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1.
Referência ; serVI(3): e32647, dez. 2024. tab
Article in Portuguese | LILACS-Express | BDENF - Nursing | ID: biblio-1558852

ABSTRACT

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.

2.
Rev. enferm. UERJ ; 32: e80274, jan. -dez. 2024.
Article in English, Spanish, Portuguese | LILACS-Express | LILACS | ID: biblio-1554400

ABSTRACT

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.

3.
Aesthetic Plast Surg ; 2024 Aug 01.
Article in English | MEDLINE | ID: mdl-39090310

ABSTRACT

BACKGROUND: Facelifts are one of the most common facial aesthetic surgery procedures. Patient satisfaction determines success of most aesthetic surgery but has been historically difficult to assess. OBJECTIVE: This study evaluated reviews by facelift patients on the aesthetic surgery social media website RealSelf.com to determine positive and negative factors underlying patient satisfaction following facelifts. METHODS: Facelift reviews were gathered from RealSelf.com with an automated web crawler. Reviews were categorized as positive or negative and by the primary and secondary reasons for the positive or negative review. Patient "worth it" and star ratings, physician specialty, and cost of procedure were also collected. RESULTS: A total of 2153 facelift reviews were collected. Overall, 1986 (92.24%) were positive and 167 (7.76%) were negative. The most common overall reasons for a positive review were aesthetic results (n=1571, 79.10%) and bedside manner (n=1488, 74.92%). The most common overall reasons for a negative review were outcome (n=137, 82.04%) and bedside manner (n=82, 49.10%). Most facelifts were performed by plastic surgeons (n=1796, 83.42%). The greatest 5-star rating percentages were seen for oral and maxillofacial surgeons (n=29, 93.55%), otolaryngologists (n=96, 92.31%), and plastic surgeons (n=1642, 91.43%). Of patients who provided a "worth it" rating, 1216 (91.91%) stated that their facelift was "worth it." CONCLUSION: Overall patient sentiment toward facelifts was positive. The factors most commonly affecting a positive patient experience were bedside manner and aesthetic results. Negative patient reviews were primarily attributed to dissatisfaction with aesthetic outcomes. Social media serves as a valuable tool for evaluating patient satisfaction with aesthetic surgery. LEVEL OF EVIDENCE IV: 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 .

4.
J Headache Pain ; 25(1): 127, 2024 Aug 01.
Article in English | MEDLINE | ID: mdl-39090530

ABSTRACT

BACKGROUND: Management of idiopathic intracranial hypertension (IIH) is complex requiring contributions from multiple specialized disciplines. In practice, this creates considerable organizational and communicational challenges. To meet those challenges, we established an interdisciplinary integrated outpatient clinic for IIH with a central coordination and a one-stop concept. Here, we aimed to evaluate effects of this one-stop concept on subjective patient satisfaction and economic outcome in patients with IIH. METHODS: In a retrospective cohort study, we compared the one-stop era with integrated care (IC, 1-JUL-2021 to 31-DEC-2022) to a reference group receiving standard care (SC, 1-JUL-2018 to 31-DEC-2019) regarding subjective patient satisfaction (assessed by the Vienna Patient Inventory). Multivariable binary linear regression models were used to adjust for confounders. RESULTS: Baseline characteristics of the IC group (n = 85) and SC group (n = 81) were comparable (female: 90.6% vs. 90.1%; mean age: 33.6 vs. 32.8 years, educational level: ≥9 years of education 60.0% vs. 59.3%; located in Vienna 75.3% vs. 76.5%). Compared to SC, management within IC concept was associated with statistically significantly higher subjective patient satisfaction (beta = 0.93; p < 0.001) with the strongest effects observed in satisfaction with treatment accessibility and availability (beta = 2.05; p < 0.001). Subgroup analyses of patients with migration background and language barrier consistently indicated stronger effects of IC in these groups. CONCLUSIONS: Interdisciplinary integrated management of IIH statistically significantly and clinically meaningfully improves patient satisfaction - particularly in socioeconomically underprivileged patient groups. Providing structured central coordination to facilitate and improve access to interdisciplinary management provides means to further improve outcome.


Subject(s)
Ambulatory Care Facilities , Patient Satisfaction , Pseudotumor Cerebri , Humans , Female , Male , Adult , Pseudotumor Cerebri/therapy , Retrospective Studies , Ambulatory Care Facilities/organization & administration , Delivery of Health Care, Integrated , Patient Care Team/organization & administration , Austria , Middle Aged
5.
BMC Public Health ; 24(1): 2082, 2024 Aug 01.
Article in English | MEDLINE | ID: mdl-39090570

ABSTRACT

INTRODUCTION: Amidst the challenges posed by Covid-19, assessing healthcare quality in India is crucial, particularly through patient satisfaction levels. METHODOLOGY: A cross-sectional survey of 277 participants in Jammu and Kashmir was conducted, utilizing a semi-structured questionnaire and PSQ-18. Data analysis was performed using SPSS (v25) including Chi-Square tests and Descriptive analysis. RESULTS: Out of 277 participants, 70.8% expressed high satisfaction with medical care. Majority (70%) agreed that doctors explained medical tests well. Additionally, 70% strongly agreed that their doctor's office was well-equipped. Dissatisfaction factors were notably low. Significant associations were found between age and alcohol use (p = 0.041), gender and alcohol use (p = 0.007), gender and tobacco use (p = 0.032), and education level and vaccination (p = 0.001). CONCLUSION: The study highlights high patient satisfaction during the pandemic. Improving accessibility and quality of primary healthcare and community centres is essential to meet patient needs effectively.


Subject(s)
COVID-19 , Patient Satisfaction , Humans , COVID-19/epidemiology , COVID-19/prevention & control , India/epidemiology , Male , Patient Satisfaction/statistics & numerical data , Female , Cross-Sectional Studies , Adult , Middle Aged , Young Adult , Delivery of Health Care/organization & administration , Surveys and Questionnaires , Quality of Health Care , Adolescent , Pandemics , Aged
6.
Front Surg ; 11: 1396432, 2024.
Article in English | MEDLINE | ID: mdl-39086922

ABSTRACT

Introduction: Conservative surgery is the gold standard for the treatment of single and small tumors and, combined with the concept of oncoplastic tumors, brings good aesthetic results while maintaining cancer safety. The objective was to comparatively analyze the degree of satisfaction of patients undergoing breast conserving surgery (BCS), with and without oncoplastic surgery (OPS) using level II OPS techniques. Methods: Review with a search in the databases MEDLINE (by PubMed), EMBASE, Clinical Trials, Scopus, Web of Science, BVS and Oppen gray. The meta-analysis of random effects was performed using the Der Simonian-Laird method considering the odds ratio (OR) with a 95% confidence interval (95% CI). Results: There was no statistically significant difference in the aesthetic outcome between women who underwent OPS and BCS (OR 0.90; 95% CI 0.62-1.30). The staging (OR 1.93; 95% CI 0.97-3.84; I 2 = 15.83%); tumor location [central (OR 1.28; 95% CI 0.06-27.49; I 2 = 17.63%); lower (OR 0.75; 95% CI 0.21-2.65; I 2 = 2.21%); superior (OR 0.67; 95% CI 0.26-1.74; I 2 = 0.00%] and tumor size (OR 8.73; 95% CI -11.82-29.28; I 2 = 93.18%) showed no association with the type of BCS performed, with or without OPS. The degree of satisfaction remains even in cases of extreme oncoplasty. Conclusion: The level of patient satisfaction in relation to BCS was similar to that of the group undergoing OPS, highlighting that OPS allows the patient's satisfaction rate to be maintained even in the case of large or multicentric tumors.

7.
Rev. Baiana Saúde Pública (Online) ; 48(2): 191-208, 20240726.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1565998

ABSTRACT

Este artigo descreve o acesso e a percepção do acesso de usuários a serviços especializados no tratamento do vírus da imunodeficiência humana e da Síndrome da Imunodeficiência Humana (HIV/AIDS) em municípios baianos por meio de um recorte epidemiológico descritivo-analítico, com abordagem quantitativa de dados primários de estudo realizado em cinco serviços localizados na capital e oito no interior do estado da Bahia, Brasil. Participaram deste estudo 475 usuários, de 21 municípios baianos, predominantemente do sexo feminino, com faixa etária entre 25 e 44 anos, negros, cristãos, desempregados, com escolaridade compreendendo o ensino fundamental, renda de até três salários mínimos, heterossexual e cisgênero. O acesso à testagem para HIV e outras Infecções Sexualmente Transmissíveis (IST), profilaxias de pós-exposição e pré-exposição e outros insumos de prevenção não constituíram motivação de inserção no serviço. O tratamento específico e a assistência médica para HIV e outras IST foi motivação para que a maioria dos participantes se direcionassem ao serviço especializado. O deslocamento até o serviço de referência é realizado principalmente por transportes coletivos, e o trajeto casa-serviço tem duração de pelo menos uma hora. O horário de funcionamento da unidade atende às necessidades da maior parte dos participantes, mas parcela dos usuários mencionaram o desejo de funcionamento em horários alternativos. A marcação de consultas é realizada principalmente de forma presencial e por telefone, com possibilidade de agendamento diário, assim a maioria dos usuários avaliaram a organização do serviço para marcação de consultas como boa ou muito boa. O tempo de espera, entre marcação e consulta, mais comum é de uma semana a um mês.


This article describes user access and perception of access to specialized HIV/AIDS services in Bahia municipalities by applying a qualitative epidemiological, descriptive-analytical approach to primary data from research conducted in five services located in the capital and eight in the countryside. A total of 475 users from 21 municipalities in Bahia participated in this study. Most were female, between 25 and 44 years old, Black, Christian, unemployed, with complete primary education, income of up to 3 minimum wages, heterosexual and cisgender. Access to HIV testing and other STIs, post-exposure and pre-exposure prophylaxis and other prevention inputs did not constitute motivation for procuring the service. Specific treatment and medical care for HIV and other STIs motivated most participants to turn to specialized services. Commuting to the reference service is made mainly by public transport and the home-service journey takes at least one hour. The unit's opening hours meet the needs of most participants, but some mentioned the desire for alternative operating times. Appointments are booked mainly in person and over the phone, with the possibility of daily scheduling, so most users rated the service organization for scheduling appointments as good or very good. The most common waiting time between booking and consultation is one week to one month.


Este artículo describe el acceso y la percepción de acceso de los usuarios a servicios especializados en el tratamiento del virus de inmunodeficiencia humana y síndrome de inmunodeficiencia humana (VIH/sida) en municipios de Bahía (Brasil) mediante un enfoque epidemiológico, descriptivo-analítico, y un enfoque cuantitativo de datos primarios de un estudio realizado en cinco servicios ubicados en la capital y ocho en el interior del estado de Bahía. Participaron en este estudio 475 usuarios, de 21 municipios de Bahía, con mayor predominio femenino, con edades de entre 25 y 44 años, negros, cristianos, desempleados, con educación primaria, ingresos de hasta tres salarios mínimos, heterosexuales y cisgénero. El acceso a pruebas de VIH y otras infecciones de transmisión sexual (ITS), profilaxis posexposición y preexposición, y otros insumos de prevención no constituyeron una motivación para ingresar al servicio. El tratamiento específico y la asistencia médica para el VIH y otras ITS fueron la razón para que la mayoría de los participantes buscaran servicios especializados. El desplazamiento al servicio de referencia se realiza principalmente en transporte público, y el trayecto desde el domicilio al servicio tiene una duración mínima de una hora. El horario de atención de la unidad satisface las necesidades de la mayoría de los participantes, pero algunos usuarios mencionaron el deseo de que operase en horarios alternativos. Las citas se realizan principalmente de forma presencial y telefónica, con posibilidad de concertación diaria, por lo que la mayoría de los usuarios valoran como buena o muy buena la organización del servicio de citas. El tiempo de espera más habitual entre la reserva y la consulta es de una semana a un mes.

8.
Article in English | MEDLINE | ID: mdl-39025127

ABSTRACT

OBJECTIVE: To explore women's experiences of mechanical labor induction using a balloon catheter with self-traction. DESIGN: Descriptive qualitative. SETTING: Birth unit of an urban hospital in Quebec, Canada. PARTICIPANTS: Fourteen women who experienced labor induction with a balloon catheter using self-traction. METHODS: We conducted individual structured interviews between May 2022 and January 2023 to collect data that we subsequently analyzed using the manifest content analysis approach of Graneheim et al. We adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ). RESULTS: We identified five categories: Expectations, Pain or Comfort Experienced, Emotions Felt, Support From Nursing Staff, and Appreciation of the Procedure. The participants anticipated rapid, effective induction, expressed concerns about potential discomfort, and appreciated control of their experiences. We found a generally positive trend in terms of appreciation for all categories. CONCLUSION: The positive experiences of participants underline the promising potential of the balloon catheter method of labor induction with self-traction. Given the continuing growth in labor induction rates, it becomes necessary to continue efforts to offer services specifically geared to women's needs. Offering an additional option such as self-traction is a step in this direction.

9.
J Hand Microsurg ; 16(3): 100051, 2024 Aug.
Article in English | MEDLINE | ID: mdl-39035862

ABSTRACT

Purpose: As stakeholders seek to improve patient outcomes while maintaining cost-effectiveness in an increasingly expensive healthcare system, metrics such as patient satisfaction are becoming more important. This present study sought to identify factors associated with and independently predictive of better surgical satisfaction two years following hand and wrist surgery. Methods: Patients undergoing hand and wrist surgery at an urban outpatient institution were enrolled preoperatively into a surgical registry and assessed two years postoperatively. Patient satisfaction with surgery was measured at two years postoperatively with the Surgical Satisfaction Questionnaire (SSQ-8). Bivariate analysis determined associations between postoperative satisfaction and patient demographics, injury specifiers, medical history, and multiple patient-reported outcomes (PROs). Multivariable analysis determined independent predictors of two-year postoperative satisfaction following hand and wrist surgery. Results: Better surgical satisfaction was associated with having never smoked, no preoperative opioid use, lack of an accompanying legal claim, lack of a workers compensation claim, no clinical history of depression/anxiety, less comorbidities, and higher preoperative expectations.Various PROs relating to function, pain, activity, and general health at both baseline and two years demonstrated associations with postoperative satisfaction. Multivariable analysis confirmed that never smoking, lack of a legal claim, and better preoperative Brief Michigan Hand Questionnaire scores were independently predictive of better surgical satisfaction two years following hand and wrist surgery. Conclusion: At two years following hand and wrist surgery, better patient satisfaction was best predicted by never smoking, no related legal claim, and better baseline Brief Michigan Hand Questionnaire scores. Level of evidence: III.

10.
J Perianesth Nurs ; 2024 Jul 15.
Article in English | MEDLINE | ID: mdl-39023478

ABSTRACT

PURPOSE: This systematic review and meta-analysis aimed to investigate the postoperative analgesic efficacy and safety of the modified thoracoabdominal nerve block through the perichondral approach (M-TAPA) in abdominal surgeries. DESIGN: Systematic review and meta-analysis. METHODS: We searched electronic databases to identify relevant studies comparing M-TAPA with conventional analgesic techniques. The primary outcome was the requirement for rescue analgesia at 12 and 24 hours postsurgery. Secondary outcomes included the 11-point numerical rating scale pain scores at 0, 1, 2, 4, 6, 8, 12, and 24 hours following surgery, global quality of recovery scores, and postoperative adverse events. FINDINGS: Five randomized controlled trials involving 308 patients were analyzed. M-TAPA showed no significant difference in the requirement for rescue analgesia at 12 hours (relative risk [RR]: 0.87; 95% confidence interval [CI]: 0.62, 1.22; P = .424; I2 = 40.7%; Ph = .185) and 24 hours (RR: 0.67; 95% CI: 0.22, 1.99; P = .252; I2 = 90.3%; Ph < .001) postsurgery compared to non-M-TAPA. No significant differences in numerical rating scale pain scores or global quality of recovery scores were found between the two groups (all P < .05). However, M-TAPA was associated with a lower occurrence of nausea (RR: 0.37; 95% CI: 0.22, 0.68; P < .001; I2 = 0%; Ph = .834), vomiting (RR: 0.32; 95% CI: 0.17, 0.62; P < .001; I2 = 0%; Ph = .884), and itching (RR: 0.38; 95% CI: 0.21, 0.70; P = .002; I2 = 0%; Ph = .826). CONCLUSIONS: There was no significant difference in analgesic efficacy and safety between M-TAPA and non-M-TAPA techniques.

11.
J Taibah Univ Med Sci ; 19(4): 711-719, 2024 Aug.
Article in English | MEDLINE | ID: mdl-39006372

ABSTRACT

Introduction: The healthcare system in KSA has been substantially transformed as part of Vision 2030, including implementation of an electronic prescribing system, called Wasfaty, to enable patients to receive their prescriptions from community pharmacies (CPs). This study assessed patient satisfaction with CPs and the Wasfaty system. Methods: This cross-sectional observational study used existing data from the Saudi Ministry of Health's patient experience program. Data were collected from patients (≥15 years of age) visiting governmental primary care clinics in 2022. Summary statistics were determined and multivariable logistic regression analyses were conducted. Results: The sample included 66,541 patients. More than 70% of patients were satisfied with the services of the CPs and the Wasfaty system. Being older and being female consistently showed a positive association with satisfaction across several services. Whereas patients in preventive clinics had higher odds of satisfaction with medication availability (OR: 1.19, 95% CI: 1.03-1.37) and waiting time (OR: 1.23; 95% CI: 1.03-1.47), patients in chronic disease clinics had lower satisfaction with medication availability (OR: 0.92, 95% CI: 0.85-0.99). Saudi patients had lower odds of being satisfied with multiple services. Conclusions: The overall high satisfaction among patients suggested the success of the Wasfaty system in meeting patient needs and expectations. However, areas for improvement exist to increase patient satisfaction, such as addressing medication shortages and ensuring clear patient-pharmacist communication. The results highlight the importance of continued monitoring and evaluation to support the patient experience with pharmacy services, and to improve patients' journeys, medication adherence, and overall healthcare outcomes.

12.
BMC Musculoskelet Disord ; 25(1): 542, 2024 Jul 15.
Article in English | MEDLINE | ID: mdl-39010061

ABSTRACT

BACKGROUND: In this study, we aimed to investigate the preoperative and postoperative anteroposterior position (AP) of the femur relative to the tibia in total knee arthroplasty (TKA) and assess the influence of change in the AP position on clinical outcomes. METHODS: We evaluated 49 knees that underwent bi-cruciate-substituted TKA using a navigation system. The preoperative and postoperative AP position of the femur relative to the tibia at maximum extension, 15°, 30°, 45°, 60°, 90°, 105°, and 120° and maximum flexion angles were calculated. The 2011 Knee Society Score was evaluated preoperatively and 1 year postoperatively. The Wilcoxon signed rank and Spearman's rank correlation tests were performed, with statistical significance set at P < 0.05. RESULTS: The postoperative AP position was significantly correlated with the preoperative AP position at each measured angle. The postoperative AP positions were statistically more anterior than those preoperatively. Furthermore, the changes in the AP position after TKA negatively correlated with the symptom (P = 0.027 at 30°, P = 0.0018 at 45°, P = 0.0003 at 60°, P = 0.01 at 90°, and P = 0.028 at 105°) and patient satisfaction (P = 0.018 at 60° and P = 0.009 at 90°) scores at 1 year postoperatively. CONCLUSION: The postoperative AP position of the femur relative to the tibia was strongly influenced by the preoperative those in TKA. Postoperative anterior deviation of the femur relative to the tibia from mid-flexion to deep flexion could worsen clinical outcomes.


Subject(s)
Arthroplasty, Replacement, Knee , Femur , Patient Satisfaction , Tibia , Humans , Arthroplasty, Replacement, Knee/methods , Female , Male , Tibia/surgery , Aged , Femur/surgery , Middle Aged , Aged, 80 and over , Range of Motion, Articular , Retrospective Studies , Knee Joint/surgery , Knee Joint/physiopathology , Treatment Outcome , Osteoarthritis, Knee/surgery
13.
J Exp Orthop ; 11(3): e12101, 2024 Jul.
Article in English | MEDLINE | ID: mdl-39050592

ABSTRACT

Purpose: The purpose of this systematic review was to compare patient satisfaction patient-reported outcomes (PROMs) levels after mechanically aligned (MA) and kinematically aligned (KA) total knee arthroplasty (TKA). Methods: A systematic literature search following PRISMA guidelines was conducted on PubMed, Embase, Medline and Scopus to identify potentially relevant articles for this review, published from the beginning of March 2013 until the end of October 2023. Only articles reporting satisfaction after KA TKA, MA TKA or both were included, which use valid and reliable tools for the evaluation and reporting of satisfaction after TKA. Title, authors, year of publication, study design, level of evidence, follow-up period, patients' demographic data, sample size, type of satisfaction score, postoperative satisfaction score, postoperative alignment, statistical significance, as well as other variables, were extracted for analysis. An Agency for Healthcare Research and Quality's (AHRQ) design-specific scale was used for assessing randomized control trials (RCTs). The nonrandomized control trials were evaluated by using the Joanna Briggs Institute's (JBI) Critical Appraisal Tool. The Newcastle-Ottawa Scale (NOS) was also used to assess cohort studies, while case series were evaluated using the NIH Quality Assessment Tool for Case Series Studies. Results: The initial search identified 316 studies, of which 178 were considered for screening. Eleven studies completely fulfilled the inclusion criteria, including one RCT, five nonrandomized control trials/quasi-experiments, three case series, and two cohort studies. The total number of patients recruited for MA TKA was 1740. Conversely, 497 patients were enrolled for KA TKA. Five studies used the visual analogue scale (VAS) for assessing postoperative patient satisfaction, four used the Knee Society Score (KSS) 2011 version and two Likert-based types of scores. Overall, the highest mean satisfaction score of KSS 2011 was 31.5 ± 6.6 in the MA group, and 29.8 ± 80 in the KA group in four studies. All of them showed high postoperative patient satisfaction rates for both MA and KA TKA, but with no statistically significant difference between them (p > 0.05). Conclusion: Both mechanically aligned total knee arthroplasty, as well as kinematically aligned total knee arthroplasty led to high rates of postoperative patient satisfaction, with no statistically significant differences between them. Level of Evidence: Level III, systematic review.

14.
JAAD Int ; 16: 192-198, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39040844

ABSTRACT

Background: Current assessments on topical treatment attributes in actinic keratosis (AK) do not evaluate safety, effectiveness, and satisfaction from both clinician and patient perspectives, creating an unmet need for more comprehensive AK-specific measures that fully capture the patient experience. Objective: To develop an actinic keratosis-specific expert panel questionnaire (AK-EPQ) of patient-reported outcomes and clinician-reported outcomes for use in research studies. Methods: Using interviews of patients with AK and targeted literature reviews, a 9-person consensus panel of dermatologists with expertise in AK treatment was convened to develop the AK-EPQ to assess AK-specific patient-reported outcomes and clinician-reported outcomes. Results: Nine expert advisers achieved consensus on 11 AK-EPQ items that encompass patient and clinician perspectives of treatment-related local skin reactions, clinical and cosmetic outcomes associated with AK, and satisfaction with treatment; the AK-EPQ will be first implemented in the Patient-Reported Outcomes for Actinic Keratosis study (NCT05260073). Limitations: The AK-EPQ does not directly measure quality of life, although it can be used with validated quality of life instruments. Conclusion: The newly developed AK-EPQ elicits insights into the patient and clinician experience with AK treatments. Comparative probing of these perspectives may help optimize precision medicine in AK treatment.

15.
Afr J Emerg Med ; 14(3): 161-166, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39040944

ABSTRACT

Introduction: Pain management is crucial for improving patients' quality of care. Persistent pain has been linked to higher depression, anxiety, and work-related difficulties. This study aimed to enhance the time to pain relief in the emergency department through triage nurse-initiated analgesia. It evaluated the impact of nurse-led analgesia on patient satisfaction compared to standard pain management at Tikur Anbessa Specialized Hospital and Kidus Paulos Specialized Hospital. Additionally, it compared the time to analgesia between the two hospitals and assessed the effect of nurse-led analgesia on reducing the length of stay for patients with pain. Methods: Using a quasi-experimental design, the study included an intervention group and a control group. Data was collected using an open data kit, and after ensuring data completeness, it was exported to SPSS and Excel for analysis. To assess the effectiveness of the intervention, the time to analgesia was compared between the intervention and control groups using an independent samples t-test. This statistical test allowed for a comparison of the mean time to analgesia between the two groups.Patient satisfaction scores were also compared between the intervention and control groups using the Mann-Whitney U test. Kaplan-Meier curves were employed to compare the time to analgesia between the intervention and control groups within both settings. A point bi-serial correlation analysis was performed to examine the association between the length of stay and the intervention of nurse-led analgesia in both hospital settings. Result and discussion: The study enrolled 179 participants, with a median age of 34 years (range: 9-80) and 67% female. The most common events leading to pain were medical conditions (21%), followed by trauma/quarrel/war, fall accidents, and underlying diseases (15%, 13%, and 13%, respectively). There was a significant correlation between the degree of pain on arrival and time to analgesia. Additionally, a significant correlation (p < 0.01) was found between time to analgesia and patient satisfaction. Conclusion and recommendation: Implementing a nurse-led analgesia protocol in the emergency department is crucial for reducing time to analgesia and improving patient satisfaction. It is recommended to scale up this approach to other healthcare facilities by incorporating it into the nursing practice guidelines of the country.

16.
BMJ Open Qual ; 13(3)2024 Jul 22.
Article in English | MEDLINE | ID: mdl-39038856

ABSTRACT

BACKGROUND: Data on patients' self-reported hospital experience can help guide quality improvement. Traditional patient survey programmes are resource intensive, and results are not always publicly accessible. Unsolicited online hospital reviews are an alternative data source; however, the nature of online reviews for Canadian hospitals is unknown. METHODS: We conducted a nationwide cross-sectional study of Canadian acute care hospitals with more than 10 Google Reviews during the 2018-2019 fiscal year. We characterised the volume and distribution of Google Reviews of Canadian hospitals, and assessed their correlation with hospital characteristics (teaching status, size, occupancy rate, length of stay, resource utilisation) and Canadian Patient Experience Survey on Inpatient Care (CPES-IC) scores. RESULTS: 167 out of 523 (31.9%) acute care hospitals in Canada met the inclusion criteria. Among included hospitals, there was a total of 10 395 Google Reviews and a median of 35 reviews per hospital. The mean Google Star Rating for included hospitals was 2.85 out of 5, with a range of 1.36-4.57. Teaching hospitals had significantly higher mean Google Star Ratings compared with non-teaching hospitals (3.16 vs 2.81, p <0.01). There was a weak, positive correlation between hospitals' Google Star Ratings and CPES-IC 'Overall Hospital Experience' scores (p =0.04), but no significant correlation between Google Star Ratings and other hospital characteristics or subcategories of CPES-IC scores. INTERPRETATION: There is significant interhospital variation in patients' self-reported care experiences at Canadian acute care hospitals. Online reviews can serve as a readily accessible source of real-time data for hospitals to monitor and improve the patient experience.


Subject(s)
Hospitals , Cross-Sectional Studies , Canada , Humans , Hospitals/statistics & numerical data , Hospitals/standards , Surveys and Questionnaires , Patient Satisfaction/statistics & numerical data , Internet
17.
Diabet Med ; : e15412, 2024 Jul 22.
Article in English | MEDLINE | ID: mdl-39039715

ABSTRACT

AIMS: Patient satisfaction is associated with positive diabetes outcomes. However, there are no identified studies that evaluate both patient- and clinic-level predictors influencing diabetes care satisfaction longitudinally. METHODS: Data from the INtegrating DEPrEssioN and Diabetes treatmENT trial was used to perform the analysis. We used fixed and random effects models to assess whether and how changes in patient-level predictors (treatment assignment, depression symptom severity, systolic blood pressure, body mass index, LDL cholesterol, and haemoglobin A1C) from 0 to 24 months and clinic-level predictors (visit frequency, visit cost, number of specialists, wait time, time spent with healthcare provider, and receiving verbal reminders) measured at 24 months influence diabetes care satisfaction from 0 to 24 months. RESULTS: Model 1 (patient-level predictors) accounted for 7% of the change in diabetes satisfaction and there was a significant negative relationship between change in depressive symptoms and care satisfaction (ß = -0.23, SE = 0.12, p < 0.05). Within Model 1, 2% of the variance was explained by clinic-level predictors. Model 2 included both patient- and clinic-level predictors and accounted for 18% of the change in diabetes care satisfaction. Within Model 2, 9% of the variance was attributed to clinic-level predictors. There was also a cross-level interaction where the change in depression had less of an impact on the change in satisfaction for those who received a verbal reminder (ß = -0.11, SE = 0.21, p = 0.34) compared with those who did not receive a reminder (ß = -0.62, SE = 0.08, p < 0.01). CONCLUSIONS: Increased burden of depressive symptoms influences diabetes care satisfaction. Clinic-level predictors also significantly influence diabetes care satisfaction and can reduce dissatisfaction in primary care, specifically, reminder calls from clinic staff.

18.
Int J Nurs Pract ; : e13286, 2024 Jul 22.
Article in English | MEDLINE | ID: mdl-39039763

ABSTRACT

INTRODUCTIONS: The aim of this study was to demonstrate the impact of individualized nursing care on patient satisfaction and trust in nurses through structural equation modelling in patients receiving treatment in internal clinics. METHODS: The study is a descriptive, exploratory and cross-sectional research conducted with patients receiving treatment in the internal admission services of an educational research hospital between January and April 2023. According to sample calculations, it was determined that a minimum of 238 patients needed to be included in the study, and 286 patients who met the inclusion criteria and agreed to participate in the research formed the study sample. Data were collected using the 'Patient Identification Form', 'Individualized Care Scale-Patient Version', 'Newcastle Nursing Care Satisfaction Scale' and the 'Trust in Nurses Scale'. RESULTS: The level of awareness of nursing actions supporting individuality was found to be 2.71 ± 0.99, the level of perceiving individuality was 2.88 ± 0.99, the average level of nursing care satisfaction measured 77.17 ± 12.67 and the average level of trust in nurses was 21.92 ± 3.04. It was determined that as patients' awareness of nursing actions supporting individuality and their perception of individuality in care increased, they remained more satisfied with their care and had greater trust in nurses. CONCLUSIONS: Patients who perceived receiving individualized care were found to have higher levels of patient satisfaction and trust in nurses. Additionally, it was observed that as participants' satisfaction with their care increased, their trust in nurses also increased.

19.
Aust Crit Care ; 2024 Jul 08.
Article in English | MEDLINE | ID: mdl-38981794

ABSTRACT

BACKGROUND: The importance of assessing family satisfaction in paediatric intensive care units (PICUs) is becoming increasingly recognised. The survey, EMpowerment of Parents in THe Intensive Care "EMPATHIC-30", was designed to assess family satisfaction and has been translated and implemented in several countries but not yet in Japan. OBJECTIVES: The objective of this study was to translate, culturally adapt, and validate the EMPATHIC-30 questionnaire in Japanese and to identify potential factors for family-centred care satisfaction. METHODS: We translated and adapted for patient-reported outcome measures via a 10-step process outlined by the Principles of Good Practice. Four paediatric PICUs in Japan participated in the validation study, and the parental enrolment criterion was a child with a PICU stay of >24 h. Reliability was measured by Cronbach's α, and congruent validity was tested with overall satisfaction-with-care scales by correlation analysis. Multivariate linear regression modelling was conducted to identify factors related to each domain of the Japanese EMPATHIC-30. RESULTS: A total of 163 parents (mean age: 31.9 ± 5.4 years; 81% were mothers) participated. The five domains of the Japanese EMPATHIC-30 showed high reliability (α = 0.87 to 0.97) and congruent validity, demonstrating high correlations with overall satisfaction in nurses (r = 0.75) and doctors (r = 0.76). Multivariate modelling found that elective admission, mechanical ventilation, and parents who had experience of a family member in an adult intensive care unit had higher satisfaction scores in all five domains (p < 0.05). Moreover, Buddhists assigned higher satisfaction scores in the Care and Treatment domain (p = 0.03). CONCLUSIONS: The Japanese EMPATHIC-30 questionnaire has demonstrated adequate reliability and validity measures. We also identified that elective admission, mechanical ventilation, and having previous adult intensive care unit experience of a family member were factors in assigning higher scores for all satisfaction domains. PICU clinicians need to be cognisant of ethical, cultural, and religious factors relating to the critically ill child and their family.

20.
Epilepsia Open ; 2024 Jul 10.
Article in English | MEDLINE | ID: mdl-38984594

ABSTRACT

OBJECTIVES: Dravet syndrome (DS) is a rare form of refractory epilepsy that begins in the first year of life. Approximately 85% of patients have a mutation in the SCN1A gene, which encodes a voltage-gated sodium channel. The main objective of the present work was to assess the degree of knowledge of DS among Spanish primary care (PC) professionals, the communication flow between them and the pediatric neurologists (PNs), and the services available and resources offered to patients in Spain when searching for a diagnosis and adequate treatment. METHODS: Two anonymized online surveys on DS diagnosis and patient management in PC were conducted with Spanish PC pediatricians (PCPs) and caregivers of DS patients in Spain. RESULTS: Most PCPs are aware of genetic epilepsy but lack full knowledge of DS and patient advocacy groups (PAGs). Access to epilepsy treatments varies among regions, with many referrals to hospitals and pediatric neurologists. Diagnosis is often delayed, with misdiagnoses and frequent emergency room (ER) visits. Treatment involves multiple drugs, and sodium channel blockers are used, which are contraindicated in DS treatment. Improved training, resources, and communication are needed for early diagnosis. SIGNIFICANCE: To improve the care and treatment of DS patients in Spain, early diagnosis is required and, possibly, specific efforts aimed at identifying patients in adulthood, generating socio-sanitary structures that integrate social and health services to provide comprehensive care, taking into account the different features and comorbidities of the disease. PLAIN LANGUAGE SUMMARY: Dravet syndrome (DS) is a form of genetic epilepsy that starts within the first year of life. We present a study showing that, while family doctors are aware of genetic epilepsies, many don't have a complete understanding of DS. Unfortunately, getting the right diagnosis can take a long time, leading to unnecessary visits to the emergency room. Patients often need several medications, and sometimes they're given drugs that aren't recommended for DS. The takeaway is that training for doctors, more resources, and improved communication could help creating better healthcare systems and therefore give easier access to the right therapies.

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