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1.
BMC Health Serv Res ; 24(1): 13, 2024 Jan 04.
Article in English | MEDLINE | ID: mdl-38178141

ABSTRACT

BACKGROUND: Despite growing evidence of the potential of arts-based modalities to translate knowledge and spark discussion on complex issues, applications to health policy are rare. This study explored the potential of a research-based theatrical video to increase public capacity and motivation to engage with the complex issues that make Emergency Department wait times such an intractable problem. METHODS: Larry Saves the Canadian Healthcare System is a digital musical micro-series developed from extensive research examining system-level causes of Emergency crowding and the ineffectiveness of prevailing approaches. We released individual episodes and a revised full-length version on YouTube, using organic promotion strategies and paid advertising. We used YouTube Analytics to track views, engagement and viewer demographics, and content-analyzed viewer comments. We also conducted five university-based screenings; 92 students completed questionnaires, rating Larry on 16 descriptors using a 7-point Likert scale. RESULTS: From June 2022 through May 2023, Larry garnered over 100,000 views (76,752 of the full-length version, 35,535 of episodes), 1329 likes, 2780 shares, and 139 comments. Views and watch time were higher among women and positively associated with age. Among YouTube comments, the predominating themes were praise for the video and criticism of the healthcare system. Many commenters applauded the show's accuracy, humor, and/or resonance with their experience; several shared healthcare horror stories. Students overwhelmingly agreed with all positive and disagreed with all negative descriptors, and nearly unanimously deemed the video informative, thought-provoking, and entertaining. Most also affirmed that it had increased their knowledge, interest, and confidence to participate in discussions about healthcare issues. Neither gender, primary language, nor employment in healthcare predicted ratings, but graduate students and those 25+ years old evaluated the video most positively. DISCUSSION: These findings highlight the promise of research-informed musical satire to inform and invigorate discourse on an urgent health policy problem. Larry has reached tens of thousands of viewers, garnered excellent feedback, and received high student ratings. Further research should directly assess educational and behavioural outcomes and explore what facilitative strategies could maximize this knowledge translation product's potential to foster informed, impactful policy dialogue.


Subject(s)
Delivery of Health Care , Emergency Service, Hospital , Social Media , Humans , Canada , Video Recording , Waiting Rooms
2.
Ann Fam Med ; 21(1): 46-53, 2023.
Article in English | MEDLINE | ID: mdl-36690495

ABSTRACT

PURPOSE: Most patients are escorted to exam rooms (escorted rooming) although patients directing themselves to their exam room (self-rooming) saves patient and staff time while increasing patient satisfaction. This study assesses patient and staff perceptions after pragmatic implementation of self-rooming. METHODS: In October-December 2020, we surveyed patients and staff in 25 primary care clinics after our institution expanded self-rooming from 4 specially built clinics during the COVID-19 pandemic. Semi-structured surveys asked about rooming process used, rooming process preferred, and perceptions of self-rooming compared with escorted rooming. RESULTS: Most patients (n = 1,561) preferred self-rooming (86%), especially among patients aged <65 years and in family medicine clinics. Few patients felt less welcomed (10.6%), less cared about (6.8%), more isolated (15.6%), more lost/confused (7.6%), or more frustrated (3.2%) with self-rooming compared with escorted rooming. Early-adopter clinics that implemented self-rooming ≤2016 had even lower rates of patients feeling more isolated, lost/confused, or frustrated with self-rooming compared with escorted rooming.Over one-half of staff (n = 241; 180 clinical, 61 nonclinical) preferred self-rooming (59%) and thought most patients liked self-rooming (65.8%), especially among clinical staff and in early adopter clinics (≤2016). Few staff reported worse waiting times for patients (12.4%), medical assistants (MAs) (15.9%), and clinicians (16.4%) or worse crowding in waiting areas (1.7%) and hallways (10.1%). Unlike patient-reported confusion (7.6%), most staff thought self-rooming led to more patient confusion (63.8%), except in early-adopter clinics (44.4%). CONCLUSIONS: Self-rooming is a patient-centered innovation that is also acceptable to staff. We demonstrated that pragmatic implementation is feasible across primary care without expensive technology or specially designed buildings.


Subject(s)
COVID-19 , Waiting Rooms , Humans , Pandemics , Ambulatory Care Facilities , Primary Health Care
3.
Health Educ Res ; 38(2): 177-191, 2023 03 23.
Article in English | MEDLINE | ID: mdl-36715740

ABSTRACT

Waiting rooms provide an ideal location to disseminate health information. In this mixed-methods study, we evaluated waiting room-based health education talks at two clinics in the Dominican Republic and explored recommendations for implementing this intervention in similar settings. The talks addressed noncommunicable diseases, sexually transmitted infections, family planning and gender-based violence. We conducted pre- and posttests to assess attendees' change in knowledge and conducted semi-structured interviews with a subset of them. We conducted a semi-structured focus group with educators. Analyses included Wilcox Signed Rank Tests and McNemar tests for pre- and posttests, conventional content analysis for individual interviews and transcript coding for the focus group. Patient participants were 69.3% female aged 39.6 years (SD = 13.5) on average at one clinic (n = 127) and 100% female aged 17.4 (SD = 1.3) on average at the second clinic (n = 24). Focus group participants (n = 5) had 4.8 years (SD = 3.3) of health educator experience on average. Pre- and posttests showed significant improvement (P < 0.05) across all talks. Qualitative interviews emphasized engaging, clear and brief content delivery with visual aids. The focus group highlighted the importance of patient-centered design with culturally concordant delivery and identified implementation challenges. Findings demonstrate that waiting room-based education talks improve knowledge and provide suggestions for similar interventions.


Subject(s)
Sexually Transmitted Diseases , Waiting Rooms , Humans , Female , Male , Dominican Republic , Health Education , Sex Education
4.
Health Promot Int ; 38(4)2023 Aug 01.
Article in English | MEDLINE | ID: mdl-37440256

ABSTRACT

Health service waiting areas commonly provide health information, resources and supports for consumers; however, the effect on health literacy and related outcomes remains unclear. This scoping review of the literature aimed to explore the use of waiting areas as a place to contribute to the health literacy and related outcomes of consumers attending health appointments. Articles were included if they focussed on health literacy or health literacy responsiveness (concept) in outpatient or primary care health service waiting areas (context) for adult consumers (population) and were published after 2010. Ten bibliographic databases, one full-text archive, dissertation repositories and web sources were searched. The search yielded 5095 records. After duplicate removal, 3942 title/abstract records were screened and 360 full-text records assessed. Data were charted into a standardized data extraction tool. A total of 116 unique articles (published empirical and grey literature) were included. Most articles were set in primary and community care (49%) waiting areas. A diverse range of health topics and resource types were available, but results demonstrated they were not always used by consumers. Outcomes measured in intervention studies were health knowledge, intentions and other psychological factors, self-reported and observed behaviours, clinical outcomes and health service utilization. Intervention studies overall demonstrated positive trends in health literacy-related outcomes, although the benefit declined after 3-6 months. Research on using waiting areas for health literacy purposes is increasing globally. Future research investigating the needs of consumers to inform optimal intervention design is needed.


Health service waiting areas are commonly used to provide health resources (such as health information, resources and supports) for consumers. Health resources which are appropriate and accessible for consumers can improve health literacy by increasing health knowledge, supporting good decision-making or changing behaviours which may result in better health. Although it is common to offer health resources in health service waiting areas, the evidence supporting this practice is unclear. This scoping review of the literature focussed on the use of health service waiting areas as a place to contribute to the health literacy of adult consumers attending outpatient or primary care health appointments. A total of 116 unique articles were included which addressed this issue. Majority of articles were set in primary and community care waiting areas (49%). A range of health topics and resource types were available but these were not always used by consumers. Overall, interventions in waiting areas targeting health literacy-related outcomes resulted in positive outcomes, although the benefit declined after 3­6 months. Research on using waiting areas for health-literacy purposes is increasing worldwide. Future research is needed to identify how to optimize the effectiveness of interventions in waiting areas to benefit consumers.


Subject(s)
Health Literacy , Waiting Rooms , Adult , Humans , Health Literacy/methods
5.
Can Assoc Radiol J ; 74(4): 695-704, 2023 Nov.
Article in English | MEDLINE | ID: mdl-37011899

ABSTRACT

Purpose: The aim was to reduce outpatient wait time and improve patient experience by optimising oral contrast use. Methods: Our multidisciplinary stakeholder collaboration implemented two simultaneous interventions: (1) Creation of 'oral contrast policy', limiting recommended indications. (2) Creation of a new shorter oral contrast regime (30 vs 60 min). We conducted a retrospective service evaluation of oral contrast use in outpatient (OP) abdominal CT at baseline and post-intervention. Patient wait times were measured and per-patient cost-savings were reported. An image quality review was performed by 2 blinded abdominal radiologists. Patient experience was evaluated with a standard voluntary survey. Statistical analysis was performed comparing baseline and evaluation outcomes using Chi-square or Fisher Exact test for categorical variables and Student's t-test or ANOVA for continuous data. Results: Over 1-month periods, OP CT scans were assessed in baseline (pre-pandemic) n = 575, baseline (pandemic) n = 495 and post-intervention n = 545 groups. Oral contrast use reduced from 420/575, 73.0% at baseline to 178/545, 32.7% post intervention. The turn-around time reduced by 15.8 minutes per patient from 70.3 to 54.5 minutes, P < .001 (Interventions 1 and 2). The diagnostic quality did not differ between the oral contrast regimes (Intervention 2, P = 1.0, P = .08). No repeat CTs were needed due to lack of oral contrast (Intervention 1) or poor opacification (Intervention 2). There was oral contrast cost reductions of 69.1-78.4% (P < .001). Patients reported their overall experience was improved post-intervention (Interventions 1 and 2). Conclusions: Optimising the CT oral contrast service through judicious use and a shorter regime, reduced patient wait times, improved patient experience and preserved diagnostic quality.


Subject(s)
Outpatients , Radiology , Humans , Retrospective Studies , Waiting Rooms , Pandemics , Tomography, X-Ray Computed/methods , Patient Outcome Assessment
6.
BMC Med ; 20(1): 75, 2022 03 03.
Article in English | MEDLINE | ID: mdl-35236353

ABSTRACT

BACKGROUND: The shortage of available organs for life-saving transplants persists worldwide. While a majority support donating their organs or tissue when they die, many have not registered their wish to do so. When registered, next of kin are much more likely to follow-through with the decision to donate. In many countries, most people visit their family physician office each year and this setting is a promising, yet underused, site where more people could register for deceased organ donation. Our primary aim was to evaluate the effectiveness of an intervention to promote organ donation registration in family physician's offices. METHODS: We developed an intervention to address barriers and enablers to organ donation registration that involved physician office reception staff inviting patients to register on a tablet in the waiting room while they waited for their appointment. We conducted a cross-sectional stepped-wedge cluster randomized controlled registry trial to evaluate the intervention. We recruited six family physician offices in Canada. All offices began with usual care and then every two weeks, one office (randomly assigned) started the intervention until all offices delivered the intervention. The primary outcome was registration for deceased organ donation in the provincial organ registration registry, assessed within the 7 days of the physician visit. At the end of the trial, we also conducted interviews with clinic staff to assess any barriers and enablers to delivering the intervention. RESULTS: The trial involved 24,616 patient visits by 13,562 unique patients: 12,484 visits in the intervention period and 12,132 in the control period. There was no statistically significant difference in the percentage of patients registered for deceased organ donation in the intervention versus control period (48.0% vs 46.2%; absolute difference after accounting for the secular trend: 0.12%; 95% CI: - 2.30, 2.54; p=0.92). Interviews with clinic staff indicated location of the tablet within a waiting room, patient rapport, existing registration, confidence and motivation to deliver the intervention and competing priorities as barriers and enablers to delivery. CONCLUSIONS: Our intervention did not increase donor registration. Nonetheless, family physician offices may still remain a promising setting to develop and evaluate better interventions to increase organ donation registration. TRIAL REGISTRATION: NCT03213171.


Subject(s)
Physicians, Family , Tissue and Organ Procurement , Cross-Sectional Studies , Humans , Registries , Waiting Rooms
7.
Med Care ; 60(1): 13-21, 2022 01 01.
Article in English | MEDLINE | ID: mdl-34739416

ABSTRACT

BACKGROUND: Previous data over an extended period indicated that Black and Hispanic patients waited significantly longer than their White counterparts to see a qualified practitioner in US emergency departments (EDs). OBJECTIVE: The objective of this study was to assess recent trends and sources of racial and ethnic disparities in patient wait time to see a qualified practitioner in US EDs. DATA SOURCES: Publicly available ED subsample of the National Hospital Ambulatory Medical Care Survey (NHAMCS), 2003-2017. RESEARCH DESIGN: A retrospective cross-sectional analysis of a nationally representative sample of visits to US EDs from 2003 to 2017. Joinpoint statistical analysis and survey-weighted regression were used to assess changes in ED wait time by race/ethnic group over time. PRINCIPAL FINDINGS: For non-Hispanic White patients, median ED wait time increased annually by 1.3 minutes from 2003 through 2008, decreased by 3.0 minutes from 2008 through 2012, and decreased by 1.7 minutes from 2012 to 2017. For non-Hispanic Black patients, median wait time increased annually by 2.0 minutes from 2003 through 2008, decreased by 3.8 minutes from 2008 through 2015, and remained fairly unchanged from 2015 through 2017. For Hispanic patients, the trend in median wait time remained statistically unchanged from 2003 through 2009. It decreased by annually by 4.7 minutes from 2009 to 2012 and by 1.5 minutes from 2012 through 2017. By the end of 2017, median ED wait time decreased to under 20 minutes across all 3 groups. CONCLUSIONS: Over time, ED wait times decreased to under 20 minutes across all racial and ethnic groups between 2003 and 2017. Observed disparities were largely the result of where minority populations accessed care and disappeared over time.


Subject(s)
Ethnicity/statistics & numerical data , Time Factors , Waiting Rooms , Adolescent , Adult , Aged , Child , Child, Preschool , Cross-Sectional Studies , Emergency Service, Hospital/organization & administration , Emergency Service, Hospital/statistics & numerical data , Female , Humans , Infant , Male , Middle Aged , Retrospective Studies , United States/ethnology
8.
Ann Bot ; 129(3): 259-270, 2022 02 11.
Article in English | MEDLINE | ID: mdl-34718377

ABSTRACT

BACKGROUND: As in most land plants, the roots of orchids (Orchidaceae) associate with soil fungi. Recent studies have highlighted the diversity of the fungal partners involved, mostly within Basidiomycotas. The association with a polyphyletic group of fungi collectively called rhizoctonias (Ceratobasidiaceae, Tulasnellaceae and Serendipitaceae) is the most frequent. Yet, several orchid species target other fungal taxa that differ from rhizoctonias by their phylogenetic position and/or ecological traits related to their nutrition out of the orchid roots (e.g. soil saprobic or ectomycorrhizal fungi). We offer an evolutionary framework for these symbiotic associations. SCOPE: Our view is based on the 'Waiting Room Hypothesis', an evolutionary scenario stating that mycorrhizal fungi of land flora were recruited from ancestors that initially colonized roots as endophytes. Endophytes biotrophically colonize tissues in a diffuse way, contrasting with mycorrhizae by the absence of morphological differentiation and of contribution to the plant's nutrition. The association with rhizoctonias is probably the ancestral symbiosis that persists in most extant orchids, while during orchid evolution numerous secondary transitions occurred to other fungal taxa. We suggest that both the rhizoctonia partners and the secondarily acquired ones are from fungal taxa that have broad endophytic ability, as exemplified in non-orchid roots. We review evidence that endophytism in non-orchid plants is the current ecology of many rhizoctonias, which suggests that their ancestors may have been endophytic in orchid ancestors. This also applies to the non-rhizoctonia fungi that were secondarily recruited by several orchid lineages as mycorrhizal partners. Indeed, from our review of the published literature, they are often detected, probably as endophytes, in extant rhizoctonia-associated orchids. CONCLUSION: The orchid family offers one of the best documented examples of the 'Waiting Room Hypothesis': their mycorrhizal symbioses support the idea that extant mycorrhizal fungi have been recruited among endophytic fungi that colonized orchid ancestors.


Subject(s)
Mycorrhizae , Orchidaceae , Endophytes , Orchidaceae/microbiology , Phylogeny , Symbiosis , Waiting Rooms
9.
Pain Manag Nurs ; 23(3): 318-323, 2022 06.
Article in English | MEDLINE | ID: mdl-34688552

ABSTRACT

BACKGROUND: This study explores live and recorded music listening in the outpatient pain clinic. There is evidence demonstrating the effectiveness of live and recorded music in a hospital setting but a comparison study of this kind has yet to be conducted. METHODS: A multimethod survey study design was used. A questionnaire utilizing rating scales was self-administered across two outpatient pain clinic waiting rooms. Patients were included through convenience sampling. In one clinic, a playlist of recorded music curated by two of the authors was provided. In the second clinic, a music therapy student played live music using guitar, flute, and voice. The questionnaire gathered data on music's impact on pain and emotional states, as well as attitudes toward music in the waiting room. Quantitative data was analyzed using descriptive statistics and qualitative data, gathered in the questionnaires open ended question, was analyzed using thematic analysis. RESULTS: The questionnaire was completed by 200 adult patients. Patients reported lowered levels of anxiety, stress, and pain in both clinics, as well as a shorter waiting time and more caring experience. Patients in the live music clinic reported that music lowered levels of stress, nervousness, agitation, and pain more than in the recorded music clinic. CONCLUSIONS: Participants in this study identified that music is a useful tool in the pain clinic waiting room. This study contributes to evidence that music should be considered as a complimentary treatment for people living with pain and in the wider hospital setting. Additional research is warranted with a control group, pre- and posttesting, and studies of music in hospitals in a range of cultural contexts.


Subject(s)
Music Therapy , Music , Adult , Anxiety , Humans , Music/psychology , Music Therapy/methods , Outpatients , Pain , Pain Clinics , Pilot Projects , Waiting Rooms
10.
Int J Qual Health Care ; 33(4)2021 Oct 26.
Article in English | MEDLINE | ID: mdl-34623440

ABSTRACT

BACKGROUND: Few studies have investigated the effects of waiting room communication strategies on health-care behavior. OBJECTIVE: We aimed to determine the effect of a waiting room communication strategy, designed to raise awareness of potential harms of unnecessary imaging, on lumbar imaging rates in the emergency department (ED). METHODS: We conducted a controlled experimental study with a replicated time series design. The design included a 6-week run-in time. Following this there were alternating 1-week intervention and control periods. The intervention group received a communication strategy describing the potential harms of unnecessary imaging for low back pain, shown on a 55" LCD screen positioned in the ED waiting room. The communication strategy was designed by a creative innovation agency and included five digital posters and a patient leaflet. The control group received standard messaging for the waiting room at the time, shown on the same 55" LCD screen, and access to the patient leaflet. The primary outcome was the number and proportion of people presenting to ED with low back pain who received at least one lumbar imaging test, measured using routinely collected ED data. Secondary patient-reported outcomes (patient satisfaction and awareness of campaign messages) were collected from a sample of people presenting for any condition who responded to a text-message-based survey. RESULTS: For the imaging outcome, 337 people presenting to ED with low back pain were included over a 4-month period (intervention n = 99; control n = 238). All had available data on lumbar imaging. Use of lumbar imaging was 25% in those exposed to the communication strategy [95% confidence interval (CI) = 18% to 35%] compared with 29% in those exposed to the standard waiting room messaging [95% CI = 23% to 35%; odds ratio (OR) = 0.83, 95% CI = 0.49 to 1.41]. For the patient-reported outcomes, 349 patients presenting to ED for any condition responded to the survey (intervention n = 170; control n = 179; response rate = 33%). There was uncertain evidence that the intervention increased awareness of the communication strategy leaflet (OR = 2.00, 95% CI = 0.90 to 4.47). Other measures did not suggest between-group differences in patient satisfaction or awareness of the campaign messages. CONCLUSION: A communication strategy displayed in the ED waiting room may slightly reduce the proportion of patients with low back pain who receive lumbar imaging, although there is uncertainty due to imprecision. The campaign did not appear to increase awareness of campaign messages or affect patient satisfaction in a sample of patients presenting to the ED for any reason. Larger studies should investigate whether simple, low-cost waiting room communication strategies can raise awareness of unnecessary healthcare and influence health-care quality. TRIAL REGISTRATION: ACTRN12620000300976, 05/03/2020.


Subject(s)
Low Back Pain , Text Messaging , Communication , Emergency Service, Hospital , Humans , Low Back Pain/diagnosis , Low Back Pain/therapy , Public Health , Waiting Rooms
11.
Pain Manag Nurs ; 22(2): 164-168, 2021 04.
Article in English | MEDLINE | ID: mdl-33223470

ABSTRACT

BACKGROUND: Best approaches to delivering patient education related to pain management and opioid safety are understudied. AIMS: This study assessed the feasibility, acceptability, and preliminary patient-reported impact of an app-based patient pain education program. DESIGN: Pilot study with data collection occurring on 43 weekdays between August 2019-February 2020. SETTING: Waiting rooms at the pain clinic and a primary care medical home within two military treatment facilities. PARTICIPANTS: Military health system beneficiaries seeking general care at the primary care medical home or pain-specific care at the pain clinic. METHODS: The Joint Pain Education and Project curriculum includes patient-focused videos describing the biopsychosocial aspects of pain and pain management, medication take-back and safe disposal, and multidimensional pain assessments. The app-based videos were available on tablets in the waiting rooms for patients to view and complete surveys on after. RESULTS: Overall, 152 patients viewed the videos and completed surveys. Most viewers were interested in receiving other tablet-based health education while in the waiting room (62%). Most viewers found videos to be moderately or very helpful (73%) and were satisfied or very satisfied with the information provided (85%). Participants at the primary care medical home were more likely to find videos helpful compared to participants at the pain clinic (OR = 2.11; 95% CI: 1.07, 4.20; p = .03). CONCLUSION: Implementing app-based pain management education is feasible across clinic settings and is well received by patients. Clinics should consider providing pain education across care setting, rather than just pain specialty clinics, to help foster discussions between clinicians and patients regarding pain management and opioid safety.


Subject(s)
Analgesics, Opioid , Mobile Applications , Analgesics, Opioid/therapeutic use , Humans , Pain Management , Pilot Projects , Waiting Rooms
12.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 46(3): 293-299, 2021 Mar 28.
Article in English, Zh | MEDLINE | ID: mdl-33927077

ABSTRACT

OBJECTIVES: The waiting room for surgery is an area set up to improve the surgical turnover rate, but the waiting time for surgery is uncertain. Patients are prone to negative emotions that affect their physiological state during waiting time. This study aims to explore the effect of Mandala painting intervention based on Mandala-self theory on the emotion and physiological state of patients waiting before operation. METHODS: The patients in the control group (n=30) were given routine nursing before operation in the waiting room, and the patients in the intervention group (n=30) were given Mandala painting intervention on the basis of routine nursing. Repeated measurement analysis of variance was used to compare patients' mood, pressure, heart rate, and waiting time of perception after intervention via SPSS 21.0. RESULTS: Diastolic pressure, heart rate, and happiness and excitement showed no statistical significance in the time effect, intervention effect, and interaction between the 2 factors (all P>0.05). Systolic pressure, fidgety, and pain and sadness showed interaction between the time effect and intervention effect (P<0.05 or P<0.01). The waiting time of perception in the intervention group was significantly shorter than that in the control group (P<0.01). CONCLUSIONS: The application of Mandala painting in the operation waiting room is feasible and can effectively regulate the patients' negative mood and systolic pressure, as well as shorten the waiting time of perception.


Subject(s)
Anxiety , Waiting Rooms , Emotions , Heart Rate , Humans , Pain
13.
Paediatr Respir Rev ; 36: 106-108, 2020 Nov.
Article in English | MEDLINE | ID: mdl-33160838

ABSTRACT

The COVID pandemic has passed its first peak for now in many countries while some are still on the rise, with some facing a second wave of cases. Precautions and infection control measures for both pediatric and adult pulmonary function testing (PFT) have been a topic of debate during the pandemic. Many centers had to close their PFT laboratories during the initial periods of the pandemic and are reopening as the numbers of new cases are decreasing. This review aims to summarize different practices of PFT laboratory management in different countries, including patient appointments, personal protective equipment, testing room requirements and telemedicine during and immediately following the COVID pandemic.


Subject(s)
COVID-19/prevention & control , Delivery of Health Care/methods , Environment, Controlled , Personal Protective Equipment , Respiratory Function Tests/methods , Air Filters , Appointments and Schedules , COVID-19/transmission , Child , Delivery of Health Care/organization & administration , Humans , Internationality , Parents , Pediatrics , Physical Distancing , Pulmonary Medicine , Telemedicine , Ventilation , Waiting Rooms
14.
Subst Abus ; 41(3): 347-355, 2020.
Article in English | MEDLINE | ID: mdl-31364948

ABSTRACT

Background: In primary care, electronic self-administered screening and brief interventions for unhealthy alcohol may overcome some of the implementation barriers of face-to-face intervention. We developed an anonymous electronic self-administered screening brief intervention device for unhealthy alcohol use and assessed its feasibility and acceptability in primary care practice waiting rooms. Two modes of delivery were compared: with or without the presence of a research assistant (RA) to make patients aware of the device's presence and help users. Using the device was optional. Methods: The devices were placed in 10 participating primary care practices waiting rooms for 6 weeks, and were accessible on a voluntary basis. Number of appointments by each practice during the course of the study was recorded. Access to the electronic brief intervention was voluntary among those who screened positive. Screening and brief intervention rates and characteristics of users were compared across the modes of delivery. Results: During the study, there were 7270 appointments and 1511 individuals used the device (20.8%). Mean age of users was 45.3 (19.5), and 57.9% screened positive for unhealthy alcohol use. Of them, 53.8% accessed the brief intervention content. The presence of the RA had a major impact on the device's usage (59.6% vs 17.4% when absent). When the RA was present, participants were less likely to screen positive (49.4% vs 60.7%, P = 0.0003) but more likely to access the intervention (62.7% vs 51.4%, P = 0.009). Results from the satisfaction survey indicated that users found the device easy to use (93.5%), questions useful (89-95%) and 77.2% reported that their friends would be willing to use it. Conclusions: This pilot project indicates that the implementation of an electronic screening and brief intervention device for unhealthy alcohol is feasible and acceptable in primary care practices but that, without human support, its use is rather limited.


Subject(s)
Alcohol-Related Disorders/diagnosis , Crisis Intervention/methods , Mass Screening/methods , Primary Health Care , Waiting Rooms , Adult , Aged , Alcohol-Related Disorders/therapy , Alcoholism/diagnosis , Alcoholism/therapy , Computers, Handheld , Diagnosis, Computer-Assisted , Feasibility Studies , Female , Humans , Male , Middle Aged , Patient Acceptance of Health Care , Patient Satisfaction , Pilot Projects , Research Personnel
15.
J Ethn Subst Abuse ; 19(1): 58-69, 2020.
Article in English | MEDLINE | ID: mdl-30040586

ABSTRACT

The annual number of opioid prescriptions for pain relief has been increasing in the United States. This increase has raised concerns about prescription opioid abuse and overdose. The purpose of this study was to examine opioid risks (risk factors that increase the chance of opioid abuse) among uninsured primary care patients utilizing a free clinic. Data were collected using a self-administered paper survey in the waiting room of the free clinic from May to July 2017 (N = 506). Higher levels of somatic symptoms were associated with higher levels of opioid risks. U.S.-born English speakers had higher levels of opioid risk than non-U.S.-born English speakers and Spanish speakers. Being employed was associated with higher levels of opioid risk while attending college or being postcollegiate was related to lower levels of opioid risk. Research surrounding best practices, prescription trends, and population risk is vital in driving health and social policy. Further research would benefit from examining where people are obtaining opioids. In addition, further research on opioid abuse among Hispanic populations would be beneficial. Finally, future studies should examine how prescribing practices are different among free clinic health professionals in comparison to health care professionals working in-patient or at for-profit clinics.


Subject(s)
Ambulatory Care/statistics & numerical data , Analgesics, Opioid/therapeutic use , Drug Prescriptions/statistics & numerical data , Educational Status , Employment/statistics & numerical data , Hispanic or Latino/statistics & numerical data , Medically Unexplained Symptoms , Medically Uninsured/statistics & numerical data , Opioid-Related Disorders/epidemiology , Practice Patterns, Physicians'/statistics & numerical data , Primary Health Care/statistics & numerical data , Adult , Female , Humans , Male , Medically Uninsured/ethnology , Middle Aged , Risk Factors , Students/statistics & numerical data , Utah/epidemiology , Utah/ethnology , Waiting Rooms
16.
Prof Inferm ; 73(4): 244-249, 2020.
Article in Italian | MEDLINE | ID: mdl-33780607

ABSTRACT

INTRODUCTION: "What was once considered an incurable disease has in many cases become a disease that can be cured or, in any case, a disease patients can live with: It is becoming more and more frequently a chronic illness that allows affected people to have an active and satisfactory life" (I numeri del cancro in Italia 2017, Associazione Italiana di Oncologia Medica). As such, the patient suffering from cancer needs important care, often undergoing daily hospitalization. At the same time, as the daily experience shows, waiting for blood withdrawal, oncology visit and therapy administration causes anxiety, stress and frustration that can compromise the quality of life and adherence to therapies. The aim of this survey is to investigate the experience of patients waiting their turn in the waiting room of an Oncology-Hematology Day Hospital in an Italian Cancer Center. METHODS: The survey was conducted using a semi-structured interview with open and closed questions. Partecipants: We considered a convenience sample of 36 patients admitted to the Oncology -Hematology Day Hospital of a Milan Research Medical Center. RESULTS: The analysis of the collected interviews shows that the waiting room experience involves a considerable number of sensations that can alter the psycho-physical balance of the patient. A prolonged waiting in an uncomfortable room is associated with negative emotions such as discomfort and fear. CONCLUSIONS: The achieved results show the need to make the waiting less stressful by paying particular attention to the various observed issues. In particular a more comfortable and adequate environment for different age groups can better respond to patient needs. Also, it is necessary to reduce the waiting room crowding, establishing defined paths and controlled accesses.


Subject(s)
Quality of Life , Waiting Rooms , Anxiety , Hospitals , Humans , Italy , Waiting Lists
17.
JAMA ; 331(12): 1066, 2024 03 26.
Article in English | MEDLINE | ID: mdl-38530259

Subject(s)
Waiting Rooms
18.
Ann Fam Med ; 20(6): 578, 2022.
Article in English | MEDLINE | ID: mdl-36443084

Subject(s)
Waiting Rooms , Humans
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