RESUMEN
INTRODUCTION: The objective of this study was to bring some validation elements to a French adaptation of an American refraction-related quality of life scale, as applied to a population of Lasik patients. METHODS: The NEI-RQL-42 scale was developed in 2003 in the United States. It comprises 42 questions and 13 scores exploring quality of vision, functional symptoms, influence of refraction on daily activities and psychological impact. The authors propose here a French adaptation and elements for its validation (internal consistency, discriminating validity and external validity). These were assessed through an observational cross-sectional study, performed in one center on all patients consecutively treated with Lasik between January and March 2008. RESULTS: The study sample (307 patients) has the expected characteristics of Lasik-treated patients. The French adaptation of the NEI-RQL-42 has a good internal consistency with Cronbach's coefficients greater or equal to 0.7 for 10 scores out of 12. The discriminating validity of the scale was shown though the reference groups techniques: quality of life is generally lower in severe hyperopes compared with non-severe myopes. The scale's external validity is confirmed by the comparison of its results to those of a satisfaction questionnaire that was simultaneously sent to patients. CONCLUSION: The results obtained are favorable arguments for the validity of the proposed French adaptation of the NEI-RQL-42. This is the first scale available in French to assess refraction-related quality of life.
Asunto(s)
Queratomileusis por Láser In Situ/psicología , Satisfacción del Paciente , Calidad de Vida , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Actividades Cotidianas , Adulto , Astigmatismo/psicología , Estudios Transversales , Femenino , Francia , Humanos , Hiperopía/psicología , Lenguaje , Masculino , Persona de Mediana Edad , Miopía/psicología , Satisfacción del Paciente/estadística & datos numéricos , Reproducibilidad de los Resultados , Adulto JovenRESUMEN
INTRODUCTION: The objective of this study was to assess the refraction-related quality of life and patients' satisfaction in a LASIK-treated sample. METHODS: The French adaptation of the NEI-RQL-42 scale and a satisfaction questionnaire were sent to all patients consecutively treated with LASIK (all ages, all indications) in a same center between January and March 2008. The 13 scores of the NEI-RQL-42 were described. The scores "satisfaction with correction" and "glare" have been further analyzed using multivariate logistic regression. Answers to the satisfaction questionnaire were also described. RESULTS: The study sample (307 patients) has the expected characteristics of LASIK-treated patients. Quality of life scores are generally high (>70/100), except for the "glare" (65/100) and "expectations" (42/100) scores. Most of the scores are higher in myopes than in hyperopes. A lower "satisfaction with correction" score was associated with hyperopia (P<0.001) and with a lower "glare" score. A lower "glare" score was associated with ametropia severity (P=0.002), secondary surgery (P=0.02) and to the use of a non-customized treatment (P=0.047). Satisfaction rate was 95%. CONCLUSIONS: Quality of life scores and satisfaction rate are high in this sample, and suggesting how the refractive results impact patients' lives. They also show the importance of glare and other visual symptoms.
Asunto(s)
Queratomileusis por Láser In Situ/psicología , Satisfacción del Paciente , Calidad de Vida , Adulto , Estudios Transversales , Femenino , Francia , Humanos , Masculino , Persona de Mediana Edad , Errores de Refracción/psicología , Encuestas y Cuestionarios , Adulto JovenRESUMEN
PURPOSE: To obtain ISO 9001-2000 certification for laser corneal refractive treatment, never before sought in Europe. MATERIAL AND METHODS: The consulting firm Veritas led the certification process with the clinic's staff manager. This ISO norm is dedicated to the implementation of a quality management system. We assessed and optimized all necessary resources, evaluating customer satisfaction using patient and referring-physician surveys. We started quality rounds including surgeons, nurses, and technicians. Based on this preparation, we redefined and explained all processes including staff responsibilities and necessary resources in the quality manual. The procedure lasted 14 months with substantial involvement on the part of the management. RESULTS: Unconditional ISO 9001-2000 certification was granted by the independent audit firm, BVQI, in december 2003 for refractive laser treatment. CONCLUSION: The 2000 version of the new ISO 9001-2000 seeks to meet the demand for improving health care delivery in this field, most particularly by establishing a clear procedural orientation. Such certification enhances team work, stabilizes methodologies, and reinforces cohesion and self-audit. Patients notice that the center follows a consistent quality policy and are assured that the clinic respects rules and regulations. Certification is an advantageous alternative when accreditation cannot be considered. Our article discusses the steps taken in upper management, quality management, procedural guidance, as well as customer and staff counselling. It also discusses the project's cost/benefit ratio for the organization.
Asunto(s)
Certificación , Queratomileusis por Láser In Situ/normas , Queratectomía Fotorrefractiva/normas , Europa (Continente) , Francia , Humanos , Láseres de Excímeros , Satisfacción del Paciente , Garantía de la Calidad de Atención de SaludRESUMEN
GOAL: The purpose of this analysis is to appreciate the patients perception of ambulatory cataract surgery performed in an out patient center localized inside a public hospital. MATERIAL AND METHODS: An anonymous postal questionnaire was designed to cover the aspects of ambulatory surgery which could influence the patients perception. 576 patients were included and the study collected 487 answers to 12 questions. Authors give attention to the pros and cons detected during the study time. RESULTS: The key question shows that most patients recommend this procedure as the treatment of choice. The percentage increases with surgical experience of surgeons: the response rate to the questionnaire was both rapid and impressive. Final visual acuity did not influence significatively the overall perceptions of patients. CONCLUSION: Answers to the 12 questions point of importance of information, coordination and preparation. A high level of surgical and anesthetic formation is required to obtain an easy out patient ambulatory procedure.