Fatores clínicos do bem-estar de mulheres em parturição: perspectivas deontológicas e da bioética principialista / Clinical factors of women in labor well-being: deontological and bioethical principlism perspectives / Factores clínicos del bienestar de la mujer en trabajo de parto: perspectivas deontológicas y de la bioética principialista

Objetivo: avaliar os fatores clínicos associados ao bem-estar das mulheres durante o trabalho de parto e parto à luz da bioética principialista e da deontologia. Método: estudo transversal com abordagem quantitativa. Participaram 396 puérperas internadas em um hospital municipal do sudoeste da Bahia, e os dados foram coletados no período de janeiro a maio de 2023, após aprovação do comitê de ética em pesquisa. Os dados foram organizados no software Excel e analisados via SPSS v.25. a partir da regressão logística multinomial. Resultados: a maior parte da amostra apresentou bem-estar com assistência em saúde, mulheres que tiveram parto realizado por profissionais não médicos apresentaram mais chances de níveis de bem-estar "adequado". E mulheres que não tiveram a via de parto cesárea apresentaram aumento de chances de bem-estar. Conclusão: é necessário que os profissionais reflitam sobre suas ações, condicionando-as à humanização no parto, em observância aos princípios bioéticos.

Objective: to evaluate the clinical factors associated with women's well-being during labor and delivery in the light of bioethics principlism and deontology. Method: a cross-sectional study with a quantitative approach was conducted. It involved 396 postpartum women admitted to a municipal hospital in the southwest of Bahia. Data were collected from January to May 2023, after approval from the research ethics committee. The data were tabulated using Excel software and analyzed using SPSS v.25 through Multinomial Logistic Regression. Results: majority of the sample exhibited well-being with health care assistance. Women who underwent delivery performed by non-medical professionals showed higher chances of "adequate" levels of well-being. Additionally, women who did not undergo cesarean delivery showed increased chances of well-being. Conclusion: It is necessary for professionals to reflect on their actions, conditioning them to the humanization of childbirth, according to bioethical principles.

Objetivo: evaluar los factores clínicos asociados al bienestar de la mujer durante el trabajo de parto y parto a la luz de la bioética y la deontología principialista. Método: estudio transversal con enfoque cuantitativo. Incluyó 396 puérperas ingresadas en un hospital municipal del suroeste de Bahía. Recolección de datos de enero a mayo de 2023, con aprobación del comité de ética en investigación. Los datos se tabularon en el software Excel y se analizaron mediante SPSS v.25. utilizando regresión logística multinomial. Resultados: la mayoría de las participantes de la muestra presentó bienestar con la atención para la salud; las que tuvieron partos realizados por profesionales no médicos tenían más probabilidades de tener niveles "adecuados" de bienestar; las que no tuvieron parto por cesárea tenían mayores probabilidades de tener bienestar. Conclusión: es necesario que los profesionales reflexionen sobre sus acciones y las adecuen para humanizar el parto, respetando los principios bioéticos.

A satisfação da grávida com os cuidados das enfermeiras obstétricas durante a pandemia COVID-19 / Pregnant women's satisfaction with the care provided by nurse midwives during the COVID-19 pandemic / Satisfacción de las embarazadas con la atención de las enfermeras obstétricas durante la pandemia de COVID-19

Resumo Enquadramento: Em tempo de pandemia, as consultas de enfermagem de vigilância da gravidez sofreram alterações, nomeadamente na restrição de acompanhantes. Por esse motivo, é importante a avaliação da satisfação das grávidas com a assistência de enfermagem durante este contexto pandémico. Objetivo: Avaliar a satisfação da grávida com a assistência das enfermeiras obstétricas nas consultas de vigilância da gravidez durante o contexto de pandemia COVID-19. Metodologia: Estudo transversal descritivo de natureza quantitativa, com uma amostra de 196 grávidas. Aplicado a Escala de Satisfação dos Pacientes com a Assistência de Enfermagem (General Practice Nurse Satisfaction Scale - GPNS), constituída pelas dimensões: relacionamento interpessoal e comunicação, confiança, credibilidade e dedicação. Resultados: As grávidas apresentam-se em média mais satisfeitas na dimensão relacionamento interpessoal e comunicação e menos satisfeitas na dimensão dedicação. Conclusão: As grávidas apresentam-se satisfeitas com a assistência de enfermagem percecionando a sua importância. Tal reforça a pertinência das consultas serem realizadas por um Enfermeiro Especialista em Enfermagem de Saúde Materna e Obstétrica.

Abstract Background: Prenatal nursing appointments underwent changes during the COVID-19 pandemic, namely in the restriction of companions. For this reason, it is important to assess pregnant women's satisfaction with nursing care during this period. Objective: To assess pregnant women's satisfaction with nurse midwife-led prenatal appointments during the COVID-19 pandemic. Methodology: A qualitative descriptive cross-sectional study was conducted with a sample of 196 pregnant women. The Portuguese version of the General Practice Nurse Satisfaction Scale (Escala de Satisfação dos Pacientes com a Assistência de Enfermagem) was administered to the sample. The tool consists of the following dimensions: interpersonal relationship and communication, confidence, credibility, and dedication. Results: Pregnant women are, on average, more satisfied in the interpersonal relationship and communication dimension and less satisfied in the dedication dimension. Conclusion: Pregnant women are satisfied with nursing care and acknowledge its importance. This finding reinforces the importance of nurse midwife-led consultations.

Resumen Marco contextual: En tiempos de pandemia, las citas de enfermería para el seguimiento del embarazo cambiaron, sobre todo la restricción de acompañantes. Por esta razón, es importante evaluar la satisfacción de las mujeres embarazadas con los cuidados de enfermería durante este contexto pandémico. Objetivo: Evaluar la satisfacción de las mujeres embarazadas con la atención prestada por las enfermeras obstétricas en las consultas de seguimiento del embarazo durante la pandemia de COVID-19. Metodología: Estudio descriptivo transversal de carácter cuantitativo, con una muestra de 196 mujeres embarazadas. Se aplicó la Escala de Satisfacción de los Pacientes con Asistencia de Enfermería (General Practice Nurse Satisfaction Scale - GPNS), compuesta por las siguientes dimensiones: relaciones interpersonales y comunicación, confianza, credibilidad y dedicación. Resultados: Las mujeres embarazadas están, de media, más satisfechas en la dimensión relaciones interpersonales y comunicación, y menos satisfechas en la dimensión dedicación. Conclusión: Las embarazadas se mostraron satisfechas con los cuidados de enfermería y se dieron cuenta de su importancia. Esto refuerza la pertinencia de que las consultas sean realizadas por una enfermera especializada en Enfermería de Salud Materna y Obstétrica.

Assessment of Pain and Satisfaction After Orofacial Harmonization Procedures.

AIMS: This long-term study assessed satisfaction and pain levels following facial aesthetic procedures. The study also aimed to correlate expectations, and psychological and social well-being immediately and after one month, describe perceived age, and assess differences in satisfaction between injectable fillers and other Orofacial Harmonization procedures such as hyaluronic acid treatments (for dark circles, nasolabial fold lips, malar, jaw), botulinum toxin injections, enzymatic lipolysis of the double chin, micro-needling, and PDO threads. METHODS: Data were collected immediately after the procedures and then again 30 days later. Among the participants, 159 (92.4%) were females and 13 (7.6%) were males, who completed FACE-Q questionnaires addressing perceived age, expectations, psychological and social well-being, satisfaction, and facial appearance, as well as the visual pain scale. RESULTS: The average age of the patients treated in the Dental Clinics in Brazil was 40.4 years (SD± 12.7), with 48.8% of participants perceiving themselves as older immediately after the procedures, decreasing to 47.7% after 30 days, and pain intensity was reported as low. The total number of Orofacial Harmonization procedures performed was 256. Satisfaction after 30 days was high, especially among those who received fillers. The psychological and social function scales were positively correlated with satisfaction with the decision, result, and appearance scales. Fillers showed a significant improvement in perceived age appearance, with half of the patients feeling younger after 30 days. The patients exhibited high satisfaction levels in one-month post-aesthetic orofacial harmonization procedures. Despite initially high expectations, patients reported enhanced psychological and social well-being, along with minimal pain during interventions CONCLUSION: Positive correlations were observed between satisfaction, decision-making, result perception, and appearance. Injectable fillers notably improved perceived aging, with a significant portion of patients initially perceiving themselves as older than their actual age, but later feeling younger post-procedure. Fillers also yielded superior satisfaction and pain relief compared to alternative interventions. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Minding the gap: Assessing patient expectations versus experiences in drug information services at community health centers (Puskesmas) in Indonesia urban settings.

In pharmaceutical care, patients' perceptions of drug information provided by pharmacists are vital for assessing pharmaceutical services at community health centers (in Indonesian known as Puskesmas). The aim of this study was to determine the alignment between patients' expectations and experiences of drug information services by pharmacists at Puskesmas in Indonesia. This multicenter cross-sectional study utilized a validated questionnaire among outpatient patients aged 18 years and above across all 47 Puskesmas in Makassar, Indonesia. A total of 622 respondents were interviewed between September to December 2023. Significant gaps were observed between patients' expectations and experiences regarding all the drug information aspects such as quantity (median: 4 vs 3, p<0.001), drug effects (median: 4 vs 3, p<0.001), dosage form (median: 3 vs 3, p<0.001), proper administration (median: 4 vs 4, p<0.001), side effects (median: 4 vs 2, p<0.001), storage (median: 3 vs 2, p<0.001), drug-drug interactions (median: 4 vs 2, p<0.001), drug-food interactions (median: 4 vs 2, p<0.001), handling missed dose (median: 3 vs 2, p<0.001), managing accidental overdoses (median: 4 vs 2, p<0.001), history of drug use (median: 3 vs 2, p<0.001), co-medications (median: 3 vs 2, p<0.001), and previous drug allergies (median: 3 vs 2, p<0.001). Sociodemographic factors influencing patients' need for drug information services encompass age, sex, educational attainment, comorbidities, family size, number of visits, monthly income, and occupation. The quality of drug information services at Puskesmas in Indonesia still requires optimization and customization to meet the specific needs of patients, taking into account their sociodemographic characteristics.

Patient Contentment Regarding Health Education Services at King Saud Medical City in Riyadh, Saudi Arabia.

BACKGROUND: Health education enhances healthcare outcomes and patient satisfaction, and with digitalized methods, it is gaining popularity in high-income nations. Effective education promotes behavioral change, treatment adherence, and overall satisfaction while maintaining interpersonal communication. Despite the strides made in medical advancements for diagnosis and treatment, interpersonal communication remains the primary conduit for information exchange, particularly manifested through health education dialogues between medical practitioners and patients. METHODOLOGY: A cross-sectional study was conducted at King Saud Medical City (KSMC), Riyadh, Saudi Arabia, to assess patient satisfaction with health education services. Data were collected through a structured questionnaire. Data were analyzed by IBM SPSS Statistics for Windows, Version 29 (Released 2021; IBM Corp., Armonk, New York, United States). RESULTS: This study on patient satisfaction with health education at KSMC in Riyadh included 225 participants, predominantly females (67.6% (n=152), mean age 38.5 years). Diabetes was the most prevalent (21.3%, n=48) among participants. Doctors were the primary source of health advice (46.2%, n=104). Structural aspects received high satisfaction (mean score of 31.8), surpassing healthcare provider delivery (mean score of 24.9) and print materials (mean score of 22.7). Demographically, occupation significantly impacted contentment (p-value=0.002), with students exhibiting the highest scores. Logistic regression highlighted patients' occupation (aOR=1.498) and patients' level of education (aOR=0.420) as predictors of contentment. CONCLUSION: This study highlighted high satisfaction with structural aspects of health education. Occupation, particularly among students, significantly impacts contentment. Tailoring education strategies based on occupation and education levels is crucial for improved patient satisfaction.

A Study on Quality Assurance and Utilization of Equipment in the Radiology Department of a Tertiary Care Teaching Hospital.

Utilizing resources to reduce costs and increase income while ensuring patient safety necessitates rigorous planning. The study aims to assess ergonomics, equipment utilization, outpatient satisfaction, and quality assurance in the Radiology Department. Four hundred outpatients, 39 radiographers, and 40 postgraduate students participated in a cross-sectional mixed-methods study that included surveys and interviews. The results were obtained using descriptive statistics, a utilization rate, and a Chi-square test with a 95% confidence interval. Three hundred eighty-two patients, or 95.5%, were satisfied with the overall service quality. Quality and explanation of the process by a radiographer 76.8%, patient knowledge of procedures 76.8%, privacy level 79%, and affordability of treatment 91.8% leading to 95.5% patient satisfaction and 87% were willing to recommend the facility to family and friends. Although there was a high percentage correlation with clinical diagnosis (81%), re-doing 43 (1%), reporting a mistake 30 (23.4%), or both might affect patient safety standards. Quality control, patient safety, and equipment utilization are all inextricably linked. Even minor changes in quality can influence utilization rates and patient safety.

Multi-Dimensional Analysis of Japanese Telemedicine Patient Satisfaction.

Introduction: Telemedicine is a growing segment of the healthcare industry. As telemedicine gains prominence in Japan, the importance of telemedicine patient satisfaction research will also grow. This study examines whether Japanese patients are equally impacted by the same latent dimensions discovered in the multi-dimensional service satisfaction model used by a United States (U.S.) study. Methods: The subjects (n = 110) were patients who received telemedicine service between January and December 2023 at Juntendo University Hospital, Tokyo, Japan. Patient satisfaction perceptions were collected using a questionnaire composed of Likert scale items. Overall patient satisfaction served as the dependent variable, and patient perceptions of various aspects of the service were the independent variables. LASSO regression analysis was used to test the impact of the independent variables on overall patient satisfaction along with cluster analysis to examine the satisfaction ratings based upon patient characteristics. Results: Japanese patient perceptions of telemedicine health benefits were the most impactful driver of overall satisfaction. Cluster analysis indicated that males were generally more satisfied than females. The least satisfied patients were predominately female and those experiencing telemedicine for the first time. Patients receiving service from a specialist physician were least satisfied with the telemedicine financial costs. Discussion: Patient satisfaction levels were found to be highly impacted by perceptions of the health benefits received and the non-financial costs of service. These benefits could be highlighted by Japanese telemedicine providers to increase utilization of telemedicine services. Patient satisfaction was also found to be influenced by patient-centered care (ie, the "soft skills" of providers) to a lesser degree. Therefore, Japanese telemedicine providers may benefit from developing patient-centered communication skills. Conclusion: The model used provides nuanced understandings of telemedicine patient satisfaction, which highlights where targeted improvements in Japanese telemedicine patient satisfaction are likely to be most impactful.

Time-efficient consultation hours in the department of gynecological endocrinology.

BACKGROUND: The aim was to conduct a benchmark pilot study to find the best practice for consultation hours in the field of gynecological endocrinology. Suitable benchmarking participants were found in China, Germany, Greece, and Switzerland. Specifically, the study aimed to find the most time-efficient and beneficial consultation type in gynecological endocrinology focused on menopause and whether a shorter face-to-face consultation correlates with lower patient satisfaction. METHODS: This was an observational study. To analyze the processes of all benchmarking participants three tools were used: a measurement of time needed for the different consultation types, a questionnaire for patients and one for physicians. The primary endpoint was the time measurement of first consultations. Secondary endpoints were the time measurements of follow-up consultations and phone consultations and patient satisfaction. RESULTS: The mean overall duration of a first consultation differed from 20.4 min to 39.7 min (p = 0.003), mainly based on differences of the mean time to acquire the patient history, 5.6 to 21.6 min (p < 0.001). The percentage of patients who felt they had enough time to discuss questions ranged from 70% to 100% (p < 0.001). The percentage of patients who felt fully understood by their physician ranged from 62.5% to 92% (p = 0.006). The duration of a first consultation did not correlate with patients feeling well consulted (r=-0.048, p = 0.557). CONCLUSIONS: A concise patient history that concentrates on the most relevant points can reduce the total consultation time. Reducing consultation time can be made without compromising how well patients feel consulted.

Oral health-related quality of life and patient satisfaction using three-dimensional printed dentures: A crossover randomized controlled trial.

OBJECTIVES: This crossover randomized controlled clinical trial (RCT) aimed to evaluate the clinical applicability of three-dimensional printed dentures (CAD-3DPs) by comparing two fabricated complete dentures, CAD-3DPs and conventional complete dentures (CCDs), and assess the non-inferiority of CAD-3DPs. The hypothesis was that CAD-3DPs would be inferior to CCDs in terms of the oral health-related quality of life (OHRQoL) and patient satisfaction. METHODS: This single-blind RCT was conducted at two university hospitals. The participants included adult patients with edentulous maxillary and mandibular arches, who had existing complete dentures and were willing to use new complete dentures. Eighteen participants were assigned to two groups: CCD-CAD-3DP and CAD-3DP-CCD, based on the order of denture delivery. Both sets of maxillary and mandibular CCDs and CAD-3DPs were delivered to all the participants. The OHRQoL using Oral Health Impact Profile for Edentulous Patients (OHIP-EDENT-J) was considered the primary outcome. General satisfaction using a 100-mm visual analog scale was also evaluated as a suboutcome. RESULTS: Based on the non-inferior test on the total score of the OHIP-EDENT and each score of the seven conceptual subdomains, the lower limit of the 95 % confidence interval was < 2.65 in seven domains. Therefore, CAD-3DP was judged to be non-inferior to CCD. Patient satisfaction was not significantly different between the CCD and CAD-3DP groups (p > 0.05). CONCLUSIONS: This RCT revealed that CAD-3DP is comparable to CCD based on the OHIP-JDENT scores and patient satisfaction. CLINICAL SIGNIFICANCE: CAD-3DP is clinically applicable and comparable to CCD in terms of patient-reported outcomes.

Health-Related Quality of Life and Satisfaction in Atrial Fibrillation Patients on Anticoagulant Therapy: Differences between Vitamin K Antagonists and Direct Oral Anticoagulants; Results from the Multicentre REGUEIFA Registry.

Background: Oral anticoagulation (OAC) is pivotal in the clinical management of atrial fibrillation (AF) patients. Vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs) prevent thromboembolic events, but information about the quality of life (QoL) and patient satisfaction in relation with the anticoagulant treatment is limited. Methods: REGUEIFA is a prospective, observational, and multicentre study that included patients with AF treated by cardiologists. We included patients treated with VKAs or DOACs. The EuroQol-5D (EQ-5D) questionnaire evaluated QoL, and the Anti-Clot Treatment Scale (ACTS) questionnaire investigated patient satisfaction with OAC. Results: A total of 904 patients were included (532 on VKA and 372 on DOACs). A total of 846 patients completed the EQ-5D questionnaire, with results significantly worse in patients on VKAs than on DOACs: more mobility limitations (37.6% vs. 24.2%, p < 0.001), more restriction in usual activities (24.7% vs. 18.3%, p = 0.026), more pain/discomfort (31.8% vs. 24.2%, p = 0.015), a lower visual analogue scale (VAS) score (66.4 ± 16.21 vs. 70.8 ± 15.6), and a lower EQ-D5 index (0.79 ± 0.21 vs. 0.85 ± 0.2, p < 0.001). After adjusting for baseline characteristics, VKA treatment was not an independent factor towards worse EQ-5D results. Also, 738 patients completed the ACTS questionnaire, and burden and profit scores were lower in patients on VKAs than for DOACs (52.1 ± 8.4 vs. 55.5 ± 6.8, p < 0.001 and 11.1 ± 2.4 vs. 11.8 ± 2.6, p < 0.001, respectively). The negative impact score was higher for VKAs than for DOACs (1.8 ± 1.02 vs. 1.6 ± 0.99, p < 0.001), with a general positive impact score lower for VKAs than for DOACs (3.6 ± 0.96 vs. 3.8 ± 1.02, p < 0.001). Conclusions: Patients on VKA have more comorbidity and worse EQ-5D and VAS scores than those on DOACs. VKA has a greater burden and higher negative impact on the patient's life than DOACs.

Polycystic Ovary Syndrome: A Comprehensive Exploration of Diagnosis Experience in Saudi Women.

Background/Objectives: Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder among women of reproductive age, characterized by symptoms such as menstrual irregularities, hyperandrogenism, and polycystic ovaries. This study aimed to explore the diagnostic experiences of women with PCOS in Saudi Arabia, evaluating the timeline to diagnosis, the adequacy of information provided, and overall patient satisfaction with the healthcare process. Methods: A cross-sectional online survey was conducted with 1182 women diagnosed with PCOS across Saudi Arabia. The survey collected data on sociodemographic characteristics, the timeline from symptom onset to diagnosis, the number of healthcare visits required for diagnosis, and satisfaction with the information and support provided during the diagnostic process. Statistical analyses, including linear regression, were performed to identify factors influencing patient satisfaction. Results: The study found that 43.2% of participants sought medical attention within a year of symptom onset, yet significant delays in diagnosis were common, with 28.6% of women waiting six months or more after seeking medical care. Only 42.7% of women reported receiving adequate information at diagnosis, and satisfaction levels varied across different aspects of care. Key predictors of lower satisfaction included marital status and longer time since diagnosis, while quicker diagnosis and more healthcare visits before diagnosis positively influenced satisfaction. Conclusions: The findings highlight critical gaps in the diagnostic process and patient education for PCOS in Saudi Arabia. The widespread dissatisfaction with the information provided underscores the need for improved patient-centered care, comprehensive education, and standardized diagnostic protocols. Addressing these issues could enhance patient satisfaction and lead to better management of PCOS, both in Saudi Arabia and globally.

Evaluating patient experience with a surgical navigation program for under-resourced patients.

BACKGROUND: This study aimed to characterize patient satisfaction with navigators and surgical care accessed through a novel navigation program for under-resourced communities. METHODS: PSN-I and PSQ-18 questionnaires assessed satisfaction with navigators and care, respectively. Primary outcomes were PSN-I and PSQ-18 scores. Secondary analyses tested associations between satisfaction and patient factors and between PSN-I and PSQ-18 scores. RESULTS: Of 294 patients contacted, 88 (29.9 â€‹%) responded. Most were Hispanic/Latinx (76.1 â€‹%), Spanish-speaking (71.5 â€‹%), and uninsured (85.2 â€‹%). Participants were highly satisfied with navigators (mean 38.5, SD 7.6; max. 45) and most care domains except Financial Aspects (mean 3.2, SD 1.0; max. 5) and Accessibility/Convenience (mean 3.5, SD 0.6; max. 5). Higher navigator satisfaction was associated with post-consultation need for surgery (coeff. 5.6, 95 â€‹% CI[0.9, 10.3]) and increased the odds of care satisfaction (OR 1.1, 95 â€‹% CI[1.0, 1.2]). CONCLUSIONS: Patients are satisfied with navigation services-a previously unstudied aspect of this unique surgical equity program.

Patient evaluation of Klick, a technology-enabled, nurse-delivered HIV outpatient pathway.

OBJECTIVES: Klick is a clinic-specific, digitally supported outpatient pathway of care for people living with HIV (PLWH). It involves a smartphone application (app) for PLWH to self-manage their care, navigate access to the clinic and communicate with their healthcare provider. We present a patient evaluation of Klick. METHODS: Patients use Klick to book/reschedule appointments, view laboratory results, request medication, access remote nurse-delivered consultations and communicate with clinicians. In October 2022, Klick was evaluated by PLWH through a questionnaire and interviews. RESULTS: Between August 2020 and April 2024, 5859 patients had registered to use Klick; during April 2024 alone, 2509 (43%) used Klick. In October 2022, 1661 PLWH were invited to complete surveys, of whom 362 (22%) responded. These respondents were 95% (340/358) male and 84% (298/354) white, and 63% (227/359) were in the age range 41-60 years. Respondents felt Klick was easy to use (average score 4.3/5), and 92% thought having a clinic-specific app was important/very important. Respondents valued the following app features as important/very important - online booking (93%); viewable results (94%); prescription requests (90%) - and rated their experience of using them highly - 91% for e-booking and 91% for viewable results. A total of 93% said they would recommend Klick to friends and 82% rated Klick as above average/excellent. CONCLUSIONS: PLWH reported high levels of satisfaction using a clinic-specific mHealth app to manage their HIV care and demonstrated sustained active use. Klick was rated easy to use, as helping to meet healthcare needs and as providing a superior experience for some aspects of care. Other HIV clinics or services managing chronic conditions could benefit from the adoption of personalized digital solutions to enhance patient care.

Feasibility, acceptability and preliminary evaluation of a user co-facilitated psychoeducational programme: a feasibility proof-of-concept randomised control trial.

BACKGROUND: Mental health settings are increasingly using co-facilitation of educational group interventions in collaboration with patient partners and service users. However, despite promising results, limited information is available regarding the feasibility and satisfaction levels of these programmes among adults newly diagnosed with attention-deficit hyperactivity/impulsivity disorder (ADHD). Hence, this study aimed to determine the feasibility, acceptability, and preliminary effects of a user co-facilitated psychoeducational group programme for adults diagnosed with ADHD. METHODS: This feasibility proof-of-concept randomised controlled trial recruited outpatients from a Norwegian community mental health centre. Outpatients randomised to the intervention group (IG) received a psychoeducational programme supplementing Treatment As Usual (TAU), while the control group received TAU. Feasibility was determined by the acceptance rate, adherence rate, and dropout rate. Acceptability was measured with the Client Satisfaction Questionnaire and a 3-item scale measuring satisfaction with the received information. To test the preliminary effects, self-efficacy, symptom severity, and quality of life were measured at baseline and pre- and post-intervention. RESULTS: Feasibility was demonstrated; most of the patients were willing to enrol, participants attended 82% of the psychoeducational programme, and only 13% dropped out of the study. The between-group analyses revealed that the IG reported significantly greater mean satisfaction than the CG. Moreover, the intervention group was more satisfied with the information they received during the psychoeducational programme. Concerning the preliminary effects, the linear mixed model showed improvement in quality of life (the subscale relationship); however, other patient-reported outcomes did not show improvements. CONCLUSIONS: This proof-of-concept randomised controlled trial supports the feasibility and acceptability of the user co-facilitated psychoeducational programme for patients newly diagnosed with ADHD in an outpatient setting. While preliminary findings indicate promise in enhancing patient-reported outcomes, a larger study is warranted to assess the intervention's effectiveness rigorously. TRIAL REGISTRATION: NCT03425, 09/11/2017.

Influencing factors on the quality of recovery after total knee arthroplasty: development of a predictive model.

Introduction: Total Knee Arthroplasty (TKA) is a widely performed procedure that significantly benefits patients with severe knee degeneration. However, the recovery outcomes post-surgery can vary significantly among patients. Identifying the factors influencing these outcomes is crucial for improving patient care and satisfaction. Methods: In this retrospective study, we analyzed 362 TKA cases performed between January 1, 2018, and July 1, 2022. Multivariate logistic regression was employed to identify key predictors of recovery within the first year after surgery. Results: The analysis revealed that Body Mass Index (BMI), age-adjusted Charlson Comorbidity Index (aCCI), sleep quality, Bone Mineral Density (BMD), and analgesic efficacy were significant predictors of poor recovery (p < 0.05). These predictors were used to develop a clinical prediction model, which demonstrated strong predictive ability with an Area Under the Receiver Operating Characteristic (AUC) curve of 0.802. The model was internally validated. Discussion: The findings suggest that personalized postoperative care and tailored rehabilitation programs based on these predictors could enhance recovery outcomes and increase patient satisfaction following TKA.

Tuberculosis patients' satisfaction with directly observed treatment short course strategy and associated factors in Southern Ethiopia: a mixed method study.

BACKGROUND: Tuberculosis (TB) is a second major global public health problem and the leading infectious cause of death in Ethiopia. Patients under directly observed treatment short-courses (DOTs) have a higher treatment success rate and reduced drug resistance. A successful treatment outcome and adherence to the treatment are related to patient satisfaction with the DOT strategy. Client satisfaction is one of the indicators of the quality of care. In this perspective, there were limited studies in Ethiopia related to patient satisfaction with the DOTs strategy in the prevention and control of TB to achieve the ''END TB Strategy.'' Therefore, this study was aimed at identifying the TB patients' satisfaction with the DOTs strategy and associated factors in Gamo Zone, Southern Ethiopia. METHODS: An institutional-based cross-sectional study design for quantitative data and a phenomenological approach were employed for qualitative data. The calculated sample size was 374. A systematic random sampling method was used to select study participants. A pre-tested structured interviewer-administered questionnaire for quantitative data and focus group discussions (FGDs) for qualitative data were used for data collection. Bivariable and multivariable analyses were used. The determinants with a p-value < 0.05 were declared to have a significant association with the outcome variable, and an adjusted odd ratio with a 95% confidence interval (CI) was used. RESULTS: A total of 358 patients participated in the study, with a response rate of 95.72%. The majority of study participants' ages ranged between 25 and 34 years. The tuberculosis DOT satisfaction rate was 61.17% [56.10-66.25%, 95%CI]. The TB patients who took treatment for 20 weeks or more were 3.97 times [AOR = 3.97; 95% CI (1.55-10.16)] more likely to be satisfied with the DOTs service provided. However, the participants who perceived transport costs as high were 79% [AOR = 0.21; 95% CI (0.06-0.71)] less likely to be satisfied with DOTs. Qualitatively, the participants reported that there was a major problem with laboratory services, which resulted in delays and long appointments to get the results in addition to lack of clean toilets and safe water to swallow medications. CONCLUSION: The satisfaction rate for tuberculosis DOTs observed in this study appears to be relatively lower in comparison to other studies. Availing DOTs service nearby patients to enhance the accessibility of the service is crucial to improving patients' satisfaction with DOTs service. Reducing laboratory result delays by improving laboratory service is essential to enhancing patients' satisfaction with DOTs. Moreover, improving toilet services, and availing safe water to swallow medications is recommended to enhancing patients' satisfaction with DOTs service.

Patient satisfaction and associated factors with inpatient health services at public hospitals in Ethiopia: a systematic review and meta-analysis.

BACKGROUND: The way the healthcare delivery system is reflected by patient satisfaction. Establishing a health system with better results depends on it. It has been assumed that higher patient satisfaction levels correlate with quality healthcare outcomes. There is little national data to support patient satisfaction with inpatient health services in Ethiopia. In order to estimate the pooled proportion of patient satisfaction and determine the associated factors with inpatient health services at public hospitals, a systematic review and meta-analysis were conducted. METHODS: The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed in the extraction of the data. To get the included studies, the following electronic databases were searched: Pub-Med, Google Scholar, Med-Line, Web of Science, Scopus and Repositories. Software called STATA version 17 was used to analyze statistical data using the random effects model. Forest plots were used to display the pooled results. RESULTS: Of the 1583 records resulted in electronic databases searching, 11 studies with 3,958 participants were included in this systematic review and meta-analysis. The estimated pooled proportion of patient satisfaction with inpatient health services was found to be 57.4% (95% CI: 50.88-64.59, I2 = 95.25%). Assuring privacy for patients (OR = 7.44, 95% CI: 3.63-15.25, I2 = 0.0%), availability of direction signs (2.96, 95% CI: 1.91-4.57, I2 = 0.0%), providing adequate information (OR = 3.27, 95% CI: 1.63-6,58, I2 = 65.60%), history of previous admission (OR = 0.29, 0.18-0.46, I2 = 86.36%) and providing on time treatment (OR = 1.63, 95% CI: 1.21-2.20, I2 = 86.36%) were statistically significant factors associated with patient satisfaction with inpatient health services. CONCLUSION: The estimated pooled level of patient satisfaction with inpatient health services is low in Ethiopia. A higher level of patient satisfaction with inpatient health treatments was predicted by factors such as privacy assurance, fast services, availability of direction signs, provision of services with adequate information transfer, and no history of previous admission. To improve patient satisfaction, the Ministry of Health and hospital administration must place a strong emphasis on ensuring the provision of high-quality, standard-based inpatient healthcare.

The impact of the Cochlear™ Osia® 2 System on patients with mixed or conductive hearing loss: A comparison with Cochlear™ Baha® Attract System outcomes.

OBJECTIVE: This prospective study assessed the efficacy of the Cochlear™ Osia® 2 System compared to the previous Baha® Attract System in patients with mixed or conductive hearing loss (MHL/CHL). METHODS: In this prospective case-control study, 10 patients (2 men and 8 women) with MHL/CHL were implanted with the Osia® 2 System. Their audiological outcomes were compared with 13 patients (2 men and 11 women) who had previously been implanted with the transcutaneous Baha® Attract system. We compared the complications and compliance of the two groups. Also, in the Osia 2 System group, subjective satisfaction was assessed using the Korean version of the International Outcome Inventory for Hearing Aids (K-IOI-HA) questionnaire and the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire. RESULTS: Complications such as poor magnetization, pain & infection, and abnormal noise were more common in the Baha Attract group, although not statistically significant. Also, the Osia 2 group exhibited better compliance. Subjective satisfaction was assessed using the K-IOI-HA and APHAB questionnaires with the Osia 2 group, revealing significantly improved scores in ease of communication, reverberation, background noise, and higher K-IOI-HA scores post-implantation. Postoperative-aided thresholds with both systems were significantly lower than preoperative-unaided thresholds, with the Osia 2 System demonstrating notably high satisfaction levels. Although both systems showed similar preoperative and postoperative word-recognition scores, the Osia 2 System provided greater audiological gain, especially at 2 kHz and 4 kHz frequencies. Additionally, the functional gain of both systems was comparable across all frequencies. CONCLUSIONS: The Osia 2 System demonstrated high subjective satisfaction and improved audiological outcomes compared to the Baha Attract system in patients with conductive or mixed hearing loss. Its superior audiological gain, particularly at critical frequencies, along with better compliance, suggests it as a favorable option for this patient population.