women's Views of Birth Postnatal Satisfaction Questionnaire. Simple and general linear regression analyses were performed. RESULTS A total of 110 participants responded, accounting for a response rate of 100%. High-risk color codes, the period of gestation, household income, and were significantly associated with maternal satisfaction during labor. The association between labor and postnatal satisfaction was significant. CONCLUSION Identifying these associated factors and differences may lead to understanding and contributing to specific and targeted strategies for tackling issues related to maternal satisfaction.
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Affiliation(s)
- Fatin Imtithal Adnan
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Norhayati Mohd Noor
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Nor Akma Mat Junoh
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
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Norhayati MN, Fatin Imtithal A, Nor Akma MJ. Psychometric properties of the Malay version of the Women's Views of Birth Labour Satisfaction Questionnaire using the Rasch measurement model: a cross sectional study. BMC Pregnancy Childbirth 2020; 20:295. [PMID: 32408901 PMCID: PMC7227260 DOI: 10.1186/s12884-020-02975-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 04/30/2020] [Indexed: 11/11/2022] Open
Abstract
Background Birth satisfaction represents a complex construct of implicit and profound relevance to a woman’s perceived birth experience. It correlates with the childbearing woman’s experience of the quality of care received and stress during labor. This study aimed to examine the psychometric properties of the Malay language version of the Women’s Views of Birth Labour Satisfaction Questionnaire (WOMBLSQ) on labor satisfaction using the Rasch rating scale model. Methods A cross-sectional study was conducted. The translated Malay version of the WOMBLSQ was completed by 200 postpartum women in a tertiary hospital. The Rasch model was applied to investigate the statistics, unidimensionality, item polarity and misfit, person misfit and person item distribution map. Results The Rasch analysis showed that the 27 items, in nine dimensions, had high item reliability and item separation at 0.98 and 7.65 respectively, while good person reliability and person separation were at 0.78 and 1.90, respectively. Item 6 (‘My birth partner/husband couldn’t have supported me any better’) (outfit MnSq = 1.74, outfit z-std = 6.9, PtMea Corr = − 0.02) and Item 5 (‘My birth partner/husband helped me to understand what was going on when I was in labor’) (outfit MnSq = 1.65, outfit z-std = 2.9, PtMea Corr = 0.13) are misfit. Item 6 needs to be re-examined for removal or rephrasing, while Item 5 correlates poorly with the construct. Eight persons have the most misfitting response strings based on Item 6 but extremely trivial differences were found in the parameter estimates after refitting the model. Ten items easily endorse satisfaction from the respondents. Conclusion The WOMBLSQ tested among postpartum women has been shown to have a good person reliability index and a high item reliability index. Items 5 and 6 do not contribute in the construction of scale but not degrading and suggested for refining. The spread of item difficulty should be improved in the future modification of items.
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Affiliation(s)
- Mohd Noor Norhayati
- Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia.
| | - Adnan Fatin Imtithal
- Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Mat Junoh Nor Akma
- Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
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Carrard V, Bourquin C, Stiefel F, Schmid Mast M, Berney A. Undergraduate training in breaking bad news: A continuation study exploring the patient perspective. Psychooncology 2019; 29:398-405. [DOI: 10.1002/pon.5276] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/14/2019] [Accepted: 10/23/2019] [Indexed: 11/10/2022]
Affiliation(s)
- Valerie Carrard
- Psychiatric Liaison Service Lausanne University Hospital (CHUV) Lausanne Switzerland
| | - Céline Bourquin
- Psychiatric Liaison Service Lausanne University Hospital (CHUV) Lausanne Switzerland
| | - Friedrich Stiefel
- Psychiatric Liaison Service Lausanne University Hospital (CHUV) Lausanne Switzerland
| | - Marianne Schmid Mast
- Department of Organizational Behavior University of Lausanne Lausanne Switzerland
| | - Alexandre Berney
- Psychiatric Liaison Service Lausanne University Hospital (CHUV) Lausanne Switzerland
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Bull C, Byrnes J, Hettiarachchi R, Downes M. A systematic review of the validity and reliability of patient-reported experience measures. Health Serv Res 2019; 54:1023-1035. [PMID: 31218671 PMCID: PMC6736915 DOI: 10.1111/1475-6773.13187] [Citation(s) in RCA: 123] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To identify patient-reported experience measures (PREMs), assess their validity and reliability, and assess any bias in the study design of PREM validity and reliability testing. DATA SOURCES/STUDY SETTING Articles reporting on PREM development and testing sourced from MEDLINE, CINAHL and Scopus databases up to March 13, 2018. STUDY DESIGN Systematic review. DATA COLLECTION/EXTRACTION METHODS Critical appraisal of PREM study design was undertaken using the Appraisal tool for Cross-Sectional Studies (AXIS). Critical appraisal of PREM validity and reliability was undertaken using a revised version of the COSMIN checklist. PRINCIPAL FINDINGS Eighty-eight PREMs were identified, spanning across four main health care contexts. PREM validity and reliability was supported by appropriate study designs. Internal consistency (n = 58, 65.2 percent), structural validity (n = 49, 55.1 percent), and content validity (n = 34, 38.2 percent) were the most frequently reported validity and reliability tests. CONCLUSIONS Careful consideration should be given when selecting PREMs, particularly as seven of the 10 validity and reliability criteria were not undertaken in ≥50 percent of the PREMs. Testing PREM responsiveness should be prioritized for the application of PREMs where the end user is measuring change over time. Assessing measurement error/agreement of PREMs is important to understand the clinical relevancy of PREM scores used in a health care evaluation capacity.
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Affiliation(s)
- Claudia Bull
- Centre for Applied Health Economics (CAHE)Griffith UniversityBrisbaneQueenslandAustralia
- Menzies Health Institute Queensland (MHIQ)BrisbaneQueenslandAustralia
| | - Joshua Byrnes
- Centre for Applied Health Economics (CAHE)Griffith UniversityBrisbaneQueenslandAustralia
- Menzies Health Institute Queensland (MHIQ)BrisbaneQueenslandAustralia
| | - Ruvini Hettiarachchi
- Centre for Applied Health Economics (CAHE)Griffith UniversityBrisbaneQueenslandAustralia
- Menzies Health Institute Queensland (MHIQ)BrisbaneQueenslandAustralia
| | - Martin Downes
- Centre for Applied Health Economics (CAHE)Griffith UniversityBrisbaneQueenslandAustralia
- Menzies Health Institute Queensland (MHIQ)BrisbaneQueenslandAustralia
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The impact of communication style on patient satisfaction. Breast Cancer Res Treat 2019; 176:349-356. [DOI: 10.1007/s10549-019-05232-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 04/10/2019] [Indexed: 10/27/2022]
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15
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Vogt KS, Hughes J, Wilkinson A, Mahmoodi N, Skull J, Wood H, McDougall S, Slade P, Greenfield DM, Pacey A, Ledger W, Jones GL. Preserving fertility in women with cancer (PreFer): Decision-making and patient-reported outcomes in women offered egg and embryo freezing prior to cancer treatment. Psychooncology 2018; 27:2725-2732. [DOI: 10.1002/pon.4866] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/03/2018] [Accepted: 07/30/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Katharina S. Vogt
- Department of Psychology, School of Social Sciences; Leeds Beckett University; Leeds UK
| | - Jane Hughes
- Department of Psychology, School of Social Sciences; Leeds Beckett University; Leeds UK
| | | | - Neda Mahmoodi
- Department of Psychology, School of Social Sciences; Leeds Beckett University; Leeds UK
| | - Jonathan Skull
- Reproductive Medicine and Surgery, Assisted Conception; Jessop Wing, Sheffield Teaching Hospitals NHS Foundation Trust; Sheffield UK
| | - Hilary Wood
- School of Health and Related Research; University of Sheffield; Sheffield UK
| | | | - Pauline Slade
- Institute of Psychology Health and Society; University of Liverpool; Liverpool UK
| | - Diana M. Greenfield
- Late Effects, Sheffield Teaching Hospitals NHS Trust and Honorary Professor, Department of Oncology and Metabolism; University of Sheffield. Weston Park Hospital; Sheffield UK
| | - Allan Pacey
- Academic Unit of Reproductive and Developmental Medicine, Department of Oncology and Metabolism; University of Sheffield; Sheffield UK
| | | | - Georgina L. Jones
- Department of Psychology, School of Social Sciences; Leeds Beckett University; Leeds UK
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The impact of automated screening with Edmonton Symptom Assessment System (ESAS) on health-related quality of life, supportive care needs, and patient satisfaction with care in 268 ambulatory cancer patients. Support Care Cancer 2018; 27:209-218. [PMID: 29931490 DOI: 10.1007/s00520-018-4304-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 06/06/2018] [Indexed: 12/22/2022]
Abstract
PURPOSE We aimed to assess the impact of implementing Edmonton Symptom Assessment System (ESAS) screening on health-related quality of life (HRQoL) and patient satisfaction with care (PSC) in ambulatory oncology patients. ESAS is now a standard of care in Ontario cancer centers, with the goal of improving symptom management in cancer patients, yet few studies examine impact of ESAS on patient outcomes. METHODS We compared ambulatory oncology patients who were not screened prior to ESAS site implementation (2011-2012), to a similar group who were screened using ESAS after site implementation (2012-2013), to examine between-group differences in patient HRQoL, PSC outcomes, and supportive care needs (Supportive Care Service Survey). Both no-ESAS (n = 160) and ESAS (n = 108) groups completed these measures: the latter completing them, along with ESAS, at baseline and 2 weeks later. RESULTS After assessing the impact of implementing ESAS, by matching for potentially confounding variables and conducting univariate analyses, no significant between-group differences were found in HRQoL or PSC. There was significant improvement in symptoms of nausea/vomiting and constipation, after 2 weeks. Lower symptom burden with decreased ESAS scores was significantly correlated with increased HRQoL. There were no between-group differences in knowledge of/access to supportive care. CONCLUSIONS Significant correlation between change in ESAS and HRQoL implies ESAS could usefully inform healthcare providers about need to respond to changes in symptom and functioning between visits. This study showed no impact of early-ESAS screening on HRQoL or PSC. Further research should explore how to better utilize ESAS screening, to improve communication, symptom management, and HRQoL.
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Dehlendorf C, Henderson JT, Vittinghoff E, Steinauer J, Hessler D. Development of a patient-reported measure of the interpersonal quality of family planning care. Contraception 2018; 97:34-40. [DOI: 10.1016/j.contraception.2017.09.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 09/10/2017] [Accepted: 09/11/2017] [Indexed: 01/17/2023]
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Carletti G, Soriani N, Mattiazzi M, Gregori D. A Social Network Approach to the Estimation of Perceived Quality of Health Care. Open Nurs J 2017; 11:219-231. [PMID: 29238425 PMCID: PMC5712639 DOI: 10.2174/1874434601711010219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 05/15/2017] [Accepted: 07/07/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Measuring service quality aids health care providers to recognize specific and unmet needs of patients. Nevertheless, perceived quality of health care services (PQC) is often investigated with inadequate techniques which may lead to biased results. OBJECTIVE The aim of the present study is to develop a proof-of-concept for estimating the PQC using the scale-up estimator, with reference to a concrete assessment in patients of a major Oncology Hospital in Veneto (IOV). Results have then been compared with those collected by the Customer Relations Office (CRO) after the annual survey conducted with traditional questionnaire based techniques. MATERIAL AND METHODS Seven hundred and eighty-three sets consisting of two questionnaires were handed out to IOV patients between 26 and 28 November 2012. The first questionnaire was the CRO annual one composed by 15 direct questions about the perception of quality satisfaction rate using a Likert scale. The second questionnaire was the scale-up (NSUM) one, composed by 20 indirect questions, 5 of which were reproducing the main target of CRO for estimating PQC. RESULTS The comparisons made over 299 sets of questionnaires showed differences between the two techniques. Network Scale-Up Method (NSUM) questionnaire seems to be able to produce lower estimates of PQC with respect to the CRO annual questionnaire. In some cases, the NSUM showed dissatisfaction rates which are 20-fold higher respect to CRO. CONCLUSION NSUM could be a promising method for assessing the perceived quality of care.
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Affiliation(s)
- Giulia Carletti
- Department of Radiotherapy and Molecular Medicine, Istituto Oncologico Veneto, Padova, Italy
| | - Nicola Soriani
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiology, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | | | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiology, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
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Aboabat A, Qannam H. Development of an Arabic inpatient satisfaction survey: application in acute medical rehabilitation setting in Saudi Arabia. BMC Health Serv Res 2017; 17:664. [PMID: 28923110 PMCID: PMC5604416 DOI: 10.1186/s12913-017-2596-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Accepted: 09/05/2017] [Indexed: 11/10/2022] Open
Abstract
Background In the management of chronic disease, evidence suggests that satisfied patients exhibit more loyalty to treatment providers and greater adherence to treatment regimens. This is particularly so in the rehabilitation setting. We aimed to develop a reliable and valid Arabic-language survey to objectively measure inpatient satisfaction in medical rehabilitation settings in Saudi Arabia. Methods The King Fahad Medical City Rehabilitation Hospital Patient Satisfaction Survey (RH PSS) is a self-administered survey that addresses four domains of rehabilitation care: access, structure, process, and outcomes. The RH PSS was developed through four steps. Step 1: An item-generation process utilizing input from patients, rehabilitation professionals, and the relevant literature. Step 2: Individual interviews and focus groups, conducted for cognitive testing of the survey and to examine content validity. Step 3: Assessment of internal consistency and construct validity. Step 4: Survey implementation wherein factor analysis and reliability and validity testing were conducted. The survey was conducted at an acute inpatient medical rehabilitation hospital in Saudi Arabia. A total of 709 rehabilitation inpatients participated. Results The RH PSS demonstrated reasonable reliability and validity. Cronbach’s alpha for all the RH PSS subscales ranged from 0.81 to 0.89, and 0.96 for the entire survey. Factor analysis showed good correlation of the 33 survey items and the subscales. The RH PSS demonstrated a good level of predictive validity through the high correlation between the global item “intent to recommend” and overall satisfaction (R2 = 0.786, adjusted R2 = 0.783, p = 0.01). Conclusions The RH PSS is the first satisfaction survey with reported validity and reliability testing to address inpatient rehabilitation settings in Saudi Arabia. Further research involving multiple sites is recommended for nationwide validation. Electronic supplementary material The online version of this article (10.1186/s12913-017-2596-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ahmed Aboabat
- Rehabilitation Hospital, King Fahad Medical City, P.O. Box 69762, Riyadh, 11557, Kingdom of Saudi Arabia.
| | - Hazem Qannam
- Rehabilitation Hospital, King Fahad Medical City, P.O. Box 59046, Riyadh, 11525, Kingdom of Saudi Arabia
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Dehlendorf C, Anderson N, Vittinghoff E, Grumbach K, Levy K, Steinauer J. Quality and Content of Patient–Provider Communication About Contraception: Differences by Race/Ethnicity and Socioeconomic Status. Womens Health Issues 2017; 27:530-538. [DOI: 10.1016/j.whi.2017.04.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 04/07/2017] [Accepted: 04/18/2017] [Indexed: 11/29/2022]
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Reducing Decisional Conflict and Enhancing Satisfaction with Information among Women Considering Breast Reconstruction following Mastectomy: Results from the BRECONDA Randomized Controlled Trial. Plast Reconstr Surg 2017; 138:592e-602e. [PMID: 27673530 DOI: 10.1097/prs.0000000000002538] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Deciding whether or not to have breast reconstruction following breast cancer diagnosis is a complex decision process. This randomized controlled trial assessed the impact of an online decision aid [Breast RECONstruction Decision Aid (BRECONDA)] on breast reconstruction decision-making. METHODS Women (n = 222) diagnosed with breast cancer or ductal carcinoma in situ, and eligible for reconstruction following mastectomy, completed an online baseline questionnaire. They were then assigned randomly to receive either standard online information about breast reconstruction (control) or standard information plus access to BRECONDA (intervention). Participants then completed questionnaires at 1 and 6 months after randomization. The primary outcome was participants' decisional conflict 1 month after exposure to the intervention. Secondary outcomes included decisional conflict at 6 months, satisfaction with information at 1 and 6 months, and 6-month decisional regret. RESULTS Linear mixed-model analyses revealed that 1-month decisional conflict was significantly lower in the intervention group (27.18) compared with the control group (35.5). This difference was also sustained at the 6-month follow-up. Intervention participants reported greater satisfaction with information at 1- and 6-month follow-up, and there was a nonsignificant trend for lower decisional regret in the intervention group at 6-month follow-up. Intervention participants' ratings for BRECONDA demonstrated high user acceptability and overall satisfaction. CONCLUSIONS Women who accessed BRECONDA benefited by experiencing significantly less decisional conflict and being more satisfied with information regarding the reconstruction decisional process than women receiving standard care alone. These findings support the efficacy of BRECONDA in helping women to arrive at their breast reconstruction decision.
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Sobanko JF, Da Silva D, Chiesa Fuxench ZC, Modi B, Shin TM, Etzkorn JR, Samimi SS, Wanat KA, Miller CJ. Preoperative telephone consultation does not decrease patient anxiety before Mohs micrographic surgery. J Am Acad Dermatol 2017; 76:519-526. [DOI: 10.1016/j.jaad.2016.09.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 09/06/2016] [Accepted: 09/22/2016] [Indexed: 10/20/2022]
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Norhayati MN, Masseni AA, Azlina I. Patient satisfaction with doctor-patient interaction and its association with modifiable cardiovascular risk factors among moderately-high risk patients in primary healthcare. PeerJ 2017; 5:e2983. [PMID: 28243527 PMCID: PMC5322751 DOI: 10.7717/peerj.2983] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 01/12/2017] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The outcomes of the physician-patient discussion intervene in the satisfaction of cardiovascular disease risk patients. Adherence to treatment, provision of continuous care, clinical management of the illness and patients' adjustment are influenced by satisfaction with physician-patient interaction. This study aims to determine the patient satisfaction with doctor-patient interaction and over six months after following prevention counselling, its associations with modifiable cardiovascular risk factors amongst moderately-high risk patients in a primary healthcare clinic in Kelantan, Malaysia. METHODS A prospective survey was conducted amongst patients with moderately-high cardiovascular risk. A total of 104 moderately-high risk patients were recruited and underwent structured prevention counselling based on the World Health Organization guideline, and their satisfaction with the doctor-patient interaction was assessed using 'Skala Kepuasan Interaksi Perubatan-11,' the Malay version of the Medical Interview Satisfaction Scale-21. Systolic blood pressure, total cholesterol and high-density lipoprotein cholesterol were measured at baseline and at a follow-up visit at six months. Descriptive analysis, paired t test and linear regression analyses were performed. RESULTS A total of 102 patients responded, giving a response rate of 98.1%. At baseline, 76.5% of the respondents were satisfied with the relation with their doctor, with the favourable domain of distress relief (85.3%) and rapport/confidence (91.2%). The unfavourable domain was interaction outcome, with satisfaction in only 67.6% of the respondents. Between the two visits, changes had occurred in total cholesterol (P = 0.022) and in systolic blood pressure (P < 0.001). Six months after the initial visits, no relationship existed between patient satisfaction scores and changes in modifiable cardiovascular risks. DISCUSSION The 'Skala Kepuasan Interaksi Perubatan-11' which represents a component of the interpersonal doctor-patient relationship can be used to assess improvements of the medical skills and in medical training to enhance the quality of therapeutic communication.
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Affiliation(s)
- Mohd Noor Norhayati
- Department of Family Medicine, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | | | - Ishak Azlina
- Department of Family Medicine, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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Association of the quality of interpersonal care during family planning counseling with contraceptive use. Am J Obstet Gynecol 2016; 215:78.e1-9. [DOI: 10.1016/j.ajog.2016.01.173] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 01/09/2016] [Accepted: 01/21/2016] [Indexed: 11/17/2022]
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Mathews M, Ryan D, Bulman D. What does satisfaction with wait times mean to cancer patients? BMC Cancer 2015; 15:1017. [PMID: 26711742 PMCID: PMC4693431 DOI: 10.1186/s12885-015-2041-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 12/21/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Patient satisfaction is an important element of quality improvement and patient-centered care, and is an indicator of the public's confidence in the health care system. Although shorter wait times are believed intuitively to lead to higher satisfaction, studies have demonstrated the importance of many other factors which contribute to patients' satisfaction with their wait time experiences. The current study explores the factors that shape patients' satisfaction with their overall wait times (i.e. from symptom to treatment). METHODS We conducted qualitative interviews with 60 breast, prostate, lung, or colorectal cancer patients to examine the reasons behind patients' satisfaction or dissatisfaction with their wait time experiences. We purposefully recruited satisfied and unsatisfied participants from our larger survey sample. Using a semi-structured interview guide, patients were asked about their wait time experiences and the reasons behind their (dis)satisfaction. Interviews were transcribed verbatim and coded using a thematic approach. RESULTS Patients' perceptions of satisfaction with wait times were influenced by three interrelated dimensions: the interpersonal skills of treating physicians (which included expressions/demonstrations of empathy and concern, quality of information exchange, accountability for errors), coordination (which included assistance navigating the health system, scheduling of appointments, sharing information between providers, coordination in scheduling appointments, and sharing of information ), and timeliness of care (which referred to providers' responsiveness to patients' symptoms, coverage during provider absences, and shared sense of urgency between patient and providers). Providers' willingness to "trouble shoot" and acknowledge errors/delays were particularly influential in patients' overall perception of their wait times. CONCLUSIONS We described three dimensions of wait-related satisfaction: physicians' interpersonal skills, coordination of care, and timeliness of care, which are often interrelated and overlapping. Furthermore, while patients wait-related satisfaction was typically based on multiple interactions with different providers, positive or negative experiences with a single provider, often (but not always) the family physician, had a substantial impact on the overall satisfaction or dissatisfaction with wait time experiences. The findings provide a conceptual basis for the development of validated instruments to measure wait time-related patient satisfaction.
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Affiliation(s)
- Maria Mathews
- Division of Community Health & Humanities, Health Sciences Centre, Room 2837, St. John's, NL, A1B 3V6, Canada.
| | - Dana Ryan
- Division of Community Health & Humanities, Health Sciences Centre, Room 2849, St. John's, NL, A1B 3V6, Canada.
| | - Donna Bulman
- Faculty of Nursing, University of New Brunswick, Fredericton, NB, E3B 5A3, Canada.
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Sanclemente-Ansó C, Salazar A, Bosch X, Capdevila C, Giménez-Requena A, Rosón-Hernández B, Corbella X. Perception of quality of care of patients with potentially severe diseases evaluated at a distinct quick diagnostic delivery model: a cross-sectional study. BMC Health Serv Res 2015; 15:434. [PMID: 26420244 PMCID: PMC4589195 DOI: 10.1186/s12913-015-1070-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 09/17/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Although hospital-based outpatient quick diagnosis units (QDU) are an increasingly recognized cost-effective alternative to hospitalization for the diagnosis of potentially serious diseases, patient perception of their quality of care has not been evaluated well enough. This cross-sectional study analyzed the perceived quality of care of a QDU of a public third-level university hospital in Barcelona. METHODS One hundred sixty-two consecutive patients aged ≥ 18 years attending the QDU over a 9-month period were invited to participate. A validated questionnaire distributed by the QDU attending physician and completed at the end of the first and last QDU visit evaluated perceived quality of care using six subscales. RESULTS Response rate was 98 %. Perceived care in all subscales was high. Waiting times were rated as 'short'/'very short' or 'better'/'much better' than expected by 69-89 % of respondents and physical environment as 'better'/'much better' than expected by 94-96 %. As to accessibility, only 3 % reported not finding the Unit easily and 7 % said that frequent travels to hospital for visits and investigations were uncomfortable. Perception of patient-physician encounter was high, with 90-94 % choosing the positive extreme ends of the clinical information and personal interaction subscales items. Mean score of willingness to recommend the Unit using an analogue scale where 0 was 'never' and 10 'without a doubt' was 9.5 (0.70). On multivariate linear regression, age >65 years was an independent predictor of clinical information, personal interaction, and recommendation, while age 18-44 years was associated with lower scores in these subscales. No schooling predicted higher clinical information and recommendation scores, while university education had remarkable negative influence on them. Having ≥4 QDU visits was associated with lower time to diagnosis and recommendation scores and malignancy was a negative predictor of time to diagnosis, clinical information, and recommendation. DISCUSSION It is worthy of note that the questionnaire evaluated patient perception and opinions of healthcare quality including recommendation rather than simply satisfaction. It has been argued that perception of quality of care is a more valuable approach than satisfaction. In addition to embracing an affective dimension, satisfaction appears more dependent on patient expectations than is perception of quality. CONCLUSIONS While appreciating that completing the questionnaire immediately after the visit and its distribution by the QDU physician may have affected the results, scores of perceived quality of care including recommendation were high. There were, however, significant differences in several subscales associated with age, education, number of QDU visits, and diagnosis of malignant vs. benign condition.
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Affiliation(s)
- Carmen Sanclemente-Ansó
- Department of Internal Medicine, Bellvitge University Hospital, University of Barcelona, Biomedical Research Institute (IDIBELL), Consultas Externas, Area de Gestión Administrativa, c/Feixa Llarga s/n, 08907-L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Albert Salazar
- Emergency Department, Bellvitge University Hospital, Department of Medicine, University of Barcelona, Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Xavier Bosch
- Department of Internal Medicine, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c/Villarroel 170, 08036, Barcelona, Spain.
| | - Cristina Capdevila
- Emergency Department, Bellvitge University Hospital, Department of Medicine, University of Barcelona, Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Amparo Giménez-Requena
- Department of Quality, Bellvitge University Hospital, University of Barcelona, Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Beatriz Rosón-Hernández
- Department of Internal Medicine, Bellvitge University Hospital, University of Barcelona, Biomedical Research Institute (IDIBELL), Consultas Externas, Area de Gestión Administrativa, c/Feixa Llarga s/n, 08907-L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Xavier Corbella
- Department of Internal Medicine, Bellvitge University Hospital, University of Barcelona, Biomedical Research Institute (IDIBELL), Consultas Externas, Area de Gestión Administrativa, c/Feixa Llarga s/n, 08907-L'Hospitalet de Llobregat, Barcelona, Spain. .,Global Institute of Public Health and Health Policy, School of Medicine, International University of Catalonia, Barcelona, Spain.
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Self-rated health supersedes patient satisfaction with service quality as a predictor of survival in prostate cancer. Health Qual Life Outcomes 2015; 13:137. [PMID: 26337960 PMCID: PMC4560081 DOI: 10.1186/s12955-015-0334-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Accepted: 08/26/2015] [Indexed: 11/10/2022] Open
Abstract
Background We have previously reported that higher patient satisfaction (PS) with service quality is associated with favorable survival outcomes in a variety of cancers. However, we argued that patients with greater satisfaction might be the ones with better self-rated health (SRH), a recognized predictor of cancer survival. We therefore investigated whether SRH can supersede patient satisfaction as a predictor of survival in prostate cancer. Methods Nine hundred seventeen prostate cancer treated at four Cancer Treatment Centers of America® hospitals between July 2011 and March 2013. PS was measured on a 7-point scale ranging from “completely dissatisfied” to “completely satisfied”. SRH was measured on a 7-point scale ranging from “very poor” to “excellent”. Both were dichotomized into two categories: top box response (7) versus all others (1–6). Patient survival was the primary end point. Cox regression was used to evaluate the association between PS and survival controlling for covariates. Results The response rate for this study was 72 %. Majority of patients (n = 517) had stage II disease. Seven hundred eighty-seven (85.8 %) patients were “completely satisfied”. Three hundred nineteen (34.8 %) patients had “excellent” SRH. There was a weak but significant correlation between satisfaction and SRH (Kendall’s tau b = 0.18; p < 0.001). On univariate analysis, “completely satisfied” patients had a significantly lower risk of mortality (HR = 0.46; 95 % CI: 0.25-0.85; p = 0.01). Similarly, patients with “excellent” SRH had a significantly lower risk of mortality (HR = 0.25; 95 % CI: 0.11-0.58; p = 0.001). On multivariate analysis, SRH was found to be a significant predictor of survival (HR = 0.31; 95 % CI: 0.12-0.79; p = 0.01) while patient satisfaction was not (HR = 0.76; 95 % CI: 0.40-1.5; p = 0.40). Conclusions SRH supersedes patient satisfaction with service quality as a predictor of survival in prostate cancer. SRH should be used as a control variable in analyses involving patient satisfaction as a predictor of clinical cancer outcomes.
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Lis CG, Patel K, Gupta D. The Relationship between Patient Satisfaction with Service Quality and Survival in Non-Small Cell Lung Cancer - Is Self-Rated Health a Potential Confounder? PLoS One 2015; 10:e0134617. [PMID: 26230934 PMCID: PMC4521936 DOI: 10.1371/journal.pone.0134617] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 07/11/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND/AIMS Previously we reported that higher patient satisfaction (PS) with service quality is associated with favorable survival outcomes in a variety of cancers. However, we cautioned the readers that patients with greater satisfaction might be the ones with better self-rated health (SRH), a well-established prognosticator of cancer survival. In other words, SRH could potentially confound the PS and survival relationship. We investigated this hypothesis in non-small cell lung cancer (NSCLC). METHODS 778 NSCLC patients (327 males and 451 females; mean age 58.8 years) treated at 4 Cancer Treatment Centers of America hospitals between July 2011 and March 2013. PS was measured on a 7-point scale ranging from "completely dissatisfied" to "completely satisfied". SRH was measured on a 7-point scale ranging from "very poor" to "excellent". Both were dichotomized into 2 categories: top box response (7) versus all others (1-6). Patient survival was the primary end point. Cox regression was used to evaluate the association between PS and survival controlling for covariates. RESULTS 74, 70, 232 and 391 patients had stage I, II, III and IV disease respectively. 631 (81.1%) patients were "completely satisfied". 184 (23.7%) patients had "excellent" SRH. There was a weak but significant correlation between overall PS and SRH (Kendall's tau b = 0.19; p<0.001). On univariate analysis, "completely satisfied" patients had a significantly lower risk of mortality (HR = 0.75; 95% CI: 0.57 to 0.99; p = 0.04). Similarly, patients with "excellent" SRH had a significantly lower risk of mortality (HR = 0.61; 95% CI: 0.46 to 0.81; p = 0.001). On multivariate analysis controlling for stage at diagnosis, treatment history and gender, SRH was found to be a significant predictor of survival (HR = 0.67; 95% CI: 0.50 to 0.89; p = 0.007) while PS was not (HR = 0.86; 95% CI: 0.64 to 1.2; p = 0.32). Among the individual PS items, the only significant independent predictor of survival was "teams communicating with each other concerning your medical condition and treatment" (HR = 0.59; 95% CI: 0.36 to 0.94; p = 0.03). CONCLUSION SRH appears to confound the PS-survival relationship in NSCLC. SRH should be used as a control/stratification variable in analyses involving PS as a predictor of clinical cancer outcomes.
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Affiliation(s)
- Christopher G. Lis
- Cancer Treatment Centers of America (CTCA), 500 Remington Road, Schaumburg, Illinois, 60173, United States of America
| | - Kamal Patel
- Cancer Treatment Centers of America (CTCA), 500 Remington Road, Schaumburg, Illinois, 60173, United States of America
| | - Digant Gupta
- Cancer Treatment Centers of America (CTCA), 500 Remington Road, Schaumburg, Illinois, 60173, United States of America
- * E-mail:
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Cancer patients' emotional distress, coping styles and perception of doctor-patient interaction in European cancer settings. Palliat Support Care 2015; 14:204-11. [PMID: 26155817 DOI: 10.1017/s1478951515000760] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE As a part of a European study, we cross-culturally examined the rate of emotional distress and maladaptive coping and their association with cancer patients' satisfaction with their interactions with the physician responsible for their care. METHODS Cancer patients (n = 302) from one Middle European (Austria) and two Southern European (Italy, Spain) countries completed the NCCN Distress Thermometer (DT), the Mini-Mental Adjustment to Cancer (Mini-MAC) Anxious Preoccupation (AP) and Hopelessness (H) sub-scales, and the Physician Patient Satisfaction with Doctors Questionnaire (PSQ). RESULTS The prevalence of emotional distress (DT caseness) was 60% (26.1% mild, 18.8% moderate, and 14.9% severe distress). Maladaptive coping (Mini-MAC cases) was found in 22.8% (hopeless cases), and 22.5% (anxious preoccupation cases). PSQ-MD was significantly correlated with Mini-MAC/H and Mini-Mac/AP, while PSQ-PS was negatively correlated with Mini-MAC/H. DT cases and those with higher levels of hopelessness reported higher scores on PSQ-MD and lower on PSQ-PS than non-cases. Some differences were found between countries both as far as patients' coping and perception of the interaction with doctors. In hierarchical multiple regression analysis, after adjusting for socio-demographic and medical variables, Mini-MAC/H significantly predicted the scores on PSQ-MD (positive direction) and PSQ-PS (negative direction). SIGNIFICANCE OF RESULTS The study confirms that about one out of three cancer patients have moderate to high level of emotional distress and about one out of four, clinically significant maladaptive coping. Also, patients showing hopelessness and distress tended to perceive their doctors as both disengaged and less supportive. These results highlights the need for physicians to monitor their patient's level of distress and coping mechanisms and to adjust their own relational and communication style according to patients' psychological condition. Also, cross-cultural issues should be taken into account when exploring psychosocial variables and cancer patients' perception of and satisfaction with the interaction with their doctors.
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Boquiren VM, Hack TF, Beaver K, Williamson S. What do measures of patient satisfaction with the doctor tell us? PATIENT EDUCATION AND COUNSELING 2015; 98:S0738-3991(15)00264-5. [PMID: 26111500 DOI: 10.1016/j.pec.2015.05.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Revised: 05/28/2015] [Accepted: 05/30/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To gain an understanding of how patient satisfaction (PS) with the doctor (PSD) is conceptualized through an empirical review of how it is currently being measured. The content of PS questionnaire items was examined to (a) determine the primary domains underlying PSD, and (b) summarize the specific doctor-related characteristics and behaviors, and patient-related perceptions, composing each domain. METHODS A scoping review of empirical articles that assessed PSD published from 2000 to November 2013. MEDLINE and PsycINFO databases were searched. RESULTS The literature search yielded 1726 articles, 316 of which fulfilled study inclusion criteria. PSD was realized in one of four health contexts, with questions being embedded in a larger questionnaire that assessed PS with either: (1) overall healthcare, (2) a specific medical encounter, or (3) the healthcare team. In the fourth context, PSD was the questionnaire's sole focus. Five broad domains underlying PSD were revealed: (1) Communication Attributes; (2) Relational Conduct; (3) Technical Skill/Knowledge; (4) Personal Qualities; and (5) Availability/Accessibility. CONCLUSIONS Careful consideration of measurement goals and purposes is necessary when selecting a PSD measure. PRACTICE IMPLICATIONS The five emergent domains underlying PSD point to potential key areas of physician training and foci for quality assessment.
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Affiliation(s)
- Virginia M Boquiren
- Behavioural Sciences & Health Research Division, University Health Network, Toronto, Ontario, Canada; College of Nursing, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
| | - Thomas F Hack
- College of Nursing, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada; School of Health, University of Central Lancashire, Preston, UK.
| | - Kinta Beaver
- School of Health, University of Central Lancashire, Preston, UK.
| | - Susan Williamson
- School of Health, University of Central Lancashire, Preston, UK.
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Development and validity of the questionnaire of patients' experiences in postacute outpatient physical therapy settings. Phys Ther 2015; 95:767-77. [PMID: 25413623 DOI: 10.2522/ptj.20140041] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 11/12/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND Patient feedback surveys are increasingly seen as a key component of health care quality monitoring and improvement. OBJECTIVE The study objective was to describe the development and initial psychometric evaluation of a fixed-length questionnaire about the experiences of patients receiving physical therapist treatment in postacute outpatient settings. DESIGN This was an instrument development study with validity and reliability testing. METHODS A total of 465 participants attending 3 rehabilitation centers for musculoskeletal conditions completed the questionnaire. A cognitive pretest was applied to the draft version (n=94), and a revised version was evaluated for test-retest reliability (n=90). Analyses to evaluate variance and nonresponse rates for items, the factor structure of the questionnaire, and the metric properties of multi-item scales were conducted. RESULTS Exploratory factor analyses yielded evidence for a 7-factor structure of the questionnaire, with 3 factors that may be conceptually viewed as professionals' attitudes and behavior (providing information and education, sensitivity to patients' changes, and emotional support) and 4 factors that conceptually reflect organizational environment (duration of attendance, interruptions during care delivery, waiting times, and patient safety). Item-scale correlations ranged from .70 to .93. The percentage of scaling success was 100% for all of the scales. Cronbach alpha coefficients ranged from .70 to .87. Intraclass correlation coefficients ranged from .57 to .80 (median=.68). LIMITATIONS Generalization to other patients is not known. CONCLUSIONS The questionnaire has test-retest reliability, and the scales have internal consistency and convergent and discriminant validity. All of the scales are distinct and unidimensional.
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Plotti F, Capriglione S, Miranda A, Scaletta G, Aloisi A, Luvero D, Ricciardi R, Terranova C, De Cicco Nardone C, Angioli R. The impact of gynecologic oncology training in the management of cancer patients: is it really necessary? A prospective cohort study. Eur J Obstet Gynecol Reprod Biol 2014; 184:19-23. [PMID: 25462214 DOI: 10.1016/j.ejogrb.2014.11.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 11/03/2014] [Accepted: 11/11/2014] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To assess patients' perceptions of physician, nurse, and care organization quality of care and services received during hospitalization with or without a sub-specialized setting in gynaecological oncology. STUDY DESIGN Consecutive patients affected by gynaecologic cancer, referred to the Division of Gynaecology of University Campus Bio-Medico of Rome to underwent to surgery (surgical ward) or to chemotherapy (medical ward) from January 2010 to April 2014, were enrolled. Eligible subjects were divided into two groups: Group A: standard unit care, consisting of doctors and nurses without a specific training and Group B: Expert unit care, consisting of doctors and nurses with specific training in gynecologic oncology. Patients were asked to complete the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Cancer Module (QLQ-C30) and the Patient Satisfaction Questionnaire (IN-PATSAT32). RESULTS The sample (n = 150) is organized into two groups: 78 patients (Group A) and 72 patients (Group B). Analysing the results of IN-PATSAT32, comparing Group A versus Group B, we find statistically significant difference considering doctors' information provision (items 7-9) (p = 0.0470), nurses' technical skills (items 12-14) (p = 0.0369) and nurses' information provision (items 18-20) (p = 0.0089) and general satisfaction (item 32) (p = 0.0214). CONCLUSIONS This study highlights the potential benefits specialty training for doctors and nurses that work in an oncologic ward (surgical or medical). In fact, the necessity for a separate sub-specialty in gynaecological oncology and a distinct training programme may be the key to achieve the higher satisfaction in this setting of patients.
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Affiliation(s)
- Francesco Plotti
- Department of Obstetrics and Gynaecology, Campus Bio Medico University of Rome, Italy
| | - Stella Capriglione
- Department of Obstetrics and Gynaecology, Campus Bio Medico University of Rome, Italy.
| | - Andrea Miranda
- Department of Obstetrics and Gynaecology, Campus Bio Medico University of Rome, Italy
| | - Giuseppe Scaletta
- Department of Obstetrics and Gynaecology, Campus Bio Medico University of Rome, Italy
| | - Alessia Aloisi
- Department of Obstetrics and Gynaecology, Campus Bio Medico University of Rome, Italy
| | - Daniela Luvero
- Department of Obstetrics and Gynaecology, Campus Bio Medico University of Rome, Italy
| | - Roberto Ricciardi
- Department of Obstetrics and Gynaecology, Campus Bio Medico University of Rome, Italy
| | - Corrado Terranova
- Department of Obstetrics and Gynaecology, Campus Bio Medico University of Rome, Italy
| | | | - Roberto Angioli
- Department of Obstetrics and Gynaecology, Campus Bio Medico University of Rome, Italy
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Bot AG, Bossen JK, Herndon JH, Ruchelsman DE, Ring D, Vranceanu AM. Informed Shared Decision-Making and Patient Satisfaction. PSYCHOSOMATICS 2014; 55:586-94. [DOI: 10.1016/j.psym.2013.12.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Revised: 12/25/2013] [Accepted: 12/27/2013] [Indexed: 10/25/2022]
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Goldzweig G, Abramovitch A, Brenner B, Perry S, Peretz T, Baider L. Expectations and Level of Satisfaction of Patients and Their Physicians: Concordance and Discrepancies. PSYCHOSOMATICS 2014; 56:521-9. [PMID: 25596021 DOI: 10.1016/j.psym.2014.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 09/27/2014] [Accepted: 09/29/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Identifying discrepancies between patients׳ expectations for support provided by their physicians, and physicians׳ appraisal of the support they provide to their patients, is a key factor in constructing effective doctor-patient communication. OBJECTIVE The current study proposes and explores a paradigm for assessing possible gaps and overlaps between perceptions of patients with cancer and physicians about the "actual" and the "ideal" (desired) emotional and cognitive support oncologists provide to patients. METHODS Participants included 1027 patients with cancer and 47 senior oncologists. Patients׳ and physicians׳ levels of expectations and satisfaction with the emotional and cognitive support offered by physicians were assessed using a quantitative measure of discrepancy between the actual and the ideal situation. The measure was developed for this study and tested on a random sample of 200 patients and 17 oncologists. RESULTS The results indicated consistency between physicians׳ and patients׳ perceptions of the needs and support that the patients received. Nevertheless, oncologists did not feel highly trusted by their patients, oncologists desired less involvement of patients in the treatment plan than the patients expected. Oncologists thought that they actually provided the desired levels of explanation to patients׳ families, whereas patients thought their families got less explanations than expected. CONCLUSION Actual and ideal levels of communication should be described from the points of view of both physicians and patients to better understand the complex picture of patient satisfaction. Oncologists should consider patients׳ expectations for support vs their own expectations to effectively address patients׳ needs.
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Affiliation(s)
- Gil Goldzweig
- School of Behavioral Sciences, The Academic College of Tel-Aviv-Yaffo, Tel-Aviv, Israel (GG).
| | - Amitai Abramovitch
- OCD and Related Disorders Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA (AA)
| | - Baruch Brenner
- Institute of Oncology, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel (BB, SP)
| | - Shlomit Perry
- Institute of Oncology, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel (BB, SP)
| | - Tamar Peretz
- Sharett Institute of Oncology, Hadassah University Hospital, Jerusalem, Israel (TP)
| | - Lea Baider
- Institute of Oncology, Assuta Medical Center, Tel-Aviv, Israel (LB)
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Huo Q, Cai C, Zhang Y, Kong X, Jiang L, Ma T, Zhang N, Yang Q. Delay in diagnosis and treatment of symptomatic breast cancer in China. Ann Surg Oncol 2014; 22:883-8. [PMID: 25212834 DOI: 10.1245/s10434-014-4076-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Delay in diagnosis and treatment of cancer may lead to advanced tumor characteristics and poor prognosis. Research and investigation from economically developing countries such as China are warranted to support these conclusions, so we studied the impact on prognosis of delays and factors predicting delay in symptomatic breast cancer patients in China. METHODS Medical records and follow-up information were collected. Variables including demographic data, and clinical and tumor characteristics, including patient age, menstrual status, residential status, initial symptom, profession, comorbidities, tumor size, lymph node metastasis, distant metastasis, history of breast disease, and family history of breast cancer, were analyzed, as was survival information. RESULTS A total of 1,431 women diagnosed with breast cancers between 1998 and 2005 in Qilu Hospital were enrolled and studied. Delays in diagnosis and treatment were correlated with larger tumor size, lymph node metastasis, late tumor stage, and worse disease-free survival, as assessed by multivariate logistic regression and Kaplan-Meier regression models. Patient residential status, initial symptom, menopausal status, and history of breast disease were independent predictors of delay. Stratified multivariate analyses confirmed that age was not associated with delay. CONCLUSIONS Delay in diagnosis and treatment predicts worse clinical outcomes. Improvement of medical service in rural areas, especially for premenopausal women, can decrease delays and benefit breast cancer patients.
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Affiliation(s)
- Qiang Huo
- Department of Breast Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China,
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Abioye Kuteyi EA, Bello IS, Olaleye TM, Ayeni IO, Amedi MI. Determinants of patient satisfaction with physician interaction: a cross-sectional survey at the Obafemi Awolowo University Health Centre, Ile-Ife, Nigeria. S Afr Fam Pract (2004) 2014. [DOI: 10.1080/20786204.2010.10874047] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Abd Aziz A, Izyan Farhana Nordin N, Mohd Noor N, Bachok N, Nor Ismalina Isa S. Psychometric properties of the 'Skala Kepuasan Interaksi Perubatan-11' to measure patient satisfaction with physician-patient interaction in Malaysia. Fam Pract 2014; 31:236-44. [PMID: 24317538 DOI: 10.1093/fampra/cmt062] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patient satisfaction influences the outcomes of the patient-physician encounter. OBJECTIVE The objective of this study was to validate the Malay version patient satisfaction (MISS-21) questionnaire using a confirmatory validity approach. METHODS A cross-sectional study was conducted involving 252 patients attending primary health clinic, Hospital Universiti Sains Malaysia. Construct validity (convergent and discriminant) using confirmatory factor analysis and internal consistency were performed after the translation, content validity and face validity processes. Criterion validity was assessed using Pearson correlations with the scale of shared decision making 9-item questionnaire (SDMQ-9). The data was analysed using Analysis of Moment Structure version 19. RESULTS A total of 252 (100%) outpatients responded to this study. The final model that consists of three domains with 11 items had a good fit; (χ (2) (df) = 65.805 (32), P < 0.001, Tucker-Lewis indices = 0.902, comparative fit index = 0.927, root mean square error of approximation = 0.061, standardized root mean square residual = 0.058). Composite reliability and average variance extracted of the domains ranged from 0.541 to 0.760 and 0.240 to 0.522, respectively. The SDMQ-9 had a moderate correlation with the total score of the final construct (r = 0.406, P <0.001). CONCLUSION The study suggested that the three-factor model with 11 items of the Malay version MISS-21 could be used to assess patient satisfaction on patient-physician interaction in primary health care setting because it is acceptably valid, reliable and simple. The validated Malay version questionnaire was called as 'Skala Kepuasan Interaksi Perubatan-11'.
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Furber L, Murtagh GM, Bonas SA, Bankart JG, Thomas AL. Improving consultations in oncology: the development of a novel consultation aid. Br J Cancer 2014; 110:1101-9. [PMID: 24548856 PMCID: PMC3950848 DOI: 10.1038/bjc.2013.749] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 10/12/2013] [Accepted: 11/01/2013] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The way in which patients receive bad news in a consultation can have a profound effect in terms of anxiety, depression and subsequent adjustment. Despite investment in well-researched communication skills training and availability of decision-making aids, communication problems in oncology continue to be encountered. METHODS We conducted a mixed-methods study in a large UK Cancer Centre to develop a novel consultation aid that could be used jointly by patients and doctors. Consultations were audio-recorded and both the doctors and the patients were interviewed. We used conversation analysis to analyse the consultation encounter and interpretative phenomenological analysis to analyse the interviews. Key themes were generated to inform the design of the aid. RESULTS A total of 16 doctors were recruited into the study along with 77 patients. Detailed analysis from 36 consultations identified key themes (including preparation, information exchange, question-asking and decision making), which were subsequently addressed in the design of the paper-based aid. CONCLUSIONS Using detailed analysis and observation of oncology consultations, we have designed a novel consultation aid that can be used jointly by doctors and patients. It is not tumour-site specific and can potentially be utilised by new and follow-up consultations.
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Affiliation(s)
- L Furber
- Department of Cancer Studies and Molecular Medicine, Osborne Building, Leicester Royal Infirmary, Leicester LE1 5WW, UK
| | - G M Murtagh
- Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
| | - S A Bonas
- Department of Clinical Psychology, University of Leicester, Leicester LE1 9HN, UK
| | - J G Bankart
- Department of Health Sciences, University of Leicester, Leicester LE1 6TP, UK
| | - A L Thomas
- Department of Cancer Studies and Molecular Medicine, Osborne Building, Leicester Royal Infirmary, Leicester LE1 5WW, UK
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Hassali MA, Alrasheedy AA, Ab Razak BA, Al-Tamimi SK, Saleem F, Ul Haq N, Aljadhey H. Assessment of general public satisfaction with public healthcare services in Kedah, Malaysia. Australas Med J 2014; 7:35-44. [PMID: 24567765 DOI: 10.4066/amj.2014.1936] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Patient satisfaction is considered an essential component of healthcare services evaluation and an additional indicator of the quality of healthcare. Moreover, patient satisfaction may also predict health-related behaviours of patients such as adherence to treatment and recommendations. AIMS The study aimed to assess patients' level of satisfaction with public healthcare services and to explore the association between socio-demographic and other study variables and patient satisfaction level. METHOD A cross-sectional study was conducted using selfadministered questionnaires distributed to a convenience sample of the general public in Kedah, Malaysia. RESULTS A total of 435 out of 500 people invited to participate in the study agreed to take part, giving a response rate of 87 per cent. In this study, only approximately half of the participants (n=198, 45.5 per cent) were fully satisfied with the current healthcare services. The majority of the participants agreed that doctors had given enough information about their state of health (n=222, 51 per cent) and were competent and sympathetic (n=231, 53.1 per cent). Almost half of the participants (n=215, 49.5 per cent) agreed that the doctors took their problems seriously. Only 174 (40 per cent) participants agreed that doctors had spent enough time on their consultation session. Some respondents (n=266, 61.2 per cent) agreed that healthcare professionals in the public health sector were highly skilled. The majority of the respondents described amenities, accessibility and facilities available in the public healthcare sector as good or better. In this study, waiting time was significantly associated with patient satisfaction as the results showed that those who waited longer than two hours were less satisfied with the services than those who waited under two hours. CONCLUSION The study findings showed that approximately half of the respondents were fully satisfied with current healthcare services. In this study, waiting time was the main factor that affected patient satisfaction level. Other factors that influenced satisfaction level included the length of consultation sessions and the process of patient registration. Hence, improvement in the health services that leads to a shorter waiting time may increase the satisfaction level of patients.
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Affiliation(s)
- Mohammed Azmi Hassali
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Alian A Alrasheedy
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Basyirah Afifah Ab Razak
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Saleh Karamah Al-Tamimi
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Fahad Saleem
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Noman Ul Haq
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Hisham Aljadhey
- Medication Safety Research Chair, Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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Brédart A, Sultan S, Regnault A. Patient satisfaction instruments for cancer clinical research or practice. Expert Rev Pharmacoecon Outcomes Res 2014; 10:129-41. [DOI: 10.1586/erp.10.7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Zhang J, Xie S, Liu J, Sun W, Guo H, Hu Y, Gao X. Validation of EORTC IN-PATSAT32 for Chinese patients with gastrointestinal cancer. Patient Prefer Adherence 2014; 8:1285-92. [PMID: 25258522 PMCID: PMC4174132 DOI: 10.2147/ppa.s67111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To test the psychometric properties and applicability of the European Organization for Research and Treatment of Cancer In-patient Satisfaction with Care Questionnaire 32 (EORTC IN-PATSAT32) for Chinese patients with gastrointestinal cancer. PATIENTS AND METHODS A total of 106 inpatients with gastrointestinal cancer at Cangzhou Center Hospital were enrolled in this study. All were treated at Cangzhou Center Hospital from July 2013-March 2014. All participants self-administered the EORTC IN-PATSAT32 and EORTC Quality of Life Questionnaire - Core 30 (EORTC QLQ-C30). RESULTS The Cronbach's α coefficients were >0.70 for all scales of the EORTC IN-PATSAT32. Multitrait scaling analysis showed that all-item scale correlation coefficients met the standard of convergent validity, while only 50.0% met the standard of discriminant validity. A weak correlation was found between the scales and single items of the EORTC IN-PATSAT32 and EORTC QLQ-C30. CONCLUSION The EORTC IN-PATSAT32 appears to be a reliable, valid, and acceptable instrument for measuring patient satisfaction among Chinese patients with gastrointestinal cancer.
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Affiliation(s)
- Jishui Zhang
- The Second Department of General Surgery, Cangzhou Central Hospital, Hebei, People’s Republic of China
| | - Shumin Xie
- Xiangya Medical School of Central South University, Changsha, People’s Republic of China
| | - Jiahao Liu
- Xiangya Medical School of Central South University, Changsha, People’s Republic of China
| | - Weilin Sun
- Tianjin Medical University, Tianjin, People’s Republic of China
| | - Hui Guo
- Tianjin Medical University, Tianjin, People’s Republic of China
| | - Yingbin Hu
- Department of General Surgery, Hunan Tumor Hospital, Xiangya School of Medicine, Central South University, Hunan, People’s Republic of China
| | - Xin Gao
- Department of Radiotherapy, Cangzhou Central Hospital, Hebei, People’s Republic of China
- Correspondence: Xin Gao, Department of Radiotherapy, Cangzhou Central Hospital, Hebei, People’s Republic of China, 061000, Tel +86 0317 207 5733, Fax +86 0317 207 5733, Email
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Gupta D, Lis CG, Rodeghier M. Can Patient Experience with Service Quality Predict Survival in Colorectal Cancer? J Healthc Qual 2013; 35:37-43. [DOI: 10.1111/j.1945-1474.2012.00217.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Gupta D, Rodeghier M, Lis CG. Patient satisfaction with service quality in an oncology setting: implications for prognosis in non-small cell lung cancer. Int J Qual Health Care 2013; 25:696-703. [PMID: 24123242 PMCID: PMC3842127 DOI: 10.1093/intqhc/mzt070] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Objective To evaluate the relationship between self-reported satisfaction with service quality and overall survival in non-small cell lung cancer (NSCLC). Design A prospective cohort study. Setting Cancer Treatment Centers of America® from July 2007 and December 2010. Participants Nine hundred and eighty-six returning NSCLC patients. Intervention Overall patient experience ‘considering everything, how satisfied are you with your overall experience’ was measured on a 7-point Likert scale ranging from ‘completely dissatisfied’ to ‘completely satisfied.’. Main Outcome Measure Patient survival was the primary end point. Results The response rate for this study was 69%. Six hundred patients were newly diagnosed, while 386 were previously treated. Four hundred sixty-nine were males, while 517 were females. 101, 59, 288 and 538 patients had stage I, II, III and IV disease, respectively. Mean age was 58.9 years. Six hundred and thirty (63.9%) patients had expired at the time of this analysis. Seven hundred and sixty-two (77.3%) patients were ‘completely satisfied’. Median overall survival was 12.1 months (95% confidence interval (CI): 10.9–13.2 months). On univariate analysis, ‘completely satisfied’ patients had a significantly lower risk of mortality compared with those not ‘completely satisfied’ [hazard ratio (HR) = 0.70; 95% CI: 0.59–0.84; P < 0.001]. On multivariate analysis controlling for stage at diagnosis, prior treatment history, age and gender, ‘completely satisfied’ patients demonstrated significantly lower mortality (HR = 0.71; 95% CI: 0.60–0.85; P < 0.001) compared with those not ‘completely satisfied’. Conclusions Self-reported experience with service quality was an independent predictor of survival in NSCLC patients undergoing oncologic treatment, a novel finding in the literature. Based on these provocative findings, further exploration of this relationship is warranted in well-designed prospective studies.
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Affiliation(s)
- Digant Gupta
- Cancer Treatment Centers of America, 1336 Basswood Road, Schaumburg, IL 60173, USA.
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Gupta D, Rodeghier M, Lis CG. Patient satisfaction with service quality as a predictor of survival outcomes in breast cancer. Support Care Cancer 2013; 22:129-34. [PMID: 24013568 DOI: 10.1007/s00520-013-1956-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Accepted: 08/27/2013] [Indexed: 11/26/2022]
Abstract
PURPOSE Despite the recognized relevance of symptom burden in breast cancer, there has been limited exploration of whether an individual patient's assessment of the overall quality of care received might influence outcome. We therefore evaluated the relationship between patient-reported satisfaction with service quality and survival in breast cancer. METHODS A random sample of 1,521 breast cancer patients treated at Cancer Treatment Centers of America. A questionnaire which covered several dimensions of patient satisfaction was administered. Items were measured on a seven-point Likert scale ranging from "completely dissatisfied" to "completely satisfied". Univariate and multivariate Cox regression was used to evaluate the association between patient satisfaction and survival. RESULTS Of 1,521 patients, 836 were newly diagnosed, and 685 had previously been treated. A number of 409, 611, 323, and 178 patients had stage I, II, III, and IV disease, respectively. A total of 1,106 (72.7 %) patients were completely satisfied with the overall service quality, while 415 (27.3 %) were not. On univariate analysis, completely satisfied patients had a significantly lower risk of mortality compared to those not completely satisfied (HR = 0.62; 95 % CI 0.50-0.76; p < 0.001). On multivariate analysis, completely satisfied patients demonstrated significantly lower mortality (HR = 0.71; 95 % CI 0.57-0.87; p = 0.001) compared to those not completely satisfied. CONCLUSIONS Patient satisfaction with service quality was an independent predictor of survival in breast cancer. Further exploration of a possible meaningful relationship between patient satisfaction with the care they receive and outcomes in breast cancer is indicated.
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Affiliation(s)
- Digant Gupta
- Cancer Treatment Centers of America®, 1336 Basswood Road, Schaumburg, IL, 60173, USA,
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Ghazali N, Roe B, Lowe D, Rogers S. Uncovering patients’ concerns in routine head and neck oncology follow up clinics: an exploratory study. Br J Oral Maxillofac Surg 2013; 51:294-300. [DOI: 10.1016/j.bjoms.2012.08.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2012] [Accepted: 08/08/2012] [Indexed: 10/28/2022]
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Sullivan PJ, Harris ML, Doyle C, Bell D. Assessment of the validity of the English National Health Service Adult In-Patient Survey for use within individual specialties. BMJ Qual Saf 2013; 22:690-6. [PMID: 23696675 DOI: 10.1136/bmjqs-2012-001466] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Healthcare improvement requires rigorous measurement. Patient experience is a key healthcare outcome and target for improvement. Its measurement requires psychometrically validated questionnaires. In England, the Adult In-Patient Survey (AIPS), which is validated for use across the entire acute inpatient population, is administered to unselected patients after discharge from National Health Service acute Trusts. The AIPS is reported at an organisational level, but subhospital level data are needed for local quality improvement; it is currently uncertain whether the AIPS retains validity in local specialty subgroups. METHODS We analysed the results of AIPS for 2010 (n=56 931 returns) by specialty (medicine, surgery, orthopaedics, renal medicine, neurosurgery, obstetrics-gynaecology and oncology) to determine whether validity is retained at a suborganisational level. RESULTS Criterion validity and internal consistency of AIPS were retained for most specialty subgroups. When small local samples were excluded, the results for Trust level specialty groups were similar over a 2-year period, indicating test stability. For oncology there was poor internal consistency in the 'doctors' domain and criterion validity, expressed as the relationship elements of experience and overall rating of care, was less than for other specialties. CONCLUSIONS The AIPS is suitable for use within many specialties, but our findings question some elements of validity for oncology inpatients. We recommend that future surveys are administered and reported by specialty, to inform local improvement and permit comparison of specialty units.
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Affiliation(s)
- P J Sullivan
- Northwest London CLAHRC and Centre for Healthcare Improvement Research, NIHR CLAHRC for Northwest London, Imperial College, London, UK.
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Implications of sperm banking for health-related quality of life up to 1 year after cancer diagnosis. Br J Cancer 2013; 108:1004-11. [PMID: 23470465 PMCID: PMC3619074 DOI: 10.1038/bjc.2013.57] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Sperm banking is recommended for all men diagnosed with cancer where treatment is associated with risk of long-term gonadatoxicity, to offer the opportunity of fatherhood and improved quality of life. However, uptake of sperm banking is lower than expected and little is known about why men refuse. Our aims were to determine: (i) demographic and medical variables associated with decisions about banking and (ii) differences in quality of life between bankers and non-bankers at diagnosis (Time 1 (T1)) and 1 year later (Time 2 (T2)). Methods: Questionnaires were completed by 91 men (response rate=86.67%) at T1 and 78 (85.71% response rate) at T2. Results: In all, 44 (56.41%) banked sperm. They were younger and less likely to have children than non-bankers. In a subset of men who were not sure if they wanted children in the future (n=36), 24 banked sperm. Among this group, those who banked were younger, more satisfied with clinic appointments and less worried about the health of future children. At T2, there were no differences in quality of life between bankers and non-bankers. Conclusion: For those who are uncertain about future reproductive plans, decisions depend on their health on diagnosis and satisfaction with clinic care. We conclude that extra care should be taken in counselling younger men who may have given little consideration to future parenting. Results support previous findings that the role of the doctor is vital in facilitating decisions, especially for those who are undecided about whether they wanted children in the future or not.
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The cancer outpatient satisfaction with care questionnaire for chemotherapy, OUT-PATSAT35 CT: a validation study for Spanish patients. Support Care Cancer 2012; 20:3269-78. [DOI: 10.1007/s00520-012-1467-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Accepted: 04/09/2012] [Indexed: 11/25/2022]
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Lelorain S, Brédart A, Dolbeault S, Sultan S. A systematic review of the associations between empathy measures and patient outcomes in cancer care. Psychooncology 2012; 21:1255-64. [PMID: 22238060 DOI: 10.1002/pon.2115] [Citation(s) in RCA: 142] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Revised: 11/21/2011] [Accepted: 11/23/2011] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Despite a call for empathy in medical settings, little is known about the effects of the empathy of health care professionals on patient outcomes. This review investigates the links between physicians' or nurses' empathy and patient outcomes in oncology. METHOD With the use of multiple databases, a systematic search was performed using a combination of terms and subject headings of empathy or perspective taking or clinician-patient communication, oncology or end-of-life setting and physicians or nurses. Among the 394 hits returned, 39 studies met the inclusion criteria of a quantitative measure of empathy or empathy-related constructs linked to patient outcomes. RESULTS Empathy was mainly evaluated using patient self-reports and verbal interaction coding. Investigated outcomes were mainly proximal patient satisfaction and psychological adjustment. Clinicians' empathy was related to higher patient satisfaction and lower distress in retrospective studies and when the measure was patient-reported. Coding systems yielded divergent conclusions. Empathy was not related to patient empowerment (e.g. medical knowledge, coping). CONCLUSION Overall, clinicians' empathy has beneficial effects according to patient perceptions. However, in order to disentangle components of the benefits of empathy and provide professionals with concrete advice, future research should apply different empathy assessment approaches simultaneously, including a perspective-taking task on patients' expectations and needs at precise moments. Indeed, clinicians' understanding of patients' perspectives is the core component of medical empathy, but it is often assessed only from the patient's point of view. Clinicians' evaluations of patients' perspectives should be studied and compared with patients' reports so that problematic gaps between the two perspectives can be addressed.
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Affiliation(s)
- Sophie Lelorain
- Laboratoire de Psychopathologie et Processus de Santé (LPPS EA 4057), IUPDP, Université Paris Descartes, Boulogne-Billancourt, France.
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Gupta D, Markman M, Rodeghier M, Lis CG. The relationship between patient satisfaction with service quality and survival in pancreatic cancer. Patient Prefer Adherence 2012; 6:765-72. [PMID: 23152670 PMCID: PMC3496532 DOI: 10.2147/ppa.s37900] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
PURPOSE Despite the recognized relevance of symptom burden in pancreatic cancer, there has been limited exploration of whether an individual patient's satisfaction with the overall quality of care received might influence outcome. We evaluated the relationship between patient satisfaction with health service quality and survival in patients with pancreatic cancer. PATIENTS AND METHODS A random sample of 496 pancreatic cancer patients treated at Cancer Treatment Centers of America(®) (CTCA) between July 2007 and December 2010. A questionnaire that covered several dimensions of patient satisfaction was administered. Items were measured on a seven-point Likert scale ranging from "completely dissatisfied" to "completely satisfied." Patient survival was the primary end point. Cox regression was used to evaluate the association between patient satisfaction and survival. RESULTS The response rate for this study was 72%. Of the 496 patients, 345 (69.6%) reported being "completely satisfied" with the care provided. Median overall survival was 7.9 months. On univariate analysis, patients reporting they were "completely satisfied" experienced superior survival compared with patients stating they were "not completely satisfied" (hazard ratio = 0.62; 95% confidence interval: 0.50-0.77; P < 0.001). On multivariate analysis controlling for stage at diagnosis, treatment history, and specific CTCA treatment center, "completely satisfied" patients demonstrated significantly lower mortality (hazard ratio = 0.63; 95% confidence interval: 0.51-0.79; P < 0.001). CONCLUSION In this exploratory analysis, patient satisfaction with health service quality was an independent predictor of survival in pancreatic cancer. Further exploration of a possible meaningful relationship between patient satisfaction with the care they have received and outcome in this difficult malignancy is indicated.
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Affiliation(s)
- Digant Gupta
- Correspondence: Digant Gupta, Cancer Treatment Centers of America, 1336 Basswood Road, Schaumburg, IL, USA 60173, Tel +1 847 342 6625, Fax +1 847 342 6626, Email
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