Increased Patient Satisfaction Research Articles

Intralesional methotrexate versus 5-flurouracil in the treatment of keratoacanthoma

BackgroundKeratoacanthoma (KA) is a benign neoplasm that affects mainly photodamaged skin. It is locally destructive and may rarely spread. Surgery is not always suitable and usually disfiguring. Thus, non-operative modalities represent good alternatives.ObjectiveTo assess and compare the efficacy of intralesional methotrexate (MTX) and 5-flurouracil (5-FU) in the treatment of KA.Patients and methodsRandomized controlled trial included 20 patients with biopsy proven KA divided into 2 equal groups; group (A) received intralesional MTX, 25 mg/ml and group (B) received intralesional 5-FU, 50 mg/ml every 2 weeks till complete clearance or for a maximum 5 sessions.ResultsIn the MTX group, complete clearance was observed in 7 patients (70%) compared to 8 patients (80%) in the 5- FU group with no statistically significant difference. However, the median number of injections needed to achieve complete response in the MTX group was 3 sessions versus only 2 sessions in the 5-FU group.Limitationsthe small sample size due to the relatively low incidence of KAs in our population.ConclusionIntralesional therapy is a good alternative to surgery in selected cases of KA. Both drugs showed comparable efficacy, but 5-FU may give faster results, hence increasing patient satisfaction and compliance.

The use of botulinum toxin in aesthetic procedures

Introduction: Botulinum toxin is a protein produced by the bacterium Clostridium botulinum. When administered orally in large quantities, it blocks nerve signals from the brain to the muscle, causing generalized paralysis, called botulism. However, by injecting very small amounts into a specific facial muscle, only the impulse that guides this muscle will be blocked, causing local relaxation. In this way, botulinum toxin acts as a blockade of the underlying muscles of the unwanted lines. In recent years, there has been an increase in the use of botulinum toxin in aesthetic procedures and knowledge about it is of great importance. Aim: The aim of this study was to demonstrate the use of botulinum toxin in aesthetic procedures. Methodology: This is a literature review study. Results: Botulinum toxin has been widely used in aesthetic procedures to temporarily reduce painful wrinkles, such as expression lines on the forehead, around the eyes (crow's feet) and between the eyebrows (glabella). Botulinum toxin is also used to treat gummy smiles, hyperhidrosis (excessive sweating) and facial asymmetry. Its aesthetic use provides a rejuvenated appearance and softens the marks of facial ageing. Clinical studies have shown positive results in terms of improved facial appearance and increased patient satisfaction with botulinum toxin procedures (CARRUTHERS, A., & CARRUTHER, J 2009). Conclusion: Botulinum toxin is extremely important in aesthetic procedures and requires a great deal of attention from professionals, as it brings great benefits if used correctly and in the correct dose.

Patient satisfaction with Saudi community pharmacy services (Wasfaty System)

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

Pengaruh Kualitas Pelayanan terhadap Kepuasan Pelanggan Miniso Big Mall Samarinda

This study aims to test whether the Quality of Laundry Service affects Patient Satisfaction in RSUD Kab. Kediri. This study used a quantitative descriptive approach with a causal research design applied to determine the cause-and-effect relationship between the independent variable (Laundry Service Quality) and the dependent variable (Patient Satisfaction). The study population consisted of 224 non-medical employees of Kediri District Hospital. Non-probability sampling techniques with purposive sampling types are used to determine samples based on certain criteria. Using the Slovin formula and the 5% error standard, a sample of 34 employees was obtained. Data were collected using the Likert scale and analyzed to test hypotheses. The results showed that the calculated value for the Laundry Service Quality variable was 7.970, which was greater than the ttable of 2.037, with a significant value of 0.000 which was smaller than 0.050. This shows that the Quality of Laundry Service has a significant effect on Patient Satisfaction, so the hypothesis (Ha) is accepted. The regression coefficient value of 0.563 indicates that an increase of one unit in Laundry Service Quality will increase Patient Satisfaction by 0.563 units, while a decrease of one unit in Laundry Service Quality will decrease Patient Satisfaction by 0.968 units. An R² value of 0.665 indicates that 66.5% of the variation in Patient Satisfaction is explained by Laundry Service Quality, while the remaining 33.5% is influenced by other variables not studied in this study.

Early Results after Thulium Laser Enucleation of the Prostate in Patients with Urodynamically Proven Detrusor Underactivity

Objectives: Benign prostatic hyperplasia is one of the most common urological diseases. Among these patients, the presence of detrusor underactivity or acontractility represents a challenging condition since no medical treatment is available. Our objective is to evaluate early term outcomes following transurethral anatomical enucleation of the prostate with Tm:YAG support. Methods: In a retrospective analysis of 115 patients who underwent this procedure between January 2019 and March 2022 due to lower urinary tract symptoms, 8 patients with urodynamic evidence of detrusor underactivity secondary to a non-neurogenic aetiology were identified. Detrusor underactivity was defined as a bladder contractility index of <100. Results: Median age, prostate volume and bladder contractility index were 73.2 years, 78.5 cm3 and 63.9, respectively. Median International Prostate Symptom Score/quality of life, Qmax and post-void residual volume were 15/3.5 points, 4.4 mL/s and 189 mL, respectively. Postoperatively, immediate catheter-removal success rate was 87.5% (7/8), at 2 months all patients were catheter-free and remained so at 1-year follow-up. Significant improvements for quality of life, Qmax and post-void residual volume were detected. Median postoperative International Prostate Symptom Score/Quality of life, Qmax and post-void residual volume were 7/2, 21.6 mL/s and 0 mL, respectively. Conclusions: This surgical approach offers high catheter-free rates, significantly improves functional voiding parameters and increases patient satisfaction in patients with benign prostatic hyperplasia and concomitant detrusor underactivity. Therefore, it can be regarded as an effective approach for such patients.

Improving access to infusion services: Results of an operational sprint.

e13522 Background: As a large clinical academic cancer center growing from 40,772 unique patients in 2021 to 44,416 patients in 2022, access for patients to begin therapy in the infusion suite was delayed by 3.2 days. In addition to delays in care the center experienced decreased patient satisfaction related to timeliness of scheduling and an inflexible scheduling template that did not allow for the maximization of chair assets. An infusion sprint was launched to address the challenges with the main goal of providing a seamless patient experience while ensuring that all 60 chair assets were maximally utilized. The multi-disciplinary team sought to accomplish this through a disciplined evaluation and intervention program with the goals of increasing access, improving patient satisfaction and growing operating income. Methods: In February 2022, a multi-disciplinary team was assembled to develop and implement a plan to increase access to the infusion suite over a period of 6 months. The team utilized LEAN-Six Sigma principles to characterize current state, desired future state and tactical interventions with metrics. Access data, available infusion appointments and activities occurring in chairs were analyzed with the goal of maximizing utilization. This was accomplished through the development of an active asset management methodology that compared available infusion appointment hours in the schedule to the actual completed hours which allowed the center to determine the growth opportunity within the current chair count. Financial performance was reviewed, and a pilot of an AI-based scheduling platform was launched. Results: Data collected in December 2022 showed that the pilot increased average daily chemotherapy infusion patient volume by 10% and overall volume by 11% over prior fiscal year from October 2021 to September 2022. Daily scheduling escalations manually resolved by leadership decreased 54% between May 2022 and September 2022. Newly created chair utilization methodology showed increased utilization from 62% to 82% in 7 months and patient satisfaction increased from 76.97% to 81.18% for “Timeliness of Scheduling.” These initiatives also resulted in an 18% increase in infusion/pharmacy income from operations from October 2021 to September 2022. All of this was accomplished without adding staff to the workforce or chairs to the infusion suite. Conclusions: A focused, intentional, multi-disciplinary infusion sprint conducted over 6 months resulted in increases of patient access, increased patient satisfaction and revenue. External validity is limited by its one site design with future investigation planned at other sites within the cancer care network to determine if results can be reproduced.

Work motivation of implementing nurses to improve the quality of health services

Introduction: The motivation of the implementing nurse is essential to improving the quality of health services. Implementing nurses plays a vital role in providing quality services to patients. High work motivation is crucial in enhancing nurses' performance and commitment to providing the best care. Objective: Knowing the motivation behind implementing nurses can improve the quality of health services. Method: This research is quantitative, with a cross-sectional study design using a quantitative analytical approach. The number of samples was 81 people using total sampling. The research instrument used was a questionnaire with a Likert scale. The analysis method uses the Fisher's exact test. Results: Based on the results of the analysis, these employees have discipline that is still lacking in completing work, while of the 5 respondents who have low work motivation, three respondents (3.7%) have good performance. This is because employees have effectiveness, efficiency, authority, responsibility, discipline, and good work initiative. The statistical test results using Fisher's exact test obtained p = 0.009, smaller than a = 0.05 (p < 0.05), which means Ho is accepted and Ha is rejected. This suggests there is a meaningful relationship between work motivation and. Conclusion: The researchers found that the work motivation of implementing nurses can improve the quality of health services. Implementing nurses can enhance healthcare quality, build team spirit, and achieve organisational goals. These efforts help increase patient satisfaction and improve job satisfaction and nurses' well-being. Therefore, understanding and applying compelling work motivation is the key to improving the quality of health services.

Chemotherapy Care Companion: Enhancing cancer care through digital remote monitoring.

1636 Background: Oncology patients often encounter preventable acute issues prompting the need for proactive monitoring and management. To manage disease and therapy complications, Ochsner Health developed Chemotherapy Care Companion (CCC) for remote monitoring of treatment patients. This abstract highlights the feasibility of digital remote monitoring (DRM) in managing oncologic patient care, while increasing patient satisfaction and reducing patient events and healthcare costs. Methods: Starting in January 2021, patients initiating an oral or intravenous cancer treatment with an active Ochsner portal account and smartphone became eligible. Providers can manually enroll patients via an order set and receive enrollment reminders within the Epic electronic medical record (EMR). Patients receive a digital WiFi-enabled monitoring scale, blood pressure cuff, and ear thermometer, at no cost. Patients are reminded via phone alerts to take vitals at 9am and 3pm, along with a daily questionnaire. The data is transmitted wirelessly to the EMR, where abnormal vital signs or questionnaire responses trigger escalations sent to an Epic in-basket pool. During clinic hours, advanced practice providers (APPs) review and intervene, utilizing embedded urgent care slots for same-day access. In August 2022, a patient satisfaction survey comprising of nine questions was distributed to all enrolled patients. Results: A retrospective analysis was conducted from September 2022 to August 2023 including 722 participants, 7,360 escalations and 668 interventions. Patient compliance reached 62%, defined as submitting at least 50% of daily vitals. The most common interventions were related to hypertension, hypotension, weight changes, and questionnaire responses. Regarding questionnaire responses, diarrhea, pain, fever, and dizziness were the mostly frequently triaged. Data analytics revealed that CCC led to a 5.9% decrease in emergency room visits, a 41.7% decrease in the rate of inpatient hospital admissions, and a 32.3% improvement in the inpatient length of stay compared to non-enrolled patients. Extrapolating this data across 5,500 oncology patients within our hospital system, CCC could prevent 172 ER visits, 914 inpatient hospital admissions and 2,006 hospital days. The survey (131 responses) revealed high satisfaction with CCC: over 80% felt a sense of security, 90% were overall satisfied, and more than 90% would recommend CCC. Conclusions: Findings highlight the value of integrating DRM in cancer care, showcasing its ability to reduce healthcare costs and optimize resource utilization while enhancing patient care and satisfaction. Moreover, the study underscores the high patient satisfaction and engagement with DRM, bolstering its feasibility and acceptance in oncology care. Further investigation is warranted to explore the financial benefits for hospitals, insurance companies, and pharmaceutical companies.

Comparison of Implant-Retained Overdenture and Conventional Complete Denture: A Survey Study to Measure Patients' Satisfaction and Quality of Life in Dental School Clinics.

Patient satisfaction and quality of life are integral to assessing oral health care quality. For many Americans still using conventional complete dentures (CDs) or implant-retained mandibular overdentures (IODs), it remains essential to consider improving their oral health outcomes and quality of life. Due to inexperienced student dentists providing dental care to dental school patients, patient grievances are generally considered a problem. Patient feedback and satisfaction have proven valuable resources for monitoring and improving patient safety. While CDs and IODs are the 2 leading treatment options for edentulism, more comparative studies in the literature need to compare their outcomes in a school setting. The research question that guided this comparative analysis was, "Is patient satisfaction and quality of life affected by the type of prostheses and provider?" A validated questionnaire was mailed to 520 individuals selected from records of patients who had received treatment for edentulous mandible at a student prosthodontic clinic at the University of Kentucky College of Dentistry from 2014 to 2016 with at least 1 year of follow-up time. A validated questionnaire for edentulous patients based on the Oral Health Impact Profile (OHIP-19) was used. In addition, information on patients' oral health-related quality of life, including questions related to the edentulous patients' satisfaction with their dentures, was collected. The response rate was 33% (N = 171). The study's findings confirm previous findings, suggesting that IODs may significantly impact oral health-related quality of life. Data show that 76% of the IOD group reported improvement in experience when using the implants to retain the mandibular denture. However, there were no statistically significant differences in the OHIP scores between overall CD and IOD patient groups. Males with IODs had lower physical pain, limitations, and disability scores than males with CD. However, females with IODs reported more significant concerns associated with a social disability and handicap domains. Comparing users who had experiences with both treatment options, this study discerned essential characteristics that contribute to increased patient satisfaction with IODs and identified significance in outcomes by gender. These findings guide prosthodontic practitioners' patient care practices and identify a continuing need to discuss CD and IOD treatment protocols within dental school curricula.

Use of computer simulation to identify effects on hospital census with reduction of transfers for non-procedural patients in community hospitals

ObjectiveIn-person healthcare delivery is rapidly changing with a shifting employment landscape and technological advances. Opportunities to care for patients in more efficient ways include leveraging technology and focusing on caring...

A pilot study of electronic blood pressure interpretation of home blood pressure readings in primary care.

Home blood pressure (BP) monitoring is an acceptable method with high accuracy and acceptability amongst patients. It has the potential to save many hours of clinical time and is less likely to suffer from white coat bias. However, it can raise anxiety in patients who may not interpret readings immediately. A pilot study using an auto formatted excel spreadsheet which gave instantaneous colour coded feedback was sent to patients to assess its acceptability. This auto interpretation tool was sent to patients with their consent. It enabled patients to receive immediate feedback about this blood pressure control. A follow-up questionnaire was later sent to ask the patients and the staff about their experience. Hypertensive patients under 75 years of age who were sending regular home BP readings were enrolled (n = 96); of these, 31 responded within 1 month. Patient satisfaction was high; 74% preferred the electronic tool, 77% found the colour indicator reassuring, and 87% wanted to continue the electronic interpretation tool regardless of their initial preference. Staff satisfaction was excellent at 100%. This hypertension triage tool allows for interpretation by patients and non-clinicians with benefits of instantaneous reassurance, user and provider satisfaction all at reduced costs. Patients without MS Excel could not use this tool. The pilot study reinforced our hypothesis that such a modality has the potential to increase patient satisfaction and safety, and can be applied to a larger number of patients. Eventually an NHS app could be developed and rolled out for the large population.

Design and Development of Automated Lower Limb Continuous Passive Motion (CPM) Machine

Abstract: Post-operative rehabilitation is critical in orthopedic surgery, especially for hip joint surgeries. Traditional therapies like manual exercises and resource limits in rehabilitation centers might be tough, but early mobilization and rehabilitation are critical for regaining joint function and allowing patient return to normal activities. Continuously Passive Motion (CPM) devices, primarily developed for knee joint rehabilitation, offer a non-invasive method for passive joint mobility, restoring joint range of motion and lowering post-operative stiffness risk. Their application in hip joint healing is gaining pace, offering better results and increased patient satisfaction. The research also investigates abduction mobility in the hip joint, which is necessary for daily actions like stepping to the side, getting out of bed, or exiting a car. Understanding hip joint biomechanics and range of motion parameters is vital for establishing efficient rehabilitation approaches. By merging clinical insights with technology innovations, this research intends to optimize post-surgery rehabilitation regimens, enhancing patient outcomes and quality of life. The subject of orthopedic rehabilitation continues to expand through interdisciplinary collaboration and innovation, bringing new choices for enhancing patient care and recovery trajectories.

Perception of Rhinoplasty Outcome Utilizing Patients' Photography.

Patient satisfaction with rhinoplasty results is evaluated in a manner of subjective and qualitative values, and to a certain degree, it can indicate successful outcomes in rhinoplasty. The present study was a descriptive study that assessed the rhinoplasty outcome of adult patients who underwent septorhinoplasty between January 2015 and August 2023 at a single center in Saudi Arabia utilizing Rhinoplasty Outcome Evaluation scores and Nasal Obstruction Symptom Evaluation scores pre-operatively, postoperatively, and postoperatively with showing the patients their photo before surgery. The comparison of Rhinoplasty Outcome Evaluation scores and Nasal Obstruction Symptom Evaluation scores showed statistically significant with P value of 0.000 when comparing these scores pre-operatively, postoperatively, and postoperatively with showing the patient their photos before surgery. Presenting patients with pre-operative images may help them recognize changes in their clinical appearance and, consequently, score higher on the postoperative satisfaction scale. It can help the surgeon to increase patient satisfaction postoperatively.

Evaluation of social appearance concerns and satisfaction after orthognathic surgery

The main aim of orthognathic surgery is to provide a good occlusion and masticatory function and to achieve positive changes in facial aesthetics. The aim of this study was to determine the reasons behind patients' acceptance of orthognathic surgery and their expectations from this treatment, to assess whether their expectations were met, the change in their self-confidence and their satisfaction, and finally, to use the results obtained to inform future surgical procedures to increase patient satisfaction. The study was designed as a cross-sectional observational study and included 73 people treated with orthognathic surgery (surgery group) and 42 people with minimal crowding who did not require treatment (control group). The study found that the primary reason for requesting orthognathic surgery was to improve facial appearance and that patients had high expectations in this regard. Using the Social Appearance Anxiety Questionnaire and the Expectation and Satisfaction Questionnaire, 73.97 % of patients in our study said the treatment met their expectations and 90.41 % said they were satisfied with the overall results of the surgery. The study also highlighted the importance of surgeon-patient communication and the satisfaction of the patient's environment with the final result in determining patient satisfaction. In conclusion, since patients' high expectations of orthognathic surgery influence treatment success and patient satisfaction, it is important to know and manage patients' expectations before treatment and to have good patient-surgeon communication to increase patient satisfaction after surgery.

Implementation of a Culturally Sensitive Caring-Based Nursing Service Model Increasing Patient Satisfaction in Hospitals

BACKGROUND: Culturally sensitive caring-based nursing services yield numerous benefits for patients, nurses, and hospitals. One of the advantages hospitals derive is enhanced patient satisfaction and loyalty, leading to financial benefits. AIM: The aim of this study was to assess the impact of culturally sensitive caring-based nursing services on patient satisfaction in hospitals. METHODS: Quasi-experimental pre-post-test control group design. The sample consisted of inpatients that were purposefully selected. The formula for the difference in proportions between the two groups was used to determine the sample size, yielding a total sample of 360 people, 180 in the intervention group and 180 in the control group. The intervention group received model socialization, module books, and 2 months of assistance with model implementation practices, while the control group only received module books without socialization and assistance. Data collection utilized a patient satisfaction questionnaire developed from the Swanson caring instrument, validated for reliability. Data analysis involved independent sample t-tests to ascertain differences in patient satisfaction between the intervention and control groups, and the general linear model repeated measure (GLM-RM) test to assess the development of patient satisfaction during the intervention and the model’s contribution to its increase. RESULTS: The independent t-test yielded a p = 0.0001 <0.05, signifying a significant difference in patient satisfaction between the intervention and control groups. The GLM-RM test demonstrated a Partial Eta Squared value of 0.715, indicating that the model contributed to a 71.50% increase in patient satisfaction, with the remainder influenced by other variables. CONCLUSION: Culturally sensitive caring-based nursing services enhance patient satisfaction in hospitals. Suggestion: This model can be implemented across hospitals.

Effectiveness of NEPIL (Pain, Elimination, Position, Infusion and Environment) Nursing Rounding Implementation on Patient Satisfaction Level: Literature Review

Introduction: This study is conducted to determine the effectiveness of Nursing Rounding Implementation on the level of patient satisfaction. Nursing Rounding can also reduce the incidence of falls, plebitis rates and bell ringing if done correctly. Objective: Nursing Rounding has an impact on patient satisfaction. Nursing Rounding can also reduce the incidence of falls, plebhitis rates and bell ringing if done properly. Method: literature review uses journals identified from Pubmed, EBSCO, crossref, Pro Quest and Google Scholar. Result: The results of the 17 journals taken from 2018-2023 state that Nursing Rounding can increase patient satisfaction rates, improve patient safety quality, reduce the incidence of plebhitis, reduce the number of bell calls and reduce the incidence of falls. Conclusion: Nursing Rounding is a systematic process used by professional health care providers to anticipate and address the fundamental needs of patients, especially in the treatment room. Nursing Rounding uses NEPIL systematics, namely pain, elimination, position, infusion, Possesion, and patient environment to improve patient satisfaction.

Patient-oriented optimization of the quality of care in aspecialized outpatient clinic in atertiary rheumatology center : Aqualitative study

The adaptation of structures and processes in treatment procedures can contribute to increasing patient satisfaction and is the focus of patient-oriented quality assurance. To identify patient satisfaction as well as needs, expectations and preferences with respect to care and, based on this, to formulate recommendations for action to optimize the quality of care at alarge tertiary rheumatology center. As part of aqualitative research approach, semi-structured patient interviews and afocus group interview consisting of physicians in rheumatology training in outpatient specialist care were conducted. The quality dimensions of Donabedian were recorded. The data material was evaluated and analyzed using the content-structuring qualitative content analysis according to Kuckartz with the MAXQDA evaluation software. Using 12patient interviews and afocus group of 3future rheumatologists, recommendations for action to optimize the quality of care were derived on the basis of the structural, process and outcome quality. There was aneed for optimization in the areas of personnel management, internal practice processes, practice equipment and treatment processes in the outpatient clinic. The results from the patient interviews and the focus group revealed the aspects in need of optimization. The methodology and results of this study can serve as areference point for analyses of other rheumatology clinics in order to improve the quality of care within the framework of patient-oriented quality management and continuous further development.

The Influence Of Online And Offline Registration Education On The Level Of Patient Satisfaction At Colomadu 1 Health Center

A very simple and fast registration service is one of the efforts to improve the quality of service to patients which will affect patient satisfaction. The development of technology and information influences various aspects, one of which is the health sector, known as e-health. One application of e-health. This is online registration which is carried out together with direct registration, but to inform the public there must be education regarding online and offline registration so that the public understands the process. The goal of service is patient satisfaction, where according to minimum service standards, the customer satisfaction level is more than 90%. It is hoped that an effective, efficient registration system and minimal waiting time will increase patient satisfaction. Quantitative research type with a cross sectional approach. The research sample of patients who registered online and manually was divided into two groups, namely the online registration group and the direct registration group using accidental sampling techniques. The data analysis technique uses the chi square statistical test. From the results of the bivariate analysis it is known that the data analyzed using the independent t-test shows that the average knowledge score in the offline group (Mean= 14.95; SD= 2.87) is greater than the average knowledge score in the group with online registration ( Mean= 11.74; SD= 2.74), and this result is statistically significant (p<0.001). Online registration group and direct registration at Colomadu 1 Community Health Center.

Efficacy and Safety of Minimally Invasive Surgery Techniques in The Treatment of Acute Appendicitis: A literature review.

An appendectomy is often used to treat acute appendicitis, which is characterized by inflammation of the vermiform appendix. Techniques in minimally invasive surgery (MIS), such as endoscopic retrograde appendicitis therapy (ERAT), single-incision laparoscopic surgery (SILS), and laparoscopic appendectomy, have become popular substitutes for open surgery. The purpose of this review is to assess the safety and effectiveness of MIS methods for treating acute appendicitis. A comprehensive analysis of English-language literature from 2019 to 2024 was carried out to evaluate the safety and efficacy of MIS procedures for acute appendicitis. Research that satisfied the inclusion requirements was examined for pertinent information on SILS, ERAT, and laparoscopic appendectomy. Compared to open surgery, laparoscopic appendectomy showed shorter hospital stays, less pain after surgery, and quicker recovery rates. Comparable to traditional laparoscopic methods in terms of effectiveness, SILS and TULS provide potential advantages in terms of cosmesis and patient satisfaction. With faster recovery durations and fewer complications, ERAT showed encouraging results; nonetheless, questions about long-term effectiveness and recurrence rates were raised. In order to treat acute appendicitis, MIS procedures provide viable options that may shorten hospital stays, ease postoperative pain, and increase patient satisfaction. More investigation is necessary to improve patient selection criteria and operative approaches in order to maximize the efficacy of MIS in the therapy of appendicitis.

Racial and Ethnic Concordance Between the Patient and Anesthesia Team and Patients' Satisfaction With Pain Management During Cesarean Delivery.

Racial and ethnic concordance between patients and health care providers increases patient satisfaction but has not been examined in obstetric anesthesia care. This study evaluated the association between racial and ethnic concordance and satisfaction with management of pain during cesarean delivery (PDCD). This was a secondary analysis on a cohort of patients undergoing cesarean deliveries under neuraxial anesthesia that examined PDCD. The outcome was satisfaction, recorded within 48 hours after delivery using the survey question, "Overall, how satisfied are you with the anesthesia care during the C-section as it relates to pain management?" Using a 5-point Likert scale, satisfaction was defined with the answer "very satisfied." Participants were also asked, "If you have another C-section, would you want the same anesthesia team?" The exposure was racial and ethnic concordance between the patient and anesthesia team members (attending with a resident, nurse anesthetist, or fellow) categorized into full concordance, partial concordance, discordance, and missing. Risk factors for satisfaction were identified using a multivariable analysis. Among 403 participants, 305 (78.2%; 95% confidence interval [CI], 73.8-82.1) were "very satisfied," and 358 of 399 (89.7%; 95% CI, 86.3-92.5) "would want the same anesthesia team." Full concordance occurred in 18 (4.5%) cases, partial concordance in 117 (29.0%), discordance in 175 (43.4%), and missing in 93 (23.1%). Satisfaction rate was 88.9% for full concordance, 71.8% for partial concordance, 81.1% for discordance, and 78.5% for missing (P value = .202). In the multivariable analysis, there was insufficient evidence for an association of concordance with satisfaction. Compared to full concordance, partial concordance was associated with a nonsignificant 57% (95% CI, -113 to 91) decrease in the odds of being satisfied, discordance with a 29% (95% CI, -251 to 85) decrease, and missing with a 39% (95% CI, -210 to 88) decrease. Risk factors for not being "very satisfied" were PDCD, anxiety disorders, pregnancy resulting from in vitro fertilization, intravenous medication administration, intrapartum cesarean with extension of labor epidural, having 3 anesthesia team members (instead of 2), and a higher intraoperative blood loss. Our inability to identify an association between concordance and satisfaction is likely due to the high satisfaction rate in our cohort (78.2%), combined with low proportion of full concordance (4.5%). Addressing elements such as PDCD, anxiety, intravenous medication administration, and use of epidural anesthesia for cesarean delivery, and a better understanding of the interplay between concordance and satisfaction are warranted.