Degree Of Patient Satisfaction Research Articles

Comparing the efficacy and safety of microneedling and its combination with other treatments in patients with acne scars: a network meta-analysis of randomized controlled trials.

This study aimed to analyze the efficacy and safety of microneedling (MN), both alone and in combination with other treatments, to refine the approach for treating acne scars using MN. We systematically searched Pubmed, Cochrane Library, Embase, and Web of Science for randomized controlled trials examining MN or its combinations in patients with acne scars. All statistical analyses were performed using Stata 18 software. A total of 24 studies involving 1546 participants were included. The analysis revealed that MN combined with chemical peels (CP) exhibited the best results in terms of degree of improvement, patient satisfaction, and treatment efficacy compared to other treatments examined, including MN alone, MN with hyaluronic acid (HA), MN with botulinum toxin‑A (TA), MN with platelet-rich plasma (PRP), PRP alone, CP, and laser therapy. The results for MN combined with additional treatments were obviously better than for MN alone. Side effects such as erythema, pain, and post-inflammatory hyperpigmentation showed no significant differences across all treatments assessed.

Pain experience with outpatient hysteroscopy: A prospective cohort study

BackgroundAbnormal uterine bleeding (AUB) affects women of all ages and is one of the most common reasons for referral to a gynaecological clinic. Operative hysteroscopic procedures allow for a see-and-treat approach to AUB, and these techniques have been shown to be feasible and acceptable in the outpatient setting. ObjectiveTo assess if there is an increase in pain scores for women who are undergoing an operative hysteroscopic procedure with Myosure LITE® (Hologic; mechanical hysteroscopic tissue removal system) compared to outpatient diagnostic hysteroscopy alone. Study designA prospective cohort study was performed. All participants attending the outpatient hysteroscopy clinic at Mercy Hospital for Women completed a pre-and post-procedure questionnaire. This included a visual analogue scale (VAS) for any pre-existing pain, anticipated pain, and actual pain experienced during procedure. Factors influencing overall satisfaction and willingness to attend again were also assessed. Data was entered into RedCap® for analysis. A difference in VAS of 10 mm or more was considered clinically significant. An alpha of p < 0.05 was assigned for statistical significance. ResultsBetween February 2020 and November 2022, 208 women underwent outpatient diagnostic hysteroscopy followed by an operative hysteroscopy with MyoSure®. To allow for standardisation of analgesia, only participants who had a cervical block before their Myosure® procedure were included for analysis (n = 111). There was statistical evidence (t(111) = 2.36, p = 0.02) of a lower mean VAS pain score for operative Myosure (36.5 mm, 95 % CI: 31.1–41.8 mm) compared to outpatient diagnostic hysteroscopy (44.1 mm, 95 % CI: 39.0–49.2 mm). The mean difference in VAS pain score was estimated as 7.7 mm (95 % CI: 1.2–14.1 mm) lower for Myosure compared to hysteroscopy. Given the threshold for clinical significance was considered as 10 mm difference in VAS, the variance in pain scores is under the likely clinically significant range. There was no significant difference in pain scores for diagnostic hysteroscopy with or without paracervical block (mean difference = 1.42; 95 % CI: −6.35 to 9.20). There was no association between pre-existing pain, and actual pain for hysteroscopy, or Myosure (p = 0.997 and p = 0.065 respectively). The anticipated pain score was weakly associated with actual pain during the operative Myosure procedure (p = 0.02), and with outpatient diagnostic hysteroscopy (p = 0.019). ConclusionOutpatient hysteroscopy procedures are generally well tolerated. The pain experience with operative Myosure was less than that reported during the diagnostic hysteroscopy by the same patient although this is unlikely of clinical significance. Importantly, Myosure was not more painful than the initial diagnostic procedure, and most patients were satisfied with the outcome and would choose to have the procedure again in an outpatient setting. This is in keeping with other studies which have shown a high degree of patient tolerance and satisfaction with this approach.

Explantation with Lateral Pedicle Mastopexy.

While breast explantation combined with mastopexy is an increasingly common procedure, it does present certain technical difficulties. We present a technique of explantation mastopexy with the use of an extended lateral pedicle for auto-augmentation. A consecutive series of 40 cases was retrospectively reviewed, with patient reported outcome questionnaire and photography at 3 and 12 months. The mean age was 57 years (range 40 - 70 years), and mean duration of implantation was 20.4 years (range 7 - 42 years). 12 women had undergone previous mastopexy (30%). Minor wound complications requiring simple dressings were seen in 7 cases (17.5%). Major infected wound problems occurred in 1 case, who was a smoker and had other co-morbidities. All except 1 case reported being satisfied or very satisfied with the outcome, with a mean patient reported satisfaction score of 4.9/5. When the photographs were independently assessed by a cosmetic practitioner, all cases were rated as average, good or very good, with a mean score of 4.1/5. The procedure is associated with low risk of post-operative complications, good cosmetic outcomes, and a high degree of patient satisfaction. We feel this technique provides a logical, reproducible method for combined explantation and mastopexy.

Comparative Study of 1444 nm Laser Monotherapy versus Integrated Liposuction in the Treatment of Axillary Osmidrosis.

Background and Objectives: The 1444 nm wavelength Neodymium:Yttrium-Aluminum-Garnet (Nd:YAG) laser treatment is an efficient method for treating axillary osmidrosis (AO); however, it has a relatively low treatment persistence. To address this issue, we performed integrated liposuction surgery with a laser to treat AO and compared the results with those of a group treated only with a laser. Materials and Methods: This study compared the outcomes of AO treatment between the two groups up to six months postoperatively. The first group of 18 patients underwent laser treatment alone, and the second group of 12 patients underwent integrated liposuction surgery in addition to laser treatment. Outcomes were assessed using the following variables: degree of malodor (DOM), sweating area, patient satisfaction, pain levels, and complications, such as burns, swelling, and contractures. Results: Compared to the laser-only group, the integrated liposuction group demonstrated significantly superior outcomes in terms of DOM (p = 0.002) and patient satisfaction (p = 0.006), as well as a reduction in the sweating area (p = 0.012). The pain rating was higher in the liposuction group, but the difference was not statistically significant (p = 0.054). Compared with the patients in the integrated liposuction treatment group, those in the laser treatment group exhibited a significantly higher number of burns under the axillae (p = 0.025). However, no significant differences were observed in the swelling or contracture between the groups. Conclusions: Integrated liposuction with laser therapy significantly improved treatment outcomes, including malodor, patient satisfaction, sweat test results, and decreased complication rates.

Ambulatory models for autologous stem-cell transplantation: a systematic review of the health impact.

Autologous stem-cell transplantation (ASCT) is the standard of care for the management of multiple myeloma and has a well-established role in the treatment of some types of lymphoma. Over the last decades, the number of ASCT performed has increased significantly, leading to elevated pressure and cost for healthcare services. Conventional model of ASCT includes the admission of patients to a specialized Transplant Unit at any stage of the procedure. To optimize healthcare provision, ambulatory (outpatient/at-home) setting should be the focus moving forward. Thus, ambulatory ASCT model permits reducing average hospital stays and pressures on healthcare services, with significant cost-saving benefits and high degree of patient and caregiver satisfaction. In addition, it facilitates the bed resource for other complex procedures such as allografts or CAR-T cell therapy. The aim of this systematic review is to document the health impact, feasibility and safety of the outpatient/at-home ASCT models, which are increasingly being applied around the world.

Comparative analysis of the degree of patient satisfaction after breast-conserving surgery with or without oncoplastic surgery: systematic review and meta-analysis.

Conservative surgery is the gold standard for the treatment of single and small tumors and, combined with the concept of oncoplastic tumors, brings good aesthetic results while maintaining cancer safety. The objective was to comparatively analyze the degree of satisfaction of patients undergoing breast conserving surgery (BCS), with and without oncoplastic surgery (OPS) using level II OPS techniques. Review with a search in the databases MEDLINE (by PubMed), EMBASE, Clinical Trials, Scopus, Web of Science, BVS and Oppen gray. The meta-analysis of random effects was performed using the Der Simonian-Laird method considering the odds ratio (OR) with a 95% confidence interval (95% CI). There was no statistically significant difference in the aesthetic outcome between women who underwent OPS and BCS (OR 0.90; 95% CI 0.62-1.30). The staging (OR 1.93; 95% CI 0.97-3.84; I 2 = 15.83%); tumor location [central (OR 1.28; 95% CI 0.06-27.49; I 2 = 17.63%); lower (OR 0.75; 95% CI 0.21-2.65; I 2 = 2.21%); superior (OR 0.67; 95% CI 0.26-1.74; I 2 = 0.00%] and tumor size (OR 8.73; 95% CI -11.82-29.28; I 2 = 93.18%) showed no association with the type of BCS performed, with or without OPS. The degree of satisfaction remains even in cases of extreme oncoplasty. The level of patient satisfaction in relation to BCS was similar to that of the group undergoing OPS, highlighting that OPS allows the patient's satisfaction rate to be maintained even in the case of large or multicentric tumors.

Establishment and analysis of quality index system for pediatric tumor nursing.

Nursing management considers nursing quality management at its core. Evaluation indexes of nursing quality not only control nursing quality, measure work enthusiasm, and judge the difference in nursing levels but also help nurses accurately understand the satisfaction degree of patients. To analyze pediatric tumor nursing quality evaluation indexes and establish a scientific and rigorous index system of children's nursing quality. Based on the "structure-process-result" in this study, the Delphi method was used to carry out questionnaire investigations and opinion collection for domestic experts in pediatrics, pediatric oncology internal medicine, and pediatric oncology surgical care and clinical aspects two times. In addition, the Kendall coordination coefficient and analytic hierarchy process were used to determine the content of indicators at all levels, set the weight, and finally establish the quality index system of pediatric tumor nursing. The response rate of 27 experts in the first round of the questionnaire was 100%, Ca0.77, Cs,0.73, Cr0.75, and the W value of the expert coordination coefficient was 0.315. In the second round of 27 expert consultations, the reply rate was 96%, Ca0.81, Cs0.80, Cr0.805, and the specialist coordination coefficient W value was 0.369. After two rounds of consultation, the importance evaluation scores of each indicator ranged from 3.31 to 4.88 and 3.29 to 5.00, respectively, and more than 94.7% of the indicators' importance evaluation scores were higher than 3.50. Finally, 3 Level-1 indicators, 12 Level-2 indicators, and 54 Level-3 indicators are established. This study has established a simple, comprehensive, and scientific quality index system for pediatric tumor nursing, highlighted the characteristics of pediatric tumor nursing, and provided an evaluation system for specialized nursing of pediatric tumors to more standardized pediatric tumor nursing and contribute to the sustainable and scientific development of pediatric tumor nursing.

Same-day Discharge Following Vaginal Hysterectomy and Native-tissue Apical Repair for Uterovaginal Prolapse: A Prospective Cohort Study.

The safety and feasibility of same-day discharge (SDD) has been consistently reported across the benign and gynecologic oncology literature. However, outcomes of SDD in the urogynecology population are sparse. The objectives of this study were to describe the success of SDD following vaginal hysterectomy and native-tissue colpopexy, and to compare the incidence of postoperative adverse events in patients discharged same-day versus postoperative day 1 (POD1). Further objectives were to compare pain, quality of recovery (QoR), and satisfaction between the groups. This was a single-center, prospective cohort study of patients with planned SDD. A standardized ERAS protocol was utilized. The QoR-40 questionnaire was administered at baseline, POD2, and the 6-week postoperative visit. Pain scores were captured similarly, and a satisfaction survey was administered at 6 weeks. The primary outcome was composite adverse events defined as any postoperative adverse event and/or health care utilization, excluding telephone calls, and urinary tract infection. A total of 101 patients were enrolled in the study; the primary outcome was available for 99. SDD was achieved for 76 patients (77.0%); 23 patients stayed overnight (23.2%). The overall incidence of composite adverse events was 20.2% (95% CI, 13.5-29.2), and was not different between the groups (26.1% vs 18.4%, p = 0.42). Additionally, there were no differences in the QoR-40 or pain scores on POD2 and at 6 weeks. Patient satisfaction was high and similar between the groups. Successful SDD was achieved in 77.0% of the patients. SDD following vaginal hysterectomy and native-tissue colpopexy appears to be safe, feasible, and associated with good QoR and a high degree of patient satisfaction.

Clinical and radiographic outcomes of a two-piece ceramic implant: one year results from a prospective clinical trial.

To describe the clinical and radiographic performance and survival rate of a new two-piece ceramic implant system after at least 12 months of follow-up. Sixty-five implants were placed and followed up for at least 12 months (12.3 ± 1.5), in 50 patients. The implants were installed both in fresh extraction sockets and in healed sites and received provisional restoration when the clinical insertion torque was greater than 35Ncm. The primary results describe the survival rate of these implants. Clinical performance was evaluated through the evaluation of the Pink Esthetic Score (PES) and the degree of satisfaction of the patients. Bone loss was measured through radiographic measurements of the marginal bone loss in the mesial (MBLM) and distal (MBLD) sites. The survival rate was 98.5%. The average MBLM was 0.24mm (± 0.53) and the MBLD was 0.27mm (± 0.57). A statistical difference was observed only when comparing immediate implants with delayed ones (MBLM - p = 0.046 and MBLD - p = 0.028) and when they received immediate provisionalization or not (MBLM - p = 0.009 and MBLD - p = 0.040). The PES before the intervention (T0) was 13.4 (± 0.8) and the PES at T2 (12-month follow-up) was 12.9 (± 1.5) (p = 1.14). The new two-piece ceramic implant used in the present study showed predictable and reliable results, similar to those found with titanium implants after one year of follow-up. These implants can be used as an alternative to titanium implants in terms of the marginal bone loss and the degree of patient satisfaction.

Retrospective evaluation of the Complementary Health and Wellbeing (CHW) service delivered at the Christie NHS trust UK.

IntroductionThe Complementary Health and Wellbeing service has been offering integrative therapies to cancer patients at The Christie Hospital NHS Trust since 1997 and has not undergone an external service evaluation in that time. It is considered a pioneering service. MethodAn external academic was invited to undertake a service evaluation based on information and experiences since the implementation of services changes as the result of the COVID 19 pandemic. Service users and therapists were interviewed along with review of quality control data and documentation. ResultsEighteen staff and eight patients were interviewed showing a high functioning and valuable service, offering a range of services to meet the needs of both inoutpatient and outpatient services. All staff are qualified and passionate, with a significant number of research outputs. However, the service is at capacity, and must rethink some delivery to ensure long term sustainability. Services offered include acupuncture, aromatherapy, massage, talking therapies and motivational behavioural changes. There is a high degree of patient satisfaction as the therapies help them manage their life affecting side effects, however accessing or being aware of the service before treatment commenced was a concern for patients. DiscussionThe Complementary Health and Wellbeing Service is well resourced, with all staff paid employees of the NHS trust funded via a charitable part of the trust. There is a self-funding education unit to provide staff training with participants coming from around the world. The therapists are expert practitioners who have undergone specialist training to work in this unique environment, however capacity to meet the needs of the service is limited, and there are gaps in the way patient evaluations are collected, which needs to be addressed for long term viability and future benchmarking. The changes to service to adapt to COVID-19 have become embedded within the service.

Long-term results of arthroscopic capsulolabral revision repair for failed anterior shoulder instability repair using suture anchors at a minimum of 10 years follow-up.

Arthroscopic revision anterior shoulder instability repair has been proposed, and early clinical results have been promising. However, long-term results after this procedure and the probable risk factors for failure have not been sufficiently discussed in the literature. Thirty-eight patients who were diagnosed with recurrent anteroinferior shoulder instability after failed Bankart repair, treated with ACRR between September 1998 and November 2003 and able to be contacted were included. Of these patients, 2 were excluded from the study due to the use of SureTak anchors for fixation, and 5 other patients refused to participate in the study due to lack of interest (3 patients) or lack of time (2 patients). The remaining shoulders were clinically examined at a minimum of ten years after surgery via the ASES, Constant, AAOS, Rowe, Dawson and VAS scores for pain and stability. Degenerative arthropathy was assessed with the modified Samilson-Prieto score. All 31 remaining shoulders were evaluated at a mean time of 11.86 years (142.4 months) after surgery. Six patients (19.35%) reported redisolcation after the revision procedure, 4 of whom were affected by a new significant shoulder trauma. The ROWE and Constant scores improved significantly. Moderate to severe dislocation arthropathy was observed in 19.4% of patients. Five patients (16.2%) were not satisfied with the procedure. Long-term follow-up after ACRR shows predictable results, with a high degree of patient satisfaction, good to excellent patient-reported outcome scores and minimal radiological degenerative changes. However, with an average recurrence rate of 19.3% after 11.86 years, the redislocation rate appears high. With careful patient selection, recurrence rates can be significantly reduced.

Methods for assessing the quality of medical care in Russia and abroad: formation and modern aspects

The study presents the results of the analysis of available literary sources covering the historical and modern aspects of assessing the quality of medical care in the healthcare systems of the Russian Federation and some foreign countries and shows the relevance and feasibility of improving the methodology for assessing the quality of medical care in the Armed Forces of the Russian Federation. At present, many methods are used for assessing the quality of medical care in the healthcare system of the Russian Federation; however, none of them contains an exhaustive set of criteria that would allow assessing the quality of medical care provided in full. In the Armed Forces of the Russian Federation, the methods used to assess the quality of medical care are also not perfect, which leads to a decrease in the effectiveness of management decisions and thereby a decrease in the effectiveness of military medical organizations and units. To this end, active development of assessment indicators and criteria for the quality of medical care, introduction of new assessment methods, including the use of automated data accounting and analysis tools, and improvement of the procedures and standards of medical care are necessary. The most promising area is the use of comprehensive methods for assessing the effectiveness and quality of medical care, which have recently become widespread. Their application provides comprehensive control over compliance with medical care requirements and allows us to investigate the conditions wherein it is indicated, assess the degree of patient satisfaction, and helps optimize the assessment procedure. In addition, to improve the effectiveness, continuity in the implementation of control measures performed at various levels both within the medical organization and with the participation of departmental and state control bodies must be ensured. To do this, close interaction of all control bodies must be organized, and their activities must be integrated into a single quality management system for medical care. The results of the assessment of the quality of medical care can help determine the main directions of the development of the medical and diagnostic process and optimize the work of medical personnel, which increases the importance of work aimed at improving the assessment methodology. In addition, the quality control of medical care in the Armed Forces of the Russian Federation must be further improved.

Cementless Total Hip Arthroplasty With Paavilainen Femoral Shortening Osteotomy Can Provide Good Results at 10 Years in Patients Who Have Crowe IV Developmental Dysplasia of the Hip

BackgroundThe aim of this study was to present the clinical and radiologic results of primary total hip arthroplasty (THA) using the femoral shortening osteotomy technique described by Paavilainen in patients who have Crowe IV developmental dysplasia of the hip. MethodsWe retrospectively analyzed the results of primary THA using the Paavilainen technique in 335 hips. The mean follow-up was 10.2 years. The degree of limp, leg-length discrepancy, and patient satisfaction were assessed. The Oxford Hip Score was used to examine functional outcomes. A number of radiographic parameters were also assessed. ResultsThe most common reason for revision surgery was nonunion of the distally advanced greater trochanter. This complication was observed in 22 hips (6.5%). The 10-year survival for acetabular components, it was 97.3%, and for femoral components was 98.7% with aseptic loosening as the end point, and 85.9% with reoperation for any reason as the end point. Patients demonstrated improved functional outcomes. The mean limb lengthening was 27.8 mm. Nonunion was more common if the contact length of the proximal femoral fragment with the lateral surface of the distal femoral fragment was less than 35 mm. ConclusionsCementless primary THA using the femoral shortening osteotomy technique described by Paavilainen in patients who have Crowe IV dysplasia of the hip demonstrates good clinical and radiologic postoperative results. If the contact between the fragments after osteotomy is less than 35 mm, there is a high risk of nonunion, and supplemental fixation may be warranted.

Gestion de la douleur à domicile après chirurgie de l’avant pied en ambulatoire

Introduction: Healthcare structures must adapt to the shift to ambulatory care. While first ray surgery lends itself well to this organization, it is known to be painful for patients who are often reluctant to undergo this procedure. We studied the evolution of post-operative pain in patients undergoing first ray surgery from D0 to D5. A home nursing protocol was used. Secondary objectives were to assess patient satisfaction and to identify complications.Methods: This is a retrospective, observational, single-center, single-operator study. One hundred and thirty-eight patients undergoing surgery on the first ray of the foot (hallux valgus or rigidus) and eligible for ambulatory care were included between April 2019 and December 2022. The operative technique for the cure of hallux valgus was open surgery by double metatarsal and phalangeal osteotomy; for hallux rigidus, open dorsal plate arthrodesis. Home follow-up was carried out by a healthcare provider. The protocol allowed pain to be managed with an IV nefopam diffuser for a maximum of 5 days, combined with oral analgesics of levels 1 to 3. Pain was recorded at D0, D1, D3 and D5 using a numerical scale from 0 to 10. Patient satisfaction was assessed retrospectively by telephone call.Results: Ten patients were excluded due to incomplete data. The series comprised 102 women and 36 men, with an average age of 59.8 years. There were 116 hallux valgus and 22 hallux rigidus. Thirty-three patients had procedures associated with their 1st ray surgery. Pain analyzed by VAS was 4.21 at D0, 2.96 at D1, 1.90 at D3, 1.33 at D5. The mean duration of nefopam infusions was 4.31 days. Treatment tolerance was satisfactory in 88.4% of cases. Eighty-four percent of patients were very satisfied with their pain management. There were 4 early scar complications that resolved with local care. One infection was noted at a distance from the operation, requiring repeat surgery and re-hospitalization. Four postoperative algoneurodystrophies were identified. Three recurrences of hallux valgus required repeat surgery. The existence of fibromyalgia, algodystrophy, chronic pain on long-term morphine therapy, chronic inflammatory disease, depression or parkinsonian syndrome correlated with higher pain.Conclusion: Pain management after outpatient first ray foot surgery using the injectable nefopam protocol is satisfactory in the majority of cases, with a very high degree of patient satisfaction. This protocol is now routinely offered to our patients undergoing first ray surgery.Level of evidence: IV; cohort study.

IJCM_133A: E- Health Literacy and Satisfaction regarding Medical Care among Patients attending a Tertiary Care Hospital in Mangalore

Background: Health literacy is crucial for understanding health information and making informed decisions. It encompasses the ability to obtain, process, and understand basic health information. Factors like education, income, and age influence health literacy, impacting health outcomes negatively when low. E Health literacy extends to navigating electronic health resources. Patient-doctor communication suffers when doctors overestimate patient literacy. Poor health literacy leads to misunderstandings, medication errors, and poorer health outcomes. In today’s healthcare landscape, patient satisfaction is key. Understanding the link between eHealth literacy, communication, compliance, and satisfaction is vital. The study aims to evaluate patients’ e-health literacy levels, evaluate the degree of patient satisfaction with healthcare services, to ascertain the relationship between patient satisfaction and eHealth literacy. Methodology: The study involved 234 patients who visited the hospitals affiliated to Kasturba Medical College, Mangalore. eHealth literacy was assessed using eHEALS, patient satisfaction was assessed using Patient Satisfaction Questionnaire Short Form (PSQ-18). The correlation between eHealth literacy scores and patient satisfaction scores was tested using Pearson correlation coefficient where P is less than 0.05 was considered statistically significant correlation. Results: Preliminary findings suggest that majority of the participants found the Internet to be useful in making decisions about health. The results of our study show that 65% of our participants have good eHealth literacy and 27.8% have moderate literacy. The comparison of patient satisfaction based on eHealth literacy showed that there was no significant difference in patient satisfaction between participants who had good literacy or poor literacy. Conclusion: Both eHealth Literacy and Patient Satisfaction among our study participants were good, however there was no correlation found between eHealth Literacy and Patient Satisfaction.

Ultrasonic Fasciotomy for the Treatment of Chronic Plantar Fasciopathy: A Prospective Study.

To evaluate the long-term efficacy and safety of an ultrasonic fasciotomy for plantar fasciopathy. Prospective observational study. Tertiary care academic medical center. Patients with chronic plantar fasciopathy refractory to standard, conservative treatments were included in this study. Patients underwent ultrasonic fasciotomy of the plantar fascia. The primary outcome measures were change in visual analog scale at 12 and 52 weeks post-procedure compared with baseline as well as patients' self-reported satisfaction with the procedure. Sixty-seven patients were included. There was a significant improvement in visual analog scale at all follow-up time points, with an average overall improvement of 5.87 ( P < 0.0001). 94% of patients reported satisfaction with the outcomes of their procedure at 12 and 52 weeks. No procedural complications were seen. This study demonstrates that an ultrasonic fasciotomy is a safe and effective treatment option for chronic plantar fasciopathy, with continued symptom improvement and a high degree of patient satisfaction up to 52 weeks post-procedure. These findings suggest that an ultrasonic fasciotomy should be considered for patients with chronic plantar fasciopathy refractory to conservative treatments.

Patient Satisfaction with the Quality of Oral Rehabilitation Dental Services: A Comparison between the Public and Private Health System.

Measuring satisfaction can help us understand patients' expectations and adopt individualized treatment according to their expectations. In the current study, we applied the DPQ (Dental Practice Questionnaire) to analyze the degree of patient satisfaction regarding medical services in the public and private sector in a Romanian city from the central region. A group of 200 patients, 100 patients from the public sector and 100 patients from the private sector, participated in the survey. The results showed significant differences in response when patients were stratified by age, gender, visit frequency and length of time attending the same practice. Significant differences between public and private practices were encountered. Moreover, the degree of patient satisfaction was found to be related to appointment promptness/length of time and the confidentiality/ability to listen/knowledge/respect shown by the dentist, while patients' recommendations to others were influenced by dentists' explanations and warmth, followed by the appointment system and confidentiality. Patient satisfaction with oral rehabilitation dental services plays an essential role in maintaining patients' addressability, but there is a multitude of factors that can influence patients' opinions. Further analysis of the evolution of the influencing factors (causing satisfaction or dissatisfaction), in time, could provide deeper insights into the links between patient satisfaction and these factors.

Quality status: A SERVQUAL approach to evaluate the effect of the quality of healthcare services on patient satisfaction in Jordan

ABSTRACT Service quality in healthcare has gained more attention from researchers after the COVID-19 pandemic, affecting almost every country, including Jordan. This research has focused on the healthcare sector, examined the quality of this sector provided to the Jordanian population, and identified the patients’ satisfaction based on the SERVQUAL model. Moreover, it investigated the quality of health services offered to Jordanian people based on the demographics and health providers (JRMS, MOH, NGOs, and private sectors). The data for the research was gathered online, and it was analyzed by using SPSS. The results highlighted that hospital service quality influences ent satisfaction. Moreover, for SERVQUAL areas, the findings revealed a significant difference between patients’ expectations and perceptions mean scores in favor of patients’ expectations. Furthermore, the results showed medium satisfaction in all age groups of patients, and there is a higher degree of satisfaction among patients receiving health services from the private sector and a lower degree of satisfaction in patients receiving health services under the Ministry of Health umbrella in all five domains. The results provided by the research are guidelines for researchers and practitioners focusing on the area of service quality in healthcare.

Supraperiosteal fat repositioning with midface lift in lower eyelid blepharoplasty: an 18-year experience.

To assess the clinical outcomes of fat repositioning via supraperiosteal dissection with midface lift for correction of tear trough deformity in a large Asian patient population. Retrospectively review 1152 Asian patients who underwent fat repositioning to the supraperiosteal plane with a midface lift between 2005 and 2022. Surgical technique, postoperative course, and complications were recorded. At the 6-month postoperative follow-up, the degree of patient satisfaction was assessed. A total of 2304 eyes from 1152 patients with an average follow-up of 10 months. These procedures were performed using a transforniceal approach in 185 patients (16%) or a transcutaneous skin excision approach in 967 patients (84%). Among the patients who underwent the transcutaneous technique, seven individuals (0.6%) experienced effective treatment of lower lid ectropion through lateral tarsal strip procedures. Nine patients (0.7%) required revision surgery to address the remaining lateral fat pad due to inadequate lateral orbital fat excision during the initial procedure. At the 6-month follow-up, most patients reported a high level of satisfaction, with 800 patients (78%) expressing extreme satisfaction and 196 patients (19.1%) reporting satisfaction with the improvement in their appearance. No one reported facial numbness, lower eyelid or cheek paralysis, newly developed diplopia or granuloma formation. The procedure of fat repositioning involving supraperiosteal dissection and a midface lift, whether performed using a transforniceal approach or a transcutaneous skin excision approach, in lower eyelid blepharoplasty proves to be a secure and auspicious surgical technique for rectifying tear trough deformity and attaining a pleasing aesthetic outcome.

The Role of TAP/RS Block in Minor Gynecologic Laparoscopic Surgery: A Randomized Clinical Trial

Objectives: The aim of the study was to compare, in patients undergoing minor gynecological laparoscopic procedures, the effects of ultrasound (US)-guided transversus abdominis plane (TAP) + rectus sheath (RS) block versus no TAP/RS block in terms of post-surgical pain control using the numeric pain rating scale (NRS) and the degree of patient satisfaction, according to the main goals of Early Recovery After Surgery (ERAS) programs. The primary outcome is to value the postoperative abdominal pain using NRS in both groups. Secondary outcomes are to evaluate blood values, presence of postoperative nausea and vomiting (PONV), postoperative ileus, level of patient expected satisfaction, time of discharge, length of stay (LOS), and the amounts of additional analgesics required. Design: In this prospective randomized controlled trial, patients were randomly assigned to loco-regional anesthesia (LRA) group, who received TAP and RS block under US guidance, or no loco-regional anesthesia (N-LRA) group. Enrolled patients were randomized 1:1 to either receive bilateral TAP/RS block with ropivacaine or sham treatment (patches were applied on the abdominal wall of the patients under general anesthesia). Participants: All patients aged between 18 and 75 years, with ASA (American Society of Anesthesiologists) physical status 1-2, undergoing laparoscopic minor gynecological surgery, were enrolled. Setting: The study was conducted to the University of Campus Bio-Medico Hospital of Rome. Methods: Half an hour before surgery, all patients received gabapentin 300 mg per os. Once the patient underwent general anesthesia, US-guided bilateral TAP/RS block was performed by the anesthesiology team, while the uterine manipulator was positioned by a gynecology resident (not involved in the study). In the operative room, all patients received the same standardized anesthetic regimen. Postoperative abdominal pain was assessed at rest, after palpation, during movement, and after a cough by evaluating the patient at 6, 12, 18, 24, 36, 48, and 72 h after surgery, using the NRS from 0 to 10 in both groups. The amount of drug used for analgesia in the first 48 h after surgery was recorded. Moreover, hemoglobin, white blood cells, and c-reactive protein levels were recorded at 24, 48, and 72 h. The presence of PONV and the postoperative ileus was recorded throughout convalescence. The expected level of patient satisfaction at discharge and finally the LOS were assessed. Limitations: The major weakness of this study is that 60 mL of 0.5% ropivacaine was administered to each patient, without considering weight differences, yet contemporary literature rarely suggests volume/dose titration in fascial blocks. Results: A total of 104 women, undergoing gynecological minor laparoscopic surgery, were enrolled and assigned to LRA group (53 pts) and N-LRA group (51 pts). Postoperative pain was significantly reduced in patients who received TAP/RS block. A reduction in the intake of non-steroidal anti-inflammatory drugs after surgery was registered in LRA group (p < 0.01). Moreover, a significant reduction of LOS (45.97 ± 9.87 vs. 65.08 ± 17.32 h; p < 0.01) and PONV was observed in the LRA group, as well as a better level of patient satisfaction at discharge (9.43 ± 0.94 vs. 8.26 ± 1.19; p < 0.01), compared to the N-LRA group. Conclusions: US-guided TAP and RS block significantly reduces postoperative pain after minor gynecologic laparoscopic surgery and improves patients’ post-operative recovery.