Quality of Postoperative Pain Management in Orthopedic Patients and Its Impact on Sleep Quality and Patient Satisfaction: An Integrative Review.

Pain is one of the most common manifestations in the postoperative stage and it has a detrimental effect on both sleep and patient satisfaction. Consequently, this integrative review seeks to identify the outcomes of pain management specifically concerning sleep quality and patient satisfaction among the patients receiving orthopedic surgeries. In a stepwise manner, peer-reviewed articles manually searched in four databases including Scopus, Science Direct, PubMed, and CINAML (Cumulated Index to Nursing and Allied Health Literature) published between 2019 and 2023 were selected. The current review finally encompassed 22 studies. The review elaborates and reaffirms the notion that pain after surgery is still a critical issue that impacts the quality of patients' sleep as well as their overall satisfaction. Chronic sleep disturbance is generally linked with pain while other factors such as light exposure and hospital environment were found to influence sleep quality. It is thus crucial to develop clear multifaceted pain management guidelines that include patient-tailored pharmacological and non-pharmacological interventions aimed at helping patients recover better, sleep better, and be satisfied with the procedures and results.

Towards the new primary care reform in Greece: a focus on patients' expectations, views and perceptions from rural healthcare centres.

INTRODUCTION: Patient perception of quality of care is an essential component in evaluating healthcare delivery. This article reports data from primary health care (PHC) centers before Greece's most recent PHC reform. The study was undertaken to offer some baseline information about patient experience, support the decision-making processes taking place, and provide valuable input for future policy-making comparisons in Greece. METHODS: The research was conducted across the 16 PHC centers of Epirus, a region of north-western Greece, from June to September 2017, with 532 patients rating the importance of different aspects of three main healthcare domains (clinical behavior, support and services, and organization of care) of PHC provision. The Greek version of the European Task Force on Patient Evaluations of General Practice (EUROPEP) questionnaire was implemented for research purposes. Univariate comparisons were performed for patients with and without chronic disease, using Pearson's χ2 test for categorical data. RESULTS: Study findings support that the organization of care domain is of highest importance and priority, with clinical behavior and support and services following closely. Among recruited patients, on average, only 2.1% of patients with a chronic disease were satisfied (rated 4 or 5 on the Likert scale) with the organization of care aspects under consideration, compared to 18.4% of patients without a chronic disease. Furthermore, only 4% of patients with a chronic disease were satisfied with the aspects examined in the clinical behavior domain, compared to 27% of patients without a chronic disease. Finally, 18% of sampled patients with a chronic disease reported being satisfied with the quality of support and services provided, compared to 38% of patients without a chronic disease. CONCLUSION: It is necessary to back up available past information to afterwards estimate reform imprinting on expectations and perceptions. The items and aspects of EUROPEP, in line with the new tasks of the personal doctor within the PHC system that patients perceive as most essential, can be used to prioritize quality improvement activities to strengthen PHC delivery in Greece. Communication skills, practices, and behavioral change skills seem to need more attention for an efficient PHC model.

Patient Satisfaction Following Orthodontic Treatment: A Systematic Review.

Patient-reported outcome measures (PROMs) have become increasingly important in orthodontic treatment as they reflect patients' perceptions of treatment outcomes. Understanding patient satisfaction with orthodontic treatment is crucial for improving healthcare delivery and patient-centered care. This systematic review aimed to critically appraise the evidence regarding patient satisfaction after orthodontic treatment, exploring the effects of different treatment types, patient demographics, and other factors on satisfaction levels. Eight electronic bibliographic databases were searched without publication time or language restrictions, including PubMed®, Scopus®, the Cochrane Central Register of Controlled Trials, Web of Science™, Embase®, Google™ Scholar, Trip, and OpenGrey. A manual search was conducted on the references in the included papers. Eligibility criteria were established based on the Population, Intervention, Comparison, Outcomes, and Study (PICOS) framework. Studies were included if they reported patient satisfaction levels following orthodontic treatment using standardized questionnaires. Two reviewers independently collected and analyzed the data. The risk of bias was assessed using Cochrane's risk of bias tool (RoB2) for randomized clinical trials, and the methodologic quality for cohort and cross-sectional studies was assessed using the modified version of the Newcastle-Ottawa scale. Fourteen studies employed various questionnaires and timings to gauge post-orthodontic treatment satisfaction. Patient satisfaction levels were generally high, with most studies reporting satisfaction rates above 91%. Fixed orthodontic appliances were associated with higher satisfaction levels compared to removable appliances. While age and gender did not significantly influence satisfaction, the quality of care and doctor-patient relationships were crucial factors in patient satisfaction. This systematic review proves that patient satisfaction with orthodontic treatment is generally high, with fixed appliances and positive doctor-patient relationships contributing to higher satisfaction levels. However, the quality of the evidence was moderate to low, highlighting the need for further high-quality clinical studies in this area.

Minimally Invasive Open Bilateral Total Thyroidectomy Using Unilateral Neck Incision in Thyroid Cancer: Preliminary Surgical and Quality of Life Outcomes.

PURPOSE: Thyroid cancer incidence has increased in recent decades, and thyroid surgery is continuously evolving in response to demands for postoperative comfort and cosmesis. This study aimed to introduce a new surgical method for minimally invasive open bilateral total thyroidectomy (MI-BTT) using a unilateral 2.5-3.0 cm neck incision. Furthermore, we reported the surgical outcomes and postoperative quality of life (QoL) using a validated Korean translated Dermatology Life Quality Index (DLQI) questionnaire. MATERIALS AND METHODS: We retrospectively evaluated 41 Asian patients who underwent MI-BTT for low-risk papillary thyroid cancer by a single surgeon from March 2019 to December 2021. RESULTS: A total of 4 male and 37 female patients were included. The mean age and body mass index were 46.2±10.1 years and 23.3±3.3 kg/m², respectively. The average tumor size was 1.1±0.6 cm, and 36 patients (87.8%) had bilateral cancer. Twenty-three (56.1%) patients had occult central lymph node (CLN) metastasis in the final pathologic report, with the mean number of dissected CLNs being 7.2±6.5. Gross capsular extension was found in 6 patients (14.6%). Moreover, 28 patients (68.3%) received additional treatment after surgery with low or high doses of radioactive iodine. The average serum-stimulated thyroglobulin value identified during treatment was 1.57±2.30 ng/mL. The mean operation time was 78.0±13.9 minutes, and postoperative complications included transient hypocalcemia (36.6%), transient hoarseness (24.4%), and seroma (2.4%). The mean total DLQI score was 2.73±0.78, indicating a small effect on QoL. CONCLUSION: MI-BTT is a novel, safe, and feasible technique to improve patient satisfaction for surgical scars and QoL.

Maximizing Satisfaction in Orthopedic Outpatient Clinics: Evidence From Ireland.

Background Patient satisfaction is a critical metric in healthcare, reflecting the quality of care provided and influencing clinical outcomes and healthcare utilization. In orthopedic outpatient clinics, patient satisfaction affects patient adherence to treatment plans and overall health outcomes. This study aims to identify and analyze key factors influencing patient satisfaction in orthopedic outpatient clinics. Methodology This cross-sectional study was conducted from April to May 2024 across 10 orthopedic outpatient clinics. In this study, family members were included as respondents to the Patient Satisfaction Questionnaire (PSQ) when patients were unable to complete the survey due to age, cognitive impairment, or physical disabilities. This approach was adopted to ensure that the experiences of all patients, particularly minors, elderly individuals, and those with disabilities, were accurately captured. The PSQ assessed various aspects of patient satisfaction, including communication, treatment plans, addressing concerns, clinic environment, and overall satisfaction. Quantitative data were analyzed using SPSS version 27.0 (IBM Corp., Armonk, NY, USA). Results The study included 172 respondents. High levels of overall satisfaction were reported, with 142 (82.6%) respondents very satisfied and 28 (16.2%) somewhat satisfied. Significant associations were found between overall satisfaction and several factors, namely, effective communication, thorough explanation of treatment plans, addressing patient concerns, and a clean, comfortable clinic environment. Shorter waiting times were also associated with higher satisfaction. Regression analysis revealed that staff rating and the thoroughness of treatment plans were significant predictors of overall satisfaction. Conclusions Effective communication, thorough treatment explanations, addressing patient concerns, and maintaining a clean clinic environment are key determinants of patient satisfaction in orthopedic outpatient clinics. Reducing waiting times and investing in staff training on communication and empathetic care can further enhance patient satisfaction. These findings provide valuable insights for healthcare providers and administrators aiming to improve patient experiences in orthopedic outpatient settings. Further research is recommended to explore these relationships in diverse settings and develop targeted interventions.

Safety net patients' satisfaction with oral health services by provider type and intent to return for more care.

OBJECTIVES: This study examined patients' satisfaction with services provided by different oral health providers, their intent to return for additional care, and associations with patients' demographics and service characteristics. METHODS: Descriptive analyses and multivariable ordinal logistic regressions were conducted using survey data from 898 patients who received care at Apple Tree Dental (ATD) in Minnesota during 2021. The questionnaire included 12 statements on patient satisfaction with the clinician's ability to explain the dental diagnosis and treatment options, to be considerate of the patient's needs and dental anxiety, and to provide technically competent services. RESULTS: In general, patients reported high satisfaction with dental care and a strong intent to return to ATD for future services. No significant differences in patient satisfaction were observed by provider type. Patients' intent to return was higher among non-White respondents (OR = 1.76; 95% CI = 1.06-2.92) and patients who were more satisfied with their providers' technical competence/treatment (OR = 1.47; 95% CI = 1.37-1.57). The association between intent to return and patient satisfaction with providers' information/communication was stronger for patients treated by dental hygienists. The association between intent to return and patient satisfaction with providers' technical competence/treatment was also stronger for patients who were more satisfied with providers' information/communication and understanding/acceptance, and for those treated by their desired or usual provider. CONCLUSIONS: The study underscores the benefits of introducing dental therapists to the oral healthcare team, showing that this can be achieved without sacrificing either the quality of patient care or patient satisfaction.

Awareness Levels About Specialty Services Offered by the Faculty of Dentistry in Sebha, Libya.

BACKGROUND: Assessment of awareness levels about any hospital is critical to judge its current standings and plan for future development. Limited literature is available about dental health in Libya. AIM: This study aimed to study the awareness and perception of the various specialty services offered by the Faculty of Dentistry (SDC), Sebha University for their quality and preference. MATERIALS AND METHODS: It was a performance monitoring research, and the data was collected by interview using a standardized questionnaire. Non-probability judgmental sampling was used. The offered services included all specialties in dentistry and oral cancer screening. Information relating to the awareness and perception of SDC specialty services was collected with few agree/disagree questions from 450 subjects. Data was collected, tabulated, and analyzed with descriptive statistics using SPSS v23.0 (IBM, Armonk, NY, USA). RESULTS: About 22.7% (n=102) were in the 45-54 years age group. Self-employed (n=108, 24%) and professional (n=108, 24%) were noted in occupation. Forty-eight (n=216) were graduates. Three hundred twenty-eight respondents (72.9%) were aware about the dental services. Four hundred twenty-eight respondents (95.1%) have visited SDC. Three hundred six respondents (68%) were satisfied, and 66 respondents (14.7%) were very much satisfied. Dental health checkups were predominantly known to the respondents (n=302, 67%). For all the other specialties, the awareness level was low. CONCLUSION: The identification of weak areas is crucial for the future planning and development of oral health care rendered by SDC.

Patients' Satisfaction After Breast Reconstruction Surgery Using Autologous versus Implants: A Meta-Analysis.

INTRODUCTION: Breast cancer is a common disease that affects women globally and causes physical and emotional challenges. Breast reconstructive surgery aims to restore the shape of the breast after a mastectomy. Two common approaches used today are tissue-based or autologous and implant-based reconstruction. Autologous breast reconstruction has the advantage of being more affordable, but the resulting shape is less attractive. At the same time, the implant technique produces a more pleasing shape at a more expensive cost. OBJECTIVE: To compare the level of patients' satisfaction after breast reconstruction using the implant technique with the autologous technique using the Breast-Q questionnaire. METHODS: This research was a meta-analytic study to compare patients' satisfaction levels with breast reconstruction using the autologous technique compared with the implant technique. We searched several research articles from PubMed, EMBASE, and the Cochrane Library from 2014 to 2023. Then, we conducted an analysis using Revman 5.4. The results of the study were presented in a forest plot diagram. RESULTS: From the search results, there were 3980 studies. Then, exclusion and inclusion were carried out, and the results obtained were 16 research articles. Of the 16 studies, analysis was then carried out, and the results obtained were satisfaction in breast patients with a sample size of 7284. The standard result of the mean difference was 0.55 (95% CI 0.41-0.68) p < 0.00001. Satisfaction with the reconstruction results with a sample size of 2935. The standard result of the mean difference was 0.48 (95% CI 0.28-0.69) p < 0.00001. Patients' sexual satisfaction with a sample size of 7149. The standard result of the mean difference was 0.27 (95% CI 0.17-0.37) p < 0.00001. Patients' satisfaction with nipple shapes with a sample of 426. The standard result of the mean difference was 0.22 (95% CI -0.00-0.44) p = 0.06. Patients' satisfaction with plastic surgeons with a sample size of 272. The standard result of the mean difference was 0.52 (95% CI 0.25-0.80) p= 0.0002. CONCLUSION: The autologous breast reconstruction technique is better than the implant-based reconstruction technique in terms of patient satisfaction with the breast, reconstruction outcome, sexual satisfaction, nipple shapes, and plastic surgeons based on the Breast-Q questionnaire. The findings of this comprehensive study indicate that breast cancer survivors who choose autologous reconstruction have higher levels of satisfaction across multiple domains than those who decide implant-based reconstruction.

Exploring Inpatients' Perspective: A Cross-Sectional Survey on Satisfaction and Experiences in Greek Hospitals.

INTRODUCTION: The aim of this study was to identify and evaluate patient-relevant experiences that fulfill the expectations and demands of society in Greece and those that could be improved by offering a better quality of care. The satisfaction of health service recipients is one of the key elements of the success of a health system. METHODS: A cross-sectional survey was conducted to obtain data on satisfaction with hospitalization from patients admitted to 10 public hospitals in Athens between June 2019 and December 2021. Statistical analysis was applied to 57 items and 7 dimensions of patient satisfaction, namely waiting-arrival-admission, nursing staff, medical staff, other staff, service and quality of food, interior environment, and procedures. RESULTS: A total of 3724 patients, aged ≥ 18 years, who had experienced hospitalization and agreed to participate in the study were included, the response rate of which was 93%. Patient satisfaction and experience with healthcare services provided by hospitals is moderate, with almost two-thirds of patients (67.38%) satisfied with the care they received. The encounter with the medical-nursing personnel (3.75/5) and other staff (4/5) were factors that positively affected patients' overall satisfaction with hospitalization. However, there were some causes of dissatisfaction, mainly associated with waiting hours, easy access to medical services or services received in emergencies, delays of planned procedures (3.50/5), or problems with old facilities and equipment (3.56/5). CONCLUSION: Based on the patients' judgment, the performance of hospitals was rated at a 'tolerable' level. Professionalism and the education of personnel led to a positive treatment outcome and improved the experience of patients to a good level. However, public hospitals continued to be underfunded and lacked strong support, which affected staff communication and responsiveness to patients' requirements, while smart technologies and the simplification of procedures were not adopted to help staff provide a better quality of healthcare. The results suggest that there is plenty of room for improvement.

Impact of removing soft contact lenses 1 day versus 1 month before surgery on the outcomes of microkeratome laser in situ keratomileusis.

PURPOSE: To compare the outcomes, safety, efficacy, and predictability of microkeratome laser in situ keratomileusis (LASIK) 24 h and one month or more after removing soft contact lenses. SETTING: ULTRALASIK Eye Center, Dubai, United Arab Emirates. METHODS: The patients were divided based on the time of discontinuation of the soft contact lenses before LASIK (Group 1 at 24 h and Group 2 at one month or longer), and the two groups were well matched. Schirmer's testing, tear break-up time, corrected distance visual acuity, uncorrected distance visual acuity, manifest refraction spherical equivalent, and infection rate were evaluated preoperatively and at one week, one month, and six months after treatment. RESULTS: Group 1 (G1) comprised 1025 eyes, and group 2 (G2) had 1052 eyes. The groups were comparable preoperatively. The overall-mentioned outcomes were comparable between groups with uncorrected distance visual acuity of - 0.084 ± 0.12 logMAR in G1 and - 0.078 ± 0.17 logMAR in the G2 at 6 months (P = 0.322). Tear break-up time as well as Schirmer's testing results was also comparable with no evidence of increased risk of dry eyes or non-inflammatory complications in any of the groups on follow-up visits at 1 week (P = 0.421), 1 month (P = 0.101), and 6 months (P = 0.399) postoperatively. Finally, no infectious complications were recorded in either of the groups. CONCLUSION: With the absence of corneal warpage, no statistical or clinical difference in microkeratome LASIK outcomes and safety was spotted between the groups despite the difference in SCL discontinuation time before the procedure.

Comparison of Remotely Applied and Face-to-Face Disease Activity Scores in Saudi Arabian Patients With Rheumatoid Arthritis: A Prospective Cohort Study.

OBJECTIVES:  This study aimed to assess the disease activity indices (DAI) of rheumatoid arthritis (RA) by telephone-based tele-visits compared to face-to-face clinic encounters. METHODS: Patients with RA attending outpatient clinics between December 2021 and May 2022 were prospectively recruited. Disease activity assessments were initially performed in the clinic using the disease activity score 28-C-reactive protein (DAS28-CRP) and disease activity score 28-erythrocyte sedimentation rate (DAS28-ESR). Within two weeks of the clinic visit, a telephone-based assessment gathered information on demographics, Routine Assessment of Patient Index Data 3 (RAPID3) score, and satisfaction. Disease activity scores were dichotomized into remission or low disease activity and moderate to high disease activity. RESULTS:  A total of 78 patients completed the two-point interview. Of those, 62 (79.49%) were women, with a mean age of 54.73±13.71 years. Seropositivity for rheumatoid factor and/or anti-citrullinated peptide was observed in 51 (83.61%) participants. Twenty-seven percent of the patients were classified as in remission or low disease activity by RAPID3. This was 71% for DAS28-CRP and 33% for DAS28-ESR. Based on the dichotomized disease activity classification, the agreement percentage between RAPID3 and DAS28-ESR was 78.08%, while it was 47.22% between RAPID3 and DAS28-CRP, which resulted in kappa statistic values of 0.48 (moderate agreement) and 0.14 (low agreement), respectively. Satisfaction rates were low. CONCLUSION:  Telephone-based RAPID3 showed a low-moderate agreeability compared to DAS28 and had low satisfaction rates. This suggests that tele-rheumatology care by this means was not feasible for following up with patients with RA and warrants further development.

Quality of Life of Autistic Children and Supported Programs in Saudi Arabia: A Cross-Sectional Study.

BACKGROUND: Autism spectrum disorder (ASD) is a neurobehavioral condition marked by social interaction challenges, communication deficits, and repetitive behaviors, with studies in Saudi Arabia showing varying prevalence rates in different regions. This study aimed to evaluate the social context of autistic children and the quality of life (QOL) for families of children with autism utilizing the Beach Center Family Quality of Life Scale (BCFQOL). METHODS: This cross-sectional study, conducted at King Abdulaziz Medical City in Saudi Arabia over a six-month period, included ASD children aged 1-14 years. The QOL was measured using the BCFQOL scale for families. Data were analyzed using the Jamovi software (Windows version 2.4.1, the Jamovi Project, retrieved from https://www.jamovi.org). RESULTS: A total of 102 responses were collected in the study. The overall satisfaction score was 93.6±16.6 out of 125, with 85.3% of participants expressing satisfaction. Domains explored included family interaction (23.8±5.29 out of 30), parenting practices (23.9±3.83 out of 30), emotional well-being (13.1±4.16 out of 20), physical and material well-being (18.7±4.24 out of 25), and disability-related support (14.2±4.0 out of 20). In terms of specific sociodemographic factors, no statistically significant differences in satisfaction were observed across various categories. CONCLUSION: Families of children with ASD in Saudi Arabia generally report high levels of satisfaction, as assessed by the BCFQOL. The study covered various domains, including family interaction, parenting practices, emotional well-being, physical well-being, and disability-related support, with most respondents expressing satisfaction in these areas. Notably, sociodemographic factors did not significantly influence satisfaction levels, underscoring the pervasive nature of the findings across different demographic groups. Further studies with a larger sample size and a longer follow-up period are required to validate these findings.

Design and evaluation of an intelligent physical examination system in improving the satisfaction of patients with chronic disease.

Background: and Purpose: Enhancing patient satisfaction remains crucial for healthcare quality. The utilization of artificial intelligence (AI) in the Internet of Health Things (loHT) can streamline the medical examination process. Most Traditional Chinese Medicine (TCM) examinations are non-invasive and contribute significantly to patient satisfaction. Our aim was to establish an intelligent physical examination system that amalgamates TCM and Western medicine and to conduct a preliminary investigation into its effectiveness in enhancing the satisfaction of patients with chronic diseases. Materials and methods: Experts from clinical departments, the equipment department, and the software development department were invited to participate in group discussions to determine the design principles and organizational structure of the intelligent physical examination system. This system integrates TCM and Western medicine. We compared the satisfaction levels of patients examined using the intelligent physical examination system with those examined using the traditional medical examination system. Results: An intelligent physical examination system, combining TCM and Western medicine, was developed. A total of 106 patients were finally enrolled (intelligent group vs. control group) to evaluate satisfaction. There were no statistically significant differences between the intelligent group and the control group in age, gender, education, or income level. We identified significant differences in five aspects of satisfaction: 1) the physical examination environment; 2) the attitude and responsiveness of doctors; 3) the attitude and responsiveness of nurses; 4) the effectiveness of obtaining results; and 5) the information regarding physical examination and medical advice (p < 0.05). Furthermore, these differences remained statistically significant even after adjusting for age, gender, education, and income level. Conclusions: The intelligent physical examination system effectively capitalized on the advantages of combining AI with the integration of TCM and Western medicine, substantially optimizing the medical examination process. In comparison to the traditional physical examination system, the intelligent system significantly enhanced patient satisfaction. Future improvements could involve integrating chronic disease follow-up technology into the system.

Patients satisfaction with the dental treatment provided at the University of Jordan's student clinics.

INTRODUCTION: To assess patients' satisfaction with the dental care provided to them by the undergraduate students at Jordan University Hospital. In addition, to investigate whether the age or gender of patients had any correlation with the level of satisfaction. MATERIALS AND METHODS: The Dental Satisfaction Questionnaire (DSQ) developed by the RAND Corporation was used to measure patient satisfaction. The questionnaire was translated to Arabic the native language of the country and it consisted of 14 questions, which measure the overall satisfaction and the subscales of access, convenience and availability, continuity of treatment and quality of dental care provided. RESULTS: A total of 94 patients (58.5% female, 41.5% male) answered the DSQ, the Overall Dental Satisfaction Index (DSI) was found to be 86.2%, and there was no correlation between gender or age groups and the DSI (p < .05). All 14 questions scored above 4/5 except the question about whether the schools' building and dental units being modern and well equipped (3.7/5), and the general satisfaction question (3.2/5). CONCLUSIONS: Patients who were treated at the student clinics at the University of Jordan, School of Dentistry were found to be satisfied about both the quality of treatment and the dental environment, while reporting some negative aspects related mainly to the clinics building which they found to be very old and crowded. This study found no correlation between patients' satisfaction and the age or gender of the participants.

Patient Satisfaction and Quality of Life After Mastectomy at King Abdulaziz Medical City, Jeddah.

Background Overall well-being after surgical intervention is one of the most important aspects of assessing quality of life (QOL), yet it is not well explored in the literature. In this paper, it was necessary to involve the patient's perspective of the nature of their QOL. The burden of being diagnosed with breast cancer is an adaptation to a new lifestyle, having to deal with disease stigma, interpersonal relations problems, and being limited to specific clothing. This can be very challenging for patients. This study aims to identify which patient group, based on their treatment regimen, exhibits higher levels of satisfaction and dissatisfaction compared to other groups. Methods A retrospective, cross-sectional study analyzing the QOL among female breast cancer patients who underwent mastectomy, with or without breast reconstruction, in King Abdulaziz Medical City, Jeddah, between 2009 and 2022. Patients' demographics and phone numbers were obtained from each patient's medical record file in our hospital. Phone call-based interviews were conducted to contact patients to assess their QOL, satisfaction, and regrets after surgery. We excluded patients who do not speak Arabic, are illiterate, have memory disorders, patients who underwent lumpectomy or palliative mastectomy, patients with metastatic stage 4 cancer at the time of diagnosis, patients who are males, and patients who passed away. Results A total of 2,309 patients were screened during the period aforementioned; a total of 346 patients met our inclusion criteria. All of whom are female participants with a current mean age of 52.3 ± 11.5 years. There were 301 (86.99%) participants reported being satisfied, while only 45 (13.01%) participants reported being unsatisfied with surgery outcomes. Although the majority of participants were satisfied after mastectomy, many of them still struggled with psychological, social, and/or emotional challenges. These challenges can have a significant impact on a patient's overall well-being and QOL and must be addressed to provide patients with the highest quality of care possible. Conclusion The study findings highlight the significant impact of mastectomy on patients' lives. It is important to consider individual patient experiences and circumstances when evaluating treatment outcomes and patient satisfaction. We observed that patient satisfaction may vary depending on several factors, including patients' baseline satisfaction. Those factors may be psychological, such as body image issues, low self-esteem, the feeling of losing a body part, and fear of recurrence or metastasis. Other factors may be postoperative-related complications, including lymphedema, redundant skin, chronic pain, and operation scar. Additionally, factors may be socially related, such as loss of confidence, social withdrawal, embarrassment, inability to buy prostheses, being limited to specific clothes, and occupational impact.

The Impact of Team Triage Method on Emergency Department Performance Indexes: A quasi-interventional study.

Introduction: One of the effective methods of patient triage in the emergency department (ED) is the use of team triage, including physicians and nurses. Considering that there is no conclusive evidence about the effectiveness of team triage, this study aimed to investigate the effect of the team triage method on ED performance indexes. Methods: The present study is a quasi-interventional study in which 200 patients were referred to the ED in the hospitals of Tabriz in 2020. Participants were randomly assigned to two groups (team triage and conventional triage) and were evaluated. Data were collected by a three-part questionnaire including the participants' demographic characteristics, the five-level triage form, and Press-Ganey satisfaction questionnaire were used. Data were analyzed by SPSS.22 statistical software. Results: The results showed that the mean score of waiting time for the first physician visit in team triage was statistically significantly lower than the conventional triage (P = 0.001). Furthermore, the mean score of waiting time for receiving the first treatment in team triage was statistically significantly lower than the conventional triage (P = 0.001). Finally, the mean score of patients' satisfaction in team and conventional triage was statistically significantly higher in team triage (P = 0.001). Conclusion: The study findings revealed that the team triage method, in comparison to conventional triage, decrease the waiting time for receiving the first service and length of stay, but leads to more patient's satisfaction. Therefore, to improve the performance indicators of the ED, it is recommended that hospital managers use the team triage method.

Examining the Effectiveness of Telephone Clinics: A Review of a Telephone Foot and Ankle Orthopaedic Clinic in a District General Hospital in the United Kingdom.

INTRODUCTION: Since the outbreak of COVID-19, significant value has been placed on preventative methods for pathogen spread. One such method is the use of telemedicine via telephone clinics (TC). This article is designed to study TC in a District General Hospital in the United Kingdom. AIMS: This clinical audit aims to evaluate the use of a TC in the United Kingdom and assess its effectiveness. It also aims to assess the use of a clinician-led triaging system to select patients who would receive subsequent telephone follow-ups (TFU). METHODOLOGY: Two cycles were conducted. The first cycle was conducted in 2020 and the second cycle in 2022. In between the two cycles, a clinician-led triage system was implemented to reduce the number of patients being called back for a face-to-face (FTF) appointment. Data was collected regarding the outcomes of the appointments and compared between the two cycles. Chi-squared test statistical test was employed with a p-value < 0.05 deeming significance. RESULTS: Overall, more discharges were made for 2022 outcomes compared to 2020 outcomes (30% vs 19%; p = 0.03) after employing the clinician-led triage. The number of patients listed for a TFU increased when comparing the 2020 versus 2022 datasets (21% vs 12%; p = 0.026), and the overall number of patients not attending appointments decreased when comparing the 2020 versus 2022 datasets (9% vs 17%; p = 0.033). CONCLUSION: This article shows that for this particular clinic, an orthopaedic clinician-led triaging system allows for a greater number of patients to be discharged, lessened need for FTF consultations, and increased adherence to appointments by patients. However, much work is yet to be done concerning the long-term consequences and issues of rolling out nationwide telemedicine.

Predictors of Patients' Satisfaction with Primary Health Care Services in the Kingdom of Saudi Arabia: A Systematic Review.

BACKGROUND: Understanding the factors influencing patients' satisfaction with primary healthcare services in the Kingdom of Saudi Arabia is essential for improving healthcare outcomes and patient experiences. OBJECTIVES: This research work is concerned with the identification of the patient satisfaction predictors with the primary health care services by conducting a systematic review in the Kingdom of Saudi Arabia. METHODS: The three databases in the form of Google Scholar, PubMed, and Medline have been used for article extraction. Keywords have been used to search the articles related to this work, such as the predictors of patient satisfaction. The different journals selected were associated with the selected data basis. The research studies selected for the systematic review were evaluated with the help of PRISMA and JBI assessments. The cross-sectional studies have been included in this systematic review. RESULTS: The 3125 articles identified were from the three databases PubMed (1352), Medline (1103), and Google Scholar (670). All the selected studies were evaluated and screened with the help of PRISMA. After extracting the 25 articles for the systematic review, the JBI assessment was applied to the methodologies. The overall quality satisfaction indicated that all the selected studies were suitable for the systematic review. CONCLUSION: Studies have consistently identified five key predictors of patient satisfaction in primary healthcare: availability, accessibility, communication, rational conduct, technical skills, and personal qualities. Policymakers, healthcare providers, and researchers can use these insights to inform strategies to optimize healthcare services and foster higher levels of patient satisfaction in the Kingdom.

Improving maternal update rates within the first hour of NICU admission.

BACKGROUND: Timely communication is essential in attaining maternal satisfaction, developing an excellent physician-patient rapport, and increasing trust. This study reports a significant improvement in maternal communication rates through the quality improvement method. METHODS: An educational module was developed, and NICU staff was presented with the slides, followed by a performance questionnaire to demonstrate understanding. The first phase was completed by obtaining feedback from mothers through a questionnaire. The first plan-do-study-act (PDSA) cycle, carried out for eight weeks looking at the rates of the maternal update provided within an hour of admission of their neonates to the NICU, was followed by the second PDSA cycle, carried out for ten weeks. The improvement was calculated using conventional statistics and a statistical process control chart. RESULTS: During the first phase of the study, thirty-six percent of the mothers were updated within an hour of admission of their neonates to the NICU. During the first PDSA cycle, we did not notice a special cause variation or process change. A significant shift, eight consecutive points above the mean, was noted on the control chart during PDSA cycle 2. The mean±SD of the weekly update rate increased significantly during PDSA cycle 2 (76.8±11) compared to PDSA cycle 1 (47.5±14), p-value = 0.0002. CONCLUSION: We improved the maternal update rates through the educational module following the QI improvement model using the PDSA cycles.

Patient and Family Satisfaction in the Intensive Care Unit of a Quaternary Care Center.

Patient and family satisfaction is an indicator of quality assessment of care provided in the intensive care unit (ICU) ensuring that the quality of services provided meets not only the patients' but also their families' needs. Investigating how different variables affect their satisfaction ratings is important. We assessed patient and family satisfaction in a quaternary care center in Pakistan. METHODS: The study was a cross-sectional survey of adult patients and families treated between December 1, 2022 and April 30, 2023 in the ICU at Pakistan Kidney and Liver Institute and Research Center (PKLI-RC), Lahore, Pakistan. We used family satisfaction in ICU 24 (FS-ICU 24) to measure satisfaction in a number of domains on a scale of 1-5 (1 = Very Dissatisfied, 5 = Fully Satisfied). RESULTS: Of the 330 patients admitted to ICU during the study period, all patients and/or one of their family members (100%) participated in the study. Out of these, 209 (63%) were male. The mean age was 42 ± 15 years, and the overall mean patient and family satisfaction scores were 4.69 ± 0.69 and 4.55 ± 0.52, respectively. The mean score in all domains was > 4, with the exception of pain management in which it was 3.98 ± 0.53. CONCLUSION: Patients and their families' satisfaction is an important measure of ICU quality. Not only the patients and their families were satisfied with our ICU quality of care but they also appreciated involvement in the decision-making process and quality assessment. There is a need for further research for improvement in the pain domain.