Patient Satisfaction Research Articles

Transient Ischaemic attack Emergency Referral (TIER): randomised feasibility trial results

BackgroundEarly assessment of patients with suspected transient ischaemic attack (TIA) is crucial to provision of effective care, including initiation of preventive therapies and identification of stroke mimics. Many patients with...

Comprehensive Analysis of UBE-Related Complications: Prevention and Management Strategies from 4685 Patients.

Unilateral biportal endoscopy (UBE) surgery is a minimally invasive approach for treatment of spinal disorders, which usually requires creation of a working and viewing channel on 1 side. The UBE technique has developed rapidly in China in recent years, and many spine surgeons have started to apply it and have shared the initial clinical research results many times at minimally invasive spine conferences. Unfortunately, these studies actually translated into fewer publications. In addition, most patients have good outcomes after UBE surgery, but a minority still experience UBE surgery-related complications, including epidural hematoma, dural sac tears, retroperitoneal effusions, inadequate decompression, postoperative back pain and headache, early recurrence, iatrogenic spinal instability, anemia, and infection, which can prolong hospital stay and seriously affect patient satisfaction. Therefore, this article reviews the complications of UBE surgery for lumbar degenerative diseases and discusses ways to prevent and handle complications associated with UBE to help spine surgeons make smart treatment decisions.

Health service quality and patients’ satisfaction among hospitals: the cohesive care of human beings and accomplishment of human rights

Purpose In this study, the researchers explored the influence of service quality-related constructs on patients’ satisfaction with Egyptian health-care centers. Design/methodology/approach In this study, the researchers used a quantitative approach and concluded the study based on 316 valid cases collected from patients of Egyptian health-care centers. Findings Using path analysis with analysis of moment structures (AMOS), this study's results demonstrate that reliability and responsiveness, empathy, nursing care and medical care positively affect patients' satisfaction. On the other hand, the tangibles have a negative effect on patient satisfaction. Practical implications This study’s findings benefit policymakers by shaping evidence-based policies. Health-care managers can implement strategies that prioritize the identified factors and can foster a more patient-centric and effective health-care system. Also, this study’s findings guide health-care institutes to maintain human rights by serving poor and needy patients. More generally, this study's outcomes enrich the depth of the domain literature. Originality/value This study’s findings add to the existing knowledge and fill contextual gaps by confirming patients’ satisfaction with the service quality of Egyptian health-care centers.

Effect of pharmacist interventions in chronic kidney disease: a meta-analysis.

Pharmacists are uniquely placed with their therapeutic knowledge to manage people with chronic kidney disease (CKD). Data is limited regarding the impact of pharmacist interventions on economic, clinical, and humanistic outcomes (ECHO). A systematic review and meta-analysis of randomized controlled trials (RCTs) of interventions with pharmacist input was conducted, which included adults with a diagnosis of CKD, including those with and without kidney replacement therapy. Data was extracted on ECHO: economic (e.g. healthcare-associated costs), clinical (e.g. mortality), and humanistic (e.g. patient satisfaction) outcomes. Where appropriate, a random-effects model meta-analysis generated a pooled estimate of effect. A direction of effect plot was used to summarize the overall effects for clinical outcome domains. 32 RCTs reported a total of 10 economic, 211 clinical, and 18 humanistic outcomes. Pharmacist interventions resulted in statistically significant improvements in systolic blood pressure and hemoglobin levels, but not in diastolic blood pressure, estimated glomerular filtration rate, creatinine, and low-density lipoprotein cholesterol levels. Mixed findings were reported for clinical and economic outcomes, whilst pharmacist interventions resulted in an improvement in humanistic outcomes such as patient satisfaction and patient knowledge. Findings showed pharmacist interventions had mixed results for various outcomes. Future studies should be more robustly designed and take into consideration the role of the pharmacist in prescribing and deprescribing, the findings of which will help inform research and clinical practice.

Day case laparoscopic cholecystectomy: a review of patient selection factors and identification of potential barriers to same-day discharge.

Day-case laparoscopic cholecystectomy (DCLC) is a useful tool for minimizing hospital admissions and prolonged presurgical wait times in suitable patient cohorts. There have been many international studies to support this finding and an increasing interest has grown in implementation in Australia. This review aims to provide clarity how to best implement this tool in gallbladder disease patient demographic. This literature review evaluates studies on day-case cholecystectomy procedures, focusing on patient factors, procedural aspects, surgical morbidity, and systemic implications. It explores inclusion and exclusion criteria for day-case suitability, factors influencing same-day discharge, reasons for hospital admission, pain management, patient quality of life, patient satisfaction, and cost implications. DCLC, when selected judiciously, is a safe alternative to overnight stay procedures for cholecystectomy with comparable surgical outcomes and patient satisfaction, affirming its viability. Strict patient selection criteria can aid in optimizing the successful implementation procedure, reducing unexpected admissions and readmissions and we have demonstrated useful criteria for guidance in establishing day-case laparoscopic cholecystectomy protocol at a hospital.

Open-Label Randomized Clinical Trial to Assess the Effects of Preoperative Acupuncture in High Anxiety Patients Undergoing Total Knee or Hip Arthroplasty.

Background: Preoperative state anxiety is a known predisposing factor for enhanced postoperative pain and hindered recovery following total knee or hip replacement. Acupuncture administered preoperatively has been associated with reduced anxiety in surgical studies, yet evidence of its efficacy in the orthopedic surgical setting is limited. Objective: This study investigated the effects of preoperative acupuncture on preoperative anxiety and pain and compared acute postoperative pain between acupuncture and control patient groups. Design: Parallel-arm, open-label, randomized controlled trial. Setting: Bone and Joint Institute, Hartford Hospital, Hartford, CT. Participants: Sixty middle-aged and elderly men and women with clinically validated preoperative anxiety undergoing elective total hip or knee replacement. Intervention: One-to-one randomization to preoperative acupuncture (n = 30) or no acupuncture treatment (n = 30) on the day of surgery. Coprimary outcomes: Anxiety before and after preoperative acupuncture using the visual analog scale and postsurgical pain using the numeric pain scale. Secondary outcomes: Incidence of acupuncture-related complications, pain before and after acupuncture, nausea and vomiting incidence, opioid consumption, anxiolytics and antiemetics use, and patient satisfaction. Results: Patients reported lower anxiety and pain preoperatively following acupuncture compared with before treatment (both p < 0.001). Postoperatively, the acupuncture group reported lower pain in the first 3 h than the control group, although this difference was not statistically significant. No significant differences in postoperative complications or patient satisfaction were observed between the study groups. Most patients were satisfied with the acupuncture treatment and reported a likelihood of considering preoperative acupuncture for future surgeries. Conclusions: These preliminary findings support that preoperative acupuncture is a safe and effective means to reduce perioperative anxiety and pain in patients undergoing total hip or knee replacement surgery. Additional studies should be conducted to best determine the value of preoperative acupuncture in total hip or knee patients presenting with surgically related anxiety. Clinical Trial Registration: ClinicalTrials.gov (10/31/2023, NCT06099223).

Investigating the Relationship Between Patient-Centered Communication and Quality of E-Consult in China: A Cross-Sectional Standardized Patient Study.

Patient-centered communication is widely acknowledged as an essential element of high-quality healthcare. Our study attempted to explore the weaknesses in the actual doctor-patient communication process and the most critical elements in patient-centered communication to improve the service quality of e-consult. We recruited ten standardized patients presenting fixed cases (urticaria and childhood diarrhea) for 321 valid interactions to measure patient-centered communication and e-consult service quality. The scores of patient-centered communication included exploring the patient's disease experience, understanding the patient's social situation, and reaching a consensus between doctors and patients. We measured the quality of e-consult services by the total words of doctor's responses, accurate diagnosis, appropriate prescription, lifestyle modification advice, patient satisfaction, continuance intention, and cost. Ordinary least-squares and logistic regression were performed to investigate the association between patient-centered communication and e-consult service quality. The total mean score of patient-centered communication was 17.67. The mean words of responses and cost were 178.55 words and 39.46 yuan, respectively. 82.87% of doctors diagnosed accurately, with 21.81% prescribing appropriate prescriptions and 81.93% providing lifestyle modification advice. 254 interactions obtained high satisfaction, and 218had continuance intention after the interactions. Doctors with higher patient-centered communication levels would provide more words of responses. They were more likely to provide accurate diagnoses, appropriate prescriptions, and lifestyle modification advice, resulting in better patient satisfaction, continuance intention, and higher costs. Therefore, it is necessary to standardize and improve the doctor-patient communication process of e-consult and develop training for different doctors.

A comparative analysis of vacuum assisted closure therapy and conventional dressings: outcomes in chronic diabetic foot ulcers among Indian patients

Background: India faces a growing diabetes epidemic, with approximately 77 million individuals affected. Chronic non-healing diabetic foot ulcers (DFUs) are a common complication of diabetes and a major healthcare challenge in Conventional wound care methods often result in prolonged healing times, increasing the risk of infection, hospitalization, and amputations. Vacuum-assisted closure (VAC) therapy, a modern treatment modality, offers a potentially more effective approach to managing these ulcers. Methods: This prospective, observational study was conducted at a tertiary care hospital in India from March 2022 to March 2024. One hundred patients with chronic non-healing DFUs were randomized into VAC therapy or conventional dressing groups. The primary outcomes included wound size reduction and healing time, while secondary outcomes involved patient satisfaction and cost-effectiveness. Results: VAC therapy significantly reduced wound size (65.2% vs. 40.5%) and shortened healing time (6.2 vs. 10.9 weeks) compared to conventional dressings. Additionally, VAC therapy led to higher patient satisfaction and proved more cost-effective due to fewer dressing changes and shorter hospital stays. Conclusions: VAC therapy outperforms conventional dressings in managing DFUs, offering faster healing, better patient satisfaction, and cost-effectiveness. Expanding its use in India could greatly improve diabetic foot care outcomes.

Clinical Outcomes of a Minimally Invasive Percutaneous Brostrom Technique without Arthroscopic Assistance

Background/Objectives: Surgical management of chronic lateral ankle instability has traditionally been performed using an open technique. Arthroscopic-assisted and all-arthroscopic techniques have gained popularity as they have achieved strong clinical outcomes. However, they rely on the surgeon’s arthroscopic skills and familiarity with arthroscopic anatomy. Recently, a minimally invasive percutaneous technique without arthroscopic assistance has been developed that incorporates the benefits of arthroscopy, such as minimal soft tissue disruption, without the additional requirements of performing an arthroscopic technique. The aim of the current study is to describe the minimally invasive percutaneous technique for chronic lateral ankle instability and report on its clinical outcomes. Methods: Fifty-four consecutive patients without intra-articular ankle pathology underwent lateral ligament repair for chronic ankle instability with a percutaneous technique at a single institution by a fellowship-trained foot and ankle surgeon. Foot Function Index (FFI) score was recorded pre-operatively and post-operatively at final follow-up. All patients had a minimum follow-up of 12 months. Post-operative complications and patient satisfaction were also recorded. Results: A significant improvement (p &lt; 0.001) in FFI compared to pre-operative values (from 55, SD 4.1, to 10, SD 1.9) was observed. A single patient required a return to the operating room for open revision with allograft reconstruction following a fall 2.5 months post-operatively. There were no other complications including infection or nerve injury. The overall rate of satisfaction after surgery was 98.1%, with one patient dissatisfied due to excessive ankle stiffness. Conclusions: The described minimally invasive percutaneous Brostrom procedure is safe and effective for the treatment of chronic lateral ankle instability without intra-articular ankle pathology.

Functionality and Scar Evaluation of the Donor Site in Extended Radial Forearm Flap Phalloplasty: How Affected Is the Arm in Day-to-Day Life?

Background: The radial forearm flap remains the gold standard in phalloplasty in gender-affirming surgery due to its versatility and functional outcome, but the significant donor site morbidity and its impact on daily functioning and aesthetic perception remains understudied. This study provides valuable insights into the mid-term functional and aesthetic outcomes of the forearm in transgender individuals following radial forearm flap phalloplasty using widespread instruments for assessment scoring systems and for the evaluation of postoperative wound healing of surgical interventions in general. Methods: Between January 2013 and March 2018, a total of 47 patients underwent radial phalloplasty at AGAPLESION Markus Hospital, and 20 consented to participate in this cross-sectional, retrospective study evaluating functional and aesthetic outcomes post-radial forearm flap phalloplasty using standardized questionnaires (DASH, POSAS, and SBSES). A univariate median regression of each score was performed to determine the associations with selected variables, and correlation analyses between scores was performed using a nonparametric Spearman rank correlation. Results: Among the 20 participants, the median Quick DASH, DASH functionality, DASH sport and music, and DASH work scores indicated minimal to no functional impairment. Scar evaluations using the PSAS, OSAS, and SBSES scales showed overall patient satisfaction with minimal concerns regarding pigmentation and scar texture. Notably, an increase of 0.27 cm2 in wound surface area added one point to the DASH sport and music score (p = 0.037). Statistical analysis also demonstrated a significant correlation between functional and aesthetic assessment scores. Conclusions: The radial forearm phalloplasty donor site, evaluated by the PSAS, OSAS, and SBSES scales, leads to minimal or no functional impairment; however, the worsening of the DASH sport and music score with increasing wound surface reflects a direct relation between wound size and functional impairment.

Body image and quality of life undergoing totally robotic versus robotic-assisted distal gastrectomy: a retrospective propensity score matched cohort study

BackgroundWith the improvement of anastomotic techniques and the iteration of anastomotic instruments, robotic intracorporeal suturing has become increasingly proficient. The era of fully intracorporeal anastomosis in robotic gastric cancer resection is emerging. This study aims to explore the impact of totally robotic distal gastrectomy (TRDG) and robotic-assisted distal gastrectomy (RADG) on patients’ quality of life.Patients and methodsThis study is a comparative retrospective study of propensity score matching. This study included 306 patients who underwent robotic distal gastrectomy for gastric cancer between June 2016 and December 2023 at our center. Covariates used in the propensity score included sex, age, BMI, ASA score, maximum tumour diameter, degree of histological differentiation, Pathological TNM stage, Pathological T stage, Pathological N stage, and Lauren classification. Outcome measures included operative time, intraoperative bleeding, time to first venting, time to first fluid intake, postoperative hospital stay, total hospitalization cost, total length of abdominal incision, postoperative complications, inflammatory response, body image, and quality of life.ResultsAccording to the results of the study, compared with the RADG group, the TRDG group had a faster recovery time for gastrointestinal function (P = 0.025), shorter length of abdominal incision (P < 0.001), fewer days in the hospital (P = 0.006) less pain (P < 0.001), less need for additional analgesia (P = 0.013), and a postoperative white blood cell count (P < 0.001) and C-reactive protein content indexes were lower (P<0.001). In addition, the TRDG group had significantly better body imagery and cosmetic scores (P = 0.015), physical function (P = 0.039), role function (P = 0.046), and global function (P = 0.021) than the RARS group. Meanwhile, the TRDG group had milder symptoms of fatigue (P = 0.037) and pain (P < 0.001). The PASQ Total Subscale Score (P < 0.001) and Global Subscale Score (P < 0.001) were significantly lower in the TRDG group than in the RADG group at postoperative 3 months.ConclusionTotally robotic distal gastrectomy has a smaller incision, faster gastrointestinal recovery time, fewer days of postoperative hospitalization, and lower inflammatory markers than robotic-assisted distal gastrectomy. At the same time, postoperative cosmetic and quality of life outcomes were satisfactory. Clinically, these benefits translate to enhanced patient recovery, reduced surgical trauma, and better postoperative outcomes. These findings could guide surgeons in selecting more effective surgical approaches for patients undergoing gastrectomy, leading to better overall patient satisfaction and outcomes.

Age Is a Key Factor Influencing the Choice of Treatment for Primary Patellar Dislocation: A Systematic Review and Meta-analysis.

Primary patellar dislocation has a certain recurrence rate after either conservative or surgical treatment, and the optimal treatment for patients with primary patellar dislocation of different ages remains unclear. This study aims to compare the clinical efficacy of surgical and conservative treatments for primary patellar dislocation across different age groups. According to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist, we conducted a systematic search for randomized controlled trials. We searched the PubMed, EMBASE, Cochrane Library, and Web of Science databases for randomized controlled trials of primary patellar dislocation treated surgically or conservatively up to January 2023. Data searching, extraction, analysis, and quality assessment were carried out in accordance with the Cochrane Collaboration guidelines. A total of nine studies with 433 patients were included in our study. There was no statistically significant difference between the two treatment modalities in terms of Kujala score, pain score, patient satisfaction, reoperation, and Tegner score. The rate of re-dislocation after surgical treatment is lower than that after conservative treatment. Subgroup analysis based on mean age showed that when the age was >20 years, Kujala scores were higher after surgical treatment than after conservative treatment (p < 0.0001, 95% confidence interval [CI] = 10.41-21.30). When the age was ≤20 years, the difference in Kujala scores between the two treatment modalities was not statistically significant. When the age was >20 years, the recurrence rate of patellar dislocation was lower after surgical treatment than after conservative treatment (p = 0.009, 95% CI = 0.08-0.70). When the age was ≤20 years, the difference in the recurrence rate of patellar dislocation between the two treatment modalities was not statistically significant. When the age of patients with primary patellar dislocation is ≤20 years, both surgical and conservative treatments result in similar clinical outcomes. When the age is >20 years, better clinical outcomes can be achieved by opting for surgical treatment. Therefore, surgery may be a better option for patients with primary patellar dislocation whose age is >20 years.

Patient satisfaction and operator proficiency in gasless transaxillary endoscopic thyroidectomy under IONM: a retrospective cohort study

BackgroundThis study aims to evaluate the surgical safety and effectiveness of gasless transaxillary endoscopic thyroidectomy (GTET), assess patients’ short-term perceptions and long-term outcomes, and delineate the learning curve and key surgical techniques of the operators.Materials and methodsClinicopathological and postoperative follow-up data from patients with unilateral thyroid cancer in the same period were collected. These patients were divided into the GTET group and the traditional open surgery group to compare and analyze the differences and explore the factors affecting the learning curve of GTET.ResultsPatients who chose GTET had better general health and thyroid conditions than those in the open group, and the quality of postoperative life was better in the GTET group than in the open group, with the main differences between the two groups being appearance and neck and shoulder function. The GTET learning curve in this study peaked at 19 cases, with slight differences between left and right, and a larger sample size is still needed to explore the factors affecting the learning curve.ConclusionsGTET has a reliable safety and efficacy profile for patients with unilateral thyroid cancer. Intraoperative nerve monitoring (IONM) techniques require some adaptation in GTET. In some respects, patients’ postoperative experience and quality of life are superior to those of conventional open surgery. There is a learning curve for GTET, but large samples are still needed to explore its true significance.

Effectiveness of rapid access chest pain clinics: a systematic review of patient outcomes and resource utilisation

BackgroundRapid Access Chest Pain Clinics (RACPC) are widely used for the outpatient assessment of chest pain, but there appears to be limited high-quality evidence justifying this model of care. This...

Analysis of Outpatient Patient Satisfaction at Jayagiri Health Center, Lembang Village, West Bandung District

The success of a company depends on how well its customers remain satisfied when using the products and services offered. Similarly, in the context of healthcare services, a hospital's positive or negative reputation is often determined by the patients' evaluations during inpatient or outpatient care. The method used in this study is a qualitative descriptive method, which aims to understand the phenomena experienced by the research subjects. The study found that the highest value of the satisfaction variable is two and is found in the question "How do you think about the suitability of service requirements with the type of service?" with an average score of 4.07 and "How do you think about the fairness of the cost/fee in the service?" with an average score of 4.07. Additionally, the lowest value is found in the statement "How do you think about the speed of service delivery?" with an average score of 3.17. Therefore, it can be concluded that the patient satisfaction variable in this study can be stated as good, as the average score of this variable is 3.86, which falls into the category of 4 (Good). The conclusion that can be drawn from this study is that patients who receive outpatient care at Jayagiri Health Center are already satisfied with the services provided by the center.

Service Quality Affects BPJS Patient Satisfaction at the Pematang Health Center, Serang Regency, Banten in 2024

Health service providers must strive to improve the quality of services for the realization of the highest degree of public health. The purpose of this study is to find out and analyze the quality of service affecting BPJS patient satisfaction at the Pematang Health Center, Serang Regency, Banten in 2024. The research design uses an analytical survey with a cross sectional design. The population in this study is all patients who are treated using BPJS as many as 4,210 people with an accidental sampling technique with a sample of 98 people. The data analysis used used was univariate analysis, bivariate using chi-square and multivariate using logistic regression. The results of the logistic regression analysis that affected were the variables of immediate service p = 0.003, politeness p = 0.005 and effective communication p = 0.000 and the most influential variable was effective communication with an Exp B value of 13.922. The conclusion of the variables that do not affect is the use of information technology, physical facilities, quick response, skills and attitudes and the variables that affect are prompt service, politeness and effective communication and the most influential is effective communication. It is recommended to the Puskesmas to make a budget for Communication Skills training for all health workers, mentoring, and implementation by making the motto of the Pematang Health Center to be (smile, greeting, polite fast and precise). Providing services in a timely, polite, friendly manner and can maintain patient privacy in order to increase patient satisfaction and provide physical facilities such as (chairs, air conditioners, loudspeakers and machines to take no queue) as well as provide information on the use of mobile JKN.

Application of Alfalfa App in the management of oral anticoagulation in patients with atrial fibrillation: a multicenter randomized controlled trial

BackgroundIn recent years, mobile medical technology has made great progress in chronic disease management, but its application in patients with atrial fibrillation (AF) still needs to be clarified.ObjectiveThis study aims to determine whether the newly developed smartphone app for patients with AF (Alfalfa App) can improve anticoagulation knowledge, drug treatment compliance, and satisfaction of AF patients.MethodsAlfalfa App integrates the functions of patient education, remote consultation, and medication reminder through a simple user interface. From June 2020 to December 2020, patients with AF were recruited in five large tertiary hospitals in China. Patients were randomly divided into the Alfalfa App or routine nursing groups. Patients’ knowledge, medication adherence, and satisfaction with anticoagulation were assessed using validated questionnaires at baseline, 1 month, and 3 months.ResultsIn this randomized controlled trial, 113 patients with AF were included, 57 patients were randomly assigned to the Alfalfa App group, and 56 patients were randomly assigned to the routine nursing group. Forty-eight patients in the Alfalfa App group completed a three-month follow-up, and 48 patients in the routine nursing group completed a three-month follow-up. Basic demographic data were comparable between the two groups. The average age of AF patients was 61.65 ± 11.01 years old, and 61.5% of them were male. With time (baseline to 3 months), the knowledge scores of the Alfalfa App group (P<.001) and the routine nursing group (P = .002) were significantly improved, the compliance scores of the routine nursing group(P<.001) and Alfalfa App group(P<.001) significantly improved. Compared with the routine nursing group, patients’ knowledge level and medication compliance using the Alfalfa App at 1 month and 3 months were significantly higher (all P < .05). There were significant differences in knowledge and compliance scores between the two groups with time (all P < .05). The satisfaction degree of drug treatment in the Alfalfa App group was significantly better than that in the routine nursing group (all P < .05).ConclusionsAlfalfa App significantly improved the anticoagulation knowledge, drug treatment compliance, and satisfaction of AF patients. In oral anticoagulation management for AF patients, mobile medical technology that integrates the functions of patient education, remote consultation, and medication reminder may be helpful.Trial registrationRegistration number, ChiCTR1900024455. Registered on July 12, 2019.

Understanding the complexity of barriers and facilitators to adherence to oral nutritional supplements among patients with malnutrition: a systematic mixed-studies review.

The aim of this systematic mixed-studies review is to summarise barriers/facilitators to adherence to and/or consumption of oral nutritional supplements (ONS) among patients with disease-related malnutrition. In March 2022, the Cochrane CENTRAL, PUBMED, PsycINFO (Ovid) and CINAHL were searched for articles with various study designs, published since 2000. Articles were identified on the basis of 'population' (patients ≥18 years with malnutrition/at nutritional risk), 'intervention' (ONS with ≥2 macronutrients and micronutrients), 'comparison' (any comparator/no comparator) and 'outcome' (factors affecting adherence or consumption) criteria. A sequential exploratory synthesis was conducted: first, a thematic synthesis was performed identifying barriers/facilitators; and second, the randomised controlled trials (RCTs) were used to support these findings. The five WHO dimensions of adherence guided the analysis. Study inclusion, data extraction, analysis and risk-of-bias assessment (MMAT 2018) were carried out independently by two researchers. From 21 835 screened articles, 171 were included with 42% RCTs and 20% qualitative studies. The two major populations were patients with malignancies (34%) and older adults (35%). In total, fifty-nine barriers/facilitators were identified. Patients' health status, motivation, product tolerance and satisfaction as well as well-functioning healthcare routines and support were factors impacting ONS consumption. Few barriers/facilitators (n = 13) were investigated in RCTs. Two of those were serving a small ONS volume and integrating ONS into ward routines. Given the complexity of ONS adherence, non-adherence to ONS should be addressed using a holistic approach. More studies are needed to investigate the effect of different approaches to increase adherence to ONS.

Three-dimensional Stereoscopic Evaluation and Quantitative Gray Scale Assessment of the Nasolabial Fold and Its Application in Injection Therapy

With the growing demand for aesthetic enhancements, particularly filler injections for nasolabial folds (NLFs), there is a need for more objective and quantitative assessment methods beyond the traditional subjective scales like the Wrinkle Severity Rating Scale (WSRS). This study introduces a novel evaluation method combining 3-dimensional (3D) imaging and grayscale analysis to objectively assess NLF severity and treatment outcomes. A total of 100 healthy participants (86 females, 14 males; mean age 41.85±11.53 years) were assessed using WSRS scores and quantitative 3D measurements. The results demonstrated a significant positive correlation between WSRS scores and gray values (r=0.985, P &lt; 0.05). Significant differences in gray values and 3D linear measurements were observed across WSRS score groups, with high intra-rater reliability confirmed by intraclass correlation coefficients. In addition, 54 patients (mean age 42.9±8.9 y) with moderate to severe NLFs received hyaluronic acid injections. One month post-treatment, WSRS scores significantly decreased (from 3.74±0.45 to 1.63±0.59, P &lt; 0.05), and significant improvements were observed in several 3D measurements. The average gray value also decreased significantly (P &lt; 0.05), indicating a reduction in wrinkle depth. These findings were supported by representative photos showing patient satisfaction and no severe complications. This study validates the use of 3D imaging and grayscale analysis as reliable tools for objectively assessing NLF severity and monitoring treatment efficacy, potentially improving the precision and reliability of aesthetic evaluations in clinical practice.

Evaluation of Breast Skin/Nipple–Areolar Complex Sensation and Quality of Life after Nipple-Sparing Mastectomy Followed by Reconstruction

Background and Objectives: Sensation of the breast skin and nipple–areolar complex (NAC) is commonly assumed to be diminished or completely absent following nipple-sparing mastectomy (NSM) with implant- or expander-based reconstruction. The purpose of this cohort study was to evaluate breast skin and NAC long-term touch pressure sensibility, from 1 month to 1 year, after NSM followed by reconstruction with an implant or expander, and patient quality of life (QoL), hypothesizing that sensibility may diminish with a small progressive return throughout the postoperative period. Materials and Methods: This was achieved by performing sensation tests using Semmes–Weinstein monofilaments (SWM) in nine predefined points of the breast and NAC, a two-point discrimination test (TPD) in the four quadrants of the breast, and QoL assessment using the BREAST-Q. We evaluated 42 patients in Pauls Stradiņš Clinical University Hospital, with a total of 66 breasts, who underwent NSM between 2021 and 2023, performing the breast sensation tests before surgery and postoperatively at 1/3/6 months and 1 year. The BREAST-Q was administered to assess patient satisfaction and well-being. Results: Our results reflect a decline in breast skin and NAC sensation in the 1-month evaluation after NSM (mean: 4.67) when compared to the assessment before surgery (mean: 2.57), with a small progressive return reflected in the 3 months (mean: 3.79), 6 months (mean: 3.68), and 1-year evaluations (mean: 3.14). The following were the mean scores obtained from the BREAST-Q: Psychosocial Well-being (mean: 66), Sexual Well-being (mean: 50), Satisfaction with Breasts Pre-OP (mean: 58), satisfaction with breast reconstruction (mean: 52), Satisfaction with Implants, Satisfaction with nipple reconstruction, Physical Well-being Chest, Adverse effects of radiation, and Satisfaction with Information. Conclusions: This study confirms that sensibility diminishes after this procedure, as observed when comparing the sensation evaluation results before the operation with the 1-month evaluation, reflecting a small progressive return in the following months.