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1.
BMC Health Serv Res ; 24(1): 465, 2024 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-38614968

RESUMO

BACKGROUND: Early access to care for carpal tunnel syndrome (CTS) can avoid higher rates of surgery and permanent harm yet is often delayed, particularly for populations more likely to underutilise care. OBJECTIVE: We sought to explore patient experiences and perspectives of health service access for CTS to inform an equity-focussed co-design of a health service for improving early care access. METHODS: In this Normalisation Process Theory (NPT)-informed qualitative study we conducted semistructured in-depth interviews with 19 adults with experience of CTS. Recruitment prioritised New Zealand Maori, Pasifika, low-income, and rural populations. Data were analysed using deductive then inductive thematic analysis. RESULTS: We identified five major themes: (1) the 'Significant Impact of CTS' of the sense-making and relational work to understand the condition, deciding when to get care, compelling clinicians to provide care, and garnering help from others; (2) 'Waiting and Paying for Care'- the enacting, relational, and appraising work to avoid long wait times unless paying privately, particularly where quality of care was low, employment relations poor, or injury compensation processes faltered; (3) circumstances of 'Occupation and CTS Onset' whereby the burden of proof to relate onset of CT symptoms to occupation created excessive relational and enacting work; (4) the 'Information Scarcity' of good information about CTS and the high relational and appraising work associated with using online resources; (5) 'Negotiating Telehealth Perspectives' where telehealth was valued if it meant earlier access for all despite the challenges it held for many. CONCLUSION: Quality, culturally and linguistically responsive information and communication from clinicians and health services will improve equitable early access to CTS care including realising the potential of telehealth modes of care. Policy changes that reduce individual burden of proof in injury compensation claims processes, enable time off work to attend health appointments, and increase public funding for surgical resources would improve early access to CTS care particularly for Maori and Pacific populations and those in small and rural workplaces. NPT is valuable for understanding where opportunities lie to reduce inequitable delays to accessing care including the impact of racism, particularly for populations more likely to underutilise care.


Assuntos
Síndrome do Túnel Carpal , Adulto , Humanos , Síndrome do Túnel Carpal/terapia , Povo Maori , Nova Zelândia , Acesso aos Serviços de Saúde , Avaliação de Resultados da Assistência ao Paciente
2.
South Med J ; 117(4): 182-186, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38569604

RESUMO

OBJECTIVES: Communication with patients and their families/caregivers to facilitate informed decision making is an integral part of patient/family-centered care. Due to the high coronavirus disease 2019 (COVID-19) infection rates and limited personal protective equipment, healthcare systems were forced to restrict patient visitors, limit patient-provider interactions, and implement other changes in treatment protocols that disturbed traditional communications and risked eroding patient/family-centered care and adversely affected patient satisfaction. This article focuses on changes in patient experience in two dedicated COVID-19 units of an academic medical center located in the US South as a result of the enhanced communication process implemented specifically during the COVID-19 pandemic. METHODS: This retrospective quality improvement project used data from Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys, fielded between January 1, 2021 and August 31, 2021, to understand the role of a proactive communication initiative in patient satisfaction. RESULTS: Our results show that HCAHPS scores for hospital unit hospital unit 4 (HSP4) in all categories increased over time, with the greatest improvements seen in the responsiveness of staff and care transition; however, HCAHPS scores for hospital unit HSP3 remained stable, with a small increase in responsiveness of staff. CONCLUSIONS: Our findings suggest that communication is a critical factor in patient satisfaction, demonstrating the efficacy of a swift and innovative initiative to improve communication with family/caregivers, which may have been linked to better patient experiences. Developing communication strategies is crucial for enhancing patient satisfaction.


Assuntos
COVID-19 , Pandemias , Humanos , Estudos Retrospectivos , Satisfação do Paciente , Comunicação , COVID-19/epidemiologia , Avaliação de Resultados da Assistência ao Paciente , Família
3.
BMC Pregnancy Childbirth ; 24(1): 227, 2024 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-38566095

RESUMO

BACKGROUND: Group prenatal care (GPC) has been shown to have a positive impact on social support, patient knowledge and preparedness for birth. We developed an interprofessional hybrid model of care whereby the group perinatal care (GPPC) component was co-facilitated by midwives (MW) and family medicine residents (FMR) and alternating individual visits were provided by family physicians (FP's) within our academic family health team (FHT) In this qualitative study, we sought to explore the impact of this program and how it supports patients through pregnancy and the early newborn period. METHODS: Qualitative study that was conducted using semi-structured telephone interviews with 18 participants who had completed GPPC in the Mount Sinai Academic Family Health Team in Toronto, Canada and delivered between November 2016 and October 2018. Interviews were audio-recorded and transcribed verbatim. Thematic analysis was conducted by team members using grounded theory. RESULTS: Four over-arching themes emerged from the data: (i) Participants highly valued information they received from multiple trusted sources, (ii) Participants felt well cared for by the collaborative and coordinated interprofessional team, (iii) The design of GPPC enabled a shared experience, allowing for increased support of the pregnant person, and (iv) GPPC facilitated a supportive transition into the community which positively impacted participants' emotional well- being. CONCLUSIONS: The four constructs of social support (emotional, informational, instrumental and appraisal) were central to the value that participants found in GPPC. This support from the team of healthcare providers, peers and partners had a positive impact on participants' mental health and helped them face the challenges of their transition to parenthood.


Assuntos
Saúde da Família , Assistência Perinatal , Gravidez , Feminino , Recém-Nascido , Criança , Humanos , Cuidado Pré-Natal , Apoio Social , Pesquisa Qualitativa , Avaliação de Resultados da Assistência ao Paciente , Equipe de Assistência ao Paciente
4.
BMC Health Serv Res ; 24(1): 492, 2024 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-38643146

RESUMO

BACKGROUND: Homelessness is associated with significant health disparities. Conventional health services often fail to address the unique needs and lived experience of homeless individuals and fail to include participatory design when planning health services. This scoping review aimed to examine areas of patient experience that are most frequently reported by people experiencing homelessness when seeking and receiving healthcare, and to identify existing surveys used to measure patient experience for this cohort. METHODS: A scoping review was undertaken reported according to the PRISMA-ScR 2020 Statement. Databases were searched on 1 December 2022: MEDLINE, EMBASE, APA PsychINFO and CINAHL. Included studies focused on people experiencing homelessness, healthcare services and patient experience, primary research, published in English from 2010. Qualitative papers and findings were extracted and synthesized against a modified framework based on the National Institute for Health and Care Excellence guidelines for care for people experiencing homelessness, the Institute of Medicine Framework and Lachman's multidimensional quality model. People with lived experience of homelessness were employed as part of the research team. RESULTS: Thirty-two studies were included. Of these, 22 were qualitative, seven quantitative and three mixed methods, from the United States of America (n = 17), United Kingdom (n = 5), Australia (n = 5) and Canada (n = 4). Health services ranged from primary healthcare to outpatient management, acute care, emergency care and hospital based healthcare. In qualitative papers, the domains of 'accessible and timely', 'person-centred', and values of 'dignity and respect' and 'kindness with compassion' were most prevalent. Among the three patient experience surveys identified, 'accessible and timely' and 'person-centred' were the most frequent domains. The least frequently highlighted domains and values were 'equitable' and 'holistic'. No questions addressed the 'safety' domain. CONCLUSIONS: The Primary Care Quality-Homeless questionnaire best reflected the priorities for healthcare provision that were highlighted in the qualitative studies of people experiencing homelessness. The most frequently cited domains and values that people experiencing homelessness expressed as important when seeking healthcare were reflected in each of the three survey tools to varying degrees. Findings suggest that the principles of 'Kindness and compassion' require further emphasis when seeking feedback on healthcare experiences and the domains of 'safety', 'equitable', and 'efficiency' are not adequately represented in existing patient experience surveys.


Assuntos
Atenção à Saúde , Pessoas Mal Alojadas , Humanos , Problemas Sociais , Pesquisa Qualitativa , Avaliação de Resultados da Assistência ao Paciente
5.
Rural Remote Health ; 24(2): 8380, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38632667

RESUMO

INTRODUCTION: Health services collect patient experience data to monitor, evaluate and improve services and subsequently health outcomes. Obtaining authentic patient experience information to inform improvements relies on the quality of data collection processes and the responsiveness of these processes to the cultural and linguistic needs of diverse populations. This study explores the challenges and considerations in collecting authentic patient experience information through survey methods with Australians who primarily speak First Nations languages. METHODS: First Nations language experts, interpreters, health staff and researchers with expertise in intercultural communication engaged in an iterative process of critical review of two survey tools using qualitative methods. These included a collaborative process of repeated translation and back translation of survey items and collaborative analysis of video-recorded trial administration of surveys with languages experts (who were also receiving dialysis treatment) and survey administrators. All research activities were audio- or video-recorded, and data from all sources were translated, transcribed and inductively analysed to identify key elements influencing acceptability and relevance of both survey process and items as well as translatability. RESULTS: Serious challenges in achieving equivalence of meaning between English and translated versions of survey items were pervasive. Translatability of original survey items was extensively compromised by the use of metaphors specific to the cultural context within which surveys were developed, English words that are familiar but used with different meaning, English terms with no equivalent in First Nations languages and grammatical discordance between languages. Discordance between survey methods and First Nations cultural protocols and preferences for seeking and sharing information was also important: the lack of opportunity to share the 'full story', discomfort with direct questions and communication protocols that preclude negative or critical responses constrained the authenticity of the information obtained through survey methods. These limitations have serious implications for the quality of information collected and result in frustration and distress for those engaging with the survey. CONCLUSION: Profound implications for the acceptability of a survey tool as well as data quality arise from differences between First Nations cultural and communication contexts and the cultural context within which survey methods have evolved. When data collection processes are not linguistically and culturally congruent there is a risk that patient experience data are inaccurate, miss what is important to First Nations patients and have limited utility for informing relevant healthcare improvement. Engagement of First Nations cultural and language experts is essential in all stages of development, implementation and evaluation of culturally safe and effective approaches to support speakers of First Nations languages to share their experiences of health care and influence change.


Assuntos
Comunicação , Avaliação de Resultados da Assistência ao Paciente , Inquéritos e Questionários , Humanos , Austrália , Traduções
7.
BMC Pulm Med ; 24(1): 164, 2024 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-38575978

RESUMO

BACKGROUND: This study aimed to compare patient experiences during bronchoscopy procedures using either topical anesthesia (TA) or monitored anesthesia care (MA). The goal was to identify circumstances where patients could achieve similar levels of tolerance and satisfaction using only TA, especially in resource-limited settings. METHODS: This study included consecutive patients who underwent bronchoscopy with either TA or MA. Data collected included demographics, indications for bronchoscopy, procedure time, and complications during the procedure. A quality assurance survey was administered to assess patient experience and satisfaction with both procedures. A pre-specified subgroup analysis was performed based on procedure invasiveness and time. RESULTS: This study enrolled 350 (TA 251; MA 99) patients, with an average age of 65 years. Main indications for bronchoscopy included tumor diagnosis (38%), esophageal cancer staging (18%), and pulmonary infection (17%). The average duration of the procedures was 20 min, with MA being associated with a significantly longer procedure time than TA (31 min vs. 16 min; P < 0.001). The overall satisfaction rating with bronchoscopy was significantly higher in the MA group (visual analogue scale, 8.9 vs. 8.2; P = 0.001). Subgroup analyses showed that when less invasive or shorter procedures were performed, TA patients reported tolerance and satisfaction levels comparable to MA patients. CONCLUSIONS: Bronchoscopy with MA offered patients a better experience and greater satisfaction; however, in settings with limited resources, TA alone may provide similar levels of patient tolerance and satisfaction during less invasive or shorter procedures.


Assuntos
Anestesia , Pneumonia , Humanos , Idoso , Broncoscopia/métodos , Medição da Dor , Avaliação de Resultados da Assistência ao Paciente , Satisfação do Paciente
8.
JAMA Netw Open ; 7(4): e245277, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38578639

RESUMO

Importance: As video-based care expands in many clinical settings, assessing patient experiences with this care modality will help optimize health care quality, safety, and communication. Objective: To develop and assess the psychometric properties of the video visit user experience (VVUE) measure, a patient-reported measure of experiences with video-based technology. Design, Setting, and Participants: In this survey study, veterans completed a web-based, mail, or telephone survey about their use of Veterans Healthcare Administration (VHA) virtual care between September 2021 and January 2022. The survey was completed by patients who reported having a VHA video visit on their own device or a VHA-issued device and linked to VHA utilization data for the 6 months following the survey. Data analysis was performed from March 2022 to February 2023. Main Outcomes and Measures: The survey included 19 items about experiences with video visits that were rated using a 4-point Likert-type scale (strongly disagree to strongly agree). First, an exploratory factor analysis was conducted to determine the factor structure and parsimonious set of items, using the McDonald Omega test to assess internal consistency reliability. Then, a confirmatory factor analysis was conducted to test structural validity, and bivariate correlations between VVUE and VHA health care engagement were calculated to test concurrent validity. Finally, predictive validity was assessed using logistic regression to determine whether VVUE was associated with future VHA video visit use. Results: Among 1887 respondents included in the analyses, 83.2% (95% CI, 81.5%-84.8%) were male, 41.0% (95% CI, 38.8%-43.1%) were aged 65 years or older, and the majority had multiple chronic medical and mental health conditions. The exploratory factor analysis identified a 10-item single-factor VVUE measure (including questions about satisfaction, user-centeredness, technical quality, usefulness, and appropriateness), explaining 96% of the total variance, with acceptable internal consistency reliability (ω = 0.95). The confirmatory factor analysis results confirmed a single-factor solution (standardized root mean squared residual = 0.04). VVUE was positively associated with VHA health care engagement (ρ = 0.47; P < .001). Predictive validity models demonstrated that higher VVUE measure scores were associated with future use of video visits, where each 1-point increase on VVUE was associated with greater likelihood of having a video visit in subsequent 6 months (adjusted odds ratio, 1.04; 95% CI, 1.02-1.06). Conclusions and Relevance: The findings of this study of veterans using video visits suggest that a brief measure is valid to capture veterans' experiences receiving VHA virtual care.


Assuntos
Atenção à Saúde , Transtornos Mentais , Humanos , Masculino , Feminino , Reprodutibilidade dos Testes , Inquéritos e Questionários , Avaliação de Resultados da Assistência ao Paciente
10.
Clin Imaging ; 109: 110119, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38490081

RESUMO

PURPOSE: This review discusses how breast centers can optimize patient experience scores among transgender patients. FINDINGS: High patient experience scores impact patient care and compliance. Increased regulations have been enacted to ensure that health systems are effectively meeting the health concerns of sexual minorities. This will be reflected in the patient experience surveys. A leading patient survey will be assessed to help breast imaging centers optimize the transgender patient experience and question types will be provided. SUMMARY: Breast Centers can be equipped to enhance the transgender patient experience.


Assuntos
Pessoas Transgênero , Humanos , Inquéritos e Questionários , Avaliação de Resultados da Assistência ao Paciente
12.
Am J Nurs ; 124(4): 42-45, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38511710

RESUMO

This article is one in a series from Press Ganey-a health care performance improvement organization-that will discuss the many facets of the human experience in health care. Using the latest national data, the series will explore the intersections of safety, reliability, experience, and service, and their impact on engagement, work culture, and nurse-sensitive outcomes. Each installment will be designed as a "deep dive" into the most recent thinking and evidence-based approaches to improvement of the patient experience with a particular focus on practical and implementable tactics in each of the above subject areas.


Assuntos
Atenção à Saúde , Pacientes , Humanos , Reprodutibilidade dos Testes , Instalações de Saúde , Avaliação de Resultados da Assistência ao Paciente
13.
BMC Gastroenterol ; 24(1): 101, 2024 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-38481137

RESUMO

Exocrine pancreatic insufficiency (EPI) stems from a deficiency of functional pancreatic enzymes with consequent maldigestion and malnutrition. EPI shares clinical symptoms and manifestations with other disorders and is a considerable burden to individuals affected. In this narrative review, we analyzed the literature to identify relevant publications on living with EPI with the scope of individuating evidence gaps, including those related to symptoms, health-related quality of life (HRQoL), emotional functioning, disease burden, presence of comorbidities, and the use of pancreatic enzyme replacement therapy (PERT). Abdominal pain emerged as one of the most prominent symptoms. HRQoL was affected in EPI, but no articles examined emotional functioning. Comorbidities reported involved other pancreatic disorders, diabetes, gastrointestinal disorders, sarcopenia and osteopenia, cardiovascular disorders, bacterial overgrowth, and nutritional deficiencies. PERT was found to be effective in improving EPI symptoms and was well tolerated by most individuals. Our review revealed a dearth of literature evidence on patients' experience with EPI, such as emotional functioning and disease burden. We also revealed that studies on long-term effects of PERT are missing, as are studies that would help advance the understanding of the disease and its progression, risk/mitigating factors, and comorbidities. Future studies should address these identified gaps.


Assuntos
Diabetes Mellitus , Insuficiência Pancreática Exócrina , Humanos , Qualidade de Vida , Insuficiência Pancreática Exócrina/etiologia , Insuficiência Pancreática Exócrina/terapia , Insuficiência Pancreática Exócrina/diagnóstico , Pâncreas , Avaliação de Resultados da Assistência ao Paciente
14.
BMC Emerg Med ; 24(1): 42, 2024 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-38475735

RESUMO

BACKGROUND: Emergency Medical Services are dispatched more frequently than before. However, many non-urgent patients do not need ambulance transportation to a healthcare facility after evaluation and treatment on scene. This study explored the experiences of non-conveyed patients. Our research questions were: (1) How have non-conveyed patients experienced the service received from EMS? (2) Does a patient's age, gender, or time of the emergency call impact the patient's experience? METHODS: This descriptive survey study examined non-conveyed Emergency Medical Services patients in the Wellbeing Services County of Southwest Finland. The study period was from March 1, 2023, to March 31, 2023. The study population was 1017. They received a questionnaire that was sent by mail. The questionnaire was formed based on questions previously used in four different questionnaires. We received 247 answers (24.3% response rate). Percentages, medians with interquartile ranges, and non-parametric tests were used in the descriptive analyses. RESULTS: Non-conveyed patients were very satisfied with the paramedics' expertise and behavior, their ability to meet their individual needs, the sense of safety provided by the paramedics, and the instructions given to the patients. Time to receive help (19% rated 3 or less on a scale from 1 to 5), how paramedics introduced themselves (16.5%), and satisfaction with non-conveyance decisions (14.6%) were more frequently rated lower than other areas. Further, pain management stood out in the less favorable evaluations. Still, patients' experiences of the service were positive. The age group, gender, or time of the emergency call were not associated with patient experience. CONCLUSIONS: Patients were very satisfied with the paramedics' interpersonal skills. A more focused approach to pain management and developing EMS to ensure faster patient outreach and clearer explanations of non-conveyance decisions could further enhance the patient experience.


Assuntos
Serviços Médicos de Emergência , Humanos , Finlândia , Ambulâncias , Inquéritos e Questionários , Avaliação de Resultados da Assistência ao Paciente
15.
Front Immunol ; 15: 1270451, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38510252

RESUMO

The effective transition from pediatric to adult care for individuals with chronic medical conditions should address the medical, psychosocial and educational needs of the cohort. The views and experiences of service users and their families are an integral component of service development. This study sought to evaluate the current provision of transition services from pediatric immunology services to adult immunology services for patients with a diagnosis of an inborn error of immunity at St. James's Hospital, Dublin. We gathered patient perspectives on the experience of the transition process using a structured survey. In addition, we adopted a micro-costing technique to estimate the cost of implementing the current standard of care for these patients. Results of a micro-costing analysis suggest that the most significant component of cost in assessing these patients is on laboratory investigation, an area where there is likely significant duplication between pediatric and adult care. Perspectives from patients suggested that the transition period went well for the majority of the cohort and that they felt ready to move to adult services, but the transition was not without complications in areas such as self-advocacy and medication management. The transition process may benefit from enhanced communication and collaboration between pediatric and adult services.


Assuntos
Transição para Assistência do Adulto , Adulto , Humanos , Criança , Hospitais , Inquéritos e Questionários , Avaliação de Resultados da Assistência ao Paciente
16.
BMJ Open ; 14(3): e079775, 2024 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-38485169

RESUMO

OBJECTIVES: This study aimed (1) to examine the association between patient engagement with a bidirectional, semiautomated postdischarge texting programme and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey outcomes, readmissions and revisit rates in a large health system and (2) to describe operational and clinical flow considerations for implementing a postdischarge texting programme. SETTING: The study involved 1 main academic hospital (beds: 2500+) and 6 community hospitals (beds: 190-400, averaging 300 beds per hospital) in Houston, Texas. METHODS: Retrospective, observational cohort study between non-engaged patients (responded with 0-2 incoming text messages) and engaged patients (responded with 3+ incoming, patient-initiated text messages) between December 2022 and May 2023. We used the two-tailed t-test for continuous variables and χ2 test for categorical variables to compare the baseline characteristics between the two cohorts. For the binary outcomes, such as the revisit (1=yes, vs 0=no) and readmissions (1=yes vs 0=no), we constructed mixed effect logistic regression models with the random effects to account for repeated measurements from the hospitals. For the continuous outcome, such as the case mix index (CMI), a generalised linear quantile mixed effect model was built. All tests for significance were two tailed, using an alpha level of 0.05, and 95% CIs were provided. Significance tests were performed to evaluate the CMI and readmissions and revisit rates. RESULTS: From 78 883 patients who were contacted over the course of this pilot implementation, 49 222 (62.4%) responded, with 39 442 (50%) responded with 3+ incoming text messages. The engaged cohort had higher HCAHPS scores in all domains compared with the non-engaged cohort. The engaged cohort used significantly fewer 30-day acute care resources, experiencing 29% fewer overall readmissions and 20% fewer revisit rates (23% less likely to revisit) and were 27% less likely to be readmitted. The results were statistically significant for all but two hospitals. CONCLUSIONS: This study builds on the few postdischarge texting studies, and also builds on the patient engagement literature, finding that patient engagement with postdischarge texting can be associated with fewer acute care resources. To our knowledge, this is the only study that documented an association between a text-based postdischarge programme and HCAHPS scores, perhaps owing to the bidirectionality and ease with which patients could interact with nurses. Future research should explore the texting paradigms to evaluate their associated outcomes in a variety of postdischarge applications.


Assuntos
Readmissão do Paciente , Envio de Mensagens de Texto , Humanos , Estudos Retrospectivos , Alta do Paciente , Assistência ao Convalescente , Participação do Paciente , Satisfação do Paciente , Hospitais Comunitários , Avaliação de Resultados da Assistência ao Paciente
17.
J Patient Rep Outcomes ; 8(1): 32, 2024 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-38498225

RESUMO

BACKGROUND: In endoscopic care, favourable patient experiences before, during and after a colonoscopy are essential for the patient's willingness to repeat the procedure. To ensure that significant experiences are measured, patients should be involved in creating the measurement instruments. Thus, the aim of the present study was to develop a colonoscopy-specific PREM by (1) operationalising patient experiences before, during and after a colonoscopy procedure and (2) evaluating its content validity. METHODS: The colonoscopy-specific PREM was developed in two stages: (1) operationalisation with item generation and (2) content validity testing. A previously developed conceptual model, based on a systematic literature review that illustrates patients' (n = 245) experiences of undergoing a colonoscopy, formed the theoretical basis. To assess the degree to which the PREM reflected patients' experiences before, during and after a colonoscopy procedure, content validity was tested-through face validity with healthcare professionals (n = 4) and cognitive interviews with patients (n = 14) having experienced a colonoscopy. Content validity index (CVI) was calculated to investigate the relevance of the items. RESULTS: The Patient Experience Colonoscopy Scale (PECS) is a colonoscopy-specific PREM consisting of five different constructs: health motivation, discomfort, information, a caring relationship and understanding. Each construct was defined and generated into a pool of items (n = 77). After face-validity assessment with healthcare professionals, a draft 52-item version of the PECS was ready for content validity testing by the patients. During cognitive interviews the patients contributed valuable insights that led to rewording and removal of items. Results from the CVI suggest that the PECS and its content are relevant (I-CVI range 0.5-1, S-CVI/Ave = 0.86). The final PECS consists of 30 items representing a colonoscopy-specific PREM. CONCLUSION: The PECS is a new 30-item PREM instrument designed for adult elective colonoscopy patients after they have undergone the procedure. Each item in the PECS derives from a conceptual model based on a systematic literature review. Patients and healthcare professionals were involved in developing the PECS, which measures colonoscopy-specific patient experiences before, during and after the procedure. The content validity testing positively contributed to the development of the PECS. Psychometric properties need to be evaluated further.


Assuntos
Colonoscopia , Avaliação de Resultados da Assistência ao Paciente , Medidas de Resultados Relatados pelo Paciente , Humanos , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários , Revisões Sistemáticas como Assunto
18.
Sci Rep ; 14(1): 5403, 2024 03 05.
Artigo em Inglês | MEDLINE | ID: mdl-38443430

RESUMO

This study evaluated patient experiences with genetic testing for inherited retinal diseases (IRDs) and the association between underlying knowledge, testing outcomes, and the perceived value of the results. An online survey was distributed to adults with IRDs and parents/guardians of dependents with IRDs who had had genetic testing. Data included details of genetic testing, pre- and post- test perceptions, Decision Regret Scale, perceived value of results, and knowledge of gene therapy. Of 135 responses (85% from adults with IRDs), genetic testing was primarily conducted at no charge through public hospitals (49%) or in a research setting (30%). Key motivations for genetic testing were to confirm IRD diagnosis and to contribute towards research. Those who had received a genetic diagnosis (odds ratio: 6.71; p < 0.001) and those self-reported to have good knowledge of gene therapy (odds ratio: 2.69; p = 0.018) were more likely to have gained confidence in managing their clinical care. For over 80% of respondents, knowing the causative gene empowered them to learn more about their IRD and explore opportunities regarding clinical trials. Key genetic counselling information needs include resources for family communications, structured information provision, and ongoing genetic support, particularly in the context of emerging ocular therapies, to enhance consistency in information uptake.


Assuntos
Retina , Doenças Retinianas , Adulto , Humanos , Estudos Transversais , Doenças Retinianas/diagnóstico , Doenças Retinianas/genética , Doenças Retinianas/terapia , Testes Genéticos , Aprendizagem , Avaliação de Resultados da Assistência ao Paciente
19.
Arch Psychiatr Nurs ; 48: 7-12, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38453285

RESUMO

Despite initiatives to eliminate restraint from acute psychiatric care, there remain times when violent episodes threaten the safety of patients and/or staff. The restraint chair may be used in these moments and provide an alternative to four-point restraint. The purpose of this study was to examine the patient experience of the restraint chair. Patients who had an episode of restraint in the restraint chair during their hospital stay were interviewed about the experience. Participants described the experience as "unpleasant," with the majority preferring the restraint chair to other methods of restraint they had experienced. Participants indicated they could "understand" why the restraint had occurred and felt staff were "helpful" and "create safety." Finally, participants stated the hospital experience was "positive." Although the goal remains to eliminate restraint, psychiatric settings may want to consider the restraint chair as an alternative to four-point restraint for situations requiring mechanical restraint. Nurses' presence and communication with patients during the restraint process is important to the patient experience. More research is needed to verify these results.


Assuntos
Agressão , Restrição Física , Humanos , Pesquisa Qualitativa , Restrição Física/psicologia , Pacientes , Avaliação de Resultados da Assistência ao Paciente
20.
Front Public Health ; 12: 1297769, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38439757

RESUMO

Objectives: No French validated concise scales are available for measuring the experience of inpatients in pediatrics. This study aims to adapt the adult PPE-15 to a pediatric population, and translating it in French, as well as to establish reference values for adults, teenagers, and parents of young children. Methods: Cultural adaptation involved forward and backward translations, along with pretests in all three populations. Dimensional structure and internal consistency were assessed using principal component analysis, exploratory factor analysis, and Cronbach's alpha. Construct validity was assessed by examining established associations between patient satisfaction and inpatient variables, including length of stay, and preventable readmission. Results: A total of 25,626 adults, 293 teenagers and 1,640 parents of young children completed the French questionnaires. Factor analysis supported a single dimension (Cronbach's alpha: adults: 0.85, teenagers: 0.82, parents: 0.80). Construct validity showed the expected pattern of association, with dissatisfaction correlating with patient- and stay-related factors, notably length of stay, and readmission. Conclusion: The French versions of the PPE-15 for adults, teenagers and parents of pediatric patients stand as valid and reliable instruments for gauging patient satisfaction regarding their hospital stay after discharge.


Assuntos
Emoções , Pacientes Internados , Adulto , Humanos , Adolescente , Criança , Pré-Escolar , Análise Fatorial , Pais , Avaliação de Resultados da Assistência ao Paciente
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