Lower Satisfaction Scores Research Articles

Body image in Australians compared to women with breast hypertrophy and US norms

**Background**: The Multidimensional Body-Self Relations Questionnaire (MBSRQ) is a widely used instrument to assess body image. This study aimed to assess MBSRQ Australian norms and test the hypotheses that these would be different to United States norms and to women with breast hypertrophy. Secondary aims were to understand socio-demographic determinants of scores and the change in body image satisfaction associated with breast reduction surgery.**Methods**: Australians ≥18 years were recruited according to the 2016 Census age and sex distribution. Participants completed MBSRQ-Appearance Scales (MBSRQ-AS) and provided socio-demographic information. A comparison was made to previously published US normative scores, to scores of women who had prospectively completed the MBSRQ before and after breast reduction surgery and to women with untreated breast hypertrophy. **Results**: Data for 1016 normative, 209 surgical and 161 breast hypertrophy control participants were analysed. MBSRQ-AS scores for Appearance evaluation and Body areas satisfaction were significantly lower for women than for men. Body mass index (BMI) was a significant predictor across all five scales, with a higher BMI associated with lower scores for appearance and satisfaction. Age and marital status were significant predictors for Body areas satisfaction and Overweight preoccupation. Differences between Australian MBSRQ-AS scale scores and US general population values were significant, with Australian values lower for both sexes. Women with breast hypertrophy had lower scores than population norms but this corrected with breast reduction surgery, with women having scores equivalent to the general population at 12 months post-surgery.**Conclusion**: The Australian population is a distinct population in terms of body image, as measured by the MBSRQ-AS. This normative dataset provides a useful reference for future health-related research in Australian cohorts. Women with breast hypertrophy have a body image that is lower than that of the normal population and this improves with surgery.

Efficacy of ultrasound guided Thoracic Paravertebral block for postoperative analgesia in Patients Undergoing Percutaneous Nephrolithotomy Surgeries

Background: percutaneous nephrolithotomy (PCNL) is a minimally invasive surgery to treat renal stones. Post-operative pain is distressing to the patient due to the injury to the capsule. Efficacy of ultrasound-guided thoracic paravertebral block at multiple level (T9–T10, T10–T11, T11–T12) was evaluated to manage postoperative analgesia in percutaneous nephrolithotomy surgeries.Methodology: a prospective randomized double-blind study of 60 cases of the American Society of Anesthesiologists I–II patients who underwent percutaneous nephrolithotomy were allocated into group P (test) and group N (control). Immediately after surgery, group P were given ultrasound-guided paravertebral block at T9–T10, T10–T11, T11–T12 on operated side using 5 ml of 0.25 % Levobupivacine at each level, while group N did not receive paravertebral block. The patients were assessed for visual analogue scale (VAS), time for first rescue analgesic, number of rescue analgesics in first 24 hrs postoperatively.Results: VAS pain scale shows significant difference between group P (4.2 + 0.8) and group N (5.3 + 1.1) (p < 0.05) at 30 mins, 2, 4, 8 hrs postoperatively. Total opioid consumption at postoperative 2, 6, and 24 hrs was less in group P than group N (P < 0.05). Number of rescue analgesics in first 24 hrs post-surgery in group P was 3.0 ± 0.4, and 4.0 ± 1.1 in group N with statistical significant difference (p = 0.0001). Total dose of opioid consumption (mg) in group P was 110 ± 40.45, and 155 ± 64.87 mg in group N with statistical significant difference (p = 0.002). The group N cases used more opioid than group P, with lower scores for satisfaction (p < 0.05). Analgesic consumption in postoperative 24 hrs of group P was less than that of group N (P = 0.001). Patient satisfaction score was significantly higher in group P than group N (P = 0.0001) in 24 hrs. No nausea and/or vomiting were noted in both groups.Conclusion: ultrasound-guided thoracic paravertebral block had more analgesic, and reduce the requirement of opioids and maintains stable hemodynamics.

Back Pain and Quality of Life 10 Years After Segmental Pedicle Screw Instrumentation for Adolescent Idiopathic Scoliosis.

Comparative cohort study. The aim of the present study was to evaluate pain and health-related quality of life (HRQoL) in surgically managed patients with a minimum follow-up of 10 years compared with patients with untreated adolescent idiopathic scoliosis (AIS) and a healthy control group. Posterior spinal fusion with pedicle screws is the standard treatment for AIS, although it remains unclear whether this procedure results in improved long-term HRQoL compared with untreated patients with AIS. Sixty-four consecutive patients at a minimum follow-up of 10 years, who underwent posterior pedicle screw instrumentation for AIS were prospectively enrolled. Fifty-three (83%) of these patients completed Scoliosis Research Society (SRS) 24 questionnaires, clinical examination, and standing spinal radiographs. Pain and HRQoL were compared with age and sex-matched patients with untreated AIS and healthy individuals. The mean major curve was 57° preoperatively and 15° at the 10-year follow-up. SRS-24 self-image domain score showed a significant improvement from preoperative to 2 years and remained significantly better at the 10-year follow-up ( P < 0.001). Patients fused to L3 or below had lower pain, satisfaction, and total score than patients fused to L2 or above ( P < 0.05), but self-image, function, and activity scores did not differ between groups at 10-year follow-up. Pain, self-image, general activity, and total SRS domains were significantly better at 10-year follow-up in the surgically treated patients as compared with untreated patients (all P < 0.05). Healthy controls had significantly higher total score s than those surgically treated at 10-year follow-ups ( P < 0.001). Patients undergoing segmental pedicle screw instrumentation for AIS maintain high-level HRQoL during a 10-year follow-up. Their HRQoL was significantly better than in the untreated patients with AIS, except for the function domain. However, HRQoL remained at a lower level than in healthy controls.

Posterior Approach Total Hip Arthroplasty Utilizing a Monoblock Dual-Mobility Construct Without Posterior Hip Precautions: A Series of 580 Hips With One Dislocation

BackgroundInstability remains a devastating complication following total hip arthroplasty. Here we describe a mini-posterior approach with a monoblock dual-mobility implant without “traditional posterior hip precautions” yielding excellent results. MethodsThere were 580 consecutive hips in 575 patients who underwent total hip arthroplasty utilizing a monoblock dual-mobility implant and a mini-posterior approach. With this technique, the acetabular component positioning does not rely on tradition intra-operative radiographic abduction and anteversion goals but rather uses patient-specific anatomic landmarks (anterior acetabular rim and, when visible, the transverse acetabular ligament) to set cup position; stability is assessed with a significant, dynamic intra-operative test of range of motion. Patients’ mean age was 64 years (range, 21 to 94), and 53.7% were women. ResultsMean abduction was 48.4° (range, 29° to 68°) and mean anteversion was 24.7° (range, −1° to 51°). Patient Reported Outcomes Measurement Information System scores improved in every measured domain from preoperative to final postoperative visit. There were seven (1.2%) patients who required reoperation, with mean time to reoperation of 1.3 months (range, one to 176 days). Only one patient (0.2%) who had a preoperative history of spinal cord injury and Charcot arthropathy dislocated. ConclusionA posterior approach hip surgeon may want to consider using a monoblock dual-mobility construct and avoidance of traditional posterior hip precautions to achieve early hip stability with an extremely low dislocation rate and high patient satisfaction scores.

Women gynecologists receive lower press ganey patient satisfaction scores in a multi-center cross-sectional study

Women gynecologists receive lower press ganey patient satisfaction scores in a multi-center cross-sectional study

Association of Pharmacy Services with Patient Satisfaction in Public and Private Tertiary Care Hospitals of Rawalpindi And Islamabad

Background: The healthcare system in Pakistan is facing a shortage of human resources and appropriate and sustainable financial measures and therefore fails to provide optimum services to the population of Pakistan. Furthermore, research is limited in the healthcare institutes; therefore, there is a scarcity of information about patient satisfaction with pharmacists and pharmacy services in Pakistan. As evident from the inadequate information in the literature, patients’ opinions about the pharmacy services in Pakistan are important. Therefore, the current study was designed to assess patient satisfaction with the pharmacy performance of the outpatient pharmacy and its variation with socio-demographic characteristics in twin cities of Pakistan (Rawalpindi and Islamabad). Method: A cross-sectional study design was used to assess the patient satisfaction through convenience sampling technique. Minimum sample size of 250 respondents who visit pharmacy department of public and private hospital for pharmaceutical care were included in this study. A pre-validated tool was used to assess the patient satisfaction. Data was clean coded and import into spss for analysis. Descriptive and inferential statistic was applied to calculate frequency, standard deviation, mean deviation and p value to find the association among different domain of patient satisfaction with different demographic characteristics of respondents. Result: Current study shows overall patients were satisfied from pharmacy services provided by government and private hospitals. Furthermore, patient satisfaction towards pharmacist medication advice was very good however patient satisfaction towards pharmacist approach was good while patient perception with pharmacy setting, drug availability and cost were underrated. Significance difference (p ≤ 0.05) was observed in pharmacist’s approach with different gender, age groups and qualification. No significant difference (p ≥ 0.05) was observed in pharmacy setting drug availability and cost with different gender, age groups and marital status of respondents. However, Significance difference (p ≤ 0.05) was observed in pharmacy setting drug availability and cost with different level of education patients with less education had better satisfaction as compared to highly educated respondents. Furthermore, Significance difference (p ≤ 0.05) was observed in pharmacy setting drug availability and cost with occupation. Self-employee and government employee had low satisfaction score while other had better satisfactory score. Significance difference (p ≤ 0.05) was observed in pharmacist’s approach with different gender, age groups and qualification. Females had better satisfactory score as compared to female. Younger age group had better satisfaction as compared to elderly. Patients belong to higher educational groups had better satisfaction toward pharmacist approach as compared to low qualification groups respondents. Furthermore, no significant difference (p ≥ 0.05) was observed in pharmacist’s approach with marital status and number of visits Conclusion: Current study concluded that overall patient had average satisfaction score. Patients shows a better satisfaction towards pharmacist behavior/ way of handling the patients, information provided by pharmacist regarding medicine. Patient had less satisfaction towards the location of pharmacy, Availability and affordability of medicine. Patient shows negative satisfaction regarding waiting area and counselling area at indoor patient pharmacy. It has been observed that educated respondents shows high level of satisfaction towards pharmacist availability and information provided by the pharmacist.

Implementation and Assessment of No Opioid Prescription Strategy at Discharge After Major Urologic Cancer Surgery

Postoperative opioid prescriptions are associated with delayed recovery, perioperative complications, opioid use disorder, and diversion of overprescribed opioids, which places the community at risk of opioid misuse or addiction. To assess a protocol for eliminating postdischarge opioid prescriptions after major urologic cancer surgery. This cohort study of the no opioid prescriptions at discharge after surgery (NOPIOIDS) protocol was conducted between May 2017 and June 2021 at a tertiary referral center. Patients undergoing open or minimally invasive radical cystectomy, radical or partial nephrectomy, and radical prostatectomy were sorted into the control group (usual opioids), the lead-in group (reduced opioids), and the NOPIOIDS group (no opioid prescriptions). The NOPIOIDS group received a preadmission educational handout, postdischarge instructions for using nonopioid analgesics, and no routine opioid prescriptions. The lead-in group received a postdischarge instruction sheet and reduced opioid prescriptions at prescribers' discretion. The control group received opioid prescriptions at prescribers' discretion. Primary outcome measures included rate and dose of opioid prescriptions at discharge and for 30 days postdischarge. Additional outcome measures included patient-reported pain and satisfaction level, unplanned health care utilization, and postoperative complications. Of 647 opioid-naive patients (mean [SD] age, 63.6 [10.0] years; 478 [73.9%] male; 586 [90.6%] White), the rate of opioid prescriptions at discharge for the control, the lead-in, and the NOPIOIDS groups was 80.9% (157 of 194), 57.9% (55 of 95), and 2.2% (8 of 358) (Kruskal-Wallis test of medians: P < .001), and the overall median (IQR) tablets prescribed was 14 (10-20), 4 (0-5.3), and 0 (0-0) per patient in the control, lead-in, and NOPIOIDS groups, respectively (Kruskal-Wallis test of medians: P < .001). In the NOPIOIDS group, median and mean opioid dose was 0 tablets for all procedure types, with the exception of kidney procedures (mean [SD], 0.5 [1.7] tablets). Patient-reported pain surveys were received from 358 patients (72.6%) in the NOPIOIDS group, demonstrating low pain scores (mean [SD], 2.5 [0.86]) and high satisfaction scores (mean [SD], 86.6 [3.8]). There was no increase in postoperative complications in the group with no opioid prescriptions. This perioperative protocol, with emphasis on nonopioid alternatives and patient instructions, may be safe and effective in nearly eliminating the need for opioid prescriptions after major abdominopelvic cancer surgery without adversely affecting pain control, complications, or recovery.

FIVE- AND TEN-YEAR FOLLOW-UP OF UNICOMPARTMENTAL KNEE ARTHROPLASTIES IN OBESE PATIENTS

Due to shorter hospital stays and faster patient rehabilitation Unicompartmental Knee Replacements (UKR) are now considered more cost effective than Total Knee Joint Replacements (TKJR). Obesity however, has long been thought of as a relative contraindication to UKR due to an unproven theoretical concern of early loosening.This study is a retrospective review of patient reported outcome scores and revision rates of all UKR with recorded BMI performed by the Canterbury District Health Board (CDHB) from January 2011 and September 2021. Patient reported outcome scores were taken preoperatively, at 6 months, 1 year, 5 years and 10 years post operatively. These included WOMAC, Oxford, HAAS, UCLA, WHOQOL, normality, pain and patient satisfaction. 873 patients had functional scores recorded at 5 years and 164 patients had scores recorded at 10 years. Further sub-group analysis was performed based on patient BMI of &lt;25, 25-30, 30-35 and &gt;35. Revision data was available for 2377 UKRs performed in Christchurch during this period.Both obese (BMI &gt;30) and non-obese (BMI &lt;30) patients had significantly improved post-operative scores compared to preoperative. Pre-operatively obese patients had significantly lower functional scores except for pain and UCLA. All functional scores were lower in obese patients at 5 years but this did not meet minimum clinical difference. At 10 years, there was significantly lower HAAS, satisfaction and WOMAC scores for obese patients but no difference in Oxford, normality, WHOQOL, UCLA and pain scores. There was no significant difference in the improvement from pre-operative scores between obese and non-obese patients. All cause revision rate for obese patients at 10 years was 0.69 per 100 observed component years compared to 0.76 in non-obese. This was not statistically significant.Our study proves that UKR is an excellent option in obese patients with post-operative improvement in functional scores and 10 year survivorship equivalent to non-obese patients.

Prevalence of erectile dysfunction in Thai scleroderma patients and associated factors.

Erectile dysfunction (ED) has been reported among patients with systemic sclerosis (SSc) and primarily limited cutaneous SSc in Caucasians. While there is no data on ED among Thais in whom the diffuse cutaneous SSc subset is common. We aimed to estimate the prevalence of ED among Thais with SSc, evaluate its severity, and determine the associated factors. We did a cross-sectional study among adult Thai male SSc patients. All eligible patients: a) completed the IIEF-15 questionnaire by themselves; b) underwent a genital examination by an experienced urologist to evaluate skin tightness of the penis, scrotum, and phimosis; and, c) were evaluated for Erection Hardness Score. A total of 60 male SSc patients were included. The respective mean age and median disease duration was 54.8±7.2 years and 3.1 years (IQR 1.2-7.2). The definition of ED was fulfilled in 53 cases for a prevalence of 88.3% (95%CI 77.4-95.2), while 65% had severe ED, and none had skin tightness of the genitalia. Eight cases had acquired phimosis, and all were in the ED group. The patients with ED vs. those without ED had significantly lower scores for orgasm, sexual desire, and intercourse satisfaction, and trended to be older, have more severe skin tightness and have higher BMI. ED is a common problem in men with SSc and is mainly categorized as severe. The severity of SSc might increase the risk of developing ED. We found phimosis was a common genital abnormality co-occurring with ED in SSc.

Frailty and the psychosocial components of the edmonton frail scale are most associated with patient experience in older kidney transplant candidates - a secondary analysis within the kidney transplantation in older people (KTOP) study.

Older people with end-stage kidney disease (ESKD) are vulnerable to frailty, which impacts on clinical and experiential outcomes. With kidney transplantation in older people increasing, a better understanding of patient experiences is necessary for guiding decision making. The Kidney Transplantation in Older People (KTOP):impact of frailty on outcomes study aims to explore this. We present a secondary analysis of the Edmonton Frail Scale (EFS) and its relationship with patient experience scores. The KTOP study is a single centre, prospective study, which began in October 2019. All ESKD patients aged ≥60 considered for transplantation at Imperial College Renal and Transplant Centre were eligible. Frailty was assessed using the EFS and 5 questionnaires assessed patient experience and quality of life (QoL) (Short Form-12(v2), Palliative Care Outcome Scale-Symptoms Renal, Depression Patient Health Questionnaire-9, Illness Intrusiveness Ratings Scale, Renal Treatment Satisfaction Questionnaire). The EFS was divided into 4 subdomains (psychosocial, physical function, medical status, and general health) and then compared with the questionnaire scores. 210 patients have been recruited (aged 60-78), 186 of whom completed EFS assessments. 118 (63.4%) participants were not frail, 36 (19.4%) vulnerable, and 32 (17.2%) were frail. Worse frailty scores were associated with poorer patient experience and QoL scores across all questionnaires. Severe deficits in the EFS psychosocial subdomain showed a statistically significant association with higher depression screen scores (coefficient 4.9, 95% CI 3.22 to 6.59), lower physical (coefficient -4.35, 95% CI -7.59 to -1.12) and mental function scores (coefficient -8.33, 95% CI -11.77 to -4.88) from the Short Form-12(v2), and lower renal treatment satisfaction scores (coefficient -5.54, 95% CI -10.70 to -0.37). Deficits in the physical function and medical status EFS subdomians showed some association with patient experience scores. In the KTOP study cohort at recruitment vulnerable and frail candidates reported worse QoL and patient experiences. Severe deficits in the psychosocial subdomains of the EFS showed a strong association with patient experience and QoL, whilst physical function and medical status deficits showed a lesser association. This has highlighted specific EFS domains that may be suitable for targeted interventions to improve experiences and optimise outcomes.

The Effect of Social Deprivation on Patient Satisfaction in Otolaryngology Clinics.

Multiple factors have been associated with lower satisfaction scores. We hypothesize that patients with a more deprived socioeconomic status will have different patient satisfaction scores than patients of higher socioeconomic status. We reviewed Press Ganey satisfaction scores for new, outpatient visits between January 1, 2014, and December 31, 2018. Due to the high ceiling effects of the survey, "satisfaction" was defined as achieving a perfect score of 100. We determined social deprivation using the 2015 Area Deprivation Index (ADI) which serves as a proxy for socioeconomic status derived from zip codes. Patient satisfaction was defined as a binary variable. Univariate and multivariate binary logistic regression analyses were used to identify factors correlated with patient satisfaction. There were 3239 unique new patients with completed surveys. Univariate analysis demonstrated decreased odds of achieving satisfaction for both the Total Score and Provider Sub-Score for each decile increase in ADI (OR 0.94; CI = 0.908-0.981; P = .003 and OR 0.94; CI = 0.91-0.98; P = .002 respectively). Multivariate analysis revealed the odds for reporting satisfaction for each decile increase in ADI were 0.96 for Total Score (CI = 0.921-0.998; P = .038) and 0.96 for Provider Sub-Score (CI = 0.92-0.993; P = .019). Patients in the most deprived quartile, compared to the least deprived, were significantly less likely to be satisfied with their care for both Total Score (OR 0.70; CI = 0.564-0.865; P = .001) and Provider Sub-Score (OR 0.69; CI = 0.558-0.852; P = .001). Increased social deprivation was an independent predictor of lower patient satisfaction in otolaryngology outpatients using the Press Ganey survey. This non-modifiable outcome should be taken into consideration when evaluating patient satisfaction scores and offers further support to the need of addressing and improving healthcare discrepancies in the field of otolaryngology. Level 3.

Job Satisfaction Among Nurses Working in King Abdul Aziz Medical City Primary Health Care Centers: A Cross-Sectional Study.

Background Job satisfaction in the nursing field directly impacts the quality of patient care. However, increased work demand puts nurses at a higher risk of job dissatisfaction, which can, in turn, affect their work performance. This study aimed to measure job satisfaction among nurses working in National Guard Primary Healthcare Centers (PHCs) and to determine the different sources of pressure at their workplace. Methods A cross-sectional quantitative study was conducted among nurses working in the National Guard PHCs in the Makkah region, Saudi Arabia, in 2022. A validated questionnaire from previous literature was used to evaluate nurses' job satisfaction. Results A total of 77 nurses completed the questionnaire, with an overall response rate of 89.5%. While 58% (n=45) of nurses were satisfied, 42% (n=32) were dissatisfied. Approximately half the participants were dissatisfied with the rate of payment (49%, n=38), working hours (47%, n=36), and future chances of promotion (44%, n=34). Moreover, 51% (n=39) of nurses attributed considerable pressure to staff shortage and 44% (n=34) to workload. Furthermore, lower mean satisfaction scores in nurses were significantly associated with their intention to leave their current center (p-value= 0.06). In addition, reduced satisfaction scores were frequently observed among females, singles, those who finished their first nurse training five to 10 years ago, those who had a previous experience outside the Ministry of National Guard Health Affairs (MNGHA), those who had only one to five service years, and the ones who belonged to centers that did not have clearly stated standards and policies for nursing practice. However, these associations were statistically not significant. Conclusion Results indicate that nurses' job satisfaction should be improved to decrease nurses' intention to leave their workplace and maintain their optimum performance in patient care. This can be achieved by addressing the sources of dissatisfaction and pressure at work.

Acceptable clinical outcomes despite high reoperation rate at minimum 12-month follow-up after concomitant arthroscopically assisted anterior cruciate ligament reconstruction and medial meniscal allograft transplantation

BackgroundSingle-stage medial meniscus allograft transplantation (MAT) with concomitant anterior cruciate ligament reconstruction (ACLR) is a technically challenging procedure for management of knee pain and instability in younger patients, but clinical and functional outcomes data are sparse. The purpose of this study was to assess surgical and patient-reported outcomes following concomitant ACLR and medial MAT.MethodsWe conducted a retrospective case series of patients who underwent medial MAT with concomitant primary or revision ACLR at our institution from 2010 to 2021 and had minimum 12-month follow-up. Complications, reoperations, visual analog scale (VAS) pain, satisfaction, Lysholm score, return to sport, and return to work outcomes were assessed. Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference, Pain Intensity, and Physical Function Scores were used to measure patients’ functional status relative to the US population. P-values < 0.05 were considered significant.ResultsThe cohort consisted of 17 knees of 16 individual patients. The cohort was majority male (82.4%) with mean age of 31.9 years (range 19–49 years) and mean body mass index (BMI) of 27.9 kg/m2 (range 22.5–53.3 kg/m2). Mean follow-up time was 56.8 months (range 13–106 months). Most patients underwent revision ACLR (64.7%). The 1-year reoperation rate was high (23.5%), with two patients (11.8%) tearing their meniscus graft. Patient-reported outcomes indicated low VAS pain (mean 2.2), high satisfaction (mean 77.9%), and fair Lysholm score (mean 81.1). Return to work rate was high (92.9%), while return to sport rate was low (42.9%). Postoperative PROMIS scores were comparable or superior to the national average and correlated significantly with patient satisfaction (p < 0.05).ConclusionsThe concomitant ACLR and MAT procedure is associated with excellent knee pain and functional outcomes and high rate of return to work after surgery, though the 1-year reoperation rate is high and rate of return to sport is low.Level of evidence: IV.

Burnout: A Call to Action From the AUA Workforce Workgroup.

We hypothesize burnout has failed to improve and certain demographics may be disproportionately affected. The AUA Workforce Workgroup examined work from the annual AUA Census over the past several years. Particular to this study, relevant burnout-related data were examined from the past 5 years. In 2021, 36.7% of urologists reported burnout compared to 36.2% in 2016. Burnout in men decreased from 36.3% to 35.2%, but increased in women from 35.3% to 49.2%. When examined by age, the largest increases in burnout were seen in those <45 years old, increasing from 37.9% to 44.8%, followed by 45-54 years old, increasing from 43.4% to 44.6%. When asked about the effect of COVID-19 on burnout, 54% of urologists didn't feel COVID-19 impacted burnout. Beyond burnout, only 25.0% of men and 4.6% of women reported no conflict between work and personal responsibilities, while 25.7% of men and 44.7% of women resolved these conflicts in favor of work or were unable to resolve them. Of respondents, 22.5% of men and 37.1% of women were "dissatisfied" with work-life balance. Similarly, 33.6% of men reported their work schedule does not leave enough time for personal/family life, compared to 57.5% of women. Overall, urologists have higher burnout now when compared to 2016. The gender discrepancy has vastly widened with women experiencing burnout at an increased rate of 14% compared to 2016, while burnout in men decreased by 1%. Burnout has increased the most in those <45 years old. Further action is needed to substantiate the causes of burnout.

Customer encounter satisfaction and narrative force: an investigation of user-generated content on TripAdvisor

ABSTRACT Customer satisfaction research is often undertaken quantitatively employing multi-item standard questionnaires. Instead, this study seeks to understand how restaurant customers themselves articulate their encounter satisfaction experiences from the user-generated content (UGC) reviews they post on TripAdvisor. UGC reviews for all fine dining restaurants in Stockholm are collected. Leximancer and Diction software are used in the analyses to determine the concepts and themes used by UGC reviewers to express their encounter satisfaction and to measure narrative force among customers expressing different levels of restaurant encounter satisfaction. Results indicate that customers who provide different satisfaction scores on TripAdvisor also post UGC that exhibits divergencies in the concepts and themes they use to communicate their experience. Additionally, narrative force is stronger among customers providing reviews exhibiting moderate and low satisfaction scores.

Waiting time and patients' satisfaction in the emergency department in Taif city, Saudi Arabia

Background: Patients' satisfaction in emergency departments (EDs) could be improved by providing estimates of the expected waiting time. Aim: The aim of this study was to determine waiting time and assess patients' satisfaction in EDs. Setting and Design: A descriptive, cross-sectional study was carried out in Taif city included patients who come to EDs of three main hospitals throughout the period from mid-August to mid-September 2022 if they aged from 18 to 65 years. Materials and Methods: Data were collected through a pretested Arabic version of the Brief Emergency Department Patient Satisfaction Scale questionnaire. Statistical Analysis: Data were entered into the Statistical Package for the Social Sciences (SPSS) software version 26 for Windows. Results: The study included 612 patients. Almost a quarter (23%) aged 25–34 years. Regarding satisfaction of patients with ED, the highest score was observed concerning physicians' care (4.31 ± 0.88) whereas the lowest satisfaction score was reported regarding arrival in reception (AIR) (3.57 ± 1.08). The highest score was observed among those who attended King Faisal Medical Complex (4.19 ± 0.74), whereas the lowest score was observed among those who attended Alhada Armed Forces Hospital (3.75 ± 0.91), P &lt; 0.001. The highest score of satisfaction was observed among patients aged 65 years/above (4.08 ± 0.76), P = 0.041. Non-Saudi patients were more likely to be satisfied compared to Saudi patients (4.33 ± 0.77 vs. 3.89 ± 0.87), P &lt; 0.001. Patients who did not read/write were more likely to be satisfied compared to educated patients (4.23 ± 0.83 vs. 3.89 ± 0.87), P = 0.001. The waiting time exceeded 2 h among 13.9% of patients. With decreasing the waiting time, the patients' satisfaction with ED was increasing, P &lt; 0.001. Conclusion: The overall patients' satisfaction with ED was high; it was lowest regarding AIR. In addition, longer waiting time was associated with patients' dissatisfaction.

Does the Satisfaction of ERP and Accounting Systems Users Differ?

This article aimed to check whether satisfaction, one of the measures of information systems’ effectiveness, varies among users of different Accounting Information Systems (AIS) types. The authors used End-User Computing Satisfaction (EUCS) questionnaire, and based on 248 responses found that ERP users scored higher satisfaction than accounting systems users only in the timeliness area. For both groups of respondents, ease of use had the lowest satisfaction scores. Based on the results, there were no significant differences in satisfaction between the ERP and accounting systems users. Additional differences between AIS users’ satisfaction scores were presented.

Racial disparities in birth satisfaction among nulliparous women

Given the known racial disparities in perinatal outcomes, we explored birth satisfaction scores among women of racial and ethnic minorities after implementing Spinning Babies® at our institution. This is a secondary analysis of a prospective cohort study investigating a delivery intervention called Spinning Babies®. Women who delivered between 6/2021 and 6/2022 received either Spinning Babies® labor techniques or standard care. Inclusion criteria were nulliparity, vertex presentation, livebirth, singleton, and gestational age > 37 weeks. We excluded precipitous deliveries (< 3 hours) and contraindications to labor. Consented subjects were asked postpartum to complete a demographic survey and the Birth Satisfaction Scale–Revised. Stress experienced during labor, personal attributes, and quality of care provision are 3 validated sub-measures contributing to the total birth satisfaction score that were further analyzed. Labor characteristics were obtained from the medical record. Of the 504 subjects with complete data, there were racial/ethnic differences in maternal age and social support (Table 1). Asian women had a significantly lower total satisfaction score compared to White, Hispanic, and Black women, though this difference was no longer significant when adjusted for complicating labor factors (Figure 1). There was a significant difference in personal attributes for Hispanic and Asian women compared to Black and White women, and this difference persisted after adjustment. There were no significant differences by racial group in stress experienced and quality of care domains. Women of racial minority groups experienced more negative personal attributes, a score capturing anxiety and lack of control, even when controlling for factors such as induction, prolonged labor or cesarean delivery. Understanding the causes of increased anxiety and lack of control in racial minority groups can help target ways to alleviate these negative experiences and promote improved maternal outcomes for all women.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Patient satisfaction after multiple revision surgeries for adult spinal deformity.

Revision surgery is often necessary for adult spinal deformity (ASD) patients. Satisfaction with management is an important component of health-related quality of life. The authors hypothesized that patients who underwent multiple revision surgeries following ASD correction would exhibit lower self-reported satisfaction scores. This was a retrospective cohort study of 668 patients who underwent ASD surgery and were eligible for a minimum 2-year follow-up. Visits were stratified by occurrence prior to the index surgery (period 0), after the index surgery only (period 1), after the first revision only (period 2), and after the second revision only (period 3). Patients were further stratified by prior spine surgery before their index surgery. Scoliosis Research Society-22 (SRS-22r) health-related quality-of-life satisfaction subscore and total satisfaction scores were evaluated at all periods using multiple linear regression and adjustment for age, sex, and Charlson Comorbidity Index. In total, 46.6% of the study patients had undergone prior spine surgery before their index surgery. The overall revision rate was 21.3%. Among patients with no spine surgery prior to the index surgery, SRS-22r satisfaction scores increased from period 0 to 1 (from 2.8 to 4.3, p < 0.0001), decreased after one revision from period 1 to 2 (4.3 to 3.9, p = 0.0004), and decreased further after a second revision from period 2 to 3 (3.9 to 3.3, p = 0.0437). Among patients with spine surgery prior to the index procedure, SRS-22r satisfaction increased from period 0 to 1 (2.8 to 4.2, p < 0.0001) and decreased from period 1 to 2 (4.2 to 3.8, p = 0.0011). No differences in follow-up time from last surgery were observed (all p > 0.3). Among patients with multiple revisions, 40% experienced rod fracture, 40% proximal junctional kyphosis, and 33% pseudarthrosis. Among patients undergoing ASD surgery, revision surgery is associated with decreased satisfaction, and multiple revisions are associated with additive detriment to satisfaction among patients initially undergoing primary surgery. These findings have direct implications for preoperative patient counseling and establishment of postoperative expectations.

Привлекательность гибких и цифровых форм занятости для Digital поколения

Digitalization and flexibilization of employment is the main direction of labor market transformation. The study aims to assess the extent of the spread and attractiveness of flexible and digital forms of employment. The key objective is to conduct a comparative analysis of employment formats in the groups of representatives of X, Y, and Z generations. The empirical base is formed on the basis of a regional sociological survey. The object of the study is the able-bodied population of the Sverdlovsk region with work experience of at least three months during the previous year at the time of the survey. The results showed a high prevalence of flexible working hours. 18.7% of respondents independently regulate the time of start, breaks and end of work at their main job, and 60.8% at an additional job. The level of such employment is 1.9 times more common among representatives of the digital generation. The frequency of work in digital forms of employment is also higher among representatives of the digital generation. Working in the flexible segment of employment on the grounds of "flexible working hours" increases the probability of job satisfaction by 25.4%; working in remote and hybrid forms - by 24.3%. The heterogeneity of the flexible employment segment in terms of well-being was revealed. Those working in a non-digital flexible format show low job satisfaction scores. It is proposed to distinguish two segments: non-digital and digital, which combines digital flexible employment and digital flexible self-employment. Flexible digital forms of employment are the most attractive for the digital generation. The introduction of such practices of organizing social and labor relations in the activities of Russian companies can be considered as a tool for attracting and retaining employees of the digital generation, allowing to ensure the competitiveness of organizations.