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Pohl P, Klerfors K, Kjörk EK. Evaluation of a Digital Previsit Tool for Identifying Stroke-Related Health Problems Before a Follow-Up Visit (Part 1): Survey Study. JMIR Hum Factors 2024; 11:e55852. [PMID: 39226546 PMCID: PMC11408892 DOI: 10.2196/55852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/28/2024] [Accepted: 08/04/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND Stroke may lead to various disabilities, and a structured follow-up visit is strongly recommended within a few months after an event. To facilitate this visit, the digital previsit tool "Strokehealth" was developed for patients to fill out in advance. The concept Strokehälsa (or Strokehealth) was initially developed in-house as a Windows application, later incorporated in 1177.se. OBJECTIVE The study's primary objective was to use a patient satisfaction survey to evaluate the digital previsit tool Strokehealth when used before a follow-up visit, with a focus on feasibility and relevance from the perspective of people with stroke. Our secondary objective was to explore the extent to which the previsit tool identified stroke-related health problems. METHODS Between November 2020 and June 2021, a web-based survey was sent to patients who were scheduled for a follow-up visit after discharge from a stroke unit and had recently filled in the previsit tool. The survey covered demographic characteristics, internet habits, and satisfaction rated using 5 response options. Descriptive statistics were used to present data from both the previsit tool and the survey. We also compared the characteristics of those who completed the previsit tool and those who did not, using nonparametric statistics. Free-text responses were thematically analyzed. RESULTS All patients filling out the previsit tool (80/171; age: median 67, range 32-91 years) were community-dwelling. Most had experienced a mild stroke and reported a median of 2 stroke-related health problems (range 0-8), and they were significantly younger than nonresponders (P<.001). The survey evaluating the previsit tool was completed by 73% (58/80; 39 men). The majority (48/58, 83%) reported using the internet daily. Most respondents (56/58, 97%) were either satisfied (n=15) or very satisfied (n=41) with how well the previsit tool captured their health problems. The highest level of dissatisfaction was related to the response options in Strokehealth (n=5). Based on the free-text answers to the survey, we developed 4 themes. First, Strokehealth was perceived to provide a structure that ensured that issues would be emphasized and considered. Second, user-friendliness and accessibility were viewed as acceptable, although respondents suggested improvements. Third, participants raised awareness about being approached digitally for communication and highlighted the importance of how to be approached. Fourth, their experiences with Strokehealth were influenced by their perceptions of the explanatory texts, the response options, and the possibility of elaborating on their answers in free text. CONCLUSIONS People with stroke considered the freely available previsit tool Strokehealth feasible for preparing in advance for a follow-up visit. Despite high satisfaction with how well the tool captured their health problems, participants indicated that additional free-text responses and revised information could enhance usability. Improvements need to be considered in parallel with qualitative data to ensure that the tool meets patient needs. TRIAL REGISTRATION Researchweb 275135; https://www.researchweb.org/is/vgr/project/275135.
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Affiliation(s)
- Petra Pohl
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Karoline Klerfors
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Emma K Kjörk
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska University Hospital, Gothenburg, Sweden
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Tse MP, Dhalla I, Nayyar D. Google star ratings of Canadian hospitals: a nationwide cross-sectional analysis. BMJ Open Qual 2024; 13:e002713. [PMID: 39038856 DOI: 10.1136/bmjoq-2023-002713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 06/29/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Data on patients' self-reported hospital experience can help guide quality improvement. Traditional patient survey programmes are resource intensive, and results are not always publicly accessible. Unsolicited online hospital reviews are an alternative data source; however, the nature of online reviews for Canadian hospitals is unknown. METHODS We conducted a nationwide cross-sectional study of Canadian acute care hospitals with more than 10 Google Reviews during the 2018-2019 fiscal year. We characterised the volume and distribution of Google Reviews of Canadian hospitals, and assessed their correlation with hospital characteristics (teaching status, size, occupancy rate, length of stay, resource utilisation) and Canadian Patient Experience Survey on Inpatient Care (CPES-IC) scores. RESULTS 167 out of 523 (31.9%) acute care hospitals in Canada met the inclusion criteria. Among included hospitals, there was a total of 10 395 Google Reviews and a median of 35 reviews per hospital. The mean Google Star Rating for included hospitals was 2.85 out of 5, with a range of 1.36-4.57. Teaching hospitals had significantly higher mean Google Star Ratings compared with non-teaching hospitals (3.16 vs 2.81, p <0.01). There was a weak, positive correlation between hospitals' Google Star Ratings and CPES-IC 'Overall Hospital Experience' scores (p =0.04), but no significant correlation between Google Star Ratings and other hospital characteristics or subcategories of CPES-IC scores. INTERPRETATION There is significant interhospital variation in patients' self-reported care experiences at Canadian acute care hospitals. Online reviews can serve as a readily accessible source of real-time data for hospitals to monitor and improve the patient experience.
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Affiliation(s)
| | - Irfan Dhalla
- Unity Health Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Dhruv Nayyar
- Unity Health Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Roe S, McGahon MK, Parkinson S, Tansey E, Murphy P. A cross-disciplinary approach to learning medical physiology and behavioral skills involving drama students performing as simulated patients. ADVANCES IN PHYSIOLOGY EDUCATION 2024; 48:297-303. [PMID: 38452329 DOI: 10.1152/advan.00019.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 02/29/2024] [Accepted: 02/29/2024] [Indexed: 03/09/2024]
Abstract
The early years of physiology education in medical curricula provide unique challenges. As well as inculcating concepts that are seen as difficult, modern curricula require that students learn in context in case-based learning courses. Additionally, regulating bodies stress that the soft skills of compassion, communication, and empathy are embedded throughout curricula. This has driven work in our organization involving drama and final-year medicine students during which they collaborate in realistic simulations of doctor/patient interactions. We adapted this transdisciplinary approach to second-year physiology tutorials. This emphasized the holistic importance of physiology to patient care, while also embedding "human factors" skills from the very earliest stages of the curriculum. After preparing by attending acting classes based on aspects of Konstantin Stanislavski's "System," the authors supervised tutorials in which drama students participated in a "physiology of hypofertility" session for second-year medical students, playing a 34-year-old woman with premature menopause (or their partner). Opinion (from all students) was evaluated by Likert questionnaires (which included open questions). A focus group of drama students was also interviewed, and the conversation was recorded for thematic analysis. Positive Likert scores were recorded for the authenticity of the tutorials, skills development, fostering empathy, and motivating students to improve. All participants evaluated the tutorial as highly enjoyable. These scores are reflected in positive open commentary on the questionnaires and in the focus group interviews. The results suggest that even basic science tutorials give opportunities for interdisciplinary study and enhancement of behavioral skills while gaining enthusiastic student acceptance.NEW & NOTEWORTHY This work details how physiology tutorials for early years medical students are transformed by taking the clinical case off the two-dimensional page and instead having the case scenario acted by drama students. This adds context and authenticity. The benefits are twofold: emphasizing the importance of physiology to the budding clinician and embedding empathy and compassion from the earliest points in a clinician's career.
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Affiliation(s)
- Seán Roe
- Centre for Biomedical Sciences Education, Queen's University Belfast, Belfast, Northern Ireland
| | - Mary K McGahon
- Centre for Biomedical Sciences Education, Queen's University Belfast, Belfast, Northern Ireland
| | - Sharon Parkinson
- Centre for Biomedical Sciences Education, Queen's University Belfast, Belfast, Northern Ireland
| | - Etain Tansey
- Centre for Biomedical Sciences Education, Queen's University Belfast, Belfast, Northern Ireland
| | - Paul Murphy
- Drama Department, School of Arts, English and Languages, University Square, Queen's University Belfast, Belfast, Northern Ireland
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Pringle H, Ragatha P, Myintmo AM, Awarah H, Chung W, Bethune R. Creation of a Patient Information Video to Improve the Patient Experience of the Surgical Assessment Unit. Cureus 2024; 16:e57926. [PMID: 38725778 PMCID: PMC11079849 DOI: 10.7759/cureus.57926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Patients who attend emergency surgical services are entering an unfamiliar environment whilst often being unwell and in pain. Patient satisfaction in emergency surgical units is often low due to poor communication with attendees and long wait times. METHODS A pilot patient questionnaire identified areas where patient satisfaction was low during attendance at the surgical assessment unit (SAU). The aim of this intervention was to improve patient satisfaction with their experience whilst attending the SAU. An education video was filmed to address the areas where services were falling short of expectations, and this was played in the waiting room. Further questionnaire results tailored the frequency of the video to achieve maximum impact. RESULTS Data were collected at three time points: firstly, prior to the introduction of the video (n=34); secondly, with the video played hourly (n=15); and finally with the video played every 30 minutes at a higher volume (n=15). Mean satisfaction scores after the final cycle improved to 7.3 from 4.9 (p=0.0009). Additionally, 94% of patients agreed that the video was in keeping with their personal experience of the SAU and agreed that the video improved their understanding of what to expect from the visit. CONCLUSIONS Interventions that improve communication with patients and adjust their expectations play an important role in improving patient satisfaction and their overall perception of care. This can be achieved with a simple patient information video.
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Affiliation(s)
- Heather Pringle
- General Surgery, Torbay and South Devon NHS Foundation Trust, Exeter, GBR
| | - Pranu Ragatha
- Surgery, Royal Devon University Healthcare NHS Foundation Trust, Exeter, GBR
| | - Aye Myat Myintmo
- Surgery, Royal Devon University Healthcare NHS Foundation Trust, Exeter, GBR
| | - Hazel Awarah
- General Practice, Sherwood Forest Hospitals NHS Foundation Trust, Sutton-in-Ashfield, GBR
| | - Waihim Chung
- General Practice, Nottingham University Hospitals NHS Foundation Trust, Nottingham, GBR
| | - Rob Bethune
- Colorectal Surgery, Royal Devon University Healthcare NHS Foundation Trust, Exeter, GBR
- Colorectal Surgery, Royal Devon and Exeter Hospital, Exeter, GBR
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Zucchelli F, van Dalen M, Sharratt N, Johnson A, Chambers J. Patients' experiences of primary healthcare and dermatology provision for alopecia. SKIN HEALTH AND DISEASE 2024; 4:e324. [PMID: 38577057 PMCID: PMC10988748 DOI: 10.1002/ski2.324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 11/23/2023] [Indexed: 04/06/2024]
Abstract
Background Alopecia describes a group of dermatological conditions characterised by hair loss, which are either non-scarring or scarring in nature, and range from bald patches to complete body hair loss, to general thinning. In the UK, the General Practitioner (GP) is typically the first point of contact, and some patients are referred for specialist dermatology consultation. However, little is known about how individuals with alopecia in the UK experience the care provided by the National Health Service. Objectives We aimed to understand patients' perceptions of primary healthcare and dermatology provision. Further, we aimed to investigate how care provision and patients' overall patient journey might be improved in the UK, and how these lessons may apply internationally. Methods An online mixed methods survey was distributed by Alopecia UK to UK-based individuals with alopecia. Open-ended text responses were analysed using qualitative content analysis. Quantitative data were analysed using descriptive analyses and dependent measures t-tests. Results A total of 291 participants completed the survey. They reported neutral-to-partial dissatisfaction with their GP appointments, with greater satisfaction in their most recent compared to their first appointment. Participants highlighted positive experiences with GPs and dermatologists as well as areas for improvement. Participants also expressed a desire for a greater degree of support and understanding about the psychological impact of alopecia. Conclusions Results highlight the importance of being empathic and caring healthcare professionals for patients with alopecia, the need for training for GPs on alopecia, as well as a simplified and joined up pathway between primary and secondary healthcare.
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Affiliation(s)
- Fabio Zucchelli
- The Centre for Appearance ResearchUniversity of the West of EnglandBristolUK
| | - Marije van Dalen
- Department of Child and Adolescent Psychiatry/PsychologyErasmus MC Sophia Children's HospitalRotterdamthe Netherlands
| | - Nick Sharratt
- The Centre for Appearance ResearchUniversity of the West of EnglandBristolUK
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Rzadkiewicz M, Chylińska J. Walking in their shoes: How primary-care experiences of adults aged 50+ reveal the benefits of e-learning intervention for general practitioners. Appl Psychol Health Well Being 2023; 15:1237-1253. [PMID: 36609871 DOI: 10.1111/aphw.12434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 12/15/2022] [Indexed: 01/09/2023]
Abstract
Patient experiences and activation are increasingly researched. However, related data are limited in three areas: interventions for general practitioners (GPs) working with mature adults (50+), dedicated e-learning interventions for GPs, and assessments of e-learning for medical staff through patient experiences. We examined how e-learning intervention focused on improving GPs' skills in activating communication (understood as promoting engagement and active participation in healthcare) can enhance the experiences of mature patients. The intervention was designed for GPs, yet innovative assessment was based on patient experiences post-visit. Three research conditions for GPs (n = 165) were introduced: (1) e-learning or (2) pdf-article intervention and (3) control. Two independent waves of their patients participated before and after the intervention. Experience measures for patients (n = 1639) included the Patient Expectations Scale (post-visit), perceived GP's Communication Skills scale, and Patient Satisfaction with Visit scale. E-learning intervention compared with the control group had a favorable effect for 5 out of 8 dimensions of patient experience. Change in emotional support and quality of life was particularly visible. Mature patient experiences can be improved with the e-learning intervention for GPs. Measuring patient experience enriches the available knowledge and can help design future research and interventions.
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Affiliation(s)
- Marta Rzadkiewicz
- Department of Health Psychology, Medical University of Warsaw, Warsaw, Poland
| | - Joanna Chylińska
- Department of Health Psychology, Medical University of Warsaw, Warsaw, Poland
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Rush KL, Seaton CL, Burton L, Loewen P, O’Connor BP, Moroz L, Corman K, Smith MA, Andrade JG. Quality of life among patients with atrial fibrillation: A theoretically-guided cross-sectional study. PLoS One 2023; 18:e0291575. [PMID: 37797044 PMCID: PMC10553272 DOI: 10.1371/journal.pone.0291575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 08/31/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Patients with atrial fibrillation (AF) have significantly lower health-related quality of life (HRQoL) compared to the general population and patients with other heart diseases. The research emphasis on the influence of AF symptoms on HRQoL overshadows the role of individual characteristics. To address this gap, this study's purpose was to test an incremental predictive model for AF-related HRQoL following an adapted HRQoL conceptual model that incorporates both symptoms and individual characteristics. METHODS Patients attending an AF specialty clinic were invited to complete an online survey. Hierarchical regression analyses were conducted to examine whether individual characteristics (overall mental health, perceived stress, sex, age, AF knowledge, household and recreational physical activity) incremented prediction of HRQoL and AF treatment satisfaction beyond AF symptom recency and overall health. RESULTS Of 196 participants (mean age 65.3 years), 63% were male and 90% were Caucasian. Most reported 'excellent' or 'good' overall and mental health, had high overall AF knowledge scores, had low perceived stress scores, and had high household and recreation physical activity. The mean overall AF Effect On Quality-Of-Life Questionnaire (AFEQT) and AF treatment satisfaction scores were 70.62 and 73.84, respectively. Recency of AF symptoms and overall health accounted for 29.6% of the variance in overall HRQoL and 20.2% of the variance in AF treatment satisfaction. Individual characteristics explained an additional 13.6% of the variance in overall HRQoL and 7.6% of the variance in AF treatment satisfaction. Perceived stress and household physical activity were the largest contributors to overall HRQoL, whereas age and AF knowledge made significant contributions to AF treatment satisfaction. CONCLUSIONS Along with AF symptoms and overall health, individual characteristics are important predictors of HRQoL and AF treatment satisfaction in AF patients. In particular, perceived stress and household physical activity could further be targeted as potential areas to improve HRQoL.
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Affiliation(s)
- Kathy L. Rush
- School of Nursing, University of British Columbia, Okanagan, Kelowna, BC, Canada
| | - Cherisse L. Seaton
- School of Nursing, University of British Columbia, Okanagan, Kelowna, BC, Canada
| | - Lindsay Burton
- School of Nursing, University of British Columbia, Okanagan, Kelowna, BC, Canada
| | - Peter Loewen
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Vancouver, BC, Canada
| | - Brian P. O’Connor
- Department of Psychology, University of British Columbia, Okanagan, Kelowna, Canada
| | - Lana Moroz
- Cardiac Atrial Fibrillation Specialty Clinic, Vancouver General Hospital, Vancouver, BC, Canada
| | - Kendra Corman
- School of Nursing, University of British Columbia, Okanagan, Kelowna, BC, Canada
| | - Mindy A. Smith
- Department of Family Medicine, Michigan State University, East Lansing, Michigan, United States of America
| | - Jason G. Andrade
- Cardiac Atrial Fibrillation Specialty Clinic, Vancouver General Hospital, Vancouver, BC, Canada
- Department of Medicine, University of British Columbia, Vancouver, Canada
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Ramsey SM, Brooks J, Briggs M, Hallett CE. Voiceless and vulnerable: An existential phenomenology of the patient experience in 21st century British hospitals. Nurs Inq 2023; 30:e12588. [PMID: 37501278 DOI: 10.1111/nin.12588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023]
Abstract
Current health policy, high-profile failures and increased media scrutiny have led to a significant focus on patient experience in Britain's National Health Service (NHS). Patient experience data is typically gathered through surveys of satisfaction. The study aimed to support a better understanding of the patient experience and patients' expression of it through consideration of the aspects of the patient experience on NHS wards which are by their nature impossible to capture through patient satisfaction surveys. Existential phenomenology was used to develop an in-depth exploratory narrative, expressed through the voices of the participants. Data collection involved in-depth face-to-face interviews with 12 purposively sampled participants, with analysis by means of hermeneutics. Though the individuality of each experience was apparent and cannot be overemphasised, common factors emerging from the data included uncertainty and unexpectedness, suffering and finitude, the futility of feedback and bureaucracy and absurdity. Overall, participants demonstrated how their individual personalities and expectations affected their response both to illness or injury and to their hospital admissions, highlighting feelings of vulnerability and voicelessness as a response to hospitalisation. The findings of this study provide useful insight into the patient experience on British hospital wards, and the value of an existential-phenomenological approach is demonstrated.
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Affiliation(s)
- Sarah M Ramsey
- Trafford General Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Jane Brooks
- School of Health Sciences, The University of Manchester, Manchester, UK
| | - Michelle Briggs
- School of Health Sciences, The University of Manchester, Manchester, UK
| | - Christine E Hallett
- School of Music, Humanities and Media, The University of Huddersfield, Huddersfield, UK
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Mahlknecht A, Engl A, Piccoliori G, Wiedermann CJ. Supporting primary care through symptom checking artificial intelligence: a study of patient and physician attitudes in Italian general practice. BMC PRIMARY CARE 2023; 24:174. [PMID: 37661285 PMCID: PMC10476397 DOI: 10.1186/s12875-023-02143-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 08/29/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Rapid advancements in artificial intelligence (AI) have led to the adoption of AI-driven symptom checkers in primary care. This study aimed to evaluate both patients' and physicians' attitudes towards these tools in Italian general practice settings, focusing on their perceived utility, user satisfaction, and potential challenges. METHODS This feasibility study involved ten general practitioners (GPs) and patients visiting GP offices. The patients used a chatbot-based symptom checker before their medical visit and conducted anamnestic screening for COVID-19 and a medical history algorithm concerning the current medical problem. The entered data were forwarded to the GP as medical history aid. After the medical visit, both physicians and patients evaluated their respective symptoms. Additionally, physicians performed a final overall evaluation of the symptom checker after the conclusion of the practice phase. RESULTS Most patients did not use symptom checkers. Overall, 49% of patients and 27% of physicians reported being rather or very satisfied with the symptom checker. The most frequent patient-reported reasons for satisfaction were ease of use, precise and comprehensive questions, perceived time-saving potential, and encouragement of self-reflection. Every other patient would consider at-home use of the symptom checker for the first appraisal of health problems to save time, reduce unnecessary visits, and/or as an aid for the physician. Patients' attitudes towards the symptom checker were not significantly associated with age, sex, or level of education. Most patients (75%) and physicians (84%) indicated that the symptom checker had no effect on the duration of the medical visit. Only a few participants found the use of the symptom checker to be disruptive to the medical visit or its quality. CONCLUSIONS The findings suggest a positive reception of the symptom checker, albeit with differing focus between patients and physicians. With the potential to be integrated further into primary care, these tools require meticulous clinical guidance to maximize their benefits. TRIAL REGISTRATION The study was not registered, as it did not include direct medical intervention on human participants.
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Affiliation(s)
- Angelika Mahlknecht
- Institute of General Practice and Public Health, College of Health Care Professions (Claudiana), Lorenz Böhler Street 13, 39100, Bolzano, Italy
| | - Adolf Engl
- Institute of General Practice and Public Health, College of Health Care Professions (Claudiana), Lorenz Böhler Street 13, 39100, Bolzano, Italy
| | - Giuliano Piccoliori
- Institute of General Practice and Public Health, College of Health Care Professions (Claudiana), Lorenz Böhler Street 13, 39100, Bolzano, Italy
| | - Christian Josef Wiedermann
- Institute of General Practice and Public Health, College of Health Care Professions (Claudiana), Lorenz Böhler Street 13, 39100, Bolzano, Italy.
- Department of Public Health, Medical Decision Making and HTA, University of Health Sciences, Medical Informatics and Technology, Eduard-Wallnöfer Place 1, 6060, Hall, Austria.
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Almohaisen NA, Alsayari NM, Abid MH, Al Subhi NF, Al Masoudi A, AlGhazali OS, Woodman A. Improving patient experience by implementing an organisational culture model. BMJ Open Qual 2023; 12:bmjoq-2022-002076. [PMID: 37220993 DOI: 10.1136/bmjoq-2022-002076] [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: 08/01/2022] [Accepted: 05/07/2023] [Indexed: 05/25/2023] Open
Abstract
A satisfactory patient care culture model can help improve most patients' quality of care in a hospital. This study aims to improve patients' experiences (PX) by implementing a culture model at King Abdul-Aziz Armed Forces Hospital in Dhahran, Saudi Arabia. To achieve the research aim, a set of interventions were implemented that included a patient and family advisory council, empathy training, recognition of the PX, leadership-patient interviews, PX champions and quality improvement. These interventions were further measured using the Hospital Consumer Assessment of Healthcare Providers and Systems survey in the inpatient, outpatient and emergency departments. The improvement project was conducted in 2020, focusing mainly on transforming the culture and launching activities targeting specific touchpoints identified as priority areas. After making these changes, the hospital saw improvements in all patient relationships, with an average score across all dimensions collectively increasing by more than 4%. The quality improvement project using the PX culture model approach demonstrated significant improvements. In addition, employee involvement in patient care has become a significant factor in improving the quality of care. The critical elements for improving the PX and culture included recognising staff and creating networks across the system through effective leadership, employee engagement and engagement of patients and their families.
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Affiliation(s)
- Noha A Almohaisen
- Continuous Quality Improvement and Patient Safety, General Directorate of Health Services, Ministry of Defense, Riyadh, Saudi Arabia
| | - Nayif M Alsayari
- Continuous Quality Improvement and Patient Safety, General Directorate of Health Services, Ministry of Defense, Riyadh, Saudi Arabia
| | - Muhammad Hasan Abid
- Continuous Quality Improvement and Patient Safety, Armed Forces Hospitals Administration, Taif, Makkah, Saudi Arabia
| | - Nada Foud Al Subhi
- Patient Experience Department, Armed Forces Hospital, Dhahran, Eastern Province, Saudi Arabia
| | - Aqeel Al Masoudi
- Hospital Administration, Armed Forces Hospital, Dhahran, Eastern Province, Saudi Arabia
| | - Ohood Saad AlGhazali
- Medical Statistics Department, Armed Forces Hospital, Dhahran, Eastern Province, Saudi Arabia
| | - Alexander Woodman
- Research Department, King Fahad Medical Complex, Dhahran, Eastern Province, Saudi Arabia
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Kim MJ, Wilkins K, Gorman B. Healthcare satisfaction at the intersections of sexual orientation and race/ethnicity. ETHNICITY & HEALTH 2023; 28:601-618. [PMID: 35803900 DOI: 10.1080/13557858.2022.2096207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 06/26/2022] [Indexed: 05/05/2023]
Abstract
OBJECTIVES Existing scholarship has consistently demonstrated disparities in healthcare experience based on sexual identity. However, relatively little research has considered intersections with race/ethnicity, despite that intersection with other characteristics may complicate healthcare experiences and satisfaction among sexual minorities. This study aims to address such a gap by examining healthcare satisfaction across the intersections of sexual and racial/ethnic identity. DESIGN Utilizing data on U.S. adults included in the 2013-2018 Behavioral Risk Factor Surveillance System (BRFSS) (n = 372,766), we investigate levels of satisfaction with care among a range of groups simultaneously embodying two identities. RESULTS Findings from ordered logistic regression models show that among adults who identify as heterosexual, the odds of reporting high satisfaction with care are lower among Blacks, Asians, and Native Americans. Among sexual minority adults, the likelihood of reporting high satisfaction with care is consistently lower among Native American gay and lesbian adults compared to gays and lesbians of other race/ethnicity or Native American and White heterosexuals, indicating heightened vulnerability to poorer healthcare experience among this multiple minority group. CONCLUSION While levels of satisfaction with care tend to be generally high across groups, future research should endeavor to investigate the driving factors that lower the odds of high healthcare satisfaction among those with intersecting minority identities.
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Affiliation(s)
- Min Ju Kim
- Department of Sociology, Rice University, Houston, TX, USA
| | - Kiana Wilkins
- Department of Sociology, Rice University, Houston, TX, USA
| | - Bridget Gorman
- Department of Sociology, Rice University, Houston, TX, USA
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Nikoloski Z, Alghaith T, Herbst CH, Hamza M, AlSaffer Q, Alluhidan M, Dong D, Alsukait R, Alqasem L, Alazemi N. Responsiveness of the healthcare system in the Kingdom of Saudi Arabia: evidence from a nationally representative survey. BMC Health Serv Res 2022; 22:1524. [PMID: 36517822 PMCID: PMC9749241 DOI: 10.1186/s12913-022-08779-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 11/02/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Responsiveness is one of the widely used metrics in assessing the performance of healthcare systems. An analysis of the determinants of health care demand and supply and how the Saudi health system responds to the needs of patients (inpatient and outpatient) is needed; hence the need for this study. METHODS We analysed data from the Saudi Health Systems Responsiveness survey - a nationally representative survey of 10,000 households interviewed in 2017. Using this dataset, we descriptively analysed the level of responsiveness of inpatient and outpatient services (using the standard World Health Organization (WHO) responsiveness dimensions). Based on a logit modelling approach, the relationship between responsiveness and its key determinants was analysed in terms of healthcare demand and supply. RESULTS Over four fifths of respondents are satisfied with the level of inpatient and outpatient responsiveness. Furthermore, we find that those in bad health tend to show lower levels of satisfaction with inpatient and outpatient care. We also find some evidence that age, gender, and to some extent nationality act as correlates of health system responsiveness. Specifically, we find evidence that Saudi nationals are less satisfied with health services compared to foreign nationals. CONCLUSION Based on these findings improving the responsiveness of public healthcare facilities would need to be prioritized. Focusing on patients in worse health and lower socio-economic status should also be one of the main priorities.
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Affiliation(s)
- Zlatko Nikoloski
- grid.13063.370000 0001 0789 5319Department of Health Policy, London School of Economics and Political Science, London, UK
| | | | | | - Mariam Hamza
- grid.431778.e0000 0004 0482 9086World Bank, Washington DC, USA
| | - Quds AlSaffer
- Saudi Health Council, Riyadh, Kingdom of Saudi Arabia
| | | | - Di Dong
- grid.431778.e0000 0004 0482 9086World Bank, Washington DC, USA
| | - Reem Alsukait
- grid.431778.e0000 0004 0482 9086World Bank, Washington DC, USA ,grid.56302.320000 0004 1773 5396Department of Community Health, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Latifah Alqasem
- grid.507413.40000 0001 2178 8237Saudi Arabian Monetary Authority, Riyadh, Kingdom of Saudi Arabia
| | - Nahar Alazemi
- Saudi Health Council, Riyadh, Kingdom of Saudi Arabia
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Pow V, Iankov I, Shierlaw E, Le H. A study in patient satisfaction regarding telemedicine consultations in radiation oncology. J Med Radiat Sci 2022; 69:327-335. [PMID: 35297219 PMCID: PMC9442294 DOI: 10.1002/jmrs.577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 03/02/2022] [Accepted: 03/02/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Telemedicine consultations can be a cost-effective and convenient method of communication, particularly with patients living in remote areas. Given the dearth of patient-reported satisfaction data with this form of consultation in Radiation Oncology, we surveyed patients to assess this in our department. METHODS The study recruited patients who had experienced both a Telemedicine consultation and an in-person consultation with the same radiation oncologist at our tertiary centre in South Australia. Eligible patients were identified from the Royal Adelaide Hospital oncology information system. The patient satisfaction questionnaire was sent via registered post with a reply-paid envelope. The questionnaire consisted of 38 questions divided into four major categories, focusing on communication, medical care, privacy/confidentiality and convenience. Results of the survey were tabulated in an excel spreadsheet. RESULTS Between 1 January 2018 and 1 January 2019, 130 eligible patients were identified. One hundred and nine patients were alive and contactable of whom 37 responded (34%). Two surveys were returned incomplete resulting in 35 patient responses available for analysis. The median age was 70 years (range 35-87); 74% were male. There was no statistically significant difference between the satisfaction scores for Telemedicine and in-person consultations with regards to communication, privacy/confidentiality or overall satisfaction. The respondent felt it was more important to be examined when the consultation was conducted in-person and found Telemedicine consultations more convenient in terms of cost and time. CONCLUSION Telemedicine used in Radiation Oncology is an effective form of consultation that is convenient, provides a similar level of patient satisfaction and maintains patient confidentiality. Telemedicine consultations should therefore be considered for all rural and remote cancer patients where feasible.
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Affiliation(s)
- Vincent Pow
- Radiation Oncology DepartmentRoyal Adelaide HospitalAdelaideSouth AustraliaAustralia
| | - Ivan Iankov
- Radiation Oncology DepartmentRoyal Adelaide HospitalAdelaideSouth AustraliaAustralia
| | - Emma Shierlaw
- Radiation Oncology DepartmentRoyal Adelaide HospitalAdelaideSouth AustraliaAustralia
| | - Hien Le
- Radiation Oncology DepartmentRoyal Adelaide HospitalAdelaideSouth AustraliaAustralia
- University of South AustraliaAdelaideSouth AustraliaAustralia
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Karabatić S, Šajnić A, Pleština S, Jakopović M, Kurtović B. Croatian National Cancer Patient Experience Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148285. [PMID: 35886137 PMCID: PMC9323016 DOI: 10.3390/ijerph19148285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/01/2022] [Accepted: 07/05/2022] [Indexed: 11/23/2022]
Abstract
Background: Cancer patients’ experiences of the healthcare system, care, and treatment are increasingly viewed as important in order to inform and improve quality of care, patient safety, and treatment efficacy. Understanding patient experience is a key step in moving toward patient-centred care. The aims of this study were to determine the experience of cancer patients in Central and Eastern European countries and to identify the needs and perspectives of oncological patients during the cancer treatment. In this paper, results from Croatia are presented. Methods: A sixty-nine item online survey was translated by native-language participating countries. Only registered members (subjects with confirmed cancer diagnosis) of the national patient oncology associations in each participating country were allowed to access and complete the online questionnaire (n = 16,458). Data were collected between October 2018 to February 2019. The Croatian Coalition of Health Associations enabled the authors of this paper to use the collected data from a sample of the Croatian participants (n = 2460) for the purposes of publication. Results: Two-thirds (67.3%) of the respondents reported satisfaction with the length of time needed for getting tests done. Bad news was delivered sensitively to 52.97% of the participants, and 52.76% received a cancer treatment plan. During the hospitalisation, 45.93% responded that they did not find someone from the hospital staff whom they could talk to about their worries and fears, and 57.48% were not given any contact information in case of concerns about their condition or treatment following the discharge. Regarding the patients’ preferences, needs, and values, 60.81% of the respondents felt that the greatest improvement would be to perform all services in one place, and 55.28% felt that improvement would be achieved through a multidisciplinary team coordinated by one person. Conclusions: The study reveals domains that need to be addressed in the overall Croatian healthcare system for oncology patients. Based on the obtained data, we can conclude that there is a large need for improvement in patient experience on the oncology pathway.
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Affiliation(s)
- Sandra Karabatić
- Department for Respiratory Diseases Jordanovac, University Hospital Centre Zagreb, 10000 Zagreb, Croatia; (A.Š.); (S.P.); (M.J.)
- Croatian Association of Patients with Lung Cancer and Other Respiratory Disease Jedra, 10000 Zagreb, Croatia
- Correspondence:
| | - Andreja Šajnić
- Department for Respiratory Diseases Jordanovac, University Hospital Centre Zagreb, 10000 Zagreb, Croatia; (A.Š.); (S.P.); (M.J.)
| | - Sanja Pleština
- Department for Respiratory Diseases Jordanovac, University Hospital Centre Zagreb, 10000 Zagreb, Croatia; (A.Š.); (S.P.); (M.J.)
- School of Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Marko Jakopović
- Department for Respiratory Diseases Jordanovac, University Hospital Centre Zagreb, 10000 Zagreb, Croatia; (A.Š.); (S.P.); (M.J.)
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Biljana Kurtović
- Department of Nursing, University of Applied Health Sciences, 10000 Zagreb, Croatia;
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Persai D, Balu RK, Singh K, Prabhu RR, Lahoti S, Rout S, Panda R. Patient Satisfaction with Quality of Primary Care Health services‐findings from India. Int J Health Plann Manage 2022; 37:2256-2265. [DOI: 10.1002/hpm.3467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 02/10/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Divya Persai
- Department of Behavioral Health and Recovery Services County of San Mateo San Mateo California USA
| | - Ravi Kumar Balu
- Department of Epidemiology and Biostatistics, School of Public Health University at Albany Albany New York USA
| | | | | | | | - Sarit Rout
- Indian Institute of Public Health Bhubaneshwar Odisha India
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Sustainable Mountain-Based Health and Wellness Tourist Destinations: The Interrelationships between Tourists’ Satisfaction, Behavioral Intentions, and Competitiveness. SUSTAINABILITY 2021. [DOI: 10.3390/su132313314] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
As mountain-based health and wellness tourism increases, destination competitiveness becomes ever fiercer. The pre-visit expectations and post-visit perceptions of tourists and the tourists’ behavioral intentions are related to the competitiveness of mountain-based health and wellness tourist destinations. Using structural equation modeling (SEM), we explored the factors that affect destination competitiveness and its relationships with tourism satisfaction and tourists’ behavioral intentions to return to and to recommend the location to others. We used a questionnaire for data collection from 550 tourists who visited a mountain-based health and wellness tourist destination in Panzhihua, China. The results suggested that there is an indirect positive correlation between tourists’ satisfaction and destination competitiveness, as well as a direct positive correlation between behavioral intentions and destination competitiveness, illustrating that tourist behavioral intentions can be an important factor in destination competitiveness. In the case of Panzhihua, the tourist source market in China has provided a competitive edge to this city. In addition, considering the environment’s capacity, developing an intention to return in tourists is important for tourism marketing in view of the increasing mountain-based health and wellness tourism competitiveness and concerns about sustainability.
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El-Haddad C, Hegazi I, Hu W. A patient expectations questionnaire for determining criteria for entrustment decisions. MEDICAL TEACHER 2021; 43:1031-1038. [PMID: 33840349 DOI: 10.1080/0142159x.2021.1907324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION To train health professionals for patient-centered care, patient engagement in medical curriculum development and assessment is widely recommended. But there are few published methods on how to consult with patients effectively, particularly when creating entrustable professional activities (EPAs). In this mixed-method study, we developed a questionnaire for facilitating patient input when developing EPA assessment criteria. METHODS We developed a questionnaire for documenting patient expectations of their doctors which included: patient interviews to identify questionnaire items, expert validation, cognitive interviews with respondents, and finally, pilot testing. For the pilot testing, 87 participants with a variety of health problems from medical/surgical wards and outpatient clinics at a tertiary hospital were recruited. The final questionnaire included open-ended and ranking-style questions. RESULTS Using the questionnaire, patients could identify their key expectations of their doctors when managing their current medical problem. Most patients wrote clear, brief free-text responses directly applicable to EPA descriptors that were time-efficient to analyze. CONCLUSIONS The questionnaire is a feasible method of recording patient expectations, enabling educators to consult with and include patient perspectives when developing criteria for entrustment decisions in a diverse range of clinical contexts.
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Affiliation(s)
- Carlos El-Haddad
- Department of Rheumatology, Liverpool Hospital, Sydney, Australia
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Iman Hegazi
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Wendy Hu
- School of Medicine, Western Sydney University, Sydney, Australia
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Singleton IM, Garfinkel RJ, Malone JB, Temkit MH, Belthur MV. Determinants of caregiver satisfaction in pediatric orthopedics. J Pediatr Orthop B 2021; 30:393-398. [PMID: 32694425 DOI: 10.1097/bpb.0000000000000778] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
This study investigates determinants of pediatric orthopedic surgery patients' parent or guardian (caregiver) satisfaction with the physician in an outpatient office setting. This was a cross-sectional survey study of 200 English-speaking caregivers of pediatric patients that checked into the pediatric orthopedic clinic at the authors' institution from 1 March 2017 to 1 November 2018. Questionnaires given in clinic include the Newest Vital Sign and The Literacy in Musculoskeletal Problems survey to measure general and musculoskeletal health literacy, respectively, demographic information, expected/estimated wait time, Consultation and Relational Empathy Measure, and Consumer Assessment of Healthcare Providers and Systems Clinician and Group. After multivariate regression, only perceived physician empathy as measured by the Consultation and Relational Empathy Measure score was significantly correlated with caregiver satisfaction (P < 0.0001), accounting for 56% of the variability of caregiver satisfaction scores. The odds of a satisfaction score of at least 9 out of 10 were 21% higher for every unit increase of the Consultation and Relational Empathy Measure score [odds ratio = 1.21 (P < 0.0001)]. After logistic regression, the caregiver's gender was also correlated with patient satisfaction and the odds of a patient satisfaction score ≥9 for males was less than 1/4th that of females [odds ratio = 0.16 (P = 0.040)]. The most important determinant of caregiver satisfaction with the physician in an outpatient pediatric orthopedic setting is perceived physician empathy. This accounts for the majority of the caregiver's satisfaction. This is the first study to determine this relationship in pediatric orthopedic surgery.
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Peterson S, Young J, King V, Meadows J. Patient Expectations for Synchronous Telerehabilitation Visits: A Survey Study of Telerehabilitation-Naive Patients. Telemed J E Health 2021; 28:422-432. [PMID: 34197221 DOI: 10.1089/tmj.2021.0083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Background: The current study evaluated patient expectations for synchronous telerehabilitation. Because the coronavirus disease 2019 (COVID-19) pandemic decreased regulatory barriers and increased accessibility of telehealth, improved understanding of expectations may direct future educational efforts, improve implementation strategies, and inform future analyses of consumer adoption and utilization of telehealth. Methods: A cross-sectional survey design was used to measure ideal expectations (what they want to happen) and realistic expectations (what they think will happen) of telerehabilitation-naive patients for synchronous telerehabilitation. Participants were recruited through e-mail and social media and in person from seven outpatient private practice physical therapy clinics across the United States. Patients completed an online anonymous adaptation of the Patients' Expectations Questionnaire (PEQ) and were asked whether they expected synchronous telerehabilitation to benefit them personally. Open-ended responses were collected and analyzed for categories and themes. Results: Of 178 participants, the greatest mean difference between ideal and realistic expectations among PEQ subscales was for outcomes (0.49; 95% confidence interval [CI], 0.37-0.60), and the greatest mean difference among individual items was for symptom reduction (0.53; 95% CI, 0.41-0.66). Although participants appeared to appreciate the value of telerehabilitation visits, with 69.7% indicating that it would benefit them personally, many expressed a preference for face-to-face visits when possible. Discussion: Expectations were mostly positive. Lower outcomes expectations may be a potential barrier to adoption and utilization of telehealth and other types of digital physical therapy in some patients. Conclusions: To improve beliefs and address potential barriers, physical therapy clinicians should discuss expectations with patients before recommending telerehabilitation visits.
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Affiliation(s)
- Seth Peterson
- The Motive Physical Therapy Specialists, Oro Valley, Arizona, USA.,Arizona School of Health Sciences, A.T. Still University, Mesa, Arizona, USA
| | - Jodi Young
- Arizona School of Health Sciences, A.T. Still University, Mesa, Arizona, USA
| | - Visnja King
- King Physical Therapist North Huntingdon, North Huntingdon, Pennsylvania, USA.,Department of Physical Therapy, South College, Knoxville, Tennessee, USA
| | - Jeff Meadows
- AntiFragile Physical Therapy, Asheville, North Carolina, USA
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Expectations, values, preferences and experiences of Hungarian primary care population when accessing services: Evaluation of the patient's questionnaires of the international QUALICOPC study. Prim Health Care Res Dev 2021; 22:e23. [PMID: 34060439 PMCID: PMC8220346 DOI: 10.1017/s1463423620000596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background: Preferences and wishes of patients is an important indicator of primary health care
provision, although there are differences between national primary care systems. Aim: The aim of this paper is to describe and evaluate the preferences and values of
Hungarian primary care (PC) patients before accessing and to analyse their experiences
after attending PC services. Methods: In the Hungarian arm of the European QUALICOPC Study, in 2013–2014,
information was collected with questionnaires; the Patient Values
contained 19 and the Patient Experiences had 41 multiple-choice
questions. Findings: The questionnaires were filled by 2149 (840 men, 1309 women) using PC services, aged
49.1 (SD ± 16.7) years, 73% of them having chronic morbidities. Women preferred to be
accompanied and rated their own health better. Patients in the lowest educational
category and women visited their GPs more often, and they are consulted more frequently
by other doctors as well. Men, older and secondary educated people reported more
frequently chronic morbidities. Longer opening hours were preferred by patients with
higher education. The most preferred expectations were availability and polite
communication of doctors, not pressures on consultation time, clear instructions
provided during consultations, shared decisions about treatments and options for
consultations, the knowledge of the doctors concerning the living conditions, social and
cultural backgrounds of patients, updated medical records, short waiting times, options
for home visits, wide scope of professional competences and trust in the doctor. Conclusion: Wishes, preferences of patients and fulfilment were similar than described in other
participating countries of the study. Although there are room to improve PC services,
most of the questioned population were satisfied with the provision.
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Tripodi N, Garrett A, Savic D, Sadrani K, Robertson L, Volarich S, Sirgiovanni T. Patient expectations of manual and non-manual therapy within an osteopathic consultation: A cross sectional study. INT J OSTEOPATH MED 2021. [DOI: 10.1016/j.ijosm.2020.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Naoum S, Konstantinidis TI, Spinthouri M, Mitseas P, Sarafis P. Patient Satisfaction and Physician Empathy at a Hellenic Air Force Health Service. Mil Med 2021; 186:1029-1036. [PMID: 33608724 DOI: 10.1093/milmed/usab060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 12/10/2020] [Accepted: 02/04/2021] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Patient satisfaction and physician empathy are important indicators of health care services quality. The purpose of this study is to investigate the factors related to the health care users' perception about physician empathy and their satisfaction with the services offered by the Medical Department of a Hellenic Air Force Combat Wing Health Service. MATERIALS AND METHODS One hundred and twenty six individuals who randomly visited the Medical Department from January to February 2019 participated in the survey. The "Measuring the satisfaction of visitors to hospital outpatient clinics" questionnaire by Aletras et al. and the Greek version of the "Jefferson Scale of Patient Perceptions of Physician Empathy" questionnaire were used for data collection. RESULTS High satisfaction scores were found in relation to the medical staff (mean 20.45, max 25), the examination room (mean 18.23, max 25), the nursing staff/secretarial support (mean 16.93, max 25), and the overall satisfaction (mean 17.15, max 25). The satisfaction score related to the infirmary was low (mean score 8.8, max 25). Physician empathy score was extremely high (mean 21.2, max 25). Statistically significant correlations were detected between physician empathy satisfaction score and the medical staff, nursing staff/secretarial support, and the overall satisfaction scores (P < .001). CONCLUSION Health care users reported high physician empathy and overall satisfaction scores but low infirmary satisfaction scores. The more positively that patients evaluated physician empathy, the more satisfaction that patients had with other measures.
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Affiliation(s)
- Symeon Naoum
- 251 Air Force General Hospital, Orthopedic Department, Athens, Attiki 115 25, Greece
| | | | - Maria Spinthouri
- Department of Nursing, Venizeleio Pananeio General Hospital of Heraklion, Heraklion, Crete 714 09, Greece
| | - Panagiotis Mitseas
- Department of Social Sciences, Hellenic Open University, Achaia, Patras 263 35, Greece
| | - Pavlos Sarafis
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol 3036, Cyprus
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Rothschild CW, Brown W, Drake AL. Incorporating Method Dissatisfaction into Unmet Need for Contraception: Implications for Measurement and Impact. Stud Fam Plann 2021; 52:95-102. [PMID: 33595116 PMCID: PMC8048066 DOI: 10.1111/sifp.12146] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
While unmet need for contraception is commonly used to assess programmatic needs, it inadequately captures the complexity of fertility and contraceptive preferences, including women's satisfaction with their contraceptive method. In their 2019 commentary, Sarah Rominski and Rob Stephenson propose reclassifying dissatisfied current users as having an unmet need for contraception. As revising the current definition based on their proposal would require significant investment to update survey and monitoring systems, understanding the potential impact on current estimates of unmet need is critical. We estimated the impact of this approach in a Kenyan cohort of modern contraceptive users. We found the prevalence of method dissatisfaction ranges from 6.6% (95% confidence interval [CI] 5.6–7.8%) to 18.9% (95% CI 17.1–20.9%); if applied nationally, this results in a large (approximately 25–70%) increase in Kenya's current estimate of unmet need for any contraception. Our findings suggest a large impact on unmet need estimates for equivalent populations. Overall, we advocate for better measurements of method satisfaction and acceptability, with metrics developed that are robust to socioeconomic gradients and validated in low‐ and middle‐income settings to ensure women's contraceptive needs are captured equitably.
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Affiliation(s)
- Claire W Rothschild
- Claire W. Rothschild, Department of Epidemiology, University of Washington, Seattle, USA
| | - Win Brown
- Win Brown, The Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Alison L Drake
- Alison L. Drake, Department of Global Health, University of Washington, Seattle, USA
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Huércanos-Esparza I, Antón-Solanas I, Orkaizagirre-Gómara A, Ramón-Arbués E, Germán-Bes C, Jiménez-Navascués L. Measuring invisible nursing interventions: Development and validation of Perception of Invisible Nursing Care-Hospitalisation questionnaire (PINC-H) in cancer patients. Eur J Oncol Nurs 2020; 50:101888. [PMID: 33341497 DOI: 10.1016/j.ejon.2020.101888] [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: 04/05/2020] [Revised: 12/04/2020] [Accepted: 12/06/2020] [Indexed: 10/22/2022]
Abstract
Visible nursing work is usually associated with formal work and physician-delegated tasks which are protocolised and usually well documented. Nevertheless, nurses carry out many actions and display specific attitudes and behaviours which, despite contributing to the well-being, recovery of patients and satisfaction with the attention received, are not as visible. Previous studies have been conducted in order to define 'invisible nursing interventions', but no quantitative instruments focused on measuring invisible nursing interventions have been found in the literature. PURPOSE To test the psychometric properties of the Perception of Invisible Nursing Care-Hospitalisation (PINC-H) questionnaire. METHODS Cross-sectional survey design. A self-administered questionnaire was completed by 381 participants recruited consecutively after discharge from a Spanish hospital. Data were collected from 2012 to 2020. RESULTS Three factors were identified from exploratory factor analysis, namely 'Caring for the person', 'Caring for the environment and the family' and 'Caring presence'. Criterion Validity Coefficient was highly significant (p < 0.001) with values ranging between 0.63 and 0.71. Cronbach's alpha was 0.96. Test-retest reliability was estimated in a subsample of 187 participants; in all the items, correlation coefficients were highly significant (p < 0.001) and within range (0.532-0.811) with a mean value of 0.680. Also, correlations between each dimension and the complete questionnaire indicated good temporal stability between measurements. CONCLUSIONS The instrument had satisfactory validity and reliability. PINC-H can contribute to highlight nursing interventions and behaviours which are often unseen and, thus, less valued. We argue that PINC-H will also be useful to evaluate the quality of invisible nursing care to oncology inpatients.
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Affiliation(s)
- Isabel Huércanos-Esparza
- Department of Nursing, Faculty of Health Sciences, San Jorge University, Autovía Mudéjar Km. 299, Villanueva de Gállego, Zaragoza, 50830, Spain; Clinical Research Unit coordinator, Hospital Clínico Universitario Lozano Blesa, Avda. San Juan Bosco, 15, Zaragoza, Zaragoza, 50009, Spain.
| | - Isabel Antón-Solanas
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, Zaragoza, Zaragoza, 50009, Spain.
| | - Aintzane Orkaizagirre-Gómara
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, Begiristain Doktorea Pasealekua, 105, Donostia-San Sebastián, Gipuzkoa, 20014, Spain
| | - Enrique Ramón-Arbués
- Department of Nursing, Faculty of Health Sciences, San Jorge University, Autovía Mudéjar Km. 299, Villanueva de Gállego, Zaragoza, 50830, Spain
| | - Concepción Germán-Bes
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, Zaragoza, Zaragoza, 50009, Spain
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Indicators of an Integrated Home Care Model Shaped by the Needs of Patients Discharged from the Emergency Department. Int J Integr Care 2020; 20:16. [PMID: 33335458 PMCID: PMC7716787 DOI: 10.5334/ijic.5480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introduction: Developing community care models aims to satisfy the needs of patients’ in-home care comprehensively. This is crucial to decrease adverse events and prevent rehospitalization. Methods: A cross-sectional study was conducted among 200 emergency department patients (EDPs) and 200 general practice patients (GPPs). The modified version of the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS), the Health Behavior Inventory (HBI), the Generalized Self-Efficacy Scale (GSES), the Patient Satisfaction Questionnaire (PSQ), and the Multidimensional Health Locus of Control Scale (MHLCS) were used. Results: The study indicated the higher level of unmet needs in EDPs than in the population of GPPs (p = 0.008). The unmet needs increased risk of hospitalization in both groups: OR = 0.28 [95%CI 0.15–0.52] for EDP and OR = 0.33, [95%CI 0.17–0.62] for GPPs groups. We also found a significant relationship between the low levels of needs satisfaction and social-demographic variables, including health profile and the level of health behavior, generalized self-efficacy, health locus of controls, and healthcare measures in general practice. Discussion and Conclusion: We suggest that the identified factors should be included into the integrated community care model to advance satisfaction of patients’ needs, especially in patients discharged from an emergency department.
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Butterworth J, Richards S, Warren F, Pitchforth E, Campbell J. Randomised feasibility trial and embedded qualitative process evaluation of a new intervention to facilitate the involvement of older patients with multimorbidity in decision-making about their healthcare during general practice consultations: the VOLITION study protocol. Pilot Feasibility Stud 2020; 6:161. [PMID: 33117558 PMCID: PMC7586675 DOI: 10.1186/s40814-020-00699-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 09/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The number of older people with multiple health problems is increasing worldwide. This creates a strain on clinicians and the health service when delivering clinical care to this patient group, who themselves carry a large treatment burden. Despite shared decision-making being acknowledged by healthcare organisations as a priority feature of clinical care, older patients with multimorbidity are less often involved in decision-making when compared with younger patients, with some evidence suggesting associated health inequalities. Interventions aimed at facilitating shared decision-making between doctors and patients are outdated in their assessments of today's older patient population who need support in prioritising complex care needs in order to maximise quality of life and day-to-day function. AIMS To undertake feasibility testing of an intervention ('VOLITION') aimed at facilitating the involvement of older patients with more than one long-term health problem in shared decision-making about their healthcare during GP consultations.To inform the design of a fully powered trial to assess intervention effectiveness. METHODS This study is a cluster randomised controlled feasibility trial with qualitative process evaluation interviews. Participants are patients, aged 65 years and above with more than one long-term health problem (multimorbidity), and the GPs that they consult with. This study aims to recruit 6 GP practices, 18 GPs and 180 patients. The intervention comprises two components: (i) a half-day training workshop for GPs in shared decision-making; and (ii) a leaflet for patients that facilitate their engagement with shared decision-making. Intervention implementation will take 2 weeks (to complete delivery of both patient and GP components), and follow-up duration will be 12 weeks (from index consultation and commencement of data collection to final case note review and process evaluation interview). The trial will run from 01/01/20 to 31/01/21; 1 year 31 days. DISCUSSION Shared decision-making for older people with multimorbidity in general practice is under-researched. Emerging clinical guidelines advise a patient-centred approach, to reduce treatment burden and focus on quality of life alongside disease control. The systematic development, testing and evaluation of an intervention is warranted and timely. This study will test the feasibility of implementing a new intervention in UK general practice for future evaluation as a part of routine care. TRIAL REGISTRATION CLINICAL TRIALS.GOV registration number NCT03786315, registered 24/12/18.
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Affiliation(s)
- Joanne Butterworth
- Exeter Collaboration for Academic Primary Care (APEx), University of Exeter Medical School, Room 110, Smeall building, St Luke’s campus, Magdalen Road, Exeter, EX1 2LU UK
| | - Suzanne Richards
- Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK
| | - Fiona Warren
- Exeter Collaboration for Academic Primary Care (APEx), University of Exeter Medical School, Room 110, Smeall building, St Luke’s campus, Magdalen Road, Exeter, EX1 2LU UK
| | - Emma Pitchforth
- Exeter Collaboration for Academic Primary Care (APEx), University of Exeter Medical School, Room 110, Smeall building, St Luke’s campus, Magdalen Road, Exeter, EX1 2LU UK
| | - John Campbell
- Exeter Collaboration for Academic Primary Care (APEx), University of Exeter Medical School, Room 110, Smeall building, St Luke’s campus, Magdalen Road, Exeter, EX1 2LU UK
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Schultz DM, Orhurhu V, Khan F, Hagedorn JM, Abd‐Elsayed A. Patient Satisfaction Following Intrathecal Targeted Drug Delivery for Benign Chronic Pain: Results of a Single-Center Survey Study. Neuromodulation 2020; 23:1009-1017. [PMID: 32378289 PMCID: PMC7687151 DOI: 10.1111/ner.13167] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/25/2020] [Accepted: 04/06/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Targeted Drug Delivery (TDD) is commonly used for the management of patients with intractable pain. Past studies have proven efficacy in pain relief and reduction in opioid use and cost-effectiveness in long-term pain management. There are few studies investigating satisfaction among patients with implanted pain pumps that are managed with targeted intrathecal medications. MATERIAL AND METHODS Patients in a single medical practice implanted with pain pumps for relief of intractable pain were identified and extracted from the electronic health record (EHR). Six hundred and ten active TDD patients were identified and an anonymous 18-question survey was administered to determine satisfaction with TDD therapy. During an 18-month period from May 2018 to August 2019, patients were invited to take a satisfaction survey. Both primary and secondary outcomes were reported as proportions; P < 0.05 was considered significant. RESULTS Four hundred and forty-three patients (74% of the active pump population) completed the survey. The majority of patients reported improvement in pain, improvement of physical function, improvement in quality of life and reduction in opioid use. Complete discontinuation of oral opioid intake was reported in 38.9% of patients. The majority of patients had a 40 cc reservoir implanted in an upper buttock pocket site and overall, 91% of patients were happy with pump pocket location. CONCLUSION Intrathecal TDD therapy can relieve pain and improve quality of life in patients with intractable pain and offers a reasonable alternative to long-term oral or skin patch opioid management. Patients utilizing TDD therapy reported high degrees of satisfaction.
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Affiliation(s)
- David M. Schultz
- Nura Pain ClinicMinneapolisMNUSA
- Department of AnesthesiologyUniversity of MinnesotaMinneapolisMNUSA
| | - Vwaire Orhurhu
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General HospitalHarvard Medical SchoolBostonMAUSA
| | - Faizan Khan
- Department of Neurology, Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA
| | - Jonathan M. Hagedorn
- Department of Anesthesiology and Perioperative MedicineDivision of Pain Medicine, Mayo ClinicRochesterMNUSA
| | - Alaa Abd‐Elsayed
- Department of AnesthesiologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWIUSA
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Moucheraud C, McBride K. Variability in Health Care Quality Measurement among Studies Using Service Provision Assessment Data from Low- and Middle-Income Countries: A Systematic Review. Am J Trop Med Hyg 2020; 103:986-992. [PMID: 32588806 PMCID: PMC7470535 DOI: 10.4269/ajtmh.19-0644] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 05/19/2020] [Indexed: 12/31/2022] Open
Abstract
Quality of care is essential for improving health outcomes, but heterogeneity in theoretical frameworks and metrics can limit studies' generalizability and comparability. This research aimed to compare definitions of care quality across research articles that incorporate data from Service Provision Assessment (SPA) surveys. Following Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, we used a keyword search in PubMed. Each author reviewed abstracts, then full texts, for inclusion criteria, and peer-reviewed publications of empirical analysis using SPA data. The search yielded 3,250 unique abstracts, and 34 publications were included in the final analysis. We extracted details on the SPA dataset(s) used, theoretical framework applied, and how care quality was operationalized. The 34 included articles used SPA data from 14 surveys in nine countries (all in sub-Saharan Africa plus Haiti). One-third of these articles (n = 13) included no theoretical or conceptual framework for care quality. Among those articles referencing a framework, the most common was the Donabedian model (n = 7). Studies operationalized quality constructs in extremely different ways. Few articles included outcomes as a quality construct, and the operationalization of structure varied widely. A key asset of SPA surveys, owing to the standardized structure and use of harmonized data collection instruments, is the potential for cross-survey comparisons. However, this is limited by the lack of a common framework for measuring and reporting quality in the existing literature using SPA data. Service Provision Assessment surveys offer unique and valuable insights, and a common framework and approach would substantially strengthen the body of knowledge on quality of care in low-resource settings.
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Affiliation(s)
- Corrina Moucheraud
- Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California
| | - Kaitlyn McBride
- Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California
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Brancazio S, Eskildsen SM, Abimbola F, Olcott CW, Kamath GV, Del Gaizo DJ. Unmet Patient Expectations for Interventions Decrease Provider Satisfaction Scores. Orthopedics 2020; 43:e378-e382. [PMID: 32602914 DOI: 10.3928/01477447-20200619-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 05/21/2019] [Indexed: 02/03/2023]
Abstract
As health care reimbursement evolves, physicians will continue to be evaluated based on the quality of care that they provide. One measure of quality is based on patient satisfaction as reported through the Consumer Assessment of Healthcare Providers and Systems Survey (CAHPS). Although previous studies have explored expectations and their role in patient satisfaction, no studies have investigated the role of patient expectations for interventions in surgical specialty clinics. Patients (N=126) were given 2 surveys, a pre-visit and a post-visit questionnaire, with options based on the CAHPS survey. Patients were asked to select common orthopedic services that they expected to receive from their appointments, rate their physicians on Likert scales, and report the services that were actually provided. Patients who left with unmet expectations for interventions (45%) rated their physicians lower than patients who had all of their expectations met (9.0±1.4 vs 9.5± 0.8; P<.05). For most individual interventions, there was no difference in satisfaction between patients with met and unmet expectations. However, patients who expected surgery and did not have their expectations met rated their physician lower than patients whose expectations for surgery were met (9.0±1.3 vs 9.7±0.6; P<.05). No statistically significant difference was found in physician rating with increased numbers of unmet expectations, individual surgeon rating, perceptions of their providers, and wait time. This study reports that patient expectations for interventions, and particularly a recommendation for surgery, may alter a patient's reported satisfaction, particularly when surgical expectations are unmet. [Orthopedics. 2020;43(5):e378-e382.].
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Mortensen B, Borkowski N, O'Connor SJ, Patrician PA, Weech-Maldonado R. The Relationship Between Hospital Interdepartmental Transfers and Patient Experience. J Patient Exp 2020; 7:263-269. [PMID: 32851150 PMCID: PMC7427363 DOI: 10.1177/2374373519836467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study examined the association between interdepartmental transfers and the perceptions of care received by adult patients who were admitted and discharged from a 300-bed, not-for-profit community tertiary hospital in the Midwest. Transfers of patient care are daily and frequent hospital processes. However, limited attention has focused on the effect that intrahospital transfers of care have on the patient experience. Understanding this relationship is important, since value-based purchasing models directly tie patient experience measures into hospital reimbursements. The key finding of this study indicates that as patients' transfers increase, their perceptions of care decrease. Therefore, by reducing the frequency of interdepartmental transfers, patient satisfaction may increase. This research provides clinicians and administrators a better understanding of the relationship between a frequent and a daily hospital process (ie, interdepartmental transfers) and its influence on patients' perceptions of their experience.
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Affiliation(s)
- Betty Mortensen
- President of Innovative Healthcare Solutions, LLC, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nancy Borkowski
- President of Innovative Healthcare Solutions, LLC, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Stephen J O'Connor
- President of Innovative Healthcare Solutions, LLC, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Patricia A Patrician
- President of Innovative Healthcare Solutions, LLC, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Robert Weech-Maldonado
- President of Innovative Healthcare Solutions, LLC, University of Alabama at Birmingham, Birmingham, AL, USA
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Patients' satisfaction associated with portable coagulometers for warfarin monitoring: a cross-sectional study. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2020; 18:386-395. [PMID: 32530403 DOI: 10.2450/2020.0005-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 04/07/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND The use of point-of-care (POC) coagulometers for monitoring patients on vitamin K antagonist (VKA) treatment makes international normalised ratio (INR) results immediately available. The aim of this study was to compare patients' satisfaction with VKA treatment in two settings characterised by distinct ways of monitoring: POC INR versus laboratory INR. MATERIALS AND METHODS We recruited adult patients on long-term warfarin treatment (July 2017-February 2018) from the Anticoagulation Clinics at five district health centres (namely Cospicua, Floriana, Mosta, Qormi, Rabat-POC INR) and at Mater Dei Hospital (Msida - Laboratory INR) in Malta. We administered two psychometric questionnaires: the Duke Anticoagulation Satisfaction Scale (DASS) (range 25-175, lower scores corresponding to higher satisfaction) and the Perception of Anticoagulation Treatment Questionnaire (PACT-Q2) (range 0-100, higher scores corresponding to higher satisfaction). RESULTS We analysed 313 questionnaires (POC INR n=159, laboratory INR n=154). In the POC INR cohort, median age was 72 years and 59.1% were males; in the laboratory INR cohort, median age was 70.5 years and 46.1% were males. The POC INR cohort obtained significantly lower overall DASS score (p<0.001) and significantly higher PACT-Q2 scores (p<0.001 for the subscale "convenience"; p=0.039 for the subscale "anticoagulant treatment satisfaction") than the laboratory INR cohort. In multiple regression analysis, the use of POC coagulometers was significantly associated with the overall DASS score (p=0.013) and the PACT-Q2 convenience score (p=0.012). DISCUSSION Patients on warfarin treatment were generally satisfied. Patients monitored with the POC INR with a dedicated time slot reported less inconvenience and burdens and better psychological impact than patients monitored with the traditional laboratory INR.
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El-Haddad C, Hegazi I, Hu W. Understanding Patient Expectations of Health Care: A Qualitative Study. J Patient Exp 2020; 7:1724-1731. [PMID: 33457636 PMCID: PMC7786689 DOI: 10.1177/2374373520921692] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Understanding and measuring patient expectations of health care is central to improving patient satisfaction and delivering patient-centered care. However, most empiric research in this field has focused on measuring patient expectations for specific diseases only. Patient expectations common to a variety of settings and clinical contexts need to be better understood to design measures with wider utility. We aimed to understand how patients express and conceptualize their expectations of health care across a range of clinical contexts and conditions. Semi-structured interviews were conducted with patients presenting to a major metropolitan hospital, informed by interpretive phenomenological analysis. Sampling continued until thematic saturation. Interview topics explored the illness experience, interactions with clinicians, how patients communicated and conceptualized their expectations of health care, and the nature of these expectations. The 26 participants conceptualized and described their expectations in 3 distinct domains: (1) health outcomes, (2) individual clinicians, and (3) the health-care system. Importantly, these domains were consistent across a variety of clinical contexts, participant demographics, and medical conditions. Despite variation in expectations due to individual patient circumstances, we identified 3 conceptual domains within which expectations consistently lie. When designing measurement tools for patient expectations, we suggest incorporating questions specifically addressing the 3 domains we have identified. With such measures, clinicians and health-care providers can be empowered to provide and monitor patient-centered care with outcomes tailored to what patients desire.
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Affiliation(s)
- Carlos El-Haddad
- School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
| | - Iman Hegazi
- Medical Education & Academic Program, School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
| | - Wendy Hu
- Medical Education, School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
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Zakare-Fagbamila RT, Howell E, Choi AY, Cheng TZ, Clement M, Neely M, Gottfried ON. Clinic Satisfaction Tool Improves Communication and Provides Real-Time Feedback. Neurosurgery 2020; 84:908-918. [PMID: 29669027 DOI: 10.1093/neuros/nyy137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 03/22/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patient-reported assessments of the clinic experience are increasingly important for improving the delivery of care. The Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) survey is the current standard for evaluating patients' clinic experience, but its format gives 2-mo delayed feedback on a small proportion of patients in clinic. Furthermore, it fails to give specific actionable results on individual encounters. OBJECTIVE To develop and assess the impact of a single-page Clinic Satisfaction Tool (CST) to demonstrate real-time feedback, individualized responses, interpretable and actionable feedback, improved patient satisfaction and communication scores, increased physician buy-in, and overall feasibility. METHODS We assessed CST use for 12 mo and compared patient-reported outcomes to the year prior. We assessed all clinic encounters for patient satisfaction, all physicians for CG-CAHPS global rating, and physician communication scores, and evaluated the physician experience 1 yr after implementation. RESULTS During implementation, 14 690 patients were seen by 12 physicians, with a 96% overall CST utilization rate. Physicians considered the CST superior to CG-CAHPS in providing immediate feedback. CG-CAHPS global scores trended toward improvement and were predicted by CST satisfaction scores (P < .05). CG-CAHPS physician communication scores were also predicted by CST satisfaction scores (P < .01). High CST satisfaction scores were predicted by high utilization (P < .05). Negative feedback dropped significantly over the course of the study (P < .05). CONCLUSION The CST is a low-cost, high-yield improvement to the current method of capturing the clinic experience, improves communication and satisfaction between physicians and patients, and provides real-time feedback to physicians.
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Affiliation(s)
| | | | - Ashley Y Choi
- School of Medicine, Duke University, Durham, North Carolina
| | - Tracy Z Cheng
- School of Medicine, Duke University, Durham, North Carolina
| | - Mary Clement
- Department of Musculoskeletal and Spine Services, Duke University Medical Center, Durham, North Carolina
| | - Megan Neely
- Depart-ment of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina
| | - Oren N Gottfried
- Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina
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Song HJ, Dennis S, Levesque JF, Harris MF. What do consumers with chronic conditions expect from their interactions with general practitioners? A qualitative study of Australian consumer and provider perspectives. Health Expect 2020; 23:707-716. [PMID: 32207220 PMCID: PMC7321729 DOI: 10.1111/hex.13050] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/25/2020] [Accepted: 03/03/2020] [Indexed: 12/26/2022] Open
Abstract
Background More than half of Australian adults manage one or more chronic conditions through ongoing interactions with general practitioners (GPs). Their experience of general practice interactions has important implications for their health outcomes and is thus important to explore in‐depth. Consumer expectations have emerged as a key consideration in this regard. How well they met in care settings can inform consumers' satisfaction and response to the care received. However, consumer expectations in Australian general practice are not well researched. Objective To identify key consumer expectations in clinical interactions in Australian general practice based on consumer and GP perspectives. Design Qualitative, phenomenological approach using thematic analysis of semi‐structured interviews. Setting and participants Thirty‐one participants: 18 patients with one or more chronic (persisting > 6 months) conditions, 10 GPs and 3 GP registrars in Sydney, Australia. Results Consumer expectations were strongly related to the context of their ongoing therapeutic relationship with a regular GP. Themes relating to some of the most commonly reported consumer expectations were as follows: (a) the importance of longevity and continuity; (b) having good rapport; (c) GP's respect for consumer opinions and expertise; (d) having effective communication; and (e) addressing mental health. Conclusion Australian GPs and consumers prioritize a positive, long‐term clinical relationship in which they respect one another and can communicate their expectations freely. This has implications for consumer satisfaction and in turn ensuring relational continuity, which is particularly relevant to the ongoing care and management of consumers with chronic conditions.
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Affiliation(s)
- Hyun Jung Song
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia
| | - Sarah Dennis
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia.,Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia.,Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Jean-Frédéric Levesque
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia.,Agency for Clinical Innovation, Chatswood, NSW, Australia
| | - Mark Fort Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia
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Fix WC, Miller CJ, Etzkorn JR, Shin TM, Howe N, Sobanko JF. Comparison of Accuracy of Patient and Physician Scar Length Estimates Before Mohs Micrographic Surgery for Facial Skin Cancers. JAMA Netw Open 2020; 3:e200725. [PMID: 32159810 PMCID: PMC7066479 DOI: 10.1001/jamanetworkopen.2020.0725] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
IMPORTANCE Patients are satisfied when surgical outcomes meet their expectations. Dissatisfaction with surgical scars is one of the most common reasons that patients sue surgeons who perform Mohs micrographic surgery (MMS). OBJECTIVE To measure the accuracy of patient and physician estimations of scar length prior to skin cancer removal with MMS. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study was conducted between December 1, 2017, and February 28, 2018, at the MMS clinic of a single tertiary referral center health system. A total of 101 adults presenting for MMS for treatment of facial skin cancers volunteered for this study, and 86 surgeons who performed the MMS procedure participated. MAIN OUTCOMES AND MEASURES Patients and physicians independently drew the anticipated scar length on the patients' skin prior to surgery. Preoperative estimates by patients and surgeons were compared with actual postoperative scar length. RESULTS Of the 101 patients who participated, 57 patients (56.4%) were men and 57 patients (56.4%) were aged 65 years or older. Eighty-four patients (83.2%) underestimated scar length, whereas 67 of the 86 surgeons (77.9%) correctly estimated the scar length (P < .001). The actual postoperative scar length was 2.2 (interquartile range, 1.5-3.6) times larger than the patients' preoperative estimate but only 1.1 (interquartile range, 1.0-1.2) times larger than the surgeons' preoperative estimate (P < .001). Preoperative consultation with the surgeon, a personal history of MMS, or patient-directed research about MMS were not associated with improvement of patients' estimations of scar length. CONCLUSIONS AND RELEVANCE This study's findings suggest that patients with facial skin cancers have unrealistic expectations regarding scars that measure, on average, less than half the length of the actual postoperative scars. Surgeons appear to accurately estimate the length of most surgical scars and have an opportunity to set realistic patient expectations about scar length before surgery.
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Affiliation(s)
- William C. Fix
- Medical student at time of writing, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | | | - Jeremy R. Etzkorn
- Department of Dermatology, University of Pennsylvania Health System, Philadelphia
| | - Thuzar M. Shin
- Department of Dermatology, University of Pennsylvania Health System, Philadelphia
| | - Nicole Howe
- Department of Dermatology, University of Pennsylvania Health System, Philadelphia
| | - Joseph F. Sobanko
- Department of Dermatology, University of Pennsylvania Health System, Philadelphia
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Duan L, Mukherjee EM, Federman DG. The physical examination: a survey of patient preferences and expectations during primary care visits. Postgrad Med 2020; 132:102-108. [PMID: 31928276 DOI: 10.1080/00325481.2020.1713618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Little is known about patient preference regarding the physical exam in non-urgent primary care settings.Objective: To determine the differences between a patient's expectations of the physical exam and the actual components of the physical examination performed during a non-urgent visit.Design: A total of 452 surveys administered in the waiting room of a VA primary care clinic in West Haven, CT.Key results: The response rate was 91.6% (n = 414). For 15 of 16 maneuvers on the survey, more respondents believed a reasonable provider should conduct it than received it at their annual physical exam; for 7 of them (breast, axillary, rectal, pelvic, total body skin exam, electrocardiogram, and stress test), over twice as many respondents believed they should be done than received them. There was an association between a patient's perception of their primary care provider and the number of maneuvers recalled at their annual exam (P < 0.001), and a gap in the number of maneuvers expected from a reasonable provider by nonwhite and white patients (P < 0.001).Limitations: Convenience sample, response bias (healthy patients are more likely to respond) and recall bias.Conclusion: Patient perception of their primary care provider is strongly associated with the number of maneuvers recalled during an annual physical. Furthermore, the number of maneuvers expected by a patient is influenced by race, with nonwhite patients desiring more. This suggests the need for further research on the role of race in the expectations of healthcare providers.
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Affiliation(s)
- Linna Duan
- Department of Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Eric Milan Mukherjee
- Department of Medicine, Yale University Waterbury Hospital Health Center, Waterbury, CT, USA
| | - Daniel Glenn Federman
- Department of Medicine, Yale School of Medicine, New Haven, CT, USA.,Department of Medicine, VA Connecticut Healthcare System, West Haven, CT, USA
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Almehman BA, Mikwar Z, Balkhy A, Jabali H, Hariri BS, Baatiah NY. Measuring Patient Satisfaction and Factors Affecting it in the General Surgery Setting in Jeddah. Cureus 2019; 11:e6497. [PMID: 31903315 PMCID: PMC6937476 DOI: 10.7759/cureus.6497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction A patient-centered approach is critical to improving the overall quality of healthcare, and this also applies to the general surgery setting. To achieve this, it is important to assess patient satisfaction with healthcare, but this topic has not been investigated in the context of Jeddah. Therefore, the present study is the first one to assess patient satisfaction with care in the general surgery department and associated factors in Jeddah. Methods This was a descriptive, cross-sectional study that used a convenience sampling technique to select 307 patients from the outpatient clinic of the general surgery department at King Abdulaziz Medical City from November to December 2018. The cohort comprised 53.1% women and the age range was 18-70 years. For data collection, we used the Short Assessment of Patient Satisfaction questionnaire, which contains seven items related to the core domains of patient satisfaction. We modified this by adding two additional items reported in other studies. We also included age, gender, and level of education as variables in the analysis. The scores assigned to each item were compared based on gender, age, and level of education. Results The analysis showed that age, gender, or level of education did not affect the overall satisfaction level, and the majority of participants (93.8%) reported that they were satisfied or very satisfied. Specifically, the majority reported that they were satisfied or very satisfied with the treatment effect, the explanation provided by the clinician, and the care provided at the clinic. Further, the majority of them also felt that they had received a thorough examination and enough time with the consultant, that they felt respected by the healthcare provider and their concerns were heard and respected, and that they were encouraged to voice their feelings and concerns. The lowest score was related to whether the participants felt like their choices were considered when it came to making healthcare decisions. This could, therefore, be a potential area of improvement. Conclusion Overall, the current findings indicate that the practitioners in the current setting use a patient-centered, adult-to-adult approach to healthcare, and the patients are highly satisfied. One area of improvement could be medical decision-making, where patients' preference could be given more consideration. Thus, these findings provide important insight into patient-centered care in this region.
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Affiliation(s)
- Bassel A Almehman
- General Surgery, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Zaher Mikwar
- Surgical Oncology, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, SAU
| | - Atheel Balkhy
- Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Heyam Jabali
- Surgery, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Bassam S Hariri
- Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Nada Y Baatiah
- Clinical Nutrition, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
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Karam M, Lambert AS, Macq J. Patients' perceptions of continuity of care across primary care level and emergency departments in Belgium: cross-sectional survey. BMJ Open 2019; 9:e033188. [PMID: 31852708 PMCID: PMC6936975 DOI: 10.1136/bmjopen-2019-033188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To assess patients' perceptions of continuity of care (COC) across primary care level and emergency departments (EDs) and to identify contextual and individual factors that influence this perception. DESIGN Cross-sectional multicentre survey. SETTING Five EDs in Brussels and Wallonia. PARTICIPANTS 501 adult patients referred to the ED by their primary care physician (PCP). Patients with cognitive impairment or in critical condition were excluded. RESULTS Patients perceived high levels of the three types of COC. On an individual level, older patients showed a perception of higher levels of continuity. Lower levels of informational and management continuity were observed among patients suffering from chronic diseases and patients with a high level of education. Patients also perceived a redundancy of medical exams, in parallel to a high degree of accessibility between care levels. On an organisational level, three structural factors were identified as barriers to COC, namely, ED workload, suboptimal sharing information system and the current fee-for-service payment system that encourages competition and hinders coordination between actors. CONCLUSION Belgian healthcare services seem satisfying for patients and easily accessible. However, efforts need to be directed towards improving their efficiency. A stronger primary care level is also needed to benefit the healthcare system by reducing overuse of emergency services. On the individual level, a more enhanced patient-centred approach could be beneficial in improving patients experience of care.
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Affiliation(s)
- Marlene Karam
- Faculty of Public Health, Institute of Health and Society, Catholic University of Louvain Health Sciences Sector, Brussels, Belgium
| | - Anne-Sophie Lambert
- Faculty of Public Health, Institute of Health and Society, Catholic University of Louvain Health Sciences Sector, Brussels, Belgium
| | - Jean Macq
- Faculty of Public Health, Institute of Health and Society, Catholic University of Louvain Health Sciences Sector, Brussels, Belgium
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Patient satisfaction as an element of healthcare quality - a single-center Polish survey. Reumatologia 2019; 57:135-144. [PMID: 31462828 PMCID: PMC6710846 DOI: 10.5114/reum.2019.86423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 06/21/2019] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The aims of the study were to define the level of patient satisfaction with services provided by selected departments of the Institute, and to identify changes that should be introduced to the process of quality management in healthcare services. MATERIAL AND METHODS A total of 455 patients from three departments of the National Institute of Geriatrics, Rheumatology and Rehabilitation in Warsaw, hospitalized between January 2016 and March 2018 were assessed retrospectively. Statistical analyses were conducted with the use of IBM SPSS Statistics 25 software. RESULTS Patients at the Institute gave the highest rates to the courtesy and kindness of doctors and nurses (mean 4.77 and 4.73, respectively), the doctor's interest in a patient's well-being, and the nurses' dexterity in performing medical procedures (4.63 and 4.72, respectively) The lowest-rated were the quality of meals (mean 3.77) and the waiting time for hospital admission on an appointed day (mean 4.07). The study demonstrated statistically significant differences in evaluations made by female and male patients: women had worse opinions about maintenance of intimacy during medical procedures, whereas men gave lower ratings to the size of served meals. The level of satisfaction in all analyzed aspects increased with older age. However, a higher level of patient education correlated negatively with satisfaction from the waiting time for hospital admission on an appointed day, the ability to receive information about the disease and treatment process, cleanliness and accessibility of bathrooms and toilets, or the ability to easily move around the Institute. CONCLUSIONS Accessibility of medical services, as well as attitudes and competences of the medical staff, are all key factors in ensuring quality care. The conditions of a hospital stay also shape the patients' opinions in a significant way. Therefore, taking into account the patients' opinions should become an important goal in the process of improving healthcare quality.
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Roder-DeWan S, Gage AD, Hirschhorn LR, Twum-Danso NAY, Liljestrand J, Asante-Shongwe K, Rodríguez V, Yahya T, Kruk ME. Expectations of healthcare quality: A cross-sectional study of internet users in 12 low- and middle-income countries. PLoS Med 2019; 16:e1002879. [PMID: 31390364 PMCID: PMC6685603 DOI: 10.1371/journal.pmed.1002879] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 07/01/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND High satisfaction with healthcare is common in low- and middle-income countries (LMICs), despite widespread quality deficits. This may be due to low expectations because people lack knowledge about what constitutes good quality or are resigned about the quality of available services. METHODS AND FINDINGS We fielded an internet survey in Argentina, China, Ghana, India, Indonesia, Kenya, Lebanon, Mexico, Morocco, Nigeria, Senegal, and South Africa in 2017 (N = 17,996). It included vignettes describing poor-quality services-inadequate technical or interpersonal care-for 2 conditions. After applying population weights, most of our respondents lived in urban areas (59%), had finished primary school (55%), and were under the age of 50 (75%). Just over half were men (51%), and the vast majority reported that they were in good health (73%). Over half (53%) of our study population rated the quality of vignettes describing poor-quality services as good or better. We used multilevel logistic regression and found that good ratings were associated with less education (no formal schooling versus university education; adjusted odds ratio [AOR] 2.22, 95% CI 1.90-2.59, P < 0.001), better self-reported health (excellent versus poor health; AOR 5.19, 95% CI 4.33-6.21, P < 0.001), history of discrimination in healthcare (AOR 1.47, 95% CI 1.36-1.57, P < 0.001), and male gender (AOR 1.32, 95% CI 1.23-1.41, P < 0.001). The survey did not reach nonusers of the internet thus only representing the internet-using population. CONCLUSIONS Majorities of the internet-using public in 12 LMICs have low expectations of healthcare quality as evidenced by high ratings given to poor-quality care. Low expectations of health services likely dampen demand for quality, reduce pressure on systems to deliver quality care, and inflate satisfaction ratings. Policies and interventions to raise people's expectations of the quality of healthcare they receive should be considered in health system quality reforms.
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Affiliation(s)
- Sanam Roder-DeWan
- Harvard T. H. Chan School of Public Health, Department of Global Health and Population, Boston, Massachusetts, United States of America
- Ifakara Health Institute, Dar es Salaam, Tanzania
- UNICEF, Dar es Salaam, Tanzania
| | - Anna D. Gage
- Harvard T. H. Chan School of Public Health, Department of Global Health and Population, Boston, Massachusetts, United States of America
| | - Lisa R. Hirschhorn
- Northwestern University, Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Nana A. Y. Twum-Danso
- MAZA, Accra, Ghana
- Gillings School of Global Public Health, Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Jerker Liljestrand
- Bill & Melinda Gates Foundation, Seattle, Washington, United States of America
| | | | | | - Talhiya Yahya
- Quality Management Unit, Health Quality Assurance Department, Ministry of Health, Dar es Salaam, Tanzania
| | - Margaret E. Kruk
- Harvard T. H. Chan School of Public Health, Department of Global Health and Population, Boston, Massachusetts, United States of America
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Poot AJ, Wopereis DM, den Elzen WPJ, Gussekloo J, Blom JW. Changes in patient satisfaction related to their perceived health state during implementation of improved integrated care for older persons. PLoS One 2019; 14:e0216028. [PMID: 31095590 PMCID: PMC6522052 DOI: 10.1371/journal.pone.0216028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 04/12/2019] [Indexed: 11/19/2022] Open
Abstract
Patient satisfaction with the general practitioner (GP) is lower in older persons with a higher level of complexity of health problems. This study investigates whether, in these older persons, changes in satisfaction with their GP, on receiving improved integrated care, is related to their perceived health state.Using the Integrated Systematic Care for Older People (ISCOPE) trial (aimed at improving person- centered integrated care) this study compared changes in satisfaction with the GP in older persons (aged ≥75 years) with a high level of complex health problems on receiving integrated care, stratified for perceived health state at baseline. Satisfaction with the GP was registered on a 5-point Likert scale. Perceived health state was estimated with the Older Persons and Informal Caregivers Survey-Composite End Point (TOPICS-CEP) at baseline, stratified into 33% percentiles. Differences in satisfaction change between the intervention and usual care/control groups (overall and stratified for perceived health state) are presented by percentages of 'very satisfied' participants and improving or deteriorating 1 or more points on the Likert scale. At baseline, the intervention (n = 151) and control group (n = 603) were mainly female (75%) and living alone (62%); mean age was 83 years. Medical status, perceived health state and characteristics of participants were similar. Overall, at baseline 44.4% of respondents in the intervention group were 'very satisfied' compared with 37.1% at follow-up, (difference -7.3%). In the control group, 'very satisfied' at baseline was 32% and at follow up 29.2% (difference -2.8%). The p-value for this difference in change is 0.56. After stratification for TOPICS-CEP the results were the same. In older persons with a high level of complexity of health problems, implementation of person- centered integrated healthcare did not influence their satisfaction with the GP, also not among those with the highest or lowest perceived health state.
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Affiliation(s)
- Antonius J. Poot
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- * E-mail:
| | - Daisy M. Wopereis
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Wendy P. J. den Elzen
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Jacobijn Gussekloo
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Jeanet W. Blom
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
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Cardiology patients' medicines management networks after hospital discharge: A mixed methods analysis of a complex adaptive system. Res Social Adm Pharm 2019; 15:505-513. [DOI: 10.1016/j.sapharm.2018.06.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 06/15/2018] [Accepted: 06/20/2018] [Indexed: 10/28/2022]
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Zakare-Fagbamila RT, Seyferth E, Cheng TZ, Clement M, Stroup B, Gottfried ON. Chief complaints and feedback from clinic satisfaction tool: Thematic analysis of a new outpatient communication tool. Int J Clin Pract 2019; 73:e13318. [PMID: 30703294 DOI: 10.1111/ijcp.13318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 01/25/2019] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Up to half of all patients leave their outpatient clinic visit with an uncommunicated need. We designed the clinic satisfaction tool (CST) as a low-cost, highly utilised assessment of the spine clinic experience that improved communication in our multidisciplinary spine practice. The purpose of this study was to qualitatively analyse chief complaints and feedback from the CSTs to determine how spine clinic patients used the form, identify the most prevalent concerns and mark areas for improvement. METHODS Institutional retrospective review of CSTs. Chief complaints and feedback were inductively coded to create a framework for patient complaints. RESULTS 832 patients presented to clinic, and 100 sets of chief complaints coded before reaching thematic saturation. Patients used the chief complaint section of CST to canvas four themes: symptoms, questions about their disease, management and treatment. Twenty-nine patients left mostly positive feedback but also wrote additional concerns about care. CONCLUSION Spine patients have a predictable pattern of chief complaints and with the CST were able to have all these complaints addressed. The CST efficiently collects practice-specific chief complaints that can be used to guide physician behaviour and design educational clinical tools that are useful for patients.
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Affiliation(s)
| | | | - Tracy Z Cheng
- School of Medicine, Duke University, Durham, North Carolina
| | - Mary Clement
- Department of Musculoskeletal & Spine Services, Duke University, Durham, North Carolina
| | - Bethany Stroup
- Department of Musculoskeletal & Spine Services, Duke University, Durham, North Carolina
| | - Oren N Gottfried
- Department of Neurosurgery, Duke University, Durham, North Carolina
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Lemetti T, Voutilainen P, Stolt M, Eloranta S, Suhonen R. Older patients’ experiences of nurse‐to‐nurse collaboration between hospital and primary health care in the care chain for older people. Scand J Caring Sci 2019; 33:600-608. [DOI: 10.1111/scs.12653] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Accepted: 12/11/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Terhi Lemetti
- Department of Nursing Science University of Turku Turku Finland
- Helsinki University Hospital Helsinki Finland
| | | | - Minna Stolt
- Department of Nursing Science University of Turku Turku Finland
| | - Sini Eloranta
- Department of Nursing Science University of Turku Turku Finland
- Turku University of Applied Sciences Turku Finland
| | - Riitta Suhonen
- Department of Nursing Science University of Turku Turku Finland
- Turku University Hospital and City of Turku Welfare Division (Riitta Suhonen) Turku Finland
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Mohamed-Ahmed R, Abdel Aziz M, Walker R. Antenatal Care in Sudan: A Qualitative Study Into Accessibility and Quality of Maternal Health Services in Khartoum. INTERNATIONAL JOURNAL OF CHILDBIRTH 2018. [DOI: 10.1891/2156-5287.8.2.77] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Antenatal care is shown to be a cost-effective intervention for reducing rates of maternal mortality. However, utilization of maternal health services in Sudan remains low and maternal deaths high. This study aims to investigate why Sudanese women do not attend antenatal care, satisfaction with services and views on improving uptake. Focus group discussions took place, with 30 women who had delivered in the past year, in five areas in Khartoum. Themes in transcripts were identified. Factors that can affect a woman’s choice to attend antenatal care extend beyond physical barriers and include misconceptions of it’s use, conflict between faith and modern medicine and dissatisfaction with previously used services. The care provider’s perceived lack of empathy, unpunctuality and lack of health promotion can also contribute to underutilization.
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46
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Hadden KB, Prince LY, Bushmiaer MK, Watson JC, Barnes CL. Health literacy and surgery expectations in total hip and knee arthroplasty patients. PATIENT EDUCATION AND COUNSELING 2018; 101:1823-1827. [PMID: 29880403 DOI: 10.1016/j.pec.2018.05.021] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 05/09/2018] [Accepted: 05/26/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES This study assessed patients' health literacy and expectations for total hip (THA) and total knee (TKA) replacement surgery, and compared health literacy levels of patients and their caregivers. METHODS A convenience sample of 200 THA/TKA participants, patients and their caregivers, participated in this study. RESULTS Results demonstrated no statistical difference in health literacy between patients and their caregivers. However, patients with lower health literacy had significantly lower expectations for walking after surgery. CONCLUSIONS Practices should be aware that caregivers may not be any better equipped to consume and use complicated patient education materials than the patient they are assisting. Additionally, lower health literacy, rather than or in addition to race or social factors, may contribute to disparities in opting for THA/TKA because of lower expectations for walking after surgery. PRACTICE IMPLICATIONS Healthcare practices should develop patient educational materials that are easy for all patients and caregivers to understand, especially those with low health literacy. Additional patient education and counseling may help patients with low health literacy realistically align their expectations and mitigate barriers to consenting to surgery due to low expectations.
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Affiliation(s)
- Kristie B Hadden
- University of Arkansas for Medical Sciences, Center for Health Literacy, Little Rock, AR 72205, USA.
| | - Latrina Y Prince
- University of Arkansas for Medical Sciences, Center for Health Literacy, Little Rock, AR 72205, USA.
| | - Marty K Bushmiaer
- University of Arkansas for Medical Sciences, Department of Orthpaedic Surgery, Little Rock, AR 72205, USA.
| | - Jamie C Watson
- University of Arkansas for Medical Sciences, Division of Medical Humanities, Little Rock, AR 72205, USA.
| | - C Lowry Barnes
- University of Arkansas for Medical Sciences, Department of Orthpaedic Surgery, Little Rock, AR 72205, USA.
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Nottingham Q, Johnson DM, Russell R. A multi-year SEM model predicting the impact of behavior attributes on overall patient satisfaction. INTERNATIONAL JOURNAL OF QUALITY & RELIABILITY MANAGEMENT 2018. [DOI: 10.1108/ijqrm-02-2018-0031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Pressure from competition; inflexible third-party reimbursements; greater demand from government, regulatory and certifying agencies; discerning patients; and the quest of healthcare entities for greater profitably place demands and high expectations for service quality impacting overall patient experience. Extending a prior multivariate, single-period model of varied medical practices predicting patient experience to a three-year time period to understand whether there was a change in overall assessment using data analytics. The paper aims to discuss these issues.
Design/methodology/approach
SEM was employed on a per year and aggregated, three-year basis to gain insights into qualitative psychometric constructs predicting overall patient experience and strength of the relationships.
Findings
Statistically significant differences were uncovered between years indicating the strength of the relationships of latent variables on overall performance.
Research limitations/implications
Study focused on data gathered from a questionnaire mailed to patients who visited various outpatient medical clinics in a rural community with over 4,000 responses during the three-year study period. A higher percentage of female respondents over the age of 45 may limit the generalizability of the findings.
Practical implications
Practitioners can gain a broader understanding of different factors influencing overall patient experience. Administrative processes associated with the primary care provider are inconsequential. Patients are not as concerned with patient flow as they are with patient safety and health.
Originality/value
This research informs healthcare quality management of psychometrics and analytics to improve the overall patient experience in outpatient medical clinics.
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Søndergaard M, Ghazanfar M, Thomsen S. Patient expectations and determinants of patient satisfaction in a dermatology outpatient clinic. J Eur Acad Dermatol Venereol 2018; 33:e32-e33. [DOI: 10.1111/jdv.15144] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M.B. Søndergaard
- Department of Dermatology Bispebjerg Hospital Copenhagen Denmark
| | - M.N. Ghazanfar
- Department of Dermatology Bispebjerg Hospital Copenhagen Denmark
| | - S.F. Thomsen
- Department of Dermatology Bispebjerg Hospital Copenhagen Denmark
- Department of Biomedical Sciences University of Copenhagen Copenhagen Denmark
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Konradsen H, Dieperink KB, Lauridsen J, Sorknaes AD, Ostergaard B. Validity and reliability of the Danish version of the Ice Expressive Family Functioning and Ice Family Perceived Support questionnaires. Scand J Caring Sci 2018; 32:1447-1457. [DOI: 10.1111/scs.12591] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 05/29/2018] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Jørgen Lauridsen
- OPEN Odense Patient data Explorative Network; Odense University Hospital; Odense Denmark
| | | | - Birte Ostergaard
- Clinical Institute; Faculty of Health; University of Southern Denmark; Odense Denmark
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Horinuki F, Noguchi-Watanabe M, Takai Y, Yamahana R, Ohno N, Okada S, Mori SI, Yamamoto-Mitani N. The Experience of Persons With Hematological Malignancy When Communicating With Health Care Professionals. QUALITATIVE HEALTH RESEARCH 2018; 28:479-490. [PMID: 29103363 DOI: 10.1177/1049732317739839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study aimed to elucidate the experiences of Japanese persons with hematological malignancy (PHMs) in communicating with health care professionals (HCPs), from diagnosis to the end of life, as recalled by their families. We interviewed 14 bereaved families and analyzed the data using the basic techniques of grounded theory. We found that PHMs lived to the fullest possible when they experienced ownership of their illness process despite their disease. The ownership was made possible by active communication from HCPs: first, acknowledging the PHM's way of life, including reaching out from the HCPs and appreciating sincerely PHMs' hopes and will; and second, paving the way ahead, including giving prospects and offering choices. The study underlines that rather than just providing information about the disease, HCPs need to actively ask about and show respect for the PHM's way of life. Only after achieving this can HCPs communicate possible future pathways with PHMs.
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Affiliation(s)
| | | | - Yukari Takai
- 2 Gunma Prefectural College of Health Sciences, Maebashi, Japan
| | | | | | - Sadamu Okada
- 3 St. Luke's International Hospital, Tokyo, Japan
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