Affect Patient Satisfaction Research Articles

The relationship among perceived value, patient loyalty and patient satisfaction in the hospitals

It is possible for patients to prefer the same hospital or to recommend it to others, which are indicators for their loyalty to hospitals, where they receive health care service, only if they are satisfied with the service they have received. When considering today's intense competition conditions in the health sector, it is more important to examine issues that will provide competitive advantage, such as perceived value, by affecting patient satisfaction and patient loyalty. There is a limited number of studies in the literature that examine the perceived value with a multidimensional scale or investigate the relationship between perceived value and patient loyalty. As well as the lack of a sufficient number of studies for consumers in Turkey, there is a limited number of studies for consumers of healthcare sector, which is an important branch of the service sector. The purpose of this study is to relationship. The study was conducted by using the survey method on 783 patients who received outpatient clinic services from the Harran University Research and Application Hospital in Şanlıurfa between 1 and 30 June 2021.

Evaluation of patients' satisfaction with bronchoscopy procedure.

The bronchoscopy (BS) experience provokes anxiety amongst some patients. It can have a negative impact on the course of the procedure and on the willingness of patients to undergo the next BS in the future. We aimed to identify factors influencing patients' satisfaction with BS. The prospective study had been conducted between January and June 2019. It included patients hospitalized in our Department, who underwent elective BS. Patients assessed their anxiety and satisfaction level before and after BS using the Visual Analogue Scale (VAS). Data concerning the course of the bronchoscopy was collected. The median level of anxiety prior to the procedure was moderate, higher in women (p<0.0001). The majority of patients (116/125, 93%) were satisfied with appropriate information before the procedure. Almost one-third of the interviewees (39/125, 31%) declared complete satisfaction (VAS = 0) with their procedure, 17 patients (14%) were dissatisfied (VAS >5/10). Overall 113 (90%) patients declared unconditional consent for future bronchoscopy. Multivariate linear regression analysis revealed two factors affecting patients' satisfaction with bronchoscopy: anxiety prior to BS (standardized regression coefficient β = 0.264, p = 0.003) and discomfort (β = 0.205, p = 0.018). Neither age, degree of amnesia, duration of the procedure nor its type added any significant value as factors affecting patient satisfaction. The most common factors inducing patients' discomfort during BS were local anesthesia of the throat (56/125, 45%) and cough (47/125, 38%). Low anxiety level before bronchoscopy and reduced discomfort during the procedure are associated with better patient satisfaction. Thus, it is important to reduce patient anxiety and discomfort during the procedure.

Administrative Data Relationship with The Accuracy of Disease Diagnosis Codes of Inpatients in Pariaman Public Hospital

ABSTRACTÂ Medical records are one of the means to support the achievement of an administrative order in the context of efforts to improve health services in hospitals. An important thing that must be considered by medical record personnel is the accuracy in providing diagnosis and procedure codes. The research problem is the accuracy of the coding of the Diagnosis &amp; Procedure on the medical records of inpatients at the Pariaman Regional General Hospital. The research objective was to describe the general characteristics and accuracy of disease coding based on diagnosis and service procedures as well as the impact of the accuracy of disease coding with inpatient disease diagnosis on the quality of service at the Pariaman Regional General Hospital. The research method is mixed methods. A quantitative approach to the patient's medical record file and a qualitative approach were obtained through FGDs with medical record management officers. The results showed that the accuracy of the main Diagnosis coding has shown results that exceed 80% of all medical records of patients selected as the study sample. However, the accuracy of the secondary diagnosis code is only 50%. Procedure code acceleration is still very low at only 15.4%, and secondary procedure only at 1.8%. The conclusion of the study, the accuracy of the diagnosis code and procedures is closely related to the quality of service. Inaccuracy of diagnosis codes as well as procedures will affect patient satisfaction, especially in payments that are not in accordance with the services they receive. Â Keywords : Encoding, Diagnosis, Procedure, Medical records

Nurse's Therapeutic Communication Affects Patient Satisfaction and Motivation Level

Introduction: Communication is not just a tool to talk to clients, communication between nurses and clients also has a therapeutic relationship aimed at fostering motivation in the client's healing process. Objective: To determine the relationship between nurse therapeutic communication with patient satisfaction and motivation to recover. Methods: The method used in this study is a cross-sectional design. The sampling technique used is a total sampling of 70 respondents. The instrument used a demographic data questionnaire, a questionnaire to assess nursing therapeutic communication, and a questionnaire to assess patient satisfaction. Demographic Data Questionnaire. The statistical test used chi-square Results: The results showed that most respondents were given therapeutic communication as many as 43 respondents (61.4%) were satisfied with as many as 46 respondents (65.7%) and had high motivation among as many as 41 respondents (58.6%). Obtained p-value = 0.001 &lt; 0.05. Conclusion: There is a significant relationship between nurses' therapeutic communication with the level of satisfaction and motivation in patients.

The Effect of Acceptance of Cosmetic Surgery, Body Appreciation, and Nasal Obstruction on Patient Satisfaction After Rhinoplasty.

Background: It is difficult to predict functional and aesthetic results and provide patient satisfaction after rhinoplasty. Objective: To investigate the effect of nasal obstruction, body appreciation, and acceptance of cosmetic surgery (ACS) in predicting patient satisfaction postrhinoplasty. Methods: We prospectively included 97 consecutive participants who underwent rhinoplasty. We recorded age, gender, marital status, education, and body mass index (BMI), and nasal obstruction symptom evaluation (NOSE) scale, body appreciation scale-2 (BAS-2), acceptance of cosmetic surgery scale (ACSS), and rhinoplasty outcome evaluation (ROE) scale were determined preoperatively and at the 3-month postoperative follow-up. Results: The preoperative and postoperative NOSE, BAS-2, ACSS, and ROE scores differed significantly. The mean ROE score improved from 36.8 preoperatively to 82.1 postoperatively. The ROEpostop score was not correlated significantly with age, BMI, ACSSpreop, BAS-2postop, or ACCSpostop. The BAS-2preop scores were correlated significantly with ACCSpreop and ACSSpostop scores. The NOSEpreop and BAS-2preop scores were significant predictors of the ROEpostop scores in the regression analysis. Conclusion: Preoperative nasal obstruction and body appreciation, but not ACS, are factors that might affect patient satisfaction after rhinoplasty.

A Multi-Site Survey Study of Patient Satisfaction with Teledermatology.

IntroductionTelemedicine has been of heightened focus due to spikes in usage during the COVID-19 pandemic. Disparities in health care may affect patient satisfaction with this resource depending on factors such as patient race, age, or socioeconomic background. The purpose of this study was to analyze patient satisfaction with teledermatology to identify any differences in satisfaction based on race, age, and income during the COVID-19 pandemic period.MethodsA 21-question, IRB-approved survey was administered to patients at two academic dermatology clinics in Kansas City. Patient satisfaction was measured using a five-point Likert scale.ResultsA total of 64 completed surveys were analyzed (17.8% response rate). Most of the participants were female (n = 48, 75%), age 45 to 60 (n = 17, 26.6%), and reported White for race (n = 55, 85.9%). Overall, 73.4% (n = 47) of patients reported being satisfied with their visit. However, only 38.7% (n = 24) of participants were likely to choose a video over an in-person visit. Reasons for low patient satisfaction included concerns regarding ability to perform an accurate physical exam with a video visit (n = 9, 14.1%), receiving inadequate care (n = 4, 6.3%), protected privacy (n = 3, 4.7%), and provider understanding the patient (n = 2, 3.1%).ConclusionsOur findings were similar to prior studies stating no difference in patient satisfaction with regards to age, income, or race and patients reporting high satisfaction with teledermatology appointments despite a preference for in-person dermatology visits. Future studies with a larger diverse cohort of participants are needed to elucidate and address possible disparities associated with teledermatology use.

Factors affecting patient satisfaction in refugee health centers in Turkey.

Turkey hosts an estimated 3.7 million Syrian refugees. Syrian refugees have access to free primary care provided through Refugee Health Centers(RHC). We aimed to determine factors that influence patient satisfaction in refugee health centers. The study was a cross-sectional quantitative study. A patient survey was administered among 4548 patients attending services in selected 16 provinces in Turkey. A quantitative questionnaire was used to collect information on patient satisfaction and experience in the healthcare facility. Information on "overall satisfaction with health services" was collected on a 5-point Likert scale and dichotomized for analysis. Logistic regression was conducted to identify factors that influenced patient satisfaction. We found that 78.2% of the participants were satisfied with the health services they received. Factors related to service quality and communication were significant determinants of patient satisfaction. The strongest predictors of satisfaction were having a sufficient consultation time (AOR: 2.37; 95% CI: 1.76-3.21; p< 0.0001), receiving a comprehensive examination (AOR: 2.01; 95% CI: 1.49-2.70; p < 0.0001) and being treated with respect by the nurse (AOR: 2.08; 95% CI: 1.52-2.85; p< 0.0001). Providing integrated, culturally and linguistically sensitive health services is important in refugee settings. The quality of service and communication with patients influence patient satisfaction in refugee health centers. As such, improvements in aspects such as consultation time and the quality of physician-patient interaction are recommended for patient satisfaction.

Satisfaction and associated factors among psychiatry service users at Amanuel mental specialized hospital. Addis Ababa, Ethiopia.

BackgroundPatient service satisfaction is the central point for the health system. Worldwide, around 450 million people suffer from mental and behavioral disorders. Clients who are dissatisfied with the service will miss appointments, abandon the treatment plan, and eventually relapse from the illness. Despite improved access to health services, the satisfaction from health institution services was decreasing from time to time and there is little information on health service consumer satisfaction.ObjectiveTo assess the satisfaction and associated factors among psychiatric service consumers at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia, 2021/2022.Methods and materialsAn institutional-based cross-sectional study was conducted among 420 psychiatric service users from December 15 to January 16, 2021/2022. Systematic random sampling was used. A face-face interview technique and chart review were used to collect the data and a standard and validated tool called the mental health service satisfaction scale (MHSSS) was used to measure satisfaction. The collected data was entered into EPI info version 7 and exported to SPSS version 22 for analysis. The binary logistic regression model was used to analyze the data and bivariable and multivariable logistic regression analyses were conducted to identify associated factors with satisfaction. The level of significance was reported at P < 0.05.ResultsThe study showed that the magnitude of patient satisfaction was 63.3% [95% CI 58.3–67.9%). Sex (AOR = 1.7, 95% CI (1.072–2.88)], educational status (AOR 4.2, 95% CI 1.64–1.8), residency [AOR = 1.8, 95% CI (1.098–3.19)], distance from the hospital [AOR 0.56, (0.34–0.93)] were significantly associated with patient satisfaction at p < 0.05.ConclusionThe magnitude of patient satisfaction was high. The study showed that Sex, educational status, residence, and distance from the hospital were significantly associated with satisfaction. Prioritizing care for female patients and those coming from a distance is necessary. More ever, it is preferable to routinely and continually monitor healthcare facilities so that timely feedback can be given and problems that affect patient satisfaction can be resolved.

The Influence of Quality of Pharmaceutical Installation Services on Satisfaction of BPJS Outboard Patients in General Hospital dr. GL Tobing Tanjung Morawa

Patient satisfaction in hospital pharmacy services to support the quality of life of outpatients. Data on BPJS outpatient visits in July 2018 decreased by 21.5% at dr. GL. Tobing in Tanjung Morawa. The waiting time for pharmaceutical services in taking drugs is &gt; 60 m+minutes and even taking drugs can be two to three days, it is suspected that the quality of pharmaceutical services has not been effective in the Pharmacy Installation. The purpose of the study was to analyze the effect of the quality of pharmacy installation services on the satisfaction of BPJS outpatients at the dr. GL. Tobing Tanjung Morawa. This type of research is quantitative with an explanatory research approach. The sample is 100 BPJS outpatients. The research was conducted in November 2019 - February 2020 through the distribution of questionnaires. Data were analyzed by univariate, bivariate and multivariate using multiple logistic regression test at a significance level of 95%. The results showed that service quality had a significant effect on BPJS outpatient satisfaction on the dimensions of reliability (p = 0.019), responsiveness (p = 0.013), assurance (p = 0.026), direct evidence ( tangible) (p=0.006), and empathy (p=0.003). The chance of patient satisfaction related to the quality of good pharmaceutical services is 86.23%. The conclusion that the dimensions of pharmaceutical service quality consist of reliability, responsiveness, assurance, direct evidence and empathy affect BPJS outpatient satisfaction. The dominant empathy variable affects patient satisfaction. The dominant empathy dimension affects patient satisfaction. It is recommended that the hospital management plan the proposed addition of pharmacists, drug planning, the availability of online entertainment services in the form of Wireless Fidelity (Wifi), regular communication training to officers and complete the identity and cellphone number in the patient's medical record.&#x0D; .

Faktor yang Memengaruhi Waktu Tunggu Pelayanan Resep Rawat Jalan di Instalasi Farmasi Rumah Sakit: Sistematik Review

Pharmacy services are one of the services that must be minimal in a hospital. One indicator to measure pharmaceutical services that meet standards is the waiting time for services, especially prescription drugs. Waiting time for services is one of the most important concerns because it affects patient satisfaction. The reality is that there are still waiting times for prescription drugs that do not meet the minimum service standards in hospitals. This research aims to determine the factors that influence waiting times for outpatient prescription services in hospital pharmacy installations. This study uses a descriptive approach. This study uses a systematic review. Several factors influence the waiting time for prescription drug services in hospital pharmacy installations, namely the lack of human resources in pharmaceutical installations, the completeness of patient files that have not been fulfilled, the lack of availability of drugs prescribed by doctors, the use of electronic and manual prescriptions together, the number of prescription doctors not in National Forum, the number of prescriptions that ask for concoction drugs, information systems in pharmaceutical installations that are less than optimal, doctors who are difficult to contact when prescriptions are difficult to read, space is inadequate. Hospitals need to pay attention to these factors so that they can maintain the quality of hospital services.

Patient Satisfaction with Clinical Laboratory Services in Public Health Sector Hospitals of Azad Kashmir, Pakistan

Objectives: To determine patient satisfaction and factors affecting patient satisfaction with laboratory services in Azad Jammu &amp; Kashmir (AJK).&#x0D; Study Design: Cross-sectional study.&#x0D; Place and Duration of Study: Seven District Headquarter Hospitals, DHQ Neelum, DHQ Hattian Bala, DHQ Pallandari, DHQ Bagh, DHQ Kotli, DHQ Bhimber and DHQ Mirpur, Kashmir Pakistan from Dec 2019 to Feb 2020.&#x0D; Methodology: The patients who were referred from the Outdoor Patient Department of the hospital for undergoing investigative tests were included, and patients of age less than 18 and critically ill patients were excluded.&#x0D; Results: The total number of respondents included in the study was 400, with the median score of patient satisfaction with laboratory services being 59 (19), ranging from 32 to 100. Statistically significant disparities in client satisfaction were observed in different DHQ hospitals (p-value=0.01) with Mirpur (63) and Pallandri (40) showing the extreme variation. Residential area, age, and education level were also identified as statistically significant determinants of patient satisfaction (p-value &lt;0.05).&#x0D; Conclusion: patient satisfaction with laboratory services in public hospitals of AJK was very low, and targeted strategies are needed to improve the overall quality of these services.

Intraoperative midflexion medial laxity using navigation affects patient expectations following posterior stabilized total knee arthroplasty.

Patient satisfaction and expectations are now recognized as an outcome measure for successful total knee arthroplasty (TKA). The purpose of this study was to determine which factors including soft tissue balance during surgery affect patient satisfaction and expectations after TKA. A total of 135 patients (157 knees) with knee osteoarthritis who underwent primary TKA with a posterior stabilized design were studied. After implantation of all components, varus/valgus laxity of the knee was measured intraoperatively with the knee at 0°, 30°, 60°, 90°, and 120° guided by an image-free navigation system. Factors that affected patient satisfaction and expectations, including lateral and medial laxities, were evaluated using the 2011 Knee Society score. The mean intraoperative lateral laxity was 1.1°, 1.6°, 0.9°, 1.3°, and 1.7° with the knee at 0°, 30°, 60°, 90°, and 120°, respectively. The mean intraoperative medial laxity was 1.1°, 1.4°, 1.1°, 1.1°, and 1.7° with the knee at 0°, 30°, 60°, 90°, and 120°, respectively. Patient satisfaction after TKA correlated positively with symptom (R = 0.61, p < 0.01) and functional activity (R = 0.47, p < 0.01) scores. Patient expectations after TKA weakly positively correlated with symptom (R = 0.29, p < 0.01) and functional activity (R = 0.20, p = 0.01) scores, and weakly negatively with medial laxity at 30° (R = -0.21, p < 0.01). Midflexion medial laxity was associated with worse patient expectations after TKA. Avoiding medial laxity could be one of the important techniques during TKA.

Analisis Kepuasan Pasien Terhadap Pelayanan Kesehatan di RSUD Lahat Tahun 2021

Satisfaction is the response or level of feeling of the patient obtained after the patient receives a health service product by comparing the perceived performance or result with the patient's needs and expectations. This study aims to analyze patient satisfaction with health services at Lahat Hospital in 2021. This study was a quantitative study with a cross sectional approach. The sampling technique used stratified random sampling obtained a sample of 97 respondents. Data was collected using a questionnaire, then the data was analyzed using the chi square test with a significance level of p value &lt;0.05. The data were also analyzed using logistic regression test to determine the dominant variables that affect patient satisfaction. The results of the Community Satisfaction Index (IKM) in the Outpatient Lahat Hospital in 2021 were 77.44 with a service quality of "B" and service performance "Good. The results of bivariate analysis showed that there was a relationship between service requirements and patient satisfaction (p=0.005), service procedures (p=0.000), service completion time (p=0.001). service fee (p=0.005), specification of service type (p=0.006), competence of service implementer (p=0.011), behavior of service provider (p=0.000), handling of complaints, suggestions and inputs, facilities and infrastructure (p=0.000). The results of multivariate analysis with logistic regression test showed that the most dominant variable was facilities and infrastructure (p=0.041) p value &lt;0.05 with the largest OR value of 383.398. It is recommended to hospitals to further improve facilities and infrastructure so that patient satisfaction can increase

Program Edukasi Pasien dan Keluarga terhadap Kepuasan Pasien

This study aims to identify how patient and family education programs affect patient satisfaction. This research method is quantitative with a quasi-experimental design using a one-group pretest-posttest approach. The results showed a significant effect between the educational program and patient satisfaction with a value of p = 0.000 (p≤0.05), where the coefficient of determination showed the magnitude of the effect of the education program on patient satisfaction with an R-value of squared = 0.133. In conclusion, there is a significant effect between educational programs on patient satisfaction on the dimensions of reliability, responsiveness, assurance, empathy, and tangibles with the most dominant influence on the dimensions of reliability.&#x0D; &#x0D; Keywords: Patient Satisfaction, Patient and Family Education Program

Survival rates, patient satisfaction, and prosthetic complications of implant fixed complete dental prostheses: a 12-month prospective study.

To determine the survival rate, incidence of prosthetic complications, and patient satisfaction of implant fixed complete dental prostheses (IFCDPs) after a mean observation period of 1.4 years. Twenty-eight (28) eligible participants were recruited according to specific inclusion and exclusion criteria. The definitive metal-acrylic resin IFCDPs consisted of titanium bars veneered with acrylic resin and acrylic denture teeth. Prosthodontic complications, divided into major and minor, were monitored. Parameters such as gender, jaw location, bruxism, and occlusal scheme were evaluated. Moreover, a questionnaire was administered throughout the study to assess patient satisfaction. Poisson regression as well as repeated measures ANOVA were used for statistical analysis. Fourteen (14) males and 14 females were enrolled and followed-up at 3, 6, and 12 months. All IFCDPs survived (100% survival rate). The most frequent minor complication was the loss of material used to close the screw access hole (20% out of total complications). The most frequent major complication was chipping of the acrylic denture teeth (77.14% out of total complications). Gender (p = 0.008) and bruxism (p = 0.030) were significant predictors for the total major complications (major wear and major chipping) while occlusal scheme was a significant predictor for major chipping events (p = 0.030). While IFCDPs demonstrated high prosthetic survival rates, they also exhibited a high number of chipping events of the acrylic veneering material, especially in males, bruxers, and individuals with canine guidance occlusion. However, the occurrence of these prosthetic complications did not negatively affect patient satisfaction.

A Systematic Review on Hospital’s Patient Satisfaction and Loyalty in Indonesia

Background: Customer loyalty is identified as a critical component of a company's success and profitability including in hospitals. Customer loyalty can only be accomplished if the company can provide high-quality services. The purpose of this study was to understand the influence or factors behind patient loyalty. Methods: Systematic literature review methods were used to process articles found in various journals and databases such as Elsevier, NCBI, Lancet, Springer, Nature, Taylor and Francis, ProQuest, Emerald, JSTOR, Web of Science, and GARUDA SINTA (the Science and Technology Index of expertise in Indonesia). Results: The initial search resulted in 1.174 (1 duplicated) and 1.173 were screened based on title and abstract. Finally, 29 articles were included for review regarding inclusion and exclusion criteria. The finding shows that concern for medical staff, perceived value, price, trust, treatment effectiveness, Service Quality, Interaction, Infrastructure, Process, and brand image, consequently affect patient satisfaction and loyalty. Those factors as an intervening variable in patient loyalty. Conclusion: In general, hospital health workers' competency, tangible factors (facilities), communication, punctuality in work (responsiveness), patient waiting time (facility satisfaction and responsiveness), queuing system, drug availability (price factor, facility satisfaction), providing information to clients (trust and communication, guarantees), equal treatment for uninsured patients, and complaint system for clients (Hospital Image) impact patient loyalty directly or indirectly.

The Relationship Between Neuropsychiatric Diagnoses and Revision Surgery After Breast Reconstruction.

A neuropsychiatric diagnosis (ND) has the potential to affect patient satisfaction after breast reconstruction. However, literature regarding the interplay between neuropsychiatric diagnoses and revision operations after reconstruction remains sparse. In this study, we aim to determine whether neuropsychiatric diagnoses result in increased revision operations and healthcare utilization of plastic surgery resources after alloplastic and autologous breast reconstruction. We retrospectively reviewed 200 patients from 2010 to 2019 who underwent postmastectomy alloplastic or autologous breast reconstruction by a single surgeon at our institution. We evaluated for the presence of neuropsychiatric diagnoses, type of neuropsychiatric diagnoses, number of revisions, and number of postreconstruction plastic surgery appointments. Continuous variables were compared using independent samples t tests, and categorical variables were compared using χ 2 tests. Of the 196 patients who met inclusion criteria, the majority underwent at least one revision (65.3%). The presence of an ND did not predict a higher number of revision operations ( P = 0.512) nor was the timing of the diagnosis (preoperative vs postoperative) significantly associated with the number of revision procedures ( P = 0.156). The patients who had a ND at any point during the reconstructive process had a significantly higher number of plastic surgery appointments and a longer duration of follow-up compared with the patients without any neuropsychiatric diagnoses ( P = 0.009 and P = 0.040, respectively). Complications did not impact the number of revision operations ( P = 0.780). Neuropsychiatric diagnoses do not significantly influence the number of revision operations after breast reconstruction. However, neuropsychiatric diagnoses result in increased healthcare utilization of plastic surgery resources that may lead to increased healthcare costs.

SP7.10 Improving Our Preop Fasting Practice

Abstract Aims Preoperative fasting has always been a tussle between patient and surgery staff. Keeping patient nil by mouth unnecessarily not only increases the anxiety, thirst, hunger, postoperative insulin resistance but can also lead to serious hypoglycemic events in diabetic patients. The objective of our study to standardize the habits of pre-operative fasting according to AABGI guidelines and make sure to curtail the fasting period to the required minimum to 2 hours for liquids. Method This retrospective study included all inpatients who had any vascular surgery done under general anaesthesia from Sep 2020 to Nov 2020 in Birmingham Heartland Hospital. As per departmental practices every patient is fasted from 0300. Anaesthesia induction time was noted for every patient from theatre logbook to calculate the fasting interval. After data analysis meetings were done with the ward sister, anaesthetic &amp; vascular surgery consultants to draw an action plan. Results Data collected from a total of 50 patients showed that average fasting period was 11 hrs 2 mins with longest fasting interval was 14 hrs 55 mins. Blanket allowance of clear fluids till 7 am, late dinner and communication of theatre list priority to the ward resulted in achieving an average fasting period of 2 hrs 53 minutes. Conclusions Identification of this simple but crucial problem is the first step towards compliance with the standard. These unassuming butchallenging implementations can significantly affect patient satisfaction and help achieve recommended fasting intervals. Pre-op fasting can easily be optimized by good communication between staff. As further evidence arises, structured peri-operative care can progress.

Prospective Evaluation of Pain and Anxiety Levels Between Wide-Awake Local Anesthesia No Tourniquet and General Anesthesia With Tourniquet in Excision of Wrist Ganglions

Excision of wrist ganglions is a common procedure in hand surgery. Our objective was to determine whether the type of anesthesia (general anesthesia [GA] vs wide-awake local anesthesia no tourniquet [WALANT] technique) would affect patient satisfaction regarding intraoperative pain control, postoperative pain management, and anxiety. This was a prospective study with patients divided into either the WALANT or GA cohort. The waiting time for surgery, Amsterdam Preoperative Anxiety and Information Scale, blood pressure, and heart rate were measured. Postsurgical questionnaires with the visual analog scale were completed. The surgeon's feedback on the ease of ganglion stalk visibility and usage of diathermy as a measure of a bloodless field was recorded. Patients reported the amount of analgesia consumed and overall satisfaction with the operation via the Surgical Satisfaction-8 questionnaire. A total of 42 patients underwent wrist ganglion excision in 2 orthopedic centers over a period of 2 years, with 21 undergoing GA and 22 undergoing WALANT. The GA group was more anxious about anesthetic use with a higher demand for information about GA (P= .04). The duration of surgery was significantly shorter in the WALANT group and with a lower diathermy usage (P < .001). There was no difference in terms of surgical difficulty and stalk visualization. The visual analog scale pain score was significantly lower in the WALANT group than in the GA group immediately after surgery (P= .04) and on discharge (P= .004). While at home for 2 weeks, the WALANT group (mean= 2.91 tablets) consumed significantly fewer analgesic tablets than the GA group (mean= 6.25 tablets). However, both groups were satisfied with their experience. Wide-awake local anesthesia no tourniquet technique in the excision of ganglions provides another option of anesthesia with painless experiences, and no pain rebound after surgery. Patients were less anxious about WALANT than GA. Excision can be performed without diathermy usage with similar visualization of the stalk. Therapeutic II.

Surgeons' perspectives on intraoperative gray area surgical complications of cataract surgery.

To explore surgeons' perspectives and practice patterns in gray area surgical complications (GASCs) within cataract surgery. Tertiary care academic referral center. Retrospective observational cross-sectional study. An anonymous, online survey consisting of 11 potential intraoperative GASC scenarios was developed and distributed to practicing and resident ophthalmologists in the U.S. Demographic data such as gender, experience, and practice settings were recorded. Using a Likert scale, respondents scaled their perception of likelihood that a GASC could lead to postoperative complications and their obligation toward patient disclosure and documentation in the operative report. Respondents also scaled their likelihood of agreement with a series of statements inserted to assess baseline anxiety levels and inherent perspectives regarding disclosure. 389 responses were analyzed. Female surgeons were more likely than male surgeons to disclose GASCs to their patients and experience psychological anxiety regarding patient outcomes. Both early- and late-stage residents were more likely to believe that GASCs could lead to vision-limiting outcomes when compared with attending surgeons. Surgeons at academic centers were more likely than community-based surgeons to disclose GASCs in the operative report and experience psychological anxiety regarding patient outcomes. Significant differences based on gender, practice setting, and level of experience exist in disclosure and documentation of intraoperative GASCs. Additional studies are needed to further explore reasons for these differences, as reporting patterns may affect patient satisfaction, medicolegal risks, and postoperative surgeon-experienced anxiety.