Patient Perspectives Research Articles

Uncovering patient dissatisfaction with Healthcare Services at a tertiary hospital in Uganda: Patient perspective in a descriptive cross-sectional study

Introduction: Patient satisfaction is a widely recognized standard for assessing the effectiveness of healthcare services in hospitals. This study aimed to discover factors associated with patient dissatisfaction with healthcare services offered at Masaka Regional Referral Hospital, Masaka District-Uganda. Methods: A descriptive cross-sectional study that employed quantitative data collection methods was conducted between February and March 2024. Using Systematic random sampling, 384 study participants were included. Data was collected using an interviewer-administered questionnaire analyzed and presented using Microsoft Excel 2019 Version. Results: Most respondents 120 (31.25%) were aged between 31-40 years, 56.77% were females, 67.71 were married or cohabiting with the majority of respondents in low-income class and, 194(50.53%) having a monthly income of less than 100,000Ug. Shs. As (53.13%) were unemployed, 221 (57.55%) were rural residents, and the majority 248(65%) traveled long distances of greater than 10 kilometers to reach the Hospital. The majority of respondents 298(77.61%) disagreed that there was an adequate seating area, the majority of respondents 304(79.17%) waited for long hours before getting services and 204(53.12%) disagreed upon being given adequate time and information regarding their health and 174(45.31%) reported that HCWs were rude to them. Conclusions: Majority of respondents were dissatisfied with the services they had received at the hospital as most of them 208(54.17%) rated the services provided as poor. Therefore, there should be Implementation of targeted Interventions to address socio-demographic disparities, Enhance Patient-Centered Care and Communication Practices, optimization of health institutional practices to improve service delivery, and further research studies are recommended to better understand the gaps in patient satisfaction with healthcare services in Uganda.

Stressors during the prodromal phase of major depressive episode (CHR-D).

Early recognition and indicated prevention is a promising approach to decrease the incidence of Major depressive episodes (MDE), targeting the patients during their clinical high-risk state of MDE (CHR-D). The identification of a set of stressors at the CHR-D increases the success of indicated prevention with personalized early interventions. The study evaluated stressors in the early phase of depression, developed on the basis of a patient survey on stressors. Sixty-eight inpatients (ICD10: F3x.xx) with a reported high risk state for major depressive episode (CHR-D) were included in the current study. Stressors during CHR-D were retrospectively explored using a semi-structured clinical interview supplemented by open-ended questions. A qualitative explorative content analysis was provided to identify a pattern of stressors during the prodromal phase of the patients, based on the patient's perspective. A frequency analysis was performed for the evaluation of the prevalence of reported source of stress. All patients reported stressors in the prodromal phase of depression. Results demonstrates that patients with depressive disorder typically report multiple stressors, with the most common number being four. First, 18 stressors-groups were identified during coding. Interpersonal conflicts and disappointments in close relationships were most frequently reported stressors during the prodromal phase at 44.1%. The second most frequent stressor mentioned was the high qualitative or quantitative demands at work (38.2%). The third frequent source of stress was changes in close relationships and in family relationships (33.8%). Based on the categories of stressors described in the patient survey during the prodromal phase we suggested a model of stressors in CHR-D during the prodromal phase of the MDE. The identification of a set of stressors at the early stage of MDE may increase opportunities for early intervention. In everyday clinical practice, preventive psychiatry needs clinical and adapted instruments for recording stressors in today's society. This knowledge is necessary in order to develop precisely indicated prevention for depressive disorders.

Remote Healthcare: Development of a Centralized Patient Monitoring System for Ward Patients.

Patient monitoring is an essential practice in healthcare settings to assess well-being and medical conditions. This study proposes a central patient monitoring system enabling healthcare personnel to have a comprehensive perspective of multiple patients' health state from a central location. The proposed prototype enables healthcare providers to detect and respond to changes in patients' condition efficiently. The project contains multiple patient monitoring units with each measuring temperature, ECG, SpO2, and heart rate along with a display on a centralized screen. The hardware of monitors is placed at each patient bed connected with all the patients and the result of each patient can be seen from the general ward counter. Different sensors are used to design monitoring units and are connected with node MCU through different pin connections. Node MCU sends the information gathered from sensors to the Raspberry pi unit using Wi-Fi. The real-time data of patients are being displayed and saved using server “thing speak”. There are different options on the server window to switch between different patients’ real time results to monitor them. The proposed prototype uses computer technology to monitor the vital signs of multiple patients on a single monitor from a centralized location using internet which may eventually reduce the time and workload of medical staff leading to improved patient care.

Supporting primary care practitioners to promote dementia risk reduction in Australian general practice: outcomes of a cross-sectional, non-randomised implementation pilot study.

Background Primary care practitioners worldwide are urged to promote dementia risk reduction as part of preventive care. To facilitate this in Australian primary care, we developed the Umbrella intervention, comprising a waiting room survey and patient information cards for use in consultations. Educational and relational strategies were employed to mitigate implementation barriers. Methods In this cross-sectional, non-randomised implementation study within the South East Melbourne Primary Health Network, we employed mixed-methods outcome evaluation. Antecedent outcomes (acceptability, appropriateness, and feasibility) and actual outcomes (adoption, penetration, and fidelity) were assessed from the perspective of primary care practitioners and patients. Results Five practices piloted the intervention and implementation strategies, including 16 primary care practitioners engaging with 159 patients. The Umbrella intervention was deemed acceptable, appropriate, and feasible, but penetration was limited. Approximately half of eligible primary care practitioners used the intervention, with moderate fidelity. Engagement with implementation strategies was similarly limited. While most strategies were well-received, improvements in online peer discussions and staff readiness were desired. Conclusions The Umbrella intervention is a viable approach to promoting dementia risk reduction in Australian general practice, supported by educational and relational strategies. Stakeholder-informed refinements to enhance uptake are recommended before advancing to a definitive trial.

Intermittent Fasting on Cancer: An Update

Intermittent fasting (IF) has garnered considerable interest as a dietary intervention with potential therapeutic benefits for various medical conditions, particularly cancer. This review provides a comprehensive update on the effects of IF on cancer, emphasizing its impact on metabolic, hormonal, and cellular mechanisms. IF has been shown to improve glycemic control and reduce liver enzyme levels in patients with non-alcoholic fatty liver disease (NAFLD), suggesting a reduction in liver cancer risk. It can significantly reduce tumor growth and enhance apoptosis in breast cancer by lowering insulin-like growth factor 1 (IGF-1) levels. In patients with polycystic ovary syndrome (PCOS), IF offers superior metabolic and hormonal regulation, potentially lowering cancer risk. IF mitigates chemotherapy-related toxicities, thereby improving patient quality of life. It modulates metabolic pathways, reduces inflammation, and enhances drug delivery in cancer therapy. Personalized dietary strategies, including IF and ketogenic diets, are crucial in cancer care. IF also benefits liver conditions by reducing inflammation and fibrosis, preventing the progression to hepatocellular carcinoma. In obesity-induced triple-negative breast cancer, IF disrupts critical processes involved in cancer progression. In addition, aligning IF with circadian rhythms has shown promise in treating lung cancer. Patient perspectives reveal that IF is feasible and acceptable, improving treatment adherence and quality of life. Overall, IF represents a multifaceted approach to cancer prevention and therapy. This review advocates for further research to establish standardized guidelines for implementing IF in oncology, aiming to develop more effective and holistic cancer treatment strategies.

Exploratory Factor Analysis of a Patient-Facing PCBH Adherence Measure: The PPAQ-Patient.

Model adherence indicates the degree to which a program or intervention is delivered as intended. In integrated primary care, where mental health services are embedded into primary care clinics, appraisal of model adherence provides insight into whether these services align with key features of this unique practice environment (e.g., brief, interdisciplinary care). To date, such evaluations have emphasized system and provider factors. This study is a preliminary evaluation of whether a novel patient-facing measure, the Primary Care Behavioral Health Provider Adherence Questionnaire-Patient Version (PPAQ-Patient), can provide insight into adherence to the Primary Care Behavioral Health (PCBH) model of integrated primary care. Survey data were collected from 281 veterans who received PCBH care. Exploratory factor analyses evaluated the data structure. Results suggest that 19 items spanning three temporally-referenced subscales may feasibly capture patient perspectives on PCBH adherence at various stages of treatment. Future work is needed to refine the measure.

Understanding Perceptions and Experiences on Acceptability of Oral Ivermectin, Topical Permethrin, and their Combination in the Treatment of Adult Filipino Patients with Scabies: A Multiple Case Study.

Oral ivermectin, a broad-spectrum anti-parasitic drug, alone or in combination with permethrin, may be a cheaper and more convenient alternative drug to topical permethrin alone in the treatment of classic scabies. There are no previous studies on the treatment acceptability of the three interventions among individual patients with scabies in the Philippines.The purpose of this study was to understand the experiences and perceptions on treatment acceptability for oral ivermectin, topical permethrin or combination treatment among patients with scabies using the multiple-case study approach. We conducted a qualitative multiple case study among adult Filipino patients with classic scabies who were prescribed oral ivermectin, topical permethrin or its combination at a government tertiary hospital dermatology outpatient clinic from December 2022 to September 2023. Semi-structured interviews were used as the primary source of data and analyzed together with chart reviews, Dermatology Life Quality Index (DLQI) scores, and clinical images. Interviews were transcribed, coded, and triangulated with other secondary data. A three-person research team employed a reflexive and iterative process of familiarization, coding, and thematic analysis using a modified Theoretical Framework of Acceptability (TFA) to generate case descriptions, within-case analyses, and cross-case syntheses. The acceptability of scabies treatments (permethrin, ivermectin, and combination therapy) was generally positive. Permethrin, used in three patient cases, was generally perceived as effective but itch relief varied. The burden of whole-body application of permethrin was context-dependent, influenced by living arrangements and family support. Perceived affordability of permethrin was linked to socioeconomic status. Ivermectin, used by one patient case, was perceived as highly effective with no side effects. Its single dose use did not interfere with patient routine. Combination therapy was also considered effective but potential antagonistic effects and the cost of adding permethrin made it less preferred. Reluctance in taking oral pills was noted. All patients valued medical advice and deferred to their physicians for treatment decisions. All three treatment options were considered effective and safe. Patients generally preferred permethrin over oral ivermectin due to its topical nature and perceived lower side effects. However, affordability and logistical challenges, especially for large households and low-income families, were noted with permethrin. Oral ivermectin elicited hesitation due to its controversial role in COVID-19 and veterinary use. Concerns about added costs and potential antagonism in combination therapy were raised. Despite these considerations, patients ultimately relied on physicians for treatment decisions. This study underscores the importance of understanding patient perspectives, experiences, and the patient-physician relationship in choosing scabies interventions. Addressing patient concerns, providing education, and ensuring ease of use and affordability can enhance treatment acceptability and adherence for better outcomes.

Patient perspectives on AI: a pilot study comparing large language model and physician-generated responses to routine cervical spine surgery questions

Aim: The purpose of this study was to elucidate differences in patient perspectives on large language model (LLM) vs. physician-generated responses to frequently asked questions about anterior cervical discectomy and fusion (ACDF) surgery. Methods: This cross-sectional study had three phases: In phase 1, we generated 10 common questions about ACDF surgery using ChatGPT-3.5, ChatGPT-4.0, and Google search. Phase 2 involved obtaining answers to these questions from two spine surgeons, ChatGPT-3.5, and Gemini. In phase 3, we recruited 5 cervical spine surgery patients and 5 age-matched controls to assess the clarity and completeness of the responses. Results: LLM-generated responses were significantly shorter, on average, than physician-generated responses (30.0 +/- 23.5 vs. 153.7 +/- 86.7 words, P < 0.001). Study participants were more likely to rate LLM-generated responses with more positive clarity ratings (H = 6.25, P = 0.012), with no significant difference in completeness ratings (H = 0.695, P = 0.404). On an individual question basis, there were no significant differences in ratings given to LLM vs. physician-generated responses. Compared with age-matched controls, cervical spine surgery patients were more likely to rate physician-generated responses as higher in clarity (H = 6.42, P = 0.011) and completeness (H = 7.65, P = 0.006). Conclusion: Despite a small sample size, our findings indicate that LLMs offer comparable, and occasionally preferred, information in terms of clarity and comprehensiveness of responses to common ACDF questions. It is particularly striking that ratings were similar, considering LLM-generated responses were, on average, 80% shorter than physician responses. Further studies are needed to determine how LLMs can be integrated into spine surgery education in the future.

Experiences and perceptions of patients with cancer receiving home-based chemotherapy: a qualitative systematic review protocol

BackgroundHome-based chemotherapy (HBC) has emerged as a standard option for treating various types of cancer, primarily to decrease the waiting time for treatment. As HBC gains more recognition, ongoing research is delving into the experiences of patients with cancer who receive chemotherapy in a home setting or chemotherapy closer to home. Understanding these experiences is vital for the use of chemotherapy delivery outside the traditional hospital environments. This review aims to synthesize and critically appraise qualitative studies that investigate the experience and perspectives of patients with cancer who received parenteral chemotherapy administration in home settings. Findings will be used to develop evidence-based policies to support home-based care models.MethodsThis review will follow JBI methods for systematic reviews of qualitative evidence. The databases for searching will include MEDLINE (PubMed), CINAHL (EBSCOhost), PsycINFO (EBSCOhost), ProQuest Health and Medical Collection, two Chinese databases, CNKI and Wanfang, and one Thai database, ThaiJO. Studies published in English, Chinese, and Thai will be considered for inclusion. Two reviewers will independently undertake study selection, data extraction, and critical appraisal of the methodological quality of studies. The synthesized findings will be assessed using the ConQual approach.DiscussionThe synthesis of qualitative studies on this topic will provide insights into the nuanced and varied experiences of patients receiving chemotherapy within the comfort of their homes. The review will also provide evidence-based recommendations to policymakers and healthcare administrators, to support the implementation of HBC for patients.Systematic review registrationSystematic review registration: PROSPERO CRD42024500476.

Care-seeking pathways and treatment practices for snakebite in Odisha, India

PurposeSnakebites represent a pressing global public health concern, with India shouldering a disproportionate burden and often dubbed the "snakebite capital." Traditional and spiritual healing methods prevail in India, yet their efficacy and potential adverse health consequences warrant investigation. This study seeks to elucidate the perspectives of healthcare providers and caretakers regarding snakebite treatment practices, with a specific emphasis on traditional healing modalities.MethodsAn exploratory study was conducted among ten healthcare providers–five traditional and five modern treatment providers, two snake trappers/catchers and 120 snakebite victims or their caretakers across three districts of Odisha, India. Data were collected through in-depth interviews and analysed using content analysis.ResultsThe analysis revealed five main categories: various snakebite treatment practices, care-seeking pathways of victims, perspectives of patients and caretakers on treatment, traditional healers’ views on modern treatment, and allopathic doctors’ views on traditional treatment. Treatment practices observed included allopathic treatment, cold treatment, spiritual healing practices at temples, brass plate treatment, mantra enchanting, herbal treatment, and self-medication. Reasons for treatment delay included strong community beliefs in traditional healing, lack of control over irrational treatment by traditional healers, suboptimal care at primary and secondary healthcare facilities, and poor community literacy on snakebites.ConclusionsThe study emphasizes the need for improved snakebite preparedness strategies, community literacy, active involvement in prevention programs, and strong political commitment to control irrational treatment practices.

Nurse-patient communication experiences from the perspective of Iranian cancer patients in an outpatient oncology clinic: a qualitative study

BackgroundEffective communication between nurses and cancer patients is essential for patient satisfaction and optimal health outcomes in outpatient oncology settings. This study explored the communication experiences of Iranian cancer patients receiving outpatient treatment.MethodsSemi-structured interviews were conducted with 14 adult cancer patients undergoing chemotherapy, radiotherapy, or follow-up treatment at an outpatient clinic in Urmia, Iran. Qualitative content analysis was used to analyze the data. This study adhered to the standards set forth in the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.ResultsThree main categories emerged from the interviews with Iranian cancer patients: communication dynamics, barriers to communication, and effective communication outcomes. Patients expressed a desire for nurses who actively listen, provide emotional support, and offer thorough education about their disease and treatment options. However, they also identified barriers to effective communication, including negative nurse behaviors (such as lack of empathy), heavy workloads, gender and language discordance, and logistical challenges within the clinic setting. When communication was positive, patients reported increased commitment to their treatment plans, improved coping mechanisms, reduced stress levels, and greater satisfaction with their overall care.ConclusionsThis study revealed the multifaceted nature of communication in outpatient oncology settings from the patient’s perspective. Findings underscore the need for interventions that enhance nurse communication skills, address workload issues, promote cultural sensitivity, and optimize clinic logistics. These efforts can significantly improve patient experiences and treatment outcomes during cancer treatment.

Qualitative perspectives of Medicaid-insured patients on ambulatory care at an academic medical center: challenges and opportunities

BackgroundAmbulatory access to academic medical centers (AMCs) for patients insured with Medi-Cal (i.e., Medicaid in California) is understudied, particularly among the 85% of beneficiaries enrolled in managed care plans. As more AMCs develop partnerships with these plans, data on patient experiences of access to care and quality are needed to guide patient-centered improvements in care delivery.MethodsThe authors conducted semi-structured, qualitative interviews with Medi-Cal-insured patients with initial visits at a large, urban AMC during 2022. Participant recruitment was informed by a database of ambulatory Medi-Cal encounters. The interview guide covered Medi-Cal enrollment, scheduling, and visit experience. Interviews were transcribed and inductively coded, then organized into themes across four domains: access, affordability, patient-provider interactions, and continuity.ResultsTwenty participant interviews were completed (55% female, 85% English speaking, 80% self-identified minority or “other” race, and 30% Hispanic or Latino) with primary and/or specialty care visits. Within the access domain, participants reported delays with Medi-Cal enrollment and access to specialist care or testing, though appointment scheduling was reported to be easy. Affordability concerns included out-of-pocket medical and parking costs, and missed income when patients or families skipped work to facilitate care coordination. Participants considered clear, bilateral communication with providers fundamental to positive patient-provider interactions. Some participants perceived discrimination by providers based on their insurance status. Participants valued continuity, but experienced frustration arising from frequent and unexpected health plan changes that disrupted care with their established AMC providers.ConclusionsThe missions of AMCs typically focus on clinical care, education, research, and equity. However, reports from Medi-Cal insured patients receiving care at AMCs highlight their stress and confusion related to inconsistent provider access, uncompensated costs, variability in perceptions of quality, and fragmented care. Recommendations based upon patient-reported concerns suggest opportunities for AMC health system-level improvements that are compatible with AMC missions.

PROs for RARE: protocol for development of a core patient reported outcome set for individuals with genetic intellectual disability

IntroductionRare genetic neurodevelopmental disorders and intellectual disability (ID), collectively called genetic ID (GID), can profoundly impact daily functioning and overall well-being of affected individuals. To improve our understanding of the impact of GID and advancing both care and research, measuring relevant patient reported outcomes (PROs) is crucial. Currently, various PROs are measured for GID. Given the shared comorbidities across disorders, we aim to develop a generic core PRO set for children and adults with GID.Methods and resultsDeveloping the generic core PRO set entails the following steps: 1) providing an overview of potentially relevant PROs by scoping reviews and qualitative research; 2) integrating and conceptualizing these PROs (i.e., describing the content of the PROs in detail) into a pilot generic core PRO set; and 3) prioritizing relevant PROs by a European Delphi survey and consensus meetings.ConclusionsThis protocol presents the steps for developing a generic core PRO set for children and adults with GID. The next step involves selecting suitable patient reported outcome measures (PROMs) to adequately measure these PROs: the generic core PROM set. This generic core PROM set needs validation in the GID population, and eventually implementation in care and research, facilitating the aggregation and analysis of PRO data and guaranteeing continuous integration of the patient perspective in both care and research.

Impact of the degree of synergy between patient and nurse perceptions on the clinical outcome of pressure injury prevention: a mixed-methods systematic review protocol

IntroductionPressure injuries are a common and significant concern in clinical practice, often serving as a vital quality indicator. While (clinical) practice guidelines have been established to offer recommendations for mitigating...

In Pursuit of a Person-Centered Approach to Care Delivery: A Qualitative Descriptive Study of the Patient Experience of a Long-Term Conditions Clinic in General Practice.

Innovative ways of working are emerging in health care to meet the complex needs of people living with multiple long-term conditions. While these initiatives are often measured for their health and economic outcomes, few studies prioritize the patient experience. This qualitative descriptive study is one of a few studies exploring the patient experience of attending a dedicated long-term conditions annual review clinic in a primary care setting in England. The service model aims to provide a person-centered, holistic approach to the management and support of people living with multiple long-term conditions. The study presents findings from in-depth interviews with 12 participants. Data analyzed through framework analysis revealed four themes relating to the patient experience: the clinic as a place, continuity, staying healthy, and partnership opportunities. Results highlight the challenges to providing personalized care. We found that attendance at the clinic prompted self-care behaviors, however, patients wanted a more holistic, integrated, and consistent service that provided continuity of therapeutic relationships that involved them in decision-making and care planning. We conclude that the experience of patients in this study suggests this service model can enable patients to manage their health and improve well-being, however, while a person-centered philosophy may underpin service models, our research shows that ensuring this philosophy is born out in service delivery and recognized by patients is problematic. Therefore, service providers need to recognize the values and perspectives of patients, aligning these with the design and delivery of services.

Underutilization of Injectable Parkinson's Disease Medication: An Analysis of Neurologist and Patient Perspectives.

We hypothesized that many neurologists underestimate patients' willingness to self-administer injectable Parkinson's disease (PD) medication. To evaluate patient and physician perceptions contributing to underutilization of PD medications for acute OFF episodes. Data were collected using an online survey including n = 4063 PD patients experiencing OFF episodes and n = 200 neurologists. 89% of patients were willing to self-inject rescue therapies to treat acute OFF episodes. After reviewing patient survey data, 54% of general neurologists and 37% of movement disorder specialist (MDS) demonstrated a change in perceptions about patients' willingness to use self-injected therapies (P < 0.05). 37% of general neurologists and 21% of MDS indicated a greater likelihood of prescribing these treatments (P < 0.05). Most patients suffering from OFF episodes would be willing to self-inject to abort their symptoms. Neurologists underestimate this patient acceptance. Understanding patient attitudes and further education about rescue therapies is likely to increase use of these therapies.

A qualitative study of preoperative anxiety in orthognathic patients: The patient perspective

Increased preoperative anxiety may have an adverse impact on the patient experience. This qualitative study therefore aimed to explore those factors affecting anxiety in the approach to orthognathic surgery. A total of 28 orthognathic patients who had completed their presurgical orthodontic treatment and were within 8 weeks before their surgery underwent one-to-one in-depth interviews. The interviews explored their experience in the preoperative period, with the focus on aspects relating to anxiety. Interviews were audio-recorded and transcribed verbatim, and data were then analyzed using a thematic framework approach. Eight themes and associated subthemes were identified. The first theme related to time and described the approach to the surgery and the transience of the side effects. The second theme discussed control and how the need for control may affect anxiety; the third focused on fear related to the surgery and the element of "the unknown." The fourth theme highlighted the importance of trust between patients and clinicians, whilst the fifth focused on information and its delivery, which was crucial for managing uncertainty. The sixth theme centered on expectations about the surgery and the patient's ability to cope, and the seventh discussed coping strategies that were effective in alleviating anxiety. The final theme focused on the benefits of a strong, effective support system in reducing anxiety. No distinct typologies emerged from the data. Recommendations for consideration by clinicians are presented. The findings provide a novel insight into the multifactorial nature of preoperative anxiety in orthognathic patients and also highlight the important role of the clinical team in creating a supportive environment to help reduce patient anxiety.

Nivolumab (Opdivo)

Reimbursement reviews are comprehensive assessments of the clinical effectiveness and cost-effectiveness, as well as patient and clinician perspectives, of a drug or drug class. The assessments inform non-binding recommendations that help guide the reimbursement decisions of Canada’s federal, provincial, and territorial governments, with the exception of Quebec. This review assesses nivolumab (Opdivo); strength: 40 mg nivolumab/4 mL (10 mg/mL) and 100 mg nivolumab/10 mL (10 mg/mL); route of administration: IV infusion. Indication: Opdivo, as monotherapy, is indicated for the adjuvant treatment of adult patients with stage IIB or IIC melanoma following complete resection.

An exploratory cross-sectional study of awareness and barriers to adoption of telemedicine services among patients in Bangladesh

Objectives Telemedicine has emerged as a promising solution to address healthcare challenges, particularly in resource-constrained settings such as Bangladesh. Understanding patient perspectives on telemedicine adoption is vital for improving healthcare delivery in such contexts. Material and Methods This cross-sectional study surveyed 120 patients in Bangladesh to explore awareness, acceptance, and barriers to telemedicine adoption. Data were collected using structured surveys administered face-to-face in 2024. Descriptive statistical techniques were employed for data analysis. Results Most respondents demonstrated awareness of telemedicine services, primarily learning about them through friends or online sources. They viewed telemedicine positively, especially for follow-up appointments and mental health services, expressing satisfaction with the services used. However, concerns regarding its effectiveness for emergency consultations were noted. Barriers to adoption included limited internet connectivity, trust/security issues, lack of awareness, regulatory challenges, and cultural resistance. Conclusion Despite positive attitudes towards telemedicine, challenges such as internet connectivity, trust concerns, and cultural barriers persist in Bangladesh. Addressing these challenges is essential for the successful implementation and widespread adoption of telemedicine, ultimately improving access to quality healthcare services. Future research should explore the perspectives of healthcare providers and policymakers and employ longitudinal and qualitative methods to gain deeper insights.

On a healing journey together and apart: A Swedish critical incident technique study on family involvement from a patient perspective in relation to elective open-heart surgery.

As family members affect patient outcomes following open-heart surgery, the objective was to provide updated knowledge on family involvement in to guide future interventions facilitating family involvement. The aim was to explore and describe the experiences and actions of important situations of family involvement asexpressed by patients who underwent elective open-heart surgery in Sweden. The critical incident technique (CIT) was used, which is a qualitative research method suitable for clinical problems when a phenomenon is known but the experiences and consequences of it are not. Considerations for patient integrity were made during the recruitment phase by ensuring that voluntary informed consent was obtained in two steps. Individual interviews were conducted with 35 patients who underwent open-heart surgery in Sweden in 2023. Important situations were analysed according to the CIT method. Two main areas emerged: Patients described important situations of family involvement as experiences of mutual dependency while also being independent individuals. These experiences led to balancing healing and risk-taking activities as a family. The positive consequences of family involvement described by patients included improved recovery through practical help at home and emotional support. As complements to preserving the existing positive aspects of family involvement, social support screening, the establishment of individualised visitation policies and the provision of professional and peer support earlier can improve patient recovery following open-heart surgery.