Comparing continent ileostomy (CI) conversion to repair/redo IPAA: favorable outcomes

PURPOSE

This study aims to compare the outcomes of repair/redo ileal pouch-anal anastomosis (repair/redo-IPAA) with the conversion of IPAA to continent ileostomy (CI) in an effort to prevent the need for a permanent ileostomy (IS) following IPAA failure.

METHODS

This research involved a retrospective analysis of surgical records, employing descriptive statistics and Kaplan-Meier survival analysis.

RESULTS

Among 57 patients with an IPAA, up to three revisions were necessary due to complications or complete failure. Ultimately, repair/redo-IPAA preserved the IPAA in 14 patients (24.6%), conversion to CI salvaged the pouch in 21 patients (36.8%), and IS was unavoidable in 22 patients (38.6%). The cumulative probability of requiring conversion surgery was calculated to be 54.0% at 20 years, thereby reducing the cumulative risk of IS to 32.3%. The 20-year cumulative probability of pouch salvage by repair/redo IPAA was only 21.9%. However, this rate increased to 67.7% when conversion procedures were considered. Following repair/redo-IPAA, only 8.3% of patients reported evacuation frequencies of ≤ 4 during the day, and 16.7% were evacuation-free at night. In contrast, after conversion to CI, 98.0% of patients reported a maximum of four evacuations in a 24-h period. After undergoing repair/redo IPAA, between half and two-thirds of patients reported experiencing incontinence or soiling, while complete continence was achieved in all patients following conversion to CI. Notably, the majority of patients expressed overall satisfaction with their respective procedures. A positive correlation was identified between very high subjective satisfaction and positive objective surgical outcomes exclusively in patients who underwent conversion to CI.

CONCLUSION

When complications or failure of IPAA occur, conversion to CI emerges as a highly viable alternative to repair/redo IPAA. This conclusion is supported by the observation that patient satisfaction appears to be closely tied to stable surgical outcomes. To reinforce these findings, further prospective studies are warranted.

How to adjust the expected waiting time to improve patient's satisfaction?

BACKGROUND

Long waiting time in hospital leads to patient's low satisfaction. In addition to reducing the actual waiting time (AWT), we can also improve satisfaction by adjusting the expected waiting time (EWT). Then how much can the EWT be adjusted to attribute a higher satisfaction?

METHODS

This study was conducted though experimental with hypothetical scenarios. A total of 303 patients who were treated by the same doctor from August 2021 to April 2022 voluntarily participated in this study. The patients were randomly divided into six groups: a control group (n = 52) and five experimental groups (n = 245). In the control group, the patients were asked their satisfaction degree regarding a communicated EWT (T₀) and AWT (T_a) under a hypothetical situation. In the experimental groups, in addition to the same T₀ and T_a as the control group, the patients were also asked about their satisfaction degree with the extended communicated EWT (T₁). Patients in five experimental groups were given T₁ values with 70, 80, 90, 100, and 110 min respectively. Patients in both control and experiment groups were asked to indicate their initial EWT, after given unfavorable information (UI) in a hypothetical situation, the experiment groups were asked to indicate their extended EWT. Each participant only participated in filling out one hypothetical scenario. 297 valid hypothetical scenarios were obtained from the 303 hypothetical scenarios given.

RESULTS

The experimental groups had significant differences between the initial indicated EWT and extended indicated EWT under the effect of UI (20 [10, 30] vs. 30 [10, 50], Z = -4.086, P < 0.001). There was no significant difference in gender, age, education level and hospital visit history (χ² = 3.198, P = 0.270; χ² = 2.177, P = 0.903; χ² = 3.988, P = 0.678; χ² = 3.979, P = 0.264) in extended indicated EWT. As for patient's satisfaction, compared with the control group, significant differences were found when T₁ = 80 min (χ² = 13.511, P = 0.004), T₁ = 90 min (χ² = 12.207, P = 0.007) and T₁ = 100 min (χ² = 12.941, P = 0.005). When T₁ = 90 min, which is equal to the T_a, 69.4% (34/49) of the patients felt "very satisfied", this proportion is not only significantly higher than that of the control group (34/ 49 vs. 19/52, χ² = 10.916, P = 0.001), but also the highest among all groups. When T₁ = 100 min (10 min longer than T_a), 62.5% (30/48) of the patients felt "very satisfied", it is significantly higher than that of the control group (30/ 48 vs. 19/52, χ² = 6.732, P = 0.009). When T₁ = 80 min (10 min shorter than T_a), 64.8% (35/54) of the patients felt "satisfied", it is significantly higher than that of the control group (35/ 54 vs. 17/52, χ² = 10.938, P = 0.001). However, no significant difference was found when T₁ = 70 min (χ² = 7.747, P = 0.052) and T₁ = 110 min (χ² = 4.382, P = 0.223).

CONCLUSIONS

Providing UI prompts can extend the EWT. When the extended EWT is closer to the AWT, the patient's satisfaction level can be improved higher. Therefore, medical institutions can adjust the EWT of patient's through UI release according to the AWT of hospitals to improve patient's satisfaction.

Analysis of factors influencing patient satisfaction after total hip arthroplasty in a Japanese cohort: the significant effect of postoperative physical activity

[Purpose] To determine patient satisfaction after total hip arthroplasty in a Japanese cohort and to identify factors that significantly influence patient satisfaction. [Participants and Methods] This study included 285 patients who underwent primary total hip arthroplasty for osteoarthritis. Postoperative satisfaction, Oxford hip score, short form-12 mental component summary score, and University of California Los Angeles activity score were investigated. Muscle strength and daily step counts were determined using a hand-held dynamometer (μ-Tas F1) and activity monitor (ActivPAL) in 89 and 26 patients, respectively. Factors associated with postoperative satisfaction, Oxford hip score-activities of daily living, and University of California Los Angeles activity score were identified. The relationship between the Oxford hip score-activities of daily living and daily step counts was examined. [Results] Overall, 94.7% of the patients reported satisfaction with total hip arthroplasty. The Oxford hip score-activities of daily living and University of California Los Angeles activity score were significantly associated with patient satisfaction. Younger age and hip abductor strength were significantly associated with a higher Oxford hip score-activities of daily living and University of California Los Angeles activity score. The average daily step count was significantly correlated with the Oxford hip score-activities of daily living. [Conclusion] Self-reported physical activity levels significantly influenced patient satisfaction and were correlated with objective muscle strength and daily step count measurements. These findings can guide total hip arthroplasty patient counseling on the importance of muscle strength and activity levels.

Assessment of patient satisfaction towards auditable pharmaceutical transactions and services implemented in outpatient hospital pharmacy in Ethiopia

BACKGROUND

Patient satisfaction is a widely used indicator to measure quality of pharmacy services. Currently, a transformational pharmacy service called auditable pharmaceutical transactions and services is being implemented nationally in Ethiopia. However, there is a dearth of evidence regarding the national impact of this system on patient satisfaction.

OBJECTIVE

To assess patient satisfaction in hospital pharmacies that have implemented auditable pharmaceutical transactions and services in Ethiopia.

METHOD

This is a national study conducted based on a cross-sectional study design. Data were collected using a structured questionnaire from September 5 to October 5, 2020. The collected data was analyzed using spreadsheet excel and Statistical Package for the Social Sciences (SPSS) version 23. The proportions, ratios, and percentages were used for presenting data. A binary logistic regression test was used to determine the association of patient satisfaction with dispensary infrastructure, medicines availability, scores of labeling, and scores of patient knowledge on dispensed medicines. A p value < 0.05 was considered statistically significant.

RESULT

A total of 650 participants were included in this study for whom a total of 1422 medicines were prescribed which gives an average of 2.19 medicine per patient. The availability of the prescribed medicines in the pharmacies was 1061 (75%), and the affordability of medicines was 1.93 WD that indicates an unaffordable price. The average written medication labels score of 3.1 out of 8 points and the average patient knowledge score for correct usage of medicines was 4.5 out of 6 points. Overall, 585 (90%) of patients reported being satisfied with pharmacy services; the counseling skill of pharmacists 609 (93.7%), and dispensing area 607 (93.4%) cited the most. The only significantly associated factor for satisfaction was the infrastructure of the pharmacy.

CONCLUSION

Overall satisfaction of patients with the auditable pharmaceutical transactions and services implemented in hospital pharmacy services was generally high. The participants were most satisfied with the pharmacist counseling and dispensary area. The medication availability is moderate but the cost is unaffordable. Advanced infrastructures have resulted in a significant improvement in patient satisfaction.

Factors associated with edentulous patients' willingness about implant-supported complete denture: a multivariate analysis

OBJECTIVE

The aim of this study was to evaluate the factors influencing edentulous patients' willingness about mandibular implant-supported complete denture.

MATERIALS AND METHODS

A cross-sectional study was carried out with 117 bimaxillary edentulous patients wearing removable complete dentures (CDs). Patients were assessed concerning denture-related items (number of previous mandibular CDs, previous denture wearing period, dentures maker professional, and regular wearing of previous mandibular dentures) and individual-related aspects, such as mandibular edentulousness period, mandibular bone height, and willingness to the use of mandibular implant-supported complete denture. Masticatory performance was evaluated by the median particle diameter. Mandibular bone height and satisfaction were assessed using a validated method. The Chi-square test was used for data analysis and prevalence ratios were adjusted by using multivariate Poisson regression, both with 95% confidence interval.

RESULTS

A total of 78 participants (66.7%) were interested in mandibular implant-supported overdenture (mean age 65.33 ± 9.49). Masticatory performance was not influenced by choosing mandibular implant-supported complete denture. The preference about mandibular implant-supported complete denture was correlated with longer mandibular complete denture experience (p = 0.021) and it was significantly associated with dissatisfaction about retention (p = 0.005).

CONCLUSION

Previous experience with mandibular complete dentures and dissatisfaction about retention influence the willingness about mandibular implant-supported overdenture.

CLINICAL RELEVANCE

Many factors are associated with rehabilitation preferences for edentulous patients and mandibular implant-supported complete denture is one of the available alternatives. Therefore, this study has demonstrated the factors influencing the decision to replace a mandibular conventional complete denture by dental implant treatment based on patient's outcomes. Such finding may be considered as a relevant aspect towards shared decision-making for prosthodontic rehabilitation of edentulous patients.

Relationship between ocular surface disease and patient's satisfaction among cataract surgical patients in Nigeria

PURPOSE

To determine the effect of clinical and cytological features of ocular surface disease on patient's satisfaction following small incision cataract surgery at a tertiary eye care centre.

METHOD

This is a prospective observational study of 70 consecutive consenting patients who underwent manual small incision cataract surgery(MSICS) at a tertiary eye care centre. All participants underwent ocular surface profile assessment using Schirmer I test (ST1), tear film break-up time (TBUT), conjunctival impression cytology (CIC) and ocular surface disease index (OSDI) at pre-operative visit, 1-week and 4-week post-operative visit. Patient's satisfaction with surgical outcome was evaluated at 6-week post-operative visit using a rating scale of 1 to 10. Data were analysed using IBM Statistical Package for the Social Sciences (SPSS) version 20.0 (IBM Corp., Armonk, NY USA).

RESULTS

The mean age was 68 ± 9.4 years with a male/female ratio of 1:1.1. The mean OSDI score decreased significantly (p < 0.001) from 33.1 ± 8.4 pre-operatively to 20.8 ± 7.4 four weeks after surgery. The TBUT was 12 ± 4.1 s pre-operatively, but significantly reduced to 11.2 ± 3.9 s (p < 0.001) at 4-week post-operative period. At 6 weeks, patients with normal CIC reduced from 53 (75.8%) pre-operatively to 8 (11.4%) (p < 0.001, z = - 7.24). Fifty percent of patients with severe post-operative ocular surface disease reported dissatisfaction with their surgical outcome (p = 0.024).

CONCLUSION

Manual small incision cataract surgery can significantly impair the ocular surface health profile of patients. The presence of ocular surface disease in patients pre-operatively can negatively impact their level of satisfaction with surgical outcome.

Associations between gait analysis parameters and patient satisfaction one year following primary total knee arthroplasty

BACKGROUND

The purpose of this prospective study was to understand the relation between gait outcomes and patient satisfaction one year after total knee arthroplasty (TKA).

METHODS

Seventy-nine patients were evaluated before and one year after TKA using clinical gait analysis. Specific gait outcomes were analyzed: gait speed, stance phase, range of motion (ROM) knee flexion and maximal knee flexion. The parameters of interest selected for the statistical analysis were: gait speed and maximal knee flexion during gait. The Western Ontario and MacMaster Osteoarthritis Index (WOMAC) and patient satisfaction were also assessed. The satisfaction was evaluated using a questionnaire and was splited in five categories: very unsatisfied, unsatisfied, neutral, satisfied or very satisfied. To assess associations between patient satisfaction and maximal knee flexion during gait and gait speed, an unadjusted ordinal logistic regression analysis was used. The analysis was then adjusted for covariates: age and Body Mass Index (BMI) before surgery and WOMAC pain one year after surgery.

RESULTS

All gait outcomes after TKA had significantly improved. The ordinal logistic regression analysis found significant associations between patient satisfaction and maximal knee flexion after TKA (unadjusted and adjusted) but not for gait speed.

CONCLUSION

These findings show that all patients improved their gait outcomes one year after TKA but only a higher maximal knee flexion during gait may influence the level of patient satisfaction.

Patient experience in a surgical assessment unit following a closed-loop audit using a Kaizen Lean system

BACKGROUND

The Acute Surgical Assessment Unit (ASAU) in University Hospital Limerick (UHL) has provided a solution to overcrowding and long waiting times since centralization of emergency services to UHL. Recognising the importance of its evolving role, the ASAU in UHL has recently undergone a major revamp to ease the pressure in the overcrowded emergency department (ED). This included a new purpose state-of-the-art-built unit and equipment, improved staffing levels and use of a Kaizen Lean system to identify key area of delays and inefficiency with subsequent implementation of suggestions derived after Kaizen Lean. Patient satisfaction reporting was analysed in the older building and subsequently in the new site post Kaizen Lean to complete a closed-loop audit. The aim of the study was to examine patient satisfaction response rates with the ASAU prior to and following Kaizen Lean implementation and transfer to a new purpose-built unit.

METHODS

The survey comprised of two phases. In phase 1, 100 questionnaires were distributed to patients in ASAU (older building, pre-Kaizen Lean). In phase 2, the survey was repeated (100 patients) after Kaizen Lean implementation and transfer to the new state-of-the-art unit. Questionnaire design was based on WHO strategy on responsiveness measurement guidelines and was tailored to a population of surgical patients. Results were analysed using IBM SPSS, version 21 and Excel 2013.

RESULTS

Two hundred questionnaires were analysed. Implementation of suggestions derived post Kaizen Lean translated into improved resource usage with reduced waiting time to be seen by nurses and doctors. Patients had better awareness about their treatment plan and planned next steps in the management. Satisfaction across different domains, perceptions of privacy and overall treatment were also improved.

CONCLUSIONS

A Kaizen Lean approach improved the transition of an ASAU to a new purpose-built unit and further improved overall patient satisfaction with services of the ASAU.

Impact of Removable Partial Denture Type on Patient Satisfaction and Abutment Survival Rate-RCT

BACKGROUND:

Patient’s satisfaction and the preservation of abutments is the most important outcomes that the clinician seeks during fabrication of any dental treatment, especially when it is concerned with removable prosthodontic rehabilitation.

AIM:

The present study evaluates three different Removable Partial Denture (RPD) types restoring mandibular class II modification I edentulous cases with regards to patient’s satisfaction and abutments survival.

METHODS:

Forty-two partially edentulous patients were divided into three groups (Group I rehabilitated with Vitallium RPD, Group II rehabilitated with Vitallium RPD where the modification area restored with the surveyed bridge, Group III rehabilitated with Thermopress RPD). The patients were followed up for twenty-four months. Using a questionnaire, prosthodontic maintenance required was documented at the delivery and after 3 months.

RESULTS:

There was a significant difference regarding patient satisfaction for group III (P-value <0.05) while for groups I and II there was a non-significant difference (P-value >0.05). Regarding the survival rate, there was a non-significant difference between the three groups (P-value >0.05) at the end of twenty-four months of follow up.

CONCLUSION:

Patient satisfaction and abutment survival were better with Thermopress RPD than conventional Vitallium RPD or Vitallium RPD with a surveyed bridge restoring the modification area. Although a non-statistically significant difference was found in the survival rate of abutments between groups, a clinically important result was revealed as no abutments failures were reported in the Thermopress group.

Postoperative Pain Perception and Patient's Satisfaction After Mandibular Third Molar Surgery by Primary Closure With Distal Wedge Surgery

Background

The aim of this study was to compare periodontal conditions of the distal aspect of mandibular second molar and patient's satisfaction between standard surgical technique and primary closure with or without distal wedge surgery used for the removal of mandibular third molar impaction (MTMI).

Methods

Twenty-four patients, aged 18 - 25 years, were invited to participate in this prospective, single-blinded, split-mouth randomized controlled study. Each participant owned similar bilateral impacted mandibular third molar. Periodontal parameters (i.e. probing depth (PD), gingival index (GI), plaque index (PI) and the distance from cusp tip to gingival margin (CT-GM)) were measured. The standard mandibular third molar surgery was performed on one side while for the other side the distal wedge surgery with or without osseous contouring was added to the protocol. Information about satisfaction was taken from questionnaire.

Results

At the site where distal wedge was performed, significant change in CT-GM occurred at all aspects and a significant PD reduction was observed at disto-buccal and mid-distal sites. Distance between cemento-enamel junction (CEJ) and gingival margin reduced significantly at all sites. No significant difference between two groups was found in GI, PI and patient's satisfaction.

Conclusions

Incorporating distal wedge surgery into MTMI removal protocol does improve periodontal health of adjacent second molar and does not affect patient's satisfaction.

Comparison of Effectiveness and Patient Satisfaction of Vaginal Versus Oral Misoprostol in Treatment of Missed Miscarriage

BACKGROUND

In recent years' medical management with misoprostol is an effective alternative to surgical evacuation. But there is a dearth of evidence to reveal the effectiveness of the different routes of misoprostol and satisfaction rate among the patients treated with these routes.

AIM

This study was conducted to compare the effectiveness and patient's satisfaction rate of vaginal versus oral misoprostol.

METHODS

It was a prospective non-interventional study. One hundred women of having missed abortion confirmed by ultrasonography examination were enrolled in the trial. Fifty-eight subjects were administered 200 mcg of oral and 42 subjects received 200 mcg of vaginal misoprostol every four hours up to four doses. If complete expulsion did not occur 12 hours after the last dose, the surgical evacuation was done.

RESULTS

There was no significant statistical difference between the effectiveness of treatment with vaginal (78.57%) and oral misoprostol (79.31%) (p = 0.928). The difference between Patients' satisfaction at the time of discharge for the vaginal group (64.29%) and oral group (65.52%) was not statistically significant (P = 0.991). There was an increase in patients' satisfaction for both groups at the follow-up session, but still, the difference was not significant (P = 0.897).

CONCLUSION

This study confirms that there is no statistical difference between the effectiveness and patient satisfaction of oral and vaginal misoprostol in the treatment of missed abortion.

Jadenu® Substituting Exjade® in Iron Overloaded β-Thalassemia Major (BTM) Patients: A Preliminary Report of the Effects on the Tolerability, Serum Ferritin Level, Liver Iron Concentration and Biochemical Profiles

Introduction

Due to the chronic nature of chelation therapy and the adverse consequences of iron overload, patient adherence to therapy is an important issue. Jadenu ^® is a new oral formulation of deferasirox (Exjade ^®) tablets for oral suspension. While Exjade^® is a dispersible tablet that must be mixed in liquid and taken on an empty stomach, Jadenu ^® can be taken in a single step, with or without a light meal, simplifying administration for the treatment of patients with chronic iron overload. This may significantly improve the compliance to treatment of patients with β-thalassemia major (BMT). The aim of this study was to evaluate the drug tolerability and the effects of chelation therapy on serum ferritin concentration, liver iron concentration (LIC) and biochemical profiles in patients with BMT and iron overload.

Patients and Methods

Twelve selected adult patients BMT (mean age: 29 years; range:15–34 years) were enrolled in the study. All patients were on monthly regular red cell transfusion therapy to keep their pre-transfusional hemoglobin (Hb) level not less than 9 g/dL. They were on Exjade^® therapy (30 mg/kg per day) for two years or more before starting Jadenu® therapy (14–28 mg/kg/day). The reason for shifting from Deferasirox^® to Jadenu^® therapy was lack of tolerability, as described by patients, such as nausea, vomiting, diarrhea, stomach pain. Most of them also reported that Deferasirox^® was not palatable. Lab investigations included monthly urine analysis and measurement of their serum concentrations of creatinine, fasting blood glucose (FBG), serum ferritin, alkaline phosphatase (ALP), alanine transferase (ALT), aspartate transferase (AST) and albumin concentrations. LIC was measured using FerriScan ^®. Thyroid function, vitamin D and serum parathormone, before and one year after starting Jadenu ^® therapy, were also assessed.

Results

Apart from some minor gastrointestinal complaints reported in 3 BMT patients that did not require discontinuation of therapy, other side effects were not registered during the treatment. Subjectively, patients reported an improvement in the palatability of Jadenu^® compared to Exjade^® therapy in 8 out of 12 BMT patients. A non-significant decrease in LIC measured by FerriScan^® and serum ferritin levels was observed after one year of treatment with Jadenu^®. A significant positive correlation was found between serum ferritin level and LIC measured by the FerriScan^® method. LIC and serum ferritin level correlated significantly with ALT level (r = 0.31 and 0.45 respectively, p < 0.05). No significant correlation was detected between LIC and other biochemical or hormonal parameters.

Conclusions

Our study shows that short-term treatment with Jadenu ^® is safe but is associated with a non-significant decrease in LIC and serum ferritin levels. Therefore, there is an urgent need for adequately-powered and high-quality trials to assess the clinical efficacy and the longterm outcomes of new deferasirox formulation.

Patients' satisfaction towards radiological service and associated factors in Hawassa University Teaching and referral hospital, Southern Ethiopia

BACKGROUND

Patient satisfaction, one of the main components of quality of care, is a crucial phenomenon for the overall health care delivery system. Even though a number of studies have been conducted about patient satisfaction in different health services, studies in radiology services are flimsy in Ethiopia. This study aimed at assessing patient satisfaction towards radiological service and associated factors in Hawassa University Teaching and Referral hospital.

METHODS

An institution based cross-sectional study was conducted among 321 adult patients presented for radiological service in the study area using stratified sampling technique. Patient satisfaction was measured using SERVQUAL (Service Quality) tool that consisted of seven items: accessibility, quality of radiological service, courtesy of radiology staff, existence of good communication with service provider and desk worker, physical environment and privacy technique. Exit interviews of patients were conducted using a structured and pretested questionnaire. Data was collected by three grade ten completed trained data collectors from May 12 to May 28, 2016. Multiple logistic regressions were used to identify independent factors associated with patient satisfaction on radiological services using SPSS version 21.

RESULTS

The overall patient satisfaction towards radiological service was 71.6%. Satisfaction to accessibility of the service was 84.5% while it was 80.6% to courtesy of the staff. Similarly, 81.6% reported satisfied with quality of the service and 59.4% and 71% of reported satisfied with physical environment and radiological service provider respectively. On the other hand, 99.7% of the respondents were dissatisfied with privacy of the service. The study revealed that patients who attended primary school (AOR = 0.317, 95% CI: 0.11-0.88), unemployed patients (AOR = 0.067, 95% CI: 0.007-0.622) and patients who had short waiting time to enter into examination room less than one hour (AOR = 4.12, 95% CI: 1.4-11.62) were factors associated with patients satisfaction.

CONCLUSION

This study found that majority of respondents was satisfied with the radiological services. Respondent's education level, occupation as well as duration of time taken to enter into examination room were important factors influencing the satisfaction condition. Hence, concerted effort is needed to constantly improve on patient satisfaction to better radiology returns arising from improved patient patronage. It is recommended to give great care and attention to clients during radiological examination procedure and also suggested that the department should decrease time taken to enter into examination room. On the other hand, the reasons behind more educated clients were less satisfied with radiologic service than more educated respondents need further investigation.

Bi-cruciate substituting total knee arthroplasty improved medio-lateral instability in mid-flexion range

PURPOSE

Appropriate medio-lateral (ML) stability is an important factor of good clinical outcome following total knee arthroplasty (TKA). We hypothesized that a newly introduced Bi-Cruciate Stabilized substituting (BCS) prosthesis reduces the medio-lateral instability in mid-flexion range. The purpose of this study was to measure the ML stability (varus ligament balance) using a new tensor device after implantation of BCS TKA and to analysis the association between varus ligament balance and clinical results after TKA.

MATERIALS AND METHODS

We evaluated 33 patients who underwent 39 Journey. 2. BCS TKA using the measured resection technique. We measured the gaps after implantation from extension to full flexion with reduced patella by constant distraction force with 120N. The varus ligament balance gap was defined as the gap calculated by subtracting from Lateral to medial component gap. The clinical results at 2years after operation was compared with intraoperative varus ligament balance.

RESULTS

Varus ligament balance showed its maximum gap at full knee extension and 120° flexion. Varus ligament balance at 30°, 60° and 90° of flexion were significant differences in the varus ligament balance at full extension. (* p < 0.05). The varus ligament balance gap was negatively corrected with postoperative 2011 Knee society score (patient's satisfaction) (r = 0.661, p = 0.001).

CONCLUSIONS

The most important findings of the present study are that BCS TKA can reduces the ML instability in mid-flexion range, and improve simultaneously the patient's satisfaction.

LEVEL OF EVIDENCE

Therapeutic study, Level III.

Relationship between' patient's rights charter' and patients' satisfaction in gynecological hospitals

BACKGROUND

Patient's satisfaction with hospital services is one of the most important indicators of efficiency and quality of services of different hospital wards.

METHODS

This cross-sectional descriptive analytical study was conducted in 2015. The study population included patients in gynecological hospitals of TUMS, and by using questionnaires; data were collected from 304 patients. Statistical analysis was performed using the SPSS 22.

RESULTS

The rights of patients were mainly observed through "quality of care" (Mean ± SD: 9.65 ± 2.62), "knowing the charges and the right to complain"; (Mean ± SD: 6.00 ± 2.5) "presence of an active system to handle complaints of patients in the hospital and explanation of the error that occurred during service provision to patients by the wrongdoer" is the lowest (7.5 ± 2.62). It was found that patients' satisfaction is below the mean and its different aspects are higher than the mean level. However, the services of physicians and feeding recorded the highest and lowest satisfaction, respectively (19.4 ± 4.25, 20.77 ± 4.39). The mean score of satisfaction of patients admitted with nursing physical care was 24.5 ± 6.2.

CONCLUSION

Overall, patients' satisfaction with hospital services was close to the mean. Deficiencies and grievances should be resolved with a correct measure.

Satisfaction with in vitro fertilization treatment: patients' experiences and professionals' perceptions

BACKGROUND

This paper investigates patients' satisfaction with various aspects of fertility care and seeks to determine to what extent fertility specialists are able to assess patient satisfaction. Patients' experiences with in-vitro fertilization (IVF) services and facilities have been compiled and examined in order to discover whether patients' satisfaction is correlated to psychological factors and demographic, socio-economic, and health characteristics, and whether patients' satisfaction has an influence on the willingness to pay (WTP) for IVF treatment.

METHODS

The study was carried out on 204 patients and 19 fertility professionals from 8 public IVF units in Israel.

RESULTS

The study found that, overall, infertile patients are satisfied with the care they received. Several demographic variables (age; education; income; number of fertility treatments) and psychological factors ('Pessimism' and 'Activeness'), were found to be significantly correlated with patient satisfaction with IVF. The results yielded a negative correlation between the WTP for IVF treatment and the satisfaction with access to care and physical conditions.

CONCLUSIONS

Patient satisfaction is an important component in the evaluation of fertility treatments as well as other medical interventions. Insights into the quality of care as seen from the patients' perspective may help healthcare staff better meet patients' needs, wishes, and priorities.