Food handling in the domestic environment: an online questionnaire study with respondents from 24 of 26 Brazilian states / Manipulação de alimentos no ambiente doméstico: um estudo realizado com emprego de questionário online respondido por habitantes de 24 dos 26 estados brasileiros

Using an online questionnaire, this study evaluated the profile of a Brazilian population's food handling practices in the home environment. The questionnaire, containing questions about domestic behavior in terms of hygiene and food handling, was built and available through social media sites. Information about the participants' profiles, their food pre-preparation, food preparation, and food post-preparation practices, and the occurrence of foodborne diseases (FBDs) was included in the questionnaire. A total of 701 responses were obtained. The interviewees included 78.31% female participants and 21.68% male participants, with an average age of 31.2 years. Nearly all (94.3%) had a complete or incomplete higher education. In the pre-preparation stage, the participants evaluated the shelf life (97.28%) and storage temperature (44.79%) of the products while purchasing them. Regarding food handling practices, only a few participants washed the food packages before storing them (31.95%) or removed hand jewelry or other adornments when washing food (61.48%). Most participants washed their hands (91.58%) and washed vegetables (99.28%). But a group of interviewees reported washing raw meat (27.81%) before preparing it. Cutting surfaces such as plastic (50.36%) and glass (49.36%) tops were the most prevalent in the study. Most respondents did not know how long they had been using their cutting boards (67.62%) and mentioned using the same surface to handle both raw and ready-to-eat products (84.17%). As for the preparation, most interviewees declared they did not check the food temperature during preparation (86.31%), ignoring the ideal cooking temperature (88.26%). Regarding the occurrence of FBDs, 79.17% of the interviewees reported having suspicious clinical signs associated with contaminated foods and 65.59% did not seek medical help. Thus, the participants demonstrated ignorance about adequate practices for food safety in the home environment, highlighting the need to conduct health education programs within the Brazilian population.(AU)

Este estudo teve como objetivo avaliar o perfil das práticas de manipulação de alimentos no ambiente domiciliar no Brasil utilizando um questionário online. Um questionário contendo perguntas sobre comportamento doméstico em nível de higiene e manipulação de alimentos foi construído e disponibilizado por redes sociais. O questionário continha informações sobre o perfil dos participantes, suas práticas de pré-preparo, preparo e pós-preparo de alimentos e a ocorrência de doenças transmitidas por alimentos (DTA). Obteve-se 701 respostas, os entrevistados foram 78,31% do sexo feminino e 21,68% do sexo masculino, com média de idade de 31,2 anos. A maioria (94,3%) possuia ensino superior completo ou incompleto. Na etapa de pré-preparo, os participantes avaliam o prazo de validade (97,28%) e a temperatura de armazenamento (44,79%) dos produtos no momento da compra. Em relação às práticas de manipulação dos alimentos, apenas alguns participantes lavavam as embalagens dos alimentos antes de armazená-los (31,95%) ou retiravam adornos ao lavar os alimentos (61,48%). A maioria dos participantes lavam as mãos (91,58%) e os vegetais (99,28%); entretanto, um grupo de entrevistados relatou lavar carne crua (27,81%) antes de prepará-la. Superfícies de corte como tábuas de plástico (50,36%) e de vidro (49,36%) foram os mais prevalentes no estudo. A maioria dos entrevistados não sabe há quanto tempo usa as tábuas de corte (67,62%) e utilizam a mesma superfície para manusear produtos crus e prontos para o consumo (84,17%). Quanto ao preparo, a maioria dos entrevistados declarou não verificar a temperatura dos alimentos durante o preparo (86,31%), ignorando a temperatura ideal de cozimento (88,26%). Em relação à ocorrência de DVA, 79,17% dos entrevistados relataram que já apresentaram sinais clínicos suspeitos associados a alimentos contaminados e 65,59% não procuraram atendimento médico. Nesse sentido, os participantes demonstraram desconhecimento sobre as práticas adequadas para a segurança dos alimentos no ambiente domiciliar, evidenciando a necessidade de realização de programas de educação em saúde com a população brasileira.(AU)

Evaluating the impact of social deprivation on Press Ganey® Outpatient Medical Practice Survey Scores.

BACKGROUND: Social deprivation has been shown to affect access to health care services, and influences outcomes for a variety of physical and psychological conditions. However, the impact on patient satisfaction remains less clear. The objective of this study was to determine if social deprivation is an independent predictor of patient satisfaction, as measured by the Press Ganey® Outpatient Medical Practice Survey (PGOMPS). METHODS: We retrospectively reviewed unique new adult patient (≥ 18 years of age) seen at a tertiary academic hospital and rural/urban outreach hospitals/clinics between January 2014 and December 2017. Satisfaction was defined a priori as achieving a score above the 33rd percentile. The 2015 Area Deprivation Index (ADI) was used to determine social deprivation (lower score signifies less social deprivation). Univariate and multivariable binary logistic regression were used to determine the impact of ADI on PGOMPS total and provider sub-scores while controlling for variables previously shown to impact scores (wait time, patient age, sex, race, specialty type, provider type, and insurance status). RESULTS: Univariate analysis of PGOMPS total scores revealed a 4% decrease in odds of patient satisfaction per decile increase in ADI (p < 0.001). Patients within the most deprived quartile were significantly less likely to report satisfaction compared to the least deprived quartile (OR 0.79, p < 0.001). Multivariable analysis revealed that the odds of achieving satisfaction decreased 2% for each decile increase in ADI on the Total Score (p < 0.001), independent of other variables previously shown to impact scores. For PGOMPS Provider Sub-Score, univariate analysis showed that patients in the lowest ADI quartile were significantly less likely be satisfied, as compared to the least deprived quartile (OR 0.77; 95% CI 0.70-0.86; p < 0.001). A 5% decrease in a patient being satisfied was observed for each decile increase in ADI (OR 0.95; 95% CI 0.94-0.96; p < 0.001). CONCLUSIONS: Social deprivation was an independent predictor of outpatient visit dissatisfaction, as measured by the Press Ganey® Outpatient Medical Practice Survey. These results necessitate consideration when developing health care delivery policies that serve to minimize inequalities between patients of differing socioeconomic groups.

Identification of quality gaps in healthcare services using the SERVQUAL instrument and importance-performance analysis in medical intensive care: a prospective study at a medical center in Taiwan.

BACKGROUND: Assessing patients' expectations and perceptions of health service delivery is challenging. To understand the service quality in intensive care units (ICUs), we investigated the expected and perceived service quality of ICU care. METHODS: We conducted this study at an ICU of a university-affiliated medical center in Taiwan from April to September 2019. Admitted patients or their family members responded to a questionnaire survey adopted from the SERVQUAL instrument consisting of 22 items in five dimensions. The questionnaire was provided on ICU admission for expectation and before ICU discharge for perception. We analyzed the quality gaps between the surveys and applied important-performance analysis (IPA). RESULTS: A total of 117 patients were included (62.4% males, average age: 65.9 years, average length of stay: 10.1 days, and 76.9% survival to ICU discharge). The overall weighted mean scores for the surveys were similar (4.57 ± 0.81 and 4.58 ± 0.52, respectively). The 'tangibles' dimension had a higher perception than expectation (3.99 ± 0.55 and 4.31 ± 0.63 for expectation and perception, respectively, p < 0.001). IPA showed that most of the items in 'reliability,' 'responsiveness' and 'assurance' were located in the quadrant of high expectation and high perception, whereas most of the items in 'tangibles' and 'empathy' were located in the quadrant of low expectation and low perception. One item (item 1 for 'tangibles') was found in the quadrant of high expectation and low perception. CONCLUSIONS: The SERVQUAL approach and IPA might provide useful information regarding the feedback by patients and their families for ICU service quality. In most aspects, the performance of the ICU satisfactorily matched the needs perceived by the patients and their families.

Quais as principais lições aprendidas da experiência de Itália?

O professor estrangeiro na Universidade Federal de Mato Grosso (UFMT), Ardigò Martino, que é italiano, fez uma avaliação da expansão da Covid-19 em seu país. Para ele, o Brasil teve a oportunidade de olhar o impacto da doença na Europa para planejar uma resposta mais eficiente para a pandemia. Ele pontua o papel da APS no território na resposta à Covid-19 e a gravidade da situação. "Primeiramente, não pode subestimar. A Itália subestimou e muitos países subestimaram. Essa doença é um túnel do tempo, você tem a possibilidade de ver o que acontecerá no seu país em algumas semanas e todos os países devem aproveitar essa oportunidade. Todo mundo está repetindo sobre a importância a Atenção Primária, os chineses, os italianos e os espanhóis, todo mundo está entendendo que esta guerra está na capacidade dos territórios de preservar UTI e vagas hospitalares. E dentro do território qual é a lição? Integralidade. Trabalho junto de saúde publica, necessidade de ter toda a equipe de vigilância, a APS e todos os atores comunitários juntos, engajar prefeitos, entidades comunitárias porque será preciso fazer planos específicos para cada território. Aquela área, aquela microrregião de saúde é que governa o processo, o hospital tem ser um recurso desse núcleo. A última questão é a participação dos componentes universitários para desenvolver atividades de validação do que está sendo feito no cotidiano", defende Ardigò.

Communicating with patients about breakdowns in care: a national randomised vignette-based survey.

BACKGROUND: Many patients are reluctant to speak up about breakdowns in care, resulting in missed opportunities to respond to individual patients and improve the system. Effective approaches to encouraging patients to speak up and responding when they do are needed. OBJECTIVE: To identify factors which influence speaking up, and to examine the impact of apology when problems occur. DESIGN: Randomised experiment using a vignette-based questionnaire describing 3 care breakdowns (slow response to call bell, rude aide, unanswered questions). The role of the person inquiring about concerns (doctor, nurse, patient care specialist), extent of the prompt (invitation to patient to share concerns) and level of apology were varied. SETTING: National online survey. PARTICIPANTS: 1188 adults aged ≥35 years were sampled from an online panel representative of the entire US population, created and maintained by GfK, an international survey research organisation; 65.5% response rate. MAIN OUTCOMES AND MEASURES: Affective responses to care breakdowns, intent to speak up, willingness to recommend the hospital. RESULTS: Twice as many participants receiving an in-depth prompt about care breakdowns would (probably/definitely) recommend the hospital compared with those receiving no prompt (18.4% vs 8.8% respectively (p=0.0067)). Almost three times as many participants receiving a full apology would (probably/definitely) recommend the hospital compared with those receiving no apology (34.1% vs 13.6% respectively ((p<0.0001)). Feeling upset was a strong determinant of greater intent to speak up, but a substantial number of upset participants would not 'definitely' speak up. A more extensive prompt did not result in greater likelihood of speaking up. The inquirer's role influenced speaking up for two of the three breakdowns (rudeness and slow response). CONCLUSIONS: Asking about possible care breakdowns in detail, and offering a full apology when breakdowns are reported substantially increases patients' willingness to recommend the hospital.

Evaluation de la culture de sécurité en Etablissement d'Hébergement pour Personnes Agées Dépendantes (EHPAD): adaptation française du questionnaire Nursing Home Survey on Patient Safety Culture.

The objective was to translate into French the American questionnaire "Nursing Home Survey on Patient Safety Culture" and to test the feasibility of its use in a sample of nursing homes. The questionnaire was translated by a multidisciplinary group of six experts and tested on a sample of people working in nursing homes. The questionnaire was then administered in five nursing homes. A first version of the French NHSPSC is proposed in this article. Despite similarities between items and ceiling effect for one item, the choices made were conservative to allow international comparisons. The administration of the questionnaire in five nursing homes confirmed the feasibility of the approach, with a participation of more than 50 per cent. This work made a French version of the NHSPSC available and confirmed that it is a feasible method for evaluating safety culture in nursing homes.

Survey Instruments to Assess Patient Experiences With Access and Coordination Across Health Care Settings: Available and Needed Measures.

BACKGROUND: Improving access can increase the providers a patient sees, and cause coordination challenges. For initiatives that increase care across health care settings, measuring patient experiences with access and care coordination will be crucial. OBJECTIVES: Map existing survey measures of patient experiences with access and care coordination expected to be relevant to patients accessing care across settings. Preliminarily examine whether aspects of access and care coordination important to patients are represented by existing measures. RESEARCH DESIGN: Structured literature review of domains and existing survey measures related to access and care coordination across settings. Survey measures, and preliminary themes from semistructured interviews of 10 patients offered VA-purchased Community Care, were mapped to identified domains. RESULTS: We identified 31 existing survey instruments with 279 items representing 6 access and 5 care coordination domains relevant to cross-system care. Domains frequently assessed by existing measures included follow-up coordination, primary care access, cross-setting coordination, and continuity. Preliminary issues identified in interviews, but not commonly assessed by existing measures included: (1) acceptability of distance to care site given patient's clinical situation; (2) burden on patients to access and coordinate care and billing; (3) provider familiarity with Veteran culture and VA processes. CONCLUSIONS: Existing survey instruments assess many aspects of patient experiences with access and care coordination in cross-system care. Systems assessing cross-system care should consider whether patient surveys accurately reflect the level of patients' concerns with burden to access and coordinate care, and adequately reflect the impact of clinical severity and cultural familiarity on patient preferences.

Evaluating CollaboRATE in a clinical setting: analysis of mode effects on scores, response rates and costs of data collection.

BACKGROUND: Shared decision-making (SDM) has become a policy priority, yet its implementation is not routinely assessed. To address this gap we tested the delivery of CollaboRATE, a 3-item patient reported experience measure of SDM, via multiple survey modes. OBJECTIVE: To assess CollaboRATE response rates and respondent characteristics across different modes of administration, impact of mode and patient characteristics on SDM performance and cost of administration per response in a real-world primary care practice. DESIGN: Observational study design, with repeated assessment of SDM performance using CollaboRATE in a primary care clinic over 15 months of data collection. Different modes of administration were introduced sequentially including paper, patient portal, interactive voice response (IVR) call, text message and tablet computer. PARTICIPANTS: Consecutive patients ≥18 years, or parents/guardians of patients <18 years, visiting participating primary care clinicians. MAIN MEASURES: CollaboRATE assesses three core SDM tasks: (1) explanation about health issues, (2) elicitation of patient preferences and (3) integration of patient preferences into decisions. Responses to each item range from 0 (no effort was made) to 9 (every effort was made). CollaboRATE scores are calculated as the proportion of participants who report a score of nine on each of the three CollaboRATE questions. KEY RESULTS: Scores were sensitive to mode effects: the paper mode had the highest average score (81%) and IVR had the lowest (61%). However, relative clinician performance rankings were stable across the different data collection modes used. Tablet computers administered by research staff had the highest response rate (41%), although this approach was costly. Clinic staff giving paper surveys to patients as they left the clinic had the lowest response rate (12%). CONCLUSIONS: CollaboRATE can be introduced using multiple modes of survey delivery while producing consistent clinician rankings. This may allow routine assessment and benchmarking of clinician and clinic SDM performance.

Assessment of Universal Healthcare Coverage in a District of North India: A Rapid Cross-Sectional Survey Using Tablet Computers.

OBJECTIVE: A rapid survey was carried out in Shaheed Bhagat Singh Nagar District of Punjab state in India to ascertain health seeking behavior and out-of-pocket health expenditures. METHODS: Using multistage cluster sampling design, 1,008 households (28 clusters x 36 households in each cluster) were selected proportionately from urban and rural areas. Households were selected through a house-to-house survey during April and May 2014 whose members had (a) experienced illness in the past 30 days, (b) had illness lasting longer than 30 days, (c) were hospitalized in the past 365 days, or (d) had women who were currently pregnant or experienced childbirth in the past two years. In these selected households, trained investigators, using a tablet computer-based structured questionnaire, enquired about the socio-demographics, nature of illness, source of healthcare, and healthcare and household expenditure. The data was transmitted daily to a central server using wireless communication network. Mean healthcare expenditures were computed for various health conditions. Catastrophic healthcare expenditure was defined as more than 10% of the total annual household expenditure on healthcare. Chi square test for trend was used to compare catastrophic expenditures on hospitalization between households classified into expenditure quartiles. RESULTS: The mean monthly household expenditure was 15,029 Indian Rupees (USD 188.2). Nearly 14.2% of the household expenditure was on healthcare. Fever, respiratory tract diseases, gastrointestinal diseases were the common acute illnesses, while heart disease, diabetes mellitus, and respiratory diseases were the more common chronic diseases. Hospitalizations were mainly due to cardiovascular diseases, gastrointestinal problems, and accidents. Only 17%, 18%, 20% and 31% of the healthcare for acute illnesses, chronic illnesses, hospitalizations and childbirth was sought in the government health facilities. Average expenditure in government health facilities was 16.6% less for acute care, 15% less for hospitalization and 50% less for childbirth than in the private healthcare facilities. Out-of-pocket expenditure was mostly on medicines followed by diagnostic and laboratory tests. Among households experiencing hospitalization, 56.5% had incurred catastrophic expenditures, which was significantly higher in the poorest compared to richest household expenditure quartile (p <0.002). CONCLUSIONS: Expenditure on healthcare remains high in Punjab state of India. Efforts to increase utilization of the public sector could decrease out-of-pocket healthcare expenditure.

Estudio actitudes sobre vacunación antigripal en profesionales sanitarios de atención primaria de Cataluña / Primary health care professionals attitudes towards influenza immunzation in Catalonia

OBJETIVO: Los trabajadores sanitarios tienen riesgo de adquirir la gripe y actuar como vectores para la transmisión nosocomial. El objetivo del estudio fue la valoración de los conocimientos y actitudes de los profesionales sobre la vacunación antigripal, y determinar los factores asociados a ella por parte de profesionales de atención primaria en Cataluña. DISEÑO: Estudio transversal mediante una encuesta anónima vía web. Emplazamiento: Profesionales sanitarios de atención primaria del Instituto Catalán de la Salud. PARTICIPANTES: Se incluyó a 1.212 profesionales de atención primaria. Se excluyó a los profesionales con contraindicación para recibir la vacuna o indicación de vacunación por condición médica de riesgo y aquellos que hubieran participado en la red centinela de vigilancia de la gripe Pla d'Informació Diària d'Infeccions Respiratòries Agudes de Catalunya (PIDIRAC). RESULTADOS: Se consideraron 423 respuestas válidas, con una cobertura vacunal global del 46,6%. Se vacunaron más los que tenían de 45 a 54 años, los pediatras, los vacunados en las 3 temporadas anteriores o en alguna de ellas y los que convivían con enfermos crónicos. Se observó asociación entre estar vacunado y considerar que la vacunación es la mejor medida preventiva, preocupación por contraer la gripe y considerar importante la vacunación del personal sanitario. CONCLUSIONES: Las actividades dirigidas a aumentar la cobertura de vacunación en profesionales sanitarios deberían dirigirse fundamentalmente a corregir concepciones erróneas sobre la vacunación de la gripe en profesionales sanitarios

OBJECTIVE: Health personnel are at risk of acquiring influenza infection and of nosocomial influenza transmission. The objective of this study was to assess the relationship between the knowledge and attitudes of primary care health personnel in Catalonia as regards influenza vaccine and the factors related to the uptake of this vaccine. DESIGN: A cross-sectional study using a web survey. SETTING: Primary care health personnel of the Catalan Health Institute. PARTICIPANTS: A total of 1212 primary health care personnel were included in the survey. Those who had medical reasons for being or not being vaccinated were excluded. RESULTS: A total of 423 replies were valid, with a 46.6% overall vaccination coverage. Vaccination rate was higher among 45 to 54 year-olds, paediatricians, those vaccinated in preceding seasons, and those living with chronic patients. There was an association between having received the vaccine and considering vaccination the best preventive action, advocating vaccination to at risk population, concern about acquiring influenza, and considering health personnel vaccination important. CONCLUSIONS: Actions taken to increase vaccination rate among health personnel should aim at correcting lack of knowledge and misconceptions about influenza vaccination of health personnel

La atmósfera psicosocial en la UHTR y su relación teórica con la alianza terapéutica de los pacientes con el equipo multidisciplinar / No disponible

El estudio de la atmósfera de las Unidades de Internamiento Psiquiátrico es una forma de conocer las características de la 'personalidad' de estos lugares; entendida como el conjunto de elementos que las definen y que nacen de las relaciones que se dan entre las personas que permanecen en ellas, en el marco de un tratamiento y en una determinada estructura. La escala de Moos es propiamente un cuestionario (WAS). Consta de 100 peguntas a las que pacientes y personal responden en sentido afirmativo o negativo. La Unidad Hospitalaria de Tratamiento y Rehabilitación, situada en el Complejo Asistencial Benito Menni de Ciempozuelos, es un centro de las Hermanas Hospitalarias, concertado con la Consejería de Sanidad de la Comunidad de Madrid. Es un dispositivo hospitalario especializado en la atención psiquiátrica integral de pacientes con trastorno mental grave, cuya complejidad imposibilita su tratamiento y rehabilitación desde un régimen ambulatorio o de hospitalización breve. El objetivo del presente estudio es relacionar las variables medidas de la atmósfera psicosocial (medida con la WAS) de la UHTR con formulaciones actuales de la Alianza Terapéutica, tomando a los colectivos de pacientes y profesionales como entidades singulares, con el propósito de reflexionar acerca de nuestro programa asistencial de rehabilitación, así como acerca de calidad de las interacciones interpersonales entre los individuos implicados

The study of the atmosphere of Psychiatric Inpatient Units is a way to know the characteristics of the 'personality' of these places; understood as the set of elements that define and born of the relationships that exist between people who stay in them as part of a treatment on a particular structure. Moos scale (WAS) is actually a questionnaire. Comprising 100 questions to which patients and staff respond in the affirmative or negative. The Hospital Treatment and Rehabilitation Unit, located in the Complejo Asistencial Benito Menni de Ciempozuelos, is a center of the Hermanas Hospitalarias, concluded with the Ministry of Health of the Community of Madrid. It is a specialized device in comprehensive hospital psychiatric care of patients with severe mental disorder, whose complexity precludes their treatment and rehabilitation from a brief outpatient or inpatient. The aim of this study is to relate the measures of psychosocial variables atmosphere (measured with WAS) of UHTR with current formulations of the Therapeutic Alliance, taking groups of patients and professionals as singular entities, in order to reflect on our clinical rehabilitation program as well as about quality of interpersonal interactions between the individuals involved

Factores determinantes de la satisfacción del paciente con la consulta de anestesia / Factors determining patient satisfaction with the pre-anaesthesia consultation

Objetivo. Analizar el grado de satisfacción de los pacientes con la atención prestada en la consulta preanestésica y los factores determinantes. Material y método. Se realizó una encuesta anónima que se distribuyó de forma aleatoria entre los pacientes atendidos en la consulta de preanestesia, y que incluyó 4 preguntas con 5 respuestas posibles en una escala categórica (muy poco satisfecho, poco satisfecho, regular de satisfecho, satisfecho y muy satisfecho), relacionadas con la puntualidad, la comprensión de la información recibida, el respeto en el trato y el grado global de satisfacción, así como una quinta sobre el conocimiento del nombre del anestesiólogo que les atendió. Se aplicó un modelo de regresión logística binaria, que identificó las variables predictoras de la satisfacción, calculó la odds ratio (OR) y sus respectivos intervalos de confianza al 95% (IC 95%). Resultados. Se analizaron 4.006 encuestas. El 99,2% (3966) de los usuarios valoraron como satisfecho/muy satisfecho la pregunta sobre el respeto en el trato, el 98,4% (3.937) la información recibida y su comprensión, el 77,4% (3.096) la puntualidad en la atención y el 97,6% (3.909) el grado de satisfacción global. Un 71% (2844) no conocía el nombre del anestesiólogo. El análisis de regresión relacionó el mayor grado de satisfacción con el trato (OR: 17,44; p < 0,0005) y la información recibidos (OR: 14,94, p < 0,0005), mientras que la puntualidad (OR: 5,40; p < 0,0005) fue el factor que menos contribuyó en el resultado. Conclusión. En nuestra población el grado de satisfacción en el ámbito de la consulta de preanestesia está unido principalmente a la capacidad de comunicación del anestesiólogo (AU)

Objective. To analyse patient satisfaction with care provided in the pre-anaesthetic consultation and its determining factors. Material and method. An anonymous questionnaire was randomly distributed to patients attending a pre-anaesthesia clinic, which included 4 questions with 5 possible answers on a (very dissatisfied, dissatisfied, fairly satisfied, satisfied and very satisfied) categorical graduated scale related to punctuality, understanding of the information received, respectful treatment, and overall satisfaction. The fifth question was about the knowledge or the name of the anaesthesiologist who attended them. A binary logistic regression model was used, which identified the predictors of satisfaction, calculated the odds ratios, and their respective 95% confidence intervals. Results. A total of 4006 questionnaires were analysed, in which 99.2% (3966) of users rated as satisfied/very satisfied the question about the respectful treatment, 98.4% (3937) of the information received and understanding, 77.4% (3096) punctuality in attending, and 97, 6% (3909) overall satisfaction. Almost three-quarters (71%, 2844) did not know the name of the anaesthesiologist. Regression analysis associated the more satisfied with their treatment (OR 17.44; P<.0005) and the information received (OR 14.94, P < .0005), while punctuality (OR 5 40; P < .0005) was the factor that contributed less to the result. Conclusion. In our population satisfaction in pre-anaesthesia consultation is due mainly to the communication skills of the anaesthesiologist (AU)

Política de visitas, diseño y confortabilidad en las unidades de cuidados intensivos españolas / Visitation policy, design and comfort in Spanish intensive care units

Objetivo. Conocer el diseño y confortabilidad de las unidades de cuidados intensivos (UCI). Analizar el horario de visitas, la información y la participación familiar en los cuidados del paciente. Diseño. Estudio multicéntrico, descriptivo. Ámbito. Unidades de cuidados intensivos de España. Método. Cuestionario enviado por correo electrónico a los socios de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC), suscriptores de la Revista Electrónica de Medicina Intensiva y difundido por el blog Proyecto HU-CI. Resultados. Se analizaron 135 encuestas pertenecientes a 131 hospitales. Horario de visitas: 3,8% tienen horario abierto 24 h, 9,8% horario abierto diurno y 67,7% tienen 2 visitas/día. Información: la realiza solamente el médico en el 75,2%, médico y enfermera juntos 4,5% con una frecuencia de una vez/día en el 79,7%. Los fines de semana se informa en el 95,5%. Información telefónica 74,4%. Participación familiar en los cuidados del paciente: higiene 11%, administración de comida 80,5% y fisioterapia 17%. Objetos personales permitidos: teléfono móvil 41%, ordenador 55%, equipo de música 77%, televisión 30%. Arquitectura y confortabilidad: todos los boxes individuales 60,2%, luz natural 54,9%, televisión 7,5%, música ambiental 12%, reloj en el box 15,8%, medidor de ruido ambiental 3,8% y sala de espera cercana a UCI 68,4%. Conclusiones. La política de visitas es restrictiva, predominando una cultura de UCI cerrada. Generalmente no se permiten medios de comunicación tecnológicos. Hay poca incorporación de la familia en los cuidados del paciente. El diseño de la UCI no garantiza la privacidad ni proporciona la confortabilidad deseable (AU)

Objective. To determine the design and comfort in the Intensive Care Units (ICUs), by analysing visiting hours, information, and family participation in patient care. Design. Descriptive, multicentre study. Setting. Spanish ICUs. Methods. A questionnaire e-mailed to members of the Spanish Society of Intensive Care Medicine, Critical and Coronary Units (SEMICYUC), subscribers of the Electronic Journal Intensive Care Medicine, and disseminated through the blog Proyecto HU-CI. Results. A total of 135 questionnaires from 131 hospitals were analysed. Visiting hours: 3.8% open 24 h, 9.8% open daytime, and 67.7% have 2 visits a day. Information: given only by the doctor in 75.2% of the cases, doctor and nurse together in 4.5%, with a frequency of once a day in 79.7%. During weekends, information is given in 95.5% of the cases. Information given over the phone 74.4%. Family participation in patient care: hygiene 11%, feeding 80.5%, physiotherapy 17%. Personal objects allowed: mobile phone 41%, computer 55%, sound system 77%, and television 30%. Architecture and comfort: all individual cubicles 60.2%, natural light 54.9%, television 7.5%, ambient music 12%, clock in the cubicle 15.8%, environmental noise meter 3.8%, and a waiting room near the ICU 68.4%. Conclusions. Visiting policy is restrictive, with a closed ICU being the predominating culture. On average, technological communication devices are not allowed. Family participation in patient care is low. The ICU design does not guarantee privacy or provide a desirable level of comfort (AU)

Creación y potenciación de las unidades de cefalea: visión de los neurólogos y jefes de servicio de neurología / Creation and enhancement of headache units: the view of neurologists and heads of neurology departments

La cefalea constituye el motivo de consulta más frecuente en neurología. Casi la tercera parte de pacientes consultados en esta especialidad lo hace por este motivo. El gradual incremento en la complejidad de asistencia a pacientes con cefalea hace necesaria una mayor especialización por parte de los neurólogos y propicia la creación de unidades especializadas donde desarrollar esta actividad asistencial más compleja. La estructuración y coordinación de las distintas unidades asistenciales corresponde a los jefes de servicio de neurología. En este artículo se recogen los resultados de una encuesta realizado a un grupo de jefes de servicio de neurología para conocer el estado actual de las unidades de cefalea: su opinión sobre la creación, función y desarrollo de unidades de cefalea en los hospitales españoles, y los parámetros de eficacia y eficiencia de éstas (AU)

Headache is the most common reason for visiting in neurology. Almost a third of all patients surveyed in this specialty visit for this reason. The gradual increase in the complexity of the care afforded to patients with headaches requires neurologists to become more specialised and leads to the creation of specialised units where this more complex care can be implemented. The heads of the neurology department are responsible for structuring and coordinating the different care units. This article shows the findings of a survey carried out on a group of heads of neurology departments in order to determine the current state of headache units, that is, their opinion regarding the creation, functioning and development of headache units in Spanish hospitals, and the parameters of their efficacy and effectiveness (AU)

Developing and validating a tablet version of an illness explanatory model interview for a public health survey in Pune, India.

BACKGROUND: Mobile electronic devices are replacing paper-based instruments and questionnaires for epidemiological and public health research. The elimination of a data-entry step after an interview is a notable advantage over paper, saving investigator time, decreasing the time lags in managing and analyzing data, and potentially improving the data quality by removing the error-prone data-entry step. Research has not yet provided adequate evidence, however, to substantiate the claim of fewer errors for computerized interviews. METHODOLOGY: We developed an Android-based illness explanatory interview for influenza vaccine acceptance and tested the instrument in a field study in Pune, India, for feasibility and acceptability. Error rates for tablet and paper were compared with reference to the voice recording of the interview as gold standard to assess discrepancies. We also examined the preference of interviewers for the classical paper-based or the electronic version of the interview and compared the costs of research with both data collection devices. RESULTS: In 95 interviews with household respondents, total error rates with paper and tablet devices were nearly the same (2.01% and 1.99% respectively). Most interviewers indicated no preference for a particular device; but those with a preference opted for tablets. The initial investment in tablet-based interviews was higher compared to paper, while the recurring costs per interview were lower with the use of tablets. CONCLUSION: An Android-based tablet version of a complex interview was developed and successfully validated. Advantages were not compromised by increased errors, and field research assistants with a preference preferred the Android device. Use of tablets may be more costly than paper for small samples and less costly for large studies.

Patient health satisfaction survey in connecticut correctional facilities.

Although routine in the community, patient satisfaction surveys are relatively rare in correctional settings. This article describes the development of an instrument specifically adapted to the correctional environment and population, the statewide implementation of the survey, the initial results, and the quality improvement initiatives evolving from this effort.

The right tool for the right job: the value of alternative patient experience measures.

Patient-reported experience of care predicts health care outcomes. Fourteen US and Canadian practices intercalated a standard ambulatory care Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey within their usual Internet-based survey to compare results from the Internet survey, Internet CAHPS survey, and a mailed CAHPS survey. They found that practice performance rankings obtained via the multi-item CAHPS survey were equivalent to a single measure captured by the Internet survey.

Measures of quality, costs and equity in primary health care instruments developed to analyse and compare primary care in 35 countries.

BACKGROUND: The Quality and Costs of Primary Care in Europe (QUALICOPC) study aims to analyse and compare how primary health care systems in 35 countries perform in terms of quality, costs and equity. This article answers the question 'How can the organisation and delivery of primary health care and its outcomes be measured through surveys of general practitioners (GPs) and patients?' It will also deal with the process of pooling questions and the subsequent development and application of exclusion criteria to arrive at a set of appropriate questions for a broad international comparative study. METHODS: The development of the questionnaires consisted of four phases: a search for existing validated questionnaires, the classification and selection of relevant questions, shortening of the questionnaires in three consensus rounds and the pilot survey. Consensus was reached on the basis of exclusion criteria (e.g. the applicability for international comparison). Based on the pilot survey, comprehensibility increased and the number of questions was further restricted, as the questionnaires were too long. RESULTS: Four questionnaires were developed: one for GPs, one for patients about their experiences with their GP, another for patients about what they consider important, and a practice questionnaire. The GP questionnaire mainly focused on the structural aspects (e.g. economic conditions) and care processes (e.g. comprehensiveness of services of primary care). The patient experiences questionnaire focused on the care processes and outcomes (e.g. how do patients experience access to care?). The questionnaire about what patients consider important was complementary to the experiences questionnaire, as it enabled weighing the answers from the latter. Finally, the practice questionnaire included questions on practice characteristics. DISCUSSION: The QUALICOPC researchers have developed four questionnaires to characterise the organisation and delivery of primary health care and to compare and analyse the outcomes. Data collected with these instruments will allow us not only to show in detail the variation in process and outcomes of primary health care, but also to explain the differences from features of the (primary) health care system.