Health Care Satisfaction Research Articles

Quality of life among schoolchildren with type 1 diabetes mellitus and the satisfaction of their guardians towards school health care in Saudi Arabia

AimsThis study aimed to assess the quality of life of schoolchildren with type 1 diabetes mellitus (T1DM) and determine their guardians’ satisfaction of diabetes health care in Saudi Arabian schools. MethodsA cross-section multicenter study was conducted from February to July 2022 among Schoolchildren with T1DM in Saudi Arabia. The study included T1DM school children aged 6–18 years. The patients’ health-related quality of life (HRQoL) data were collected and determined using a modified version of the PedsQL 3.0 Diabetes Module. ResultsThe grand total median PedQL-DM score among the included participants (N = 283) was 64.7, while items related to diabetes symptoms and diabetes management were 61.1 and 68.7, respectively. Schoolchildren who have lower HbA1c levels and take care of regular monitoring of their blood glucose showed significantly better quality of life concerning diabetes symptoms. A significant number of guardians claimed they were not satisfied with the current status of diabetes management at schools. ConclusionsThe overall HRQoL among schoolchildren with T1DM was average and acceptable to some extent. The PedsQL-DM median score was higher among those who received health care during school time. The guardians’ satisfaction of diabetes health care was low, emphasizing the role of health clinics in schools.

The relationship between healthcare workers’ satisfaction level and patients’ satisfaction: Results of a path analysis model

IntroductionPatient and healthcare workers’ satisfaction is an important issue in the healthcare sector today. This study aims to evaluate the relationship between healthcare workers and patient satisfaction levels among Turkish individuals, with particular emphasis on the contribution of the former to the latter. Materials and methodsThe current study was conducted in a state hospital in İstanbul, Türkiye. Face-to-face surveys were conducted from January to April 2022 to administer two diverse questionnaires for inpatients and attending healthcare workers in the same clinic. Path analysis was used to examine the relationships. ResultsThe path analysis demonstrated that 25.2% of patient satisfaction was constituted by the satisfaction of healthcare workers. The final model had an excellent fit with the data x2 (112.89), x2/df (2.130); SRMR=0.0679, CFI=0.956, RMSEA=0.0798. According to the results of this analysis, healthcare worker satisfaction positively influences patient satisfaction and causes it to increase. ConclusionHealthcare satisfaction plays a central role in providing patient satisfaction, which in turn helps with the challenges that healthcare faces today.

Care challenges of home health patients living with dementia: a pathway forward with palliative care

BackgroundHome health care (HHC) is a leading source of care support for older adults with serious illness, particularly patients living with dementia (PLWD). Demand for HHC is expected to continue to grow, driven by an aging population and preference for non-institutional care. HHC agencies are frequently under pressure to find effective approaches for improving care delivery and quality. One strategy that has the potential to improve the quality of life and patient satisfaction in HHC for PLWD is the integration of palliative care. Therefore, we sought to understand the experiences and needs of PLWD and their family caregivers specifically focusing on ways that HHC and palliative care may be integrated as part of the care transition from hospital to home, to better support PLWD and their families.MethodsWe conducted a descriptive qualitative study focusing on the perspectives of patients, caregivers, and healthcare team members about palliative care delivery for patients receiving HHC. Interviews were audio-recorded and professionally transcribed. In this analysis, we specifically report on dementia-related content using an iterative, team-based thematic analysis approach.ResultsWe identified three themes: 1) ’Living in the Whirlwind’ which describes the many competing demands on caregivers time and the associated feeling of loss of control, 2) ’Thinking Ahead’ which describes the importance of thinking beyond the day-to-day tasks to begin planning for the future, and 3) ‘Pathways Forward’ which describes the integration of palliative care into HHC to provide enhanced support for PLWD and their caregivers.ConclusionIn this qualitative study, our formative work identified the importance of providing anticipatory guidance (e.g., safety, advance care planning) coupled with emotional and pragmatic care supports (e.g., finding resources, navigating insurance) to sustain caregivers who are struggling with the whirlwind.

Job satisfaction and perception of workloads among dietitians and nutritionists registered in South Africa

Background: Personal perspective concerning work demands directly impacts quality health care and patient satisfaction. Little is known about job satisfaction amongst dietitians and nutritionist, while workload has not previously been studied in this population. Methods: A descriptive cross-sectional study was performed using an online questionnaire. Data were collected on sociodemography. Job satisfaction was measured with Spector’s Job Satisfaction Survey (JSS) (including an added subscore for resource availability) and workload with the National Aeronautics and Space Administration Task Load Index (NASA-TLX). Results: Respondents (n = 238) had a median age of 32.0 years (IQR: 27−39 years); 92.4% were female; 95.7% were dietitians, 2.4% were nutritionists and 18.9% had a postgraduate degree. Respondents had practised the profession for a median of 8 years (IQR 3−15 years), and 225 were in dietetic and nutrition-related jobs. Median scores indicated that they were slightly satisfied with their jobs (n = 224) and experienced slightly high workload (n = 224). Most respondents were moderately satisfied with the nature of their work and found it rewarding. The median scores for salaries, promotion opportunities, work environment and availability of resources were low. Total JSS was higher in older and more experienced dietitians and nutritionists than in younger ones (p < 0.05). Those employed in the government sector (n = 100) experienced higher physical demands and levels of frustration, and had lower JJS than those employed elsewhere (n = 124), particularly regarding promotion opportunities and resources availability. Conclusion: Despite being generally positive towards practising their profession, South African dietitians and nutritionists, particularly in the public health sector, experienced only slight job satisfaction, related to salary and promotion issues and lack of resources, and were slightly overworked. Understanding the factors that shape perceptions of work within nutrition and dietetics may assist managers in recruiting and retaining a highly skilled workforce, particularly in developing countries with overburdened healthcare systems.

Exploring patient perspectives: A qualitative inquiry into healthcare perceptions, experiences and satisfaction in Lebanon.

Patient perspectives have received increasing importance within health systems over the past four decades. Measures of patient experience and satisfaction are commonly used. However, these measures do not capture all the information that is available through engaging with patients. An improved understanding of the various types of patient perspectives and the distinctions between them is needed. The lack of such knowledge limits the usefulness of including patient perspectives as components within pay-for-performance initiatives. This study aimed to explore patient perspectives on hospital care in Lebanon. It also aimed to contribute insights that may improve the national pay-for-performance initiative and to the knowledge on engaging patients towards person-centered health systems. We conducted a qualitative study using focus group discussions with persons recently discharged after hospitalization under the coverage of the Lebanese Ministry of Public Health. This study was implemented in 2017 and involved 42 participants across eight focus groups. Qualitative content analysis was used to analyze the information provided by participants. Five overall themes supported by 17 categories were identified, capturing the meaning of the participants' perspectives: health is everything; being turned into second class citizens; money and personal connections make all the difference; wanting to be treated with dignity and respect; and tolerating letdown, for the sake of right treatment. The most frequently prioritized statement in a ranking exercise regarding patient satisfaction was regular contact with the patient's doctor. Patient perspectives include more than what is traditionally incorporated in measures of patient satisfaction and experience. Patient valuing of health and their perceptions on each of the health system, and access and quality of care should also be taken into account. Hospital pay-for-performance initiatives can be made more responsive through a broader consideration of these perspectives. More broadly, health systems would benefit from wider engagement of patients. We propose a framework relating patient perspectives to value-based healthcare and health system performance.

Implementation of Case Discussion Reflection to Improve Nurse Professionalism: A Literature Review

Patient safety is a global issue. Nurses are expected to enhance their abilities and skills in providing quality and safe healthcare to patients. Case-based reflection is one effective method to improve nurses' understanding of complex clinical situations and enhance their performance in addressing challenges in clinical practice. This study aims to explore implementing case discussion reflection to improve nurse professionalism. The method used in this study was a literature review through electronic databases, including ProQuest, Science Direct, PubMed, and Google Scholar. Inclusion criteria for the literature review process were national and international journals discussing the implementation of case-based reflection in hospitals, nursing professionalism, articles published in the last five years (2018-2022), articles written in Indonesian or English, full-text journal articles, and open access. The electronic database search through ProQuest, Science Direct, PubMed, and Google Scholar yielded 85 articles. After abstract screening and exclusion of articles published before 2018, duplicates/same journals, and irrelevant topics, 21 articles remained. Further screening of all articles resulted in 6 articles that will be reviewed for data extraction. The review findings indicate that through case-based reflection, nurses can expand their knowledge and skills in identifying, evaluating, and managing patient care more effectively. This can positively impact healthcare quality, patient safety, and patient satisfaction with the services provided. Therefore, the implementation of case-based reflection is crucial in enhancing nursing professionalism.

High-performance work systems and employee attitudes: evidence from Indian healthcare industry

PurposeBy following the “employee-centric” approach, this study aims at identifying the impact of high-performance work systems (HPWS) on specific employee attitudinal outcomes such as work engagement, job satisfaction and affective commitment in the Indian healthcare industry.Design/methodology/approachThe target population for this study includes the nurses working in large private multi-specialty tertiary care hospitals in India. Partial Least Squares Structural Equation Modelling (PLS-SEM) techniques are used on a sample of 152 nurses working in two large specialty hospitals.FindingsIn the Indian healthcare industry context, the nurse's perception of HPWS has shown a significant positive effect on their attitudinal variables such as work engagement, job satisfaction and affective commitment. When checked for mediation of work engagement and job satisfaction variables in HPWS – affective commitment relationship, nurse's job satisfaction partially mediated the relationship, but nurse's work engagement has shown no mediation effect.Originality/valueThis is one of the pioneering studies conducted in the Indian healthcare industry context, especially on the nurse's sample in identifying the impact of high-performance work systems on their attitudinal outcomes. Underscoring the paucity of HPWS research in the Indian healthcare industry, this study's findings will be an addition to the HPWS literature and also to the nursing research in the Indian healthcare settings.

Patients' Satisfaction with Obstetrics-Gynecology, and Pediatric Healthcare Services in Vietnam: A Multicentre Cross-Sectional Study.

Despite improvements in maternal and child health in Vietnam, sustained efforts are required to improve healthcare quality and resolve persistent disparities, highlighting the universal significance of customer satisfaction in healthcare. This study aims to assess patient satisfaction with healthcare services and associated factors at obstetrics-gynecology and pediatric hospitals across different geographical areas in Vietnam. A cross-sectional study was conducted in 2019 among 647 patients or caregivers of hospitalized children at three major obstetrics-gynecology and pediatric hospitals, representing different geographical areas in Northern Vietnam. A Ministry of Health-approved satisfaction instrument was utilized to assess patient satisfaction. The instrument included 31 items measuring five dimensions of perceived satisfaction. Exploratory factor analysis examined the construct validity of the satisfaction measurement, and multivariate linear regression determined the factors associated with patient satisfaction. Among the 643 participants, 520 were female (89.87%), and nearly half were aged 18-29 years old (43.7%). Factor analysis revealed three dimensions: "Competency and Outcomes", "Accessibility and Procedures", and "Facilities and Equipment", with mean domain scores of 4.6 ± 0.43, 4.28 ± 0.67, and 4.53 ± 0.51, respectively. The proportion of participants completely satisfied with overall service quality was 48.52%, and expectation met was 34.53%. Multivariate linear regression indicated that patients from hospitals in the Red River Delta region had higher satisfaction scores than those in the Middle region across all domains (p<0.05). Higher health insurance coverage was associated with increased satisfaction, while education level, economic status, and ethnicity also influenced satisfaction. The study revealed moderate to high levels of satisfaction among patients at three major obstetrics-gynecology and pediatric hospitals in northern Vietnam. The findings may provide useful evidence for implementing hospital quality control in Vietnam, focusing on patient-centered goals.

The Association Between Patient Satisfaction and other Related Factors at the Outpatient Department

Improving the quality of health in Malaysia contributes to improving national development. Patient satisfaction in public healthcare is the yardstick for healthcare quality to provide healthcare services effectively and accurately. The study aimed to define the relationship between patient satisfaction and other related factors in the outpatient department in a public clinic. Related factors investigated in this study were waiting time, staff interpersonal and technical quality, services, facility, and overall. The questionnaires were distributed to the patients visiting the outpatient department at a public clinic in Johor. A quantitative approach was used in this study. Although 500 questionnaires were distributed, only 447 were identified as complete questionnaires. The collected data on patient satisfaction from the questionnaire were analysed by SPSS Software using descriptive statistics (frequency (%), mean and standard deviation) and inferential statistics (independent t-test and ANOVA). The questionnaire analysed using SPSS software showed patient demographic information, disease characteristics, treatment, and other related factors. The level of patient satisfaction for waiting time, staff interpersonal and technical quality, service, and overall was tested using an independent t-test to determine whether there was a statistically significant difference between genders. The other is a one-way ANOVA, which examines whether status, the highest income, and frequency of hospital visits significantly affect patient satisfaction with waiting time.

A systematic review of models of care for polycystic ovary syndrome highlights the gap in the literature, especially in developing countries.

The aim of the study was to identify available polycystic ovary syndrome (PCOS) models of care (MoCs) and describe their characteristics and alignment with the international PCOS guideline. Ovid MEDLINE, All EBM, PsycINFO, Embase, and CINAHL were searched from inception until 11 July 2022. Any study with a description of a PCOS MoC was included. Non-evidence-based guidelines, abstracts, study protocols, and clinical trial registrations were excluded. We also excluded MoCs delivered in research settings to minimize care bias. Meta-analysis was not performed due to heterogeneity across MoCs. We describe and evaluate each MoC based on the recommendations made by the international evidence-based guideline for assessing and managing PCOS. Of 3,671 articles, six articles describing five MoCs were included in our systematic review. All MoCs described a multidisciplinary approach, including an endocrinologist, dietitian, gynecologist, psychologist, dermatologist, etc. Three MoCs described all aspects of PCOS care aligned with the international guideline recommendations. These include providing education on long-term risks, lifestyle interventions, screening and management of emotional well-being, cardiometabolic diseases, and the dermatological and reproductive elements of PCOS. Three MoCs evaluated patients' and healthcare professionals' satisfaction, with generally positive findings. Only one MoC explored the impact of their service on patients' health outcomes and showed improvement in BMI. There is limited literature describing PCOS MoCs in routine practice. Future research should explore developing cost-effective co-created multidisciplinary PCOS MoCs globally. This may be facilitated by the exchange of best practices between institutions with an established MoC and those who are interested in setting one up. https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=346539, identifier CRD42022346539.

Adverse COVID-19 experiences and health-related quality of life in cancer survivors: indirect effects of COVID-19-related depression and financial burden

BackgroundCancer survivors are at greater risk for poor health outcomes due to COVID-19. However, the pandemic's impact on patients’ health-related quality of life (HRQoL) is not well known. This study hypothesized that cancer survivors' adverse COVID-19 experiences would be associated with worse HRQoL. Further, this association would be moderated by psychosocial resiliency factors (perceived social support, benefits, and ability to manage stress) and mediated by psychosocial risk factors (anxiety, depression; health, financial and social concerns).Methods1,043 cancer survivors receiving care at Northwestern Medicine completed a cross-sectional survey on COVID-19 practical and psychosocial concerns from 6/2021 to 3/2022. Participants reported on 21 adverse COVID-19 experiences (e.g., COVID-19 hospitalization, death of family/friends, loss of income, medical delays). The survey assessed 9 psychosocial factors related to COVID-19: anxiety, depression; health care, financial, and social disruptions; health care satisfaction; social support, perceived benefits, and stress management skills. The FACT-G7 assessed HRQoL. Hypotheses were tested in a structural equation model. The number of reported adverse COVID-19 experiences was the primary (observed) independent variable. The dependent variable of HRQoL, and the proposed mediating and moderating factors, were entered as latent variables indicated by their respective survey items. Latent interaction terms between the independent variable and each resiliency factor tested moderation effects. Analyses were adjusted for demographic and COVID-specific variables.ResultsParticipants were, on average, aged 58 years and diagnosed with cancer 4.9 years prior. They were majority female (73.3%), White (89.6%), non-Hispanic/Latino (94.5%), college-educated (81.7%), and vaccinated for COVID-19 (95.5%). An average of 3.8 adverse COVID-19 experiences were reported. Results of structural equation modeling demonstrated that the association between adverse COVID-19 experiences and HRQoL was explained by indirect effects through COVID-19-related depression (β = − 0.10, percentile bootstrap 95% CI − 0.15 to − 0.07) and financial concerns (β = − 0.04, percentile bootstrap 95% CI − 0.07 to − 0.01). Hypotheses testing moderation by resiliency factors were not significant.ConclusionsAdverse COVID-19 experiences were associated with higher depression symptoms and financial concerns about COVID-19, and in turn, worse HRQoL. Oncology clinics should be cognizant of the experience of adverse COVID-19 events when allocating depression and financial support resources.

The Italian version of the Pediatric Quality of Life Inventory™ (PEDSQL™) 3.0 healthcare satisfaction hematology/oncology module: reliability and validity in radiation oncology

BackgroundHealth-related quality of life (HRQOL) measurement has become an important health care outcome even in oncological pediatric scenario. During radiation therapy care path, pediatric patients and their relatives may suffer from emotional and psychosocial distress not only related to cancer diagnosis, but also due to the procedure and the required daily routine. Despite the high prevalence of psychosocial consequences in this setting, instruments that inquire pediatric HRQOL and healthcare satisfaction have rarely been studied in Italy. Purpose of this study was to investigate reliability and linguistic validation of the PedsQL™ healthcare satisfaction Hematology/Oncology module from its original English version to Italian language.MethodsThree phases standard procedure of cross-culture adaptation were used to create Italian version of PedsQL™ healthcare satisfaction Hematology/Oncology module. Forward translations and backward translations were performed. Finally, a pilot-testing for understandability of the ‘pre-final’ version was conducted with parents of children attending our Radiotherapy Center using two methodologies of Cognitive Interviewing (“Think-aloud Interviews” and “Respondent Debriefing”), in order to obtain the final Italian version of the PedsQL™ healthcare satisfaction Hematology/Oncology module.ResultsTwenty-five parents (2 father, 23 mothers) were recruited during their children’s radiotherapy treatment and the grammatically and conceptually acceptable pre-final version of the PedsQL™ Healthcare Satisfaction Hematology/Oncology Module was administered. The questionnaire was well understood reflecting its linguistic adaptation. Compliance with questionnaire administration was optimal. All subjects stated that the questions were interesting to express their opinion, most of them reported that all the questions of each section were clearly comprehensible and easy to understand, suggesting minimal changes that were double-checked with back translation. Furthermore, six of them spontaneously asked to complete the questionnaire in order to review the assistance received during radiotherapy.ConclusionOur Italian version of the PedsQL™ 3.0 Healthcare Satisfaction Hematology/Oncology Module seems to be a valid and functional instrument to indagate Healthcare Satisfaction.

Healthcare utilization and satisfaction among enrolees in an online course about multiple sclerosis: A cross-sectional study.

Healthcare utilization and satisfaction are important for health outcomes among people living with multiple sclerosis (PwMS). However, there is little current evidence around healthcare utilization among PwMS, and less comparing PwMS to those not living with MS. To evaluate healthcare utilization and satisfaction among Understanding MS online course enrolees and to identify factors associated with healthcare satisfaction. In this international cross-sectional study, we evaluated participant characteristics (including health literacy and quality of life), healthcare utilization (number of visits, number of provider types), and satisfaction with healthcare (perceived healthcare sufficiency, quality, accessibility) among enrolees in the Understanding MS online course (N=1068). We evaluated study outcomes using summary statistics. We compared participant characteristics and study outcomes between PwMS and those not living with MS using chi square and t-tests. In this study cohort, PwMS were older, less likely to have a university degree, had lower health literacy, and lower quality of life. PwMS had significantly more healthcare visits in the previous year and visited a more diverse range of provider types than those not living with MS. PwMS were also more likely to report being satisfied with the healthcare they received. Among both PwMS and those not living with MS, higher health literacy and higher healthcare utilization were significantly associated with satisfaction with healthcare sufficiency, quality, and accessibility. PwMS were more likely to be satisfied with the healthcare they received compared to those not living with MS. This may be due in part to the differences in health literacy and healthcare utilization between the two groups. We recommend that these relationships be rigorously assessed in future research.

A Stress Management Tool in Nurses: Mindfulness- Based Stress Reduction

Health, which is a state of complete physical, social and spiritual well-being, is under the influence of various stressors. Stress occurs due to the negative effects on the organism physically and mentally. Stress is encountered in every field in our daily life and affects our health negatively. Nurses working in the healthcare field, which is one of the stressful environments, experience intense stress. Therefore, nurses working in such an environment need to use stress management effectively to protect their own health and increase patient care quality and satisfaction. One of these methods is Mindfulness- Based Stress Reduction. The evidence-based program that includes mindfulness meditation, breathwork, basic yoga, and other relaxation methods for 8 weeks. This review will discuss Mindfulness- Based Stress Reduction in nurses.

Transition competence as an indicator of health outcomes related to transition.

Adolescents and young adults (AYAs) with chronic conditions face a transfer, defined as an actual shift from paediatric to adult-oriented health care. Transition competence as the self-perceived knowledge, skills and abilities regarding the transition process was considered extremely useful. This study was designed to investigate the impact of transition competence before and after the transfer on disease-specific quality of life (QoL) and health care satisfaction of AYAs with diabetes. In total, a sample of N = 90 AYAs with diabetes self-reported their transition competence, diabetes-specific QoL and satisfaction with care. Multiple linear regressions were used to analyse the impact of transition competence on satisfaction with care and QoL. Transition competence positively influenced the outcomes of satisfaction with care and QoL. Young adults with diabetes showed higher transition competence scores than adolescents with diabetes.

Ethical Implications of Artificial Intelligence in the Healthcare Sector

This research paper examines the ethical implications of AI in healthcare, covering the benefits and risks of using AI in healthcare services and provision. The paper highlights the applications of AI in healthcare, which can improve efficiency and accuracy of providing healthcare services by health professionals. The benefits of AI cover reducing the need for human intervention and increasing productivity through automation, delivering personalised experiences by recommendations, assisting with informed decision-making by providing real-time data analysis and insights, predicting outcomes or identifying potential threats, improving healthcare and overall customer satisfaction. The paper highlights the ethical implications of the use of AI in healthcare, including privacy and security, bias and discrimination, transparency and explainability, responsibility and accountability, informed consent and human interaction and empathy. The paper recommends that as AI becomes more prevalent in healthcare, establishing clear guidelines for responsible use, and maintaining the importance of human interaction and empathy in patient care, enhances healthcare outcomes while safeguarding patient rights and welfare. Continued research and development of the ethical implications of AI in healthcare for low-income countries as further work can promote the ethical use of AI in healthcare worldwide. Keywords: Artificial Intelligence, Ethics, Ethical Implication, Healthcare, Privacy

Technological machines and artificial intelligence in nursing practice.

This article is a theoretical discourse about technological machines and artificial intelligence, highlighting their effective interactive outcomes in nursing. One significant influence is technological efficiency which positively affects nursing care time, enabling nurses to focus more on their patients as the core of nursing. The article examines the impact of technology and artificial intelligence on nursing practice in this era of rapid technological advancements and technological dependence. Strategic opportunities in nursing are advanced, exemplified by robotics technology and artificial intelligence. A survey of recent literature focused on what is known about the influence of technology, healthcare robotics, and artificial intelligence on nursing in the contexts of industrialization, societal milieu, and human living environments. Efficient, precision-driven machines with artificial intelligence support a technology-centered society in which hospitals and healthcare systems become increasingly technology-dependent, impacting healthcare quality and patient care satisfaction. As a result, higher levels of knowledge, intelligence, and recognition of technologies and artificial intelligence are required for nurses to render quality nursing care. Designers of health facilities should be particularly aware of nursing's increasing dependence on technological advancements in their practice.

International Spinal Cord Injury Community Survey: Socioeconomic and Healthcare Satisfaction in Spain.

Survey study. People living with spinal cord injury (SCI) are major healthcare and rehabilitation services consumers and have unmet healthcare needs. This study aimed to describe the socioeconomic characteristics of people living with SCI in Spain and to determine the level of use and satisfaction with the public healthcare system. We conducted a survey (the Spanish version of the International Spinal Cord Injury Community Survey) consisting of 134 questions. We analyzed the age, sex, neurological classification of the injury on the American Spinal Injury Association Impairment Scale, time of injury, socio-occupational and socioeconomic status, and level of use and satisfaction with the public health system. 472 people responded to the survey [68.9% male; mean age 51.2years (standard deviation: 13.9years); 61.7% with paraplegia and 38.3% with tetraplegia]. 89.2% of those surveyed were unemployed and 77.1% received a disability pension. The number of medical visits was 2.3/year, and 19.8% of the patients required at least 1 hospital admission during the previous year. 94.7% of the people with SCI considered the health care received as good or very good. Respondents with SCI in Spain considered they had good access to primary and specialized care and were satisfied with the healthcare system. Notably, we observed a high average of annual visits to medical professionals but a low rate of hospitalizations. Technical aids and state services related to disability should be the most important elements to be improved.

Initial results of the implementation of an ambulatory mini percutaneous nephrolithotomy program

ObjectiveTo present our program for ambulatory mini percutaneous nephrolithotomy (mini-PCNL) and evaluate its initial results. Material and methodsWe analyzed the implementation of the protocol into the clinical practice with the first 30 outpatient mini-PCNL cases performed in our center between April 2021 and September 2022. Demographic characteristics, perioperative variables, complications and need for unplanned health care, stone-free rate (SFR), stone type and patient satisfaction with the major ambulatory surgery (MAS) process were collected. ResultsA total of 30 patients with a mean age of 60.2 ± 11.6 years who met the inclusion criteria underwent surgery. The mean stone size was 15 mm [range: 5−20]. No intraoperative complications were recorded. All patients except one were discharged the same day of surgery as planned. In the month following discharge, the rate of complications, emergency department (ED) revisits or hospital readmissions rates were 0%. Stone-free-rate (SFR) at 3 months was 83%. Overall satisfaction with the whole perioperative process was assessed with the EVAN-G questionnaire, obtaining 124.3 points out of a maximum of 150, which is equivalent to a 78.6% level of satisfaction. ConclusionAmbulatory mini-PCNL can be implemented as a treatment option in centers with experience in endourology, an established MAS Unit, and strictly selected patients. Our initial results show an adequate safety profile and high overall satisfaction perceived by patients undergoing the ambulatory approach.

Postoperative pain-related outcomes and perioperative pain management in China: a population-based study

Postoperative pain poses a significant challenge to the healthcare system and patient satisfaction and is associated with chronic pain and long-term narcotic use. However, systemic assessment of the quality of postoperative pain management in China remains unavailable. In this cross-sectional study, we analyzed data collected from a nationwide registry, China Acute Postoperative Pain Study (CAPOPS), between September 2019 and August 2021. Patients aged 18 years or above were required to complete a self-reported pain outcome questionnaire on the first postoperative day (POD1). Perioperative pain management and pain-related outcomes, including the severity of pain, adverse events caused by pain or pain management, and perception of care and satisfaction with pain management were analyzed. A total of 26,193 adult patients were enrolled. There were 48.7% of patients who had moderate-to-severe pain on the first day after surgery, and pain severity was associated with poor recovery and patient satisfaction. The systemic opioid use was 68% on the first day after surgery, and 89% of them were used with intravenous patient-controlled analgesia, while the rate of postoperative nerve blocks was low. Currently, almost half of patients still suffer from moderate-to-severe pain after surgery in China. The relatively high rate of systemic opioid use and low rate of nerve blocks used after surgery suggests that more effort is needed to improve the management of acute postoperative pain in China. National Key Research and Development Program of China (No. 2018YFC2001905).