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Wolf A, Erichsen Andersson A, Wikström E, Bååthe F. Untangling the perception of value in value-based healthcare - an interview study. Leadersh Health Serv (Bradf Engl) 2024; 37:130-141. [PMID: 38635293 DOI: 10.1108/lhs-07-2023-0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
PURPOSE Value-based health care (VBHC) argues that health-care needs to re-focus to maximise value creation, defining value as the quota when dividing the outcomes important for the patient, by the cost for health care to deliver such outcomes. This study aims to explore the perception of value among different stakeholders involved in the process of implementing VBHC at a Swedish hospital to support leaders to be more efficient and effective when developing health care. DESIGN/METHODOLOGY/APPROACH Participants comprised 19 clinicians and non-clinicians involved in the implementation of VBHC. Semi-structured interviews were conducted and content analysis was performed. FINDINGS The clinicians described value as a dynamic concept, dependent on the patient and the clinical setting, stating that improving outcomes was more important than containing costs. The value for non-clinicians appeared more driven by the interplay between the outcome and the cost. Non-clinicians related VBHC to a strategic framework for governance or for monitoring different continuous improvement processes, while clinicians appreciated VBHC, as they perceived its introduction as an opportunity to focus more on outcomes for patients and less on cost containment. ORIGINALITY/VALUE There is variation in how clinicians and non-clinicians perceive the key concept of value when implementing VBHC. Clinicians focus on increasing treatment efficacy and improving medical outcomes but have a limited focus on cost and what patients consider most valuable. If the concept of value is defined primarily by clinicians' own assumptions, there is a clear risk that the foundational premise of VBHC, to understand what outcomes patients value in their specific situation in relation to the cost to produce such outcome, will fail. Health-care leaders need to ensure that patients and the non-clinicians' perception of value, is integrated with the clinical perception, if VBHC is to deliver on its promise.
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Affiliation(s)
- Axel Wolf
- Institute of Health Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden and Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Annette Erichsen Andersson
- Institute of Health Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden and Department of Orthopedics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ewa Wikström
- Department of Business Administration, School of Business, Economics and Law, University of Gothenburg, Gothenburg, Sweden, and
| | - Fredrik Bååthe
- Institute for Studies of the Medical Profession, LEFO, Oslo, Norway; Institute of Stress Medicine at Region Västra Götaland, Gothenburg, Sweden and Institute of Health Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Braun M, Wollny M, Schoebel C, Sommer JU, Heiser C. Patient-reported experience with hypoglossal nerve stimulation in the treatment of obstructive sleep apnea. Sleep Breath 2024; 28:221-230. [PMID: 37542679 PMCID: PMC10955022 DOI: 10.1007/s11325-023-02887-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/18/2023] [Accepted: 07/21/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND Breathing-synchronized hypoglossal nerve stimulation (HNS) is routinely used as an alternative treatment for patients with obstructive sleep apnea (OSA). Significant and clinically relevant improvements in disease severity and OSA symptoms such as daytime sleepiness as well as overall quality of life have been reported in randomized-controlled trials and large real-world cohort studies. However, so far, few data exist on patient-reported experience with the treatment. METHODS A structured survey with 22 questions was constructed using five-level Likert scales (1 = no agreement, 5 = complete agreement) to evaluate patient experience with HNS and perception of the treatment in the domains "Overall experience with therapy," "Experience with treatment process," and "Side-effects from treatment." Additional data were collected on current symptom status, measured with Epworth sleepiness scale (ESS) questionnaire, and OSA disease history. Multiple linear regression analysis was conducted to test associations of medical variables and response behavior. Correlations between variables and domains, as well as individual items, were assessed using Spearman rank test. RESULTS A total of 75 patients from Germany who were treated with breathing-synchronized HNS were enrolled (mean age 57.3 years, 78% male), and 71 questionnaires with complete data were included for analysis. Two-thirds of participants (67%) had a history of OSA history for 5 years or longer. Of all patients, 76% had normalized OSA symptoms at time of the study (ESS: 6.4 ± 5.0) and 98% reported using stimulation therapy every night. Regression analysis revealed an association of current symptoms measured with ESS and response behavior. Hence, patients with normalized daytime sleepiness reported significantly more positive experience across all domains assessed, compared to patients with residual daytime sleepiness. Overall, only 2% of participants reported side effects that made them reduce or discontinue stimulation therapy. The rate of reported side effects was associated with current symptom control under therapy. CONCLUSIONS Overall patient-reported experience with breathing-synchronized HNS therapy was positive and high satisfaction with the treatment process was observed. Side effects occurred, but rarely affected subjective use of the therapy or satisfaction. Subjective experience and perception are influenced by residual daytime sleepiness with stimulation therapy.
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Affiliation(s)
- M Braun
- Department of Pneumology, University Medicine Essen - Ruhrlandklinik, West German Lung Center, University Duisburg-Essen, Duisburg, Germany.
- Faculty of Sleep and Telemedicine, University Medicine Essen - Ruhrlandklinik, West German Lung Center, University Duisburg-Essen, Duisburg, Germany.
| | - M Wollny
- MedImbursement, Tarmstedt, Germany
| | - C Schoebel
- Department of Pneumology, University Medicine Essen - Ruhrlandklinik, West German Lung Center, University Duisburg-Essen, Duisburg, Germany
- Faculty of Sleep and Telemedicine, University Medicine Essen - Ruhrlandklinik, West German Lung Center, University Duisburg-Essen, Duisburg, Germany
| | - J U Sommer
- Department of Otorhinolaryngology/Head and Neck Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- ENT-Center Mangfall-Inn, Bad Aibling, Germany
| | - C Heiser
- Department of Otorhinolaryngology/Head and Neck Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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Eton DT, Yost KJ, Ridgeway JL, Bucknell B, Wambua M, Erbs NC, Allen SV, Rogers EA, Anderson RT, Linzer M. Development and acceptability of PETS-Now, an electronic point-of-care tool to monitor treatment burden in patients with multiple chronic conditions: a multi-method study. BMC Prim Care 2024; 25:77. [PMID: 38429702 PMCID: PMC10908048 DOI: 10.1186/s12875-024-02316-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 02/20/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND The aim of this study was to develop a web-based tool for patients with multiple chronic conditions (MCC) to communicate concerns about treatment burden to their healthcare providers. METHODS Patients and providers from primary-care clinics participated. We conducted focus groups to identify content for a prototype clinical tool to screen for treatment burden by reviewing domains and items from a previously validated measure, the Patient Experience with Treatment and Self-management (PETS). Following review of the prototype, a quasi-experimental pilot study determined acceptability of using the tool in clinical practice. The study protocol was modified to accommodate limitations due to the Covid-19 pandemic. RESULTS Fifteen patients with MCC and 18 providers participated in focus groups to review existing PETS content. The pilot tool (named PETS-Now) consisted of eight domains (Living Healthy, Health Costs, Monitoring Health, Medicine, Personal Relationships, Getting Healthcare, Health Information, and Medical Equipment) with each domain represented by a checklist of potential concerns. Administrative burden was minimized by limiting patients to selection of one domain. To test acceptability, 17 primary-care providers first saw 92 patients under standard care (control) conditions followed by another 90 patients using the PETS-Now tool (intervention). Each treatment burden domain was selected at least once by patients in the intervention. No significant differences were observed in overall care quality between patients in the control and intervention conditions with mean care quality rated high in both groups (9.3 and 9.2, respectively, out of 10). There were no differences in provider impressions of patient encounters under the two conditions with providers reporting that patient concerns were addressed in 95% of the visits in both conditions. Most intervention group patients (94%) found that the PETS-Now was easy to use and helped focus the conversation with the provider on their biggest concern (98%). Most providers (81%) felt they had learned something new about the patient from the PETS-Now. CONCLUSION The PETS-Now holds promise for quickly screening and monitoring treatment burden in people with MCC and may provide information for care planning. While acceptable to patients and clinicians, integration of information into the electronic medical record should be prioritized.
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Affiliation(s)
- David T Eton
- Outcomes Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9169 Medical Center Drive, Rockville, MD, 20850, USA.
| | - Kathleen J Yost
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Jennifer L Ridgeway
- Division of Health Care Delivery Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Bayly Bucknell
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Mike Wambua
- Hennepin Healthcare Research Institute, Minneapolis, MN, USA
| | - Natalie C Erbs
- Department of Family Medicine, Mayo Clinic, Rochester, MN, USA
| | - Summer V Allen
- Department of Family Medicine, Mayo Clinic, Rochester, MN, USA
| | - Elizabeth A Rogers
- Departments of Medicine and of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Roger T Anderson
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Mark Linzer
- Department of Medicine, Hennepin Healthcare and University of Minnesota, Minneapolis, MN, USA
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Abelsen B, Pedersen K, Løyland HI, Aandahl E. Expanding general practice with interprofessional teams: a mixed-methods patient perspective study. BMC Health Serv Res 2023; 23:1327. [PMID: 38037165 PMCID: PMC10691031 DOI: 10.1186/s12913-023-10322-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 11/14/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Across healthcare systems, current health policies promote interprofessional teamwork. Compared to single-profession general practitioner care, interprofessional primary healthcare teams are expected to possess added capacity to care for an increasingly complex patient population. This study aims to explore patients' experiences when their usual primary healthcare encounter with general practice shifts from single-profession general practitioner care to interprofessional team-based care. METHODS Qualitative and quantitative data were collected through interviews and a survey among Norwegian patients. The interviews included ten patients (five women and five men) aged between 28 and 89, and four next of kin (all women). The qualitative analysis was carried out using thematic analysis and a continuity framework. The survey included 287 respondents, comprising 58 per cent female and 42 per cent male participants, aged 18 years and above. The respondents exhibited multiple diagnoses and often a lengthy history of illness. All participants experienced the transition to interprofessional teamwork at their general practitioner surgery as part of a primary healthcare team pilot. RESULTS The interviewees described team-based care as more fitting and better coordinated, including more time and more learning than with single-profession general practitioner care. Most survey respondents experienced improvements in understanding and mastering their health problems. Multi-morbid elderly interviewees and interviewees with mental illness shared experiences of improved information continuity. They found that important concerns they had raised with the nurse were known to the general practitioner and vice versa. None of the interviewees expressed dissatisfaction with the inclusion of a nurse in their general practitioner relationship. Several interviewees noted improved access to care. The nurse was seen as a strengthening link to the general practitioner. The survey respondents expressed strong agreement with being followed up by a nurse. The interviewees trusted that it was their general practitioner who controlled what happened to them in the general practitioner surgery. CONCLUSION From the patients' perspective, interprofessional teamwork in general practice can strengthen management, informational, and relational continuity. However, a prerequisite seems to be a clear general practitioner presence in the team.
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Affiliation(s)
- Birgit Abelsen
- Department of Community Medicine, National Centre for Rural Medicine, UiT The Arctic University of Norway, Postbox 6050 Langnes, 9037, Tromsø, Norway.
| | - Kine Pedersen
- Oslo Economics, Klingenberggata 7, Oslo, 0161, Norway
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Pedersen H, Skliarova T, Attkisson CC, Lara-Cabrera ML, Havnen A. Measuring patient satisfaction with four items: validity of the client satisfaction questionnaire 4 in an outpatient population. BMC Psychiatry 2023; 23:808. [PMID: 37936112 PMCID: PMC10630992 DOI: 10.1186/s12888-023-05310-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/25/2023] [Indexed: 11/09/2023] Open
Abstract
INTRODUCTION Patient satisfaction with mental health services has for several decades been considered an important component when evaluating service quality. It is often assessed in the context of monitoring quality of care, developing or evaluating newly implemented interventions or changes in practice. Because of this, patient satisfaction questionnaires are often added to longer questionnaire batteries, and shorter questionnaires are preferred to prevent respondent fatigue and non-compliance and to secure easy implementation. However, most studies use unvalidated patient satisfaction measures, making comparisons between studies difficult. Validation studies of short patient satisfaction measures are therefore warranted. METHODS The primary aim was to examine the construct validity and internal reliability of the Client Satisfaction Questionnaire-4 (CSQ-4) in a Norwegian outpatient mental health setting. A total of 467 patients were recruited from an outpatient psychiatric care clinic in Central Norway. The secondary aim was to examine an earlier proposed cutoff for classifying dissatisfied patients in this new population. A principal component analysis was conducted to evaluate factor structure, correlation analyses were conducted to test for predicted relationships, and Cronbach's alpha was calculated to examine internal reliability. RESULTS The CSQ-4 showed a clear unidimensional structure with one factor explaining 80% of its variance. Its internal reliability was very high, with a Cronbach's alpha of 0.92. As hypothesised this study found no statistically significant sex differences in satisfaction and no statistically significant association between age and satisfaction. Positive changes in symptoms during treatment and higher post-treatment functional impairment were associated with higher patient-reported treatment satisfaction scores, which indicates good construct validity. CONCLUSION This is the first study to evaluate the CSQ-4 in a psychiatric population. The CSQ-4 demonstrated good structural validity and internal reliability and was correlated with outcome variables in terms of symptom change and post-treatment functioning. In sum, this indicates that the CSQ-4 is a good short alternative for evaluating patient satisfaction in routine outpatient mental health care.
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Affiliation(s)
- Henrik Pedersen
- Division of Psychiatry, Nidaros Community Mental Health Centre, St. Olavs University Hospital, Trondheim, Norway.
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Tatiana Skliarova
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - C Clifford Attkisson
- Department of Psychiatry and Graduate Division, University of California, San Francisco, USA
- Tamalpais Matrix Systems, LLC, Chicago, USA
| | - Mariela L Lara-Cabrera
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Division of Psychiatry, Nidelv Community Mental Health Centre, St. Olavs University Hospital, Trondheim, Norway
| | - Audun Havnen
- Division of Psychiatry, Nidaros Community Mental Health Centre, St. Olavs University Hospital, Trondheim, Norway
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Colomer-Lahiguera S, Canella C, Giacomini S, Van KL, Pedrazzani C, Naegele M, Thouvenin L, O'Meara Stern A, Condorelli R, Corbière T, Witt CM, Eicher M, Ribi K. Patient-reported experiences of cancer care related to the COVID-19 pandemic in Switzerland. Support Care Cancer 2023; 31:410. [PMID: 37347278 DOI: 10.1007/s00520-023-07871-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 06/07/2023] [Indexed: 06/23/2023]
Abstract
PURPOSE This study aims to describe the experience of Swiss oncological patients during the COVID-19 pandemic. METHODS A national multi-center study including five hospitals covering the three main language regions of Switzerland was conducted between March and July 2021. Patients with melanoma, breast, lung, or colon cancer receiving active systemic anti-cancer treatment at the time of the COVID-19 pandemic were included. We conducted semi-structured telephone or onsite interviews alongside the administration of distress and resilience-validated questionnaires. Thematic analysis was performed for the qualitative data and descriptive statistics for the quantitative data. RESULTS Sixty-two cancer patients with a mean age of 61 (SD=14) (58% female) were interviewed. Based on the interviews, we identified that the experience of having cancer during the COVID-19 pandemic was related to five dimensions: psychological, social, support, healthcare, and vaccination. Three themes transverse the five dimensions: (a) needs, (b) positive changes, and (c) phases of the pandemic. In general, patients did not experience delays or disruptions in their cancer treatment nor felt additionally burdened by the pandemic. Lockdown and isolation were reported as mixed experiences (positive and negative), and access to vaccination reassured patients against the risk of infection and instilled hope to return to normalcy. Additionally, we found low distress levels (M=2.9; SD=2.5) and high resilience scores (M=7; SD=1.3) in these patients. CONCLUSION Swiss patients with cancer did not express major needs or disruptions in their care during this period of the COVID-19 pandemic. Results identify the mixed experiences of patients and highlight the high resilience levels.
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Affiliation(s)
- Sara Colomer-Lahiguera
- Institute of Higher Education and Research & Department of Oncology Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Office 01/169 - PROLINE - Rte de la Corniche, 10-1010, Lausanne, Switzerland.
| | - Claudia Canella
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zürich, Switzerland
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Stellio Giacomini
- Institute of Higher Education and Research & Department of Oncology Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Office 01/169 - PROLINE - Rte de la Corniche, 10-1010, Lausanne, Switzerland
| | - Kim Lê Van
- Institute of Higher Education and Research & Department of Oncology Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Office 01/169 - PROLINE - Rte de la Corniche, 10-1010, Lausanne, Switzerland
| | - Carla Pedrazzani
- Department of Economics, Health and Social Sciences, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Matthias Naegele
- Cantonal Hospital St. Gallen, Department of Development and Quality Management in Nursing, Network Oncology, St. Gallen, Switzerland
- Comprehensive Cancer Center Zurich, University Hospital Zurich, Zürich, Switzerland
| | - Laure Thouvenin
- Department of Oncology, University Hospitals of Geneva (HUG), Geneva, Switzerland
| | - Alix O'Meara Stern
- Department of Medical Oncology, Réseau Hospitalier Neuchatelois, Neuchâtel, Switzerland
| | - Rosaria Condorelli
- Department of Medical Oncology, EOC - Istituto Oncologico della Svizzera Italiana, Bellinzona, Switzerland
| | - Tourane Corbière
- Institute of Higher Education and Research & Department of Oncology Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Office 01/169 - PROLINE - Rte de la Corniche, 10-1010, Lausanne, Switzerland
| | - Claudia M Witt
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zürich, Switzerland
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Social Medicine, Epidemiology and Health Economics, Berlin, Germany
| | - Manuela Eicher
- Institute of Higher Education and Research & Department of Oncology Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, Office 01/169 - PROLINE - Rte de la Corniche, 10-1010, Lausanne, Switzerland
| | - Karin Ribi
- Department Health, Kalaidos University of Applied Sciences, Zürich, Switzerland
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Ferreira J, Patel P, Guadagno E, Ow N, Wray J, Emil S, Poenaru D. Patient experience or patient satisfaction? A systematic review of child- and family-reported experience measures in pediatric surgery. J Pediatr Surg 2023; 58:862-870. [PMID: 36797113 DOI: 10.1016/j.jpedsurg.2023.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 01/02/2023] [Indexed: 01/21/2023]
Abstract
PURPOSE Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) are increasingly recognized as important health care quality indicators. PREMs measure patients' perception of the care they have received, differing from satisfaction ratings, which measure their expectations. The use of PREMs in pediatric surgery is limited, prompting this systematic review to assess their characteristics and identify areas for improvement. METHODS A search was conducted in eight databases from inception until January 12, 2022, to identify PREMs used with pediatric surgical patients, with no language restrictions. We focused on studies of patient experience but also included studies that assessed satisfaction and sampled experience domains. The quality of the included studies was appraised using the Mixed Methods Appraisal Tool. RESULTS Following title and abstract screening of 2633 studies, 51 were included for full-text review, of which 22 were subsequently excluded because they measured only patient satisfaction rather than experience, and 14 were excluded for a range of other reasons. Out of the 15 included studies, questionnaires used in 12 studies were proxy-reported by parents and in 3 by both parents and children; none focused only on the child. Most instruments were developed in-house for each specific study, without patients' involvement in the process, and were not validated. CONCLUSIONS Although PROMs are increasingly used in pediatric surgery, PREMs are not yet in use, being typically substituted by satisfaction surveys. Significant efforts are needed to develop and implement PREMs in pediatric surgical care, in order to effectively capture children's and families' voices. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Julia Ferreira
- McGill University Faculty of Medicine and Health Sciences, Montreal, Quebec, Canada; Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada
| | - Prachikumari Patel
- Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada
| | - Elena Guadagno
- Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada
| | - Nikki Ow
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jo Wray
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Sherif Emil
- McGill University Faculty of Medicine and Health Sciences, Montreal, Quebec, Canada; Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada
| | - Dan Poenaru
- McGill University Faculty of Medicine and Health Sciences, Montreal, Quebec, Canada; Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada.
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Pedersen H, Havnen A, Brattmyr M, Attkisson CC, Lara-Cabrera ML. A digital Norwegian version of the client satisfaction questionnaire 8: factor validity and internal reliability in outpatient mental health care. BMC Psychiatry 2022; 22:671. [PMID: 36316661 PMCID: PMC9623922 DOI: 10.1186/s12888-022-04281-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 09/28/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Validated measures of patient-reported experiences are essential for assessing and improving the quality of mental health services and interventions. In Norwegian mental healthcare settings, the Client Satisfaction Questionnaire (CSQ-8) is increasingly being used for this purpose, but the validity and reliability of the Norwegian translation have not been investigated. METHODS We examined the factor structure and internal consistency of a digitally administrated Norwegian translation of the CSQ-8 in a sample of 338 patients recruited from outpatient treatment. The relationship between satisfaction scores and the change in symptom severity during treatment, measured by the Patient Health Questionnaire-4, was also investigated. RESULTS The Norwegian CSQ-8 showed a clear unidimensional structure with one factor explaining 74% of the variance. Internal consistency was very high, with a Cronbach's alpha of 0.95. Satisfaction showed a small-to-moderate negative relationship with change in symptom severity. Satisfaction scores were negatively skewed, and the presence of ceiling effects is discussed. CONCLUSION Our results support the use of the Norwegian CSQ-8 as a valid and reliable measure of satisfaction with mental healthcare services. Further studies are needed to determine the test-retest reliability of the questionnaire, its sensitivity to change, and to assess its propensity to ceiling effects.
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Affiliation(s)
- Henrik Pedersen
- Nidaros Community Mental Health Centre, Division of Psychiatry, St. Olavs University Hospital, Trondheim, Norway. .,Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Audun Havnen
- grid.52522.320000 0004 0627 3560Nidaros Community Mental Health Centre, Division of Psychiatry, St. Olavs University Hospital, Trondheim, Norway ,grid.5947.f0000 0001 1516 2393Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Martin Brattmyr
- grid.5947.f0000 0001 1516 2393Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - C. Clifford Attkisson
- grid.266102.10000 0001 2297 6811Department of Psychiatry, University of California, San Francisco, United States ,Tamalpais Matrix Systems, LLC, San Fransisco, United States
| | - Mariela L. Lara-Cabrera
- grid.5947.f0000 0001 1516 2393Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway ,grid.52522.320000 0004 0627 3560Nidelv Community Mental Health Centre, Division of Psychiatry, St. Olavs University Hospital, Trondheim, Norway , Trondheim, Norway
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Wardrop RC, Cass AL, Quinn SA, Wercholuk AN, Parikh AA, Snyder RA. Racial and ethnic differences in patient ratings of colorectal and non-small-cell lung cancer care: A SEER-CAHPS study. Cancer Causes Control 2022. [PMID: 35864368 DOI: 10.1007/s10552-022-01606-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 06/27/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Although significant racial and ethnic disparities exist in colorectal and lung cancer treatment and survival, racial differences in patient-reported experience of care are not well understood. The purpose of this study was to examine differences in patient-reported ratings of colorectal and non-small-cell lung cancer care by race/ethnicity. METHODS Medicare beneficiaries with AJCC stage I-IV colorectal and non-small-cell lung cancer (2003-2013) who completed a Medicare Consumer Assessment of Healthcare Providers (CAHPS) survey within 5 years of cancer diagnosis were identified in the linked SEER-CAHPS dataset. Scores were compared by race/ethnicity, defined as White, Black, or any other race/ethnicity. RESULTS Of the 2,621 identified patients, 161 (6.1%) were Black, 2,279 (87.0%) White, and 181 (6.9%) any other race/ethnicity. Compared to White patients, Black patients were younger, had lower educational level, and had higher census tract poverty indicator (p < 0.001). Black patients rated their ability to get care quickly significantly lower than White patients (63.5 (SE 3.38) vs. 71.4 (SE 2.12), p < 0.01), as did patients of any other race/ethnicity (LS mean 66.2 (SE 2.89), p = 0.02). Patients of any other race/ethnicity reported their ability to get needed care significantly lower than White patients (LS mean 81.9 (SE 2.46) vs. 86.7 (SE 1.75), p = 0.02); however, there was no difference in ability to get needed care between Black and White patients. CONCLUSION Patient ratings for getting care quickly were lower in non-White patients, indicating racial disparities in perceived timeliness of care.
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Markowitz JT, Rofail D, Vandenberg G, Baldasaro J, Sanchez RJ, Pignolo RJ, Keen R, Davis M, Marquis P. "I Can't Take off My Shirt or Do My Own Hair"-A Qualitative Investigation of the Symptoms and Impact Experience of Children and Adolescents with Fibrodysplasia Ossificans Progressiva (FOP). Adv Ther 2022; 39:2796-805. [PMID: 35429282 DOI: 10.1007/s12325-022-02096-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 02/17/2022] [Indexed: 11/21/2022]
Abstract
Introduction Fibrodysplasia ossificans progressiva (FOP) is an ultra-rare, severely disabling, autosomal dominant, congenital disease characterized by progressive multi-focal heterotopic ossification (HO) of skeletal muscle, ligaments, tendons, and fascia. Past FOP studies have focused on the clinical aspects of the disease; therefore, there is a paucity of qualitative research on the patient experience. Our objective was to better understand the experience of children and adolescents living with FOP from their and their parents’ perspectives. Methods We conducted a qualitative research study comprising in-depth, open-ended interviews with children and adolescents with FOP and their parents. Semi-structured interviews were conducted via phone call or Microsoft Teams with parent-child dyads (n = 11), adolescents (n = 6), and two clinicians. Children/adolescents and their parents were asked open-ended questions to elicit their daily experience of FOP. Results Concepts were organized into two major themes: symptoms of FOP and the impact of FOP on daily life. Symptoms of FOP reported by children/adolescents, parents, and clinicians were pain, swelling, redness, and stiffness. Functional impacts of flares and FOP in general included accommodations, mobility, activities of daily living, daily activities, and social activities. Impacts were attributed to the difficulties children and adolescents faced living with a disease that prohibited common activities. Conclusions This research documented the experience of children and adolescents with FOP and its effects on their daily lives. It provides a conceptual model for further exploration of the symptoms and impacts important to children and adolescents with FOP and their parents. Children and adolescents and their parents offered novel insights into life with the disease that have not previously been discussed in published literature. Future studies should build upon our conceptual model to create a holistic view of the patient experience of FOP, to inform clinical practice, and the assessment of the patient experience in clinical trials for the disease. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-022-02096-3.
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Braun M, Schmidt O, Schultz T, Woehrle H, Sundrup MG, Schöbel C. [Experiences with digital care of patients with chronic and acute lung diseases during the SARS-CoV-2 pandemic]. Internist (Berl) 2022; 63:255-265. [PMID: 35181796 PMCID: PMC8856116 DOI: 10.1007/s00108-022-01266-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Management of patients with respiratory disorders, such as asthma or chronic obstructive pulmonary disease (COPD), became challenging during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic due to infection prevention measures. To maintain care, a remote monitoring program was initiated, comprising a smartphone app and a Bluetooth spirometry device. OBJECTIVE To assess patient- and physician-related experience with remote monitoring. MATERIAL AND METHODS Structured questionnaires were developed to rate experiences from the patient or physician perspective on six-level Likert scales. Interactions between patients and physicians via the digital platform and overall utilization was analyzed. RESULTS A total of 745 patients with asthma, COPD, post-coronavirus disease 2019 (COVID-19) and other respiratory diseases were enrolled from 31 centers in Germany. Mean follow-up was 49.4 ± 12.6 weeks. Each participant submitted on average 289 measurements. Patient-reported experience with the remote monitoring program was positive, with the highest satisfaction reported for "Experience with home measurement" (1.4 ± 0.5; 99% positive), followed by "Communication/interaction" (1.8 ± 0.9; 83% positive) and "Overall satisfaction with program" (1.8 ± 0.8; 87% positive). In all, 70% reported subjective quality of life improvements related to participation in the program. Physician satisfaction with the program was also high with a mean rating of 2.2 ± 1.2. DISCUSSION App-based remote monitoring was successfully implemented in routine care during the SARS-CoV‑2 pandemic and demonstrated potential for improvements in care. Patient-relevant experience was positive in all dimensions and remote monitoring was well accepted. Physicians who participated in the program also expressed positive experiences, as demonstrated by a high level of interaction with the platform and positive evaluations of effects from the program.
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Affiliation(s)
- Marcel Braun
- Universitätsmedizin Essen, Ruhrlandklinik - Westdeutsches Lungenzentrum, Klinik für Pneumologie, Lehrstuhl für Schlaf- und Telemedizin, Universität Duisburg-Essen, Essen, Deutschland
| | - Olaf Schmidt
- KPPK Studienzentrum Koblenz/Pneumologische Gemeinschaftspraxis Koblenz, Koblenz, Deutschland
| | - Thomas Schultz
- PneumologenLichterfelde Berlin, Berlin, Deutschland
- Pneumologische VersorgungsForschung e. V. (PVF), Berlin, Deutschland
| | | | - Martina Große Sundrup
- Universitätsmedizin Essen, Ruhrlandklinik - Westdeutsches Lungenzentrum, Klinik für Pneumologie, Lehrstuhl für Schlaf- und Telemedizin, Universität Duisburg-Essen, Essen, Deutschland
| | - Christoph Schöbel
- Universitätsmedizin Essen, Ruhrlandklinik - Westdeutsches Lungenzentrum, Klinik für Pneumologie, Lehrstuhl für Schlaf- und Telemedizin, Universität Duisburg-Essen, Essen, Deutschland.
- Ruhrlandklinik, Westdeutsches Lungenzentrum am Universitätsklinikum Essen gGmbH, Universitätsmedizin Essen, Tüschener Weg 40, 45239, Essen, Deutschland.
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Bilkhu P, Sivardeen Z, Chen C, Craig JP, Mann K, Wang MTM, Jivraj S, Mohamed-Noriega K, Charles-Cantú DE, Wolffsohn JS. Patient-reported experience of dry eye management: An international multicentre survey. Cont Lens Anterior Eye 2021; 45:101450. [PMID: 33941501 DOI: 10.1016/j.clae.2021.101450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 04/07/2021] [Accepted: 04/22/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE To explore the journey taken by patients in a range of different countries to manage their dry eye symptoms. METHOD Members of the general public who responded positively to the question "Do your eyes ever feel dry?" completed a questionnaire describing their demographics, the impact of their symptomology, the advice they have received and the management options they have tried. The Ocular Surface Disease Index (OSDI) questionnaire was also completed. RESULTS A total of 916 individuals (Canada = 235, Mexico = 127, New Zealand = 157, Taiwan = 246, UK = 151) of similar age distribution (median 38 years, IQR: 27-50) completed the survey. The reported duration of symptoms was longest in Canada (median 4 years, range 2-10) and least in Taiwan (2 years, range 1-3; p < 0.001), and similar trends were observed for symptom severity (p = 0.001). However, there was no statistically significant difference between countries with respect to the impact of symptoms on quality of life (median 3/10; p = 0.08). Less than half of the individuals in any country had consulted with a health professional. About half had tried a treatment for their dry eye symptoms, with artificial tears being the most common treatment, followed by warm compresses, and both therapies were rated as reasonably effective (median 5-7/10). CONCLUSION Many people with dry eye symptoms are not consulting health care professionals who can confirm the diagnosis, exclude differential diagnoses, and offer a wide range of treatments targeted at the dry eye subtype.
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Affiliation(s)
- Paramdeep Bilkhu
- Optometry and Vision Science, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Zimar Sivardeen
- Optometry and Vision Science, College of Health and Life Sciences, Aston University, Birmingham, UK; School of Health and Care Professions, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
| | - Connie Chen
- Department of Optometry, Chung Shan Medical University, Taiwan
| | - Jennifer P Craig
- Optometry and Vision Science, College of Health and Life Sciences, Aston University, Birmingham, UK; Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, New Zealand
| | - Kylie Mann
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, New Zealand
| | - Michael T M Wang
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, New Zealand
| | - Saleel Jivraj
- Optometry and Vision Science, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Karim Mohamed-Noriega
- Ophthalmology Department, University Hospital and Faculty of Medicine, Autonomous University of Nuevo Leon (UANL), Monterrey, Mexico
| | - David E Charles-Cantú
- Ophthalmology Department, University Hospital and Faculty of Medicine, Autonomous University of Nuevo Leon (UANL), Monterrey, Mexico
| | - James S Wolffsohn
- Optometry and Vision Science, College of Health and Life Sciences, Aston University, Birmingham, UK.
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Yamaguchi S, Ojio Y, Koike J, Matsunaga A, Ogawa M, Tachimori H, Kikuchi A, Kimura H, Inagaki A, Watanabe H, Kishi Y, Yoshida K, Hirooka T, Oishi S, Matsuda Y, Fujii C. Associations between readmission and patient-reported measures in acute psychiatric inpatients: a study protocol for a multicenter prospective longitudinal study (the ePOP-J study). Int J Ment Health Syst 2019; 13:40. [PMID: 31182972 PMCID: PMC6555753 DOI: 10.1186/s13033-019-0298-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 05/28/2019] [Indexed: 02/06/2023] Open
Abstract
Background Several previous observational studies have reported the risk factors associated with readmission in people with mental illness. While patient-reported experiences and outcomes have become increasingly important in healthcare, only a few studies have examined these parameters in terms of their direct association with readmission in an acute psychiatric setting. This project will investigate multiple factors associated with readmission and community living in acute psychiatric patients in Japan. This study will primarily investigate whether patient-reported experiences at discharge, particularly quality of life (QoL), are associated with future readmission and whether readmission after the index hospitalization is associated with changes in patient-reported outcomes during the study period. Here, we describe the rationale and methods of this study. Methods This multicenter prospective cohort study is being conducted in 21 participating Japanese hospitals, with a target sample of approximately 600 participants admitted to the acute psychiatric ward. The study has four planned assessment points: time of index admission (T1), time of discharge (from the index admission) (T2), 6 months after discharge from the index admission (T3), and 12 months after discharge from the index admission (T4). Participants will complete self-reported measures including a QoL scale, a subjective disability scale, and an empowerment- and self-agency-related scale at each assessment point; additionally, service satisfaction, subjective view of need for services, and subjective relationships with family members will be assessed at T2 and T3. We will assess the participants’ hospitalization during the study period and evaluate several potential individual- and service-level factors associated with readmission and patient-reported experiences and outcomes. Multivariate analyses will be conducted to identify potential associations between readmission and patient-reported experiences and outcomes. Discussion The present study may produce evidence on how patient-reported experiences at discharge influence readmission and on the influence of readmission on the course of patient-reported outcomes from admission to community living after discharge. The study may contribute to improving care for both patients’ subjective views of their own health conditions and their community lives in an acute psychiatric setting. Trial registration University Hospital Medical Information Network—Clinical Trials Registry (UMIN-CTR) UMIN000034220. Registered on September 20, 2018. Electronic supplementary material The online version of this article (10.1186/s13033-019-0298-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sosei Yamaguchi
- 1Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553 Japan
| | - Yasutaka Ojio
- 1Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553 Japan
| | - Junko Koike
- 1Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553 Japan
| | - Asami Matsunaga
- 1Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553 Japan
| | - Makoto Ogawa
- 1Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553 Japan
| | - Hisateru Tachimori
- 2Translational Medical Center, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553 Japan.,3The Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, 1-21-1 Toyama Shinjuku-ku, Tokyo, 162-8655 Japan
| | - Akiko Kikuchi
- 1Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553 Japan
| | - Hiroshi Kimura
- 4Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670 Japan.,Department of Psychiatry, Gakuji-kai, Kimura Hospital, 6-19 Higashi-honcho, Chuo-ku, Chiba, 260-8670 Japan
| | - Ataru Inagaki
- 6College of Education, Psychology and Human Studies, Aoyama Gakuin University, 4-4-25 Shibuya, Shibuya-ku, Tokyo, 150-8366 Japan
| | - Hiroyuki Watanabe
- Department of Psychiatry, Gakuji-kai, Kimura Hospital, 6-19 Higashi-honcho, Chuo-ku, Chiba, 260-8670 Japan.,7Division of Medical Treatment and Rehabilitation, Center of Forensic Mental Health, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670 Japan
| | - Yoshiki Kishi
- 8Department of Psychiatry, Okayama Psychiatric Medical Center, 3-16 Shikata-Honmachi, Kita-ku, Okayama, Japan
| | - Koji Yoshida
- 9Department of Human Care and Support, Toyo University, 48-1 Oka, Asaka, 351-8510 Japan
| | - Takaaki Hirooka
- 10Department of Psychiatry, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami, Sagamihara, 252-0374 Japan
| | - Satoru Oishi
- 10Department of Psychiatry, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami, Sagamihara, 252-0374 Japan
| | - Yasuhiro Matsuda
- 11Department of Psychiatry, Nara Medical University School of Medicine, 840 Shijo, Kashihara, 634-8521 Japan
| | - Chiyo Fujii
- 1Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, 187-8553 Japan
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