Patient satisfaction as an element of healthcare quality - a single-center Polish survey.

OBJECTIVES: The aims of the study were to define the level of patient satisfaction with services provided by selected departments of the Institute, and to identify changes that should be introduced to the process of quality management in healthcare services. MATERIAL AND METHODS: A total of 455 patients from three departments of the National Institute of Geriatrics, Rheumatology and Rehabilitation in Warsaw, hospitalized between January 2016 and March 2018 were assessed retrospectively. Statistical analyses were conducted with the use of IBM SPSS Statistics 25 software. RESULTS: Patients at the Institute gave the highest rates to the courtesy and kindness of doctors and nurses (mean 4.77 and 4.73, respectively), the doctor's interest in a patient's well-being, and the nurses' dexterity in performing medical procedures (4.63 and 4.72, respectively) The lowest-rated were the quality of meals (mean 3.77) and the waiting time for hospital admission on an appointed day (mean 4.07). The study demonstrated statistically significant differences in evaluations made by female and male patients: women had worse opinions about maintenance of intimacy during medical procedures, whereas men gave lower ratings to the size of served meals. The level of satisfaction in all analyzed aspects increased with older age. However, a higher level of patient education correlated negatively with satisfaction from the waiting time for hospital admission on an appointed day, the ability to receive information about the disease and treatment process, cleanliness and accessibility of bathrooms and toilets, or the ability to easily move around the Institute. CONCLUSIONS: Accessibility of medical services, as well as attitudes and competences of the medical staff, are all key factors in ensuring quality care. The conditions of a hospital stay also shape the patients' opinions in a significant way. Therefore, taking into account the patients' opinions should become an important goal in the process of improving healthcare quality.

Knowledge and beliefs in a selected group of parents of children aged 2 and less concerning preventive vaccination

OBJECTIVE: The objective of this research was to get to know the level of knowledge and beliefs concerning preventive vaccination among parents of children up to 2 years of age MATERIAL AND METHODS: The survey was carried out in 2015 in a group of 120 parents of children aged 2 or less in the capital city of Warsaw and its vicinity. An original survey questionnaire was applied. Descriptive statistics methods were applied RESULTS: The most numerous researched group were people aged 20-40 (79.2%) with higher education (76.8%). The majority of respondents declared their positive attitude to rationality of vaccination (76.7%). Only 1.7% of respondents declared that they remained unconvinced as to giving their children preventive vaccination. Women were convinced about the usefulness and preventive effectiveness of preventive vaccination. Among all the respondents 11.7% claimed they did not get enough information on preventive vaccination from medical staff. According to 7.5% of the respondents, the information provided by medical personnel is incomprehensible and insufficient. According to 50.8% of the respondents the effectiveness of parents' education in the scope of preventive vaccination administered to children should be improved CONCLUSIONS: The parents of children aged 2 or less point out to lack of sufficient information on preventive vaccination. It is therefore necessary to involve medical personnel more in order to increase the effectiveness of education of small children's parents in the discussed field

Is Balance Training Using Biofeedback Effective in the Prophylaxis of Falls in Women over the Age of 65?

The paper aims to investigate the usefulness of training in improving mobility and reducing the risk of falls of patients with osteoarthritis by using a force plate and virtual reality as rehabilitation tools. The study involved 72 women randomly divided into two equal groups: the force plate training group, which underwent virtual balance training with visual motor feedback, and the gym training group, which received conventional balance training only. The functional balance assessment was performed before and after the rehabilitation by computerized posturography in a relaxed upright position with open and closed eyes, with visual motor feedback. In the FPT group in the feedback measurement, the mean radius of sways was 30% smaller after rehabilitation (p < 0.00002); the feedback coordination coefficient was more than 10% bigger after rehabilitation (p < 0.001) and reached 92%, which is excellent for elderly people. Total stagnation and stumbling reported by patients decreased after rehabilitation compared to the first examination. Both tested forms of training can contribute to reducing the risk of falls. However, a more significant improvement was obtained in the force plate training group perhaps because the physical effort on a force plate trains the precise movements needed to reposition the centre of gravity without generating excessive inertia forces responsible for loss of balance and falls. Perhaps the most desirable method of intervention is to train a person's ability to perform slow but definite body movements.

Need for comprehensive management of frailty at an individual level: European perspective from the advantage joint action on frailty.

OBJECTIVES: ADVANTAGE Joint Action is a large collaborative project co-founded by the European Commission and its Member States to build a common understanding of frailty for Member States on which to base a common management approach for older people who are frail or at risk of developing frailty. One of the key objectives of the project is presented in this paper; how to manage frailty at the individual level. METHODS: A systematic review of the literature was conducted, including grey literature and good practices when possible. RESULTS: The management of frailty should be directed towards comprehensive and holistic treatment in multiple and related fields. Prevention requires a multifaceted approach addressing factors that have resonance across the individual's life course. Comprehensive geriatric assessment to diagnose the condition and plan a personalized multidomain treatment increases better outcomes. Multicomponent exercise programmes, adequate protein and vitamin D intake, when insufficient, and reduction in polypharmacy and inadequate prescription, are the most effective strategies found in the literature to manage frailty effectively. CONCLUSION: Frailty can be effectively prevented and managed with a multidomain intervention strategy based on comprehensive geriatric assessment.