Safe Hands Research Articles

The public washroom - friend or foe? An observational study of washroom cleanliness combined with microbiological investigation of hand hygiene facilities

BackgroundMany people use handwashing and hand-drying facilities in public washrooms under the impression that these amenities are hygienic. However, such facilities may be potential sites for the transmission of pathogenic bacteria. This study aimed to examine the hygiene facilities provided including handwashing and hand-drying facilities in public washrooms. Total bacterial counts and species identification were determined for hand-drying facilities. Antimicrobial susceptibilities were performed.MethodsThe bacterial contamination levels of 55 public washrooms ranging in category from low class communities to high end establishments, were examined. The hygienic environment and facilities of the washrooms were analysed using an electronic checklist to facilitate immediate data entry. Pre-moistened sterile swabs were used to collect samples from areas around the outlet of paper towel dispensers, air outlet of air dryers, exit door handles and paper towels in the washrooms. Total bacterial counts were performed and isolates identified using matrix-assisted laser desorption ionisation time-of-flight mass spectrometry. Antimicrobial susceptibility was determined by disk diffusion.ResultsThe high and middle-income categories washrooms generally had cleaner facilities and environment followed by those in low categories. Fifty-two bacterial species were identified from the 55 investigated washrooms. Over 97% of the pathogenic Staphylococcus spp. tested were resistant to at least one first-line antimicrobial therapeutic agent, including penicillin, cefoxitin, erythromycin, co-trimoxazole, clindamycin and gentamicin, and 22.6% demonstrated co-resistance to at least three antimicrobial agents, with co-resistance to penicillin, erythromycin and clindamycin being the most common.ConclusionOur findings suggest that hand-drying facilities in public washrooms can act as reservoirs of drug-resistant bacteria. The importance of frequent cleaning and maintenance of public washrooms to promote safe hand hygiene practices for the public are emphasised.

Hand Hygiene Compliance Study at a Large Central Hospital in Vietnam.

Lack of proper hand hygiene among healthcare workers has been identified as a core facilitator of hospital-acquired infections. Although the concept of hand hygiene quality assurance was introduced to Vietnam relatively recently, it has now become a national focus in an effort to improve the quality of care. Nonetheless, barriers such as resources, lack of education, and cultural norms may be limiting factors for this concept to be properly practiced. Our study aimed to assess the knowledge and attitude of healthcare workers toward hand hygiene and to identify barriers to compliance, as per the World Health Organization’s guidelines, through surveys at a large medical center in Vietnam. In addition, we aimed to evaluate the compliance rate across different hospital departments and the roles of healthcare workers through direct observation. Results showed that, in general, healthcare workers had good knowledge of hand hygiene guidelines, but not all believed in receiving reminders from patients. The barriers to compliance were identified as: limited resources, patient overcrowding, shortage of staff, allergic reactions to hand sanitizers, and lack of awareness. The overall compliance was 31%; physicians had the lowest rate of compliance at 15%, while nurses had the highest rate at 39%; internal medicine had the lowest rate at 16%, while the intensive care unit had the highest rate at 40%. In summary, it appears that addressing cultural attitudes in addition to enforcing repetitive quality assurance and assessment programs are needed to ensure adherence to safe hand washing.

Jabil: Navigating through Supply Chain Uncertainty

In 2018, as the trade wars between the United States and China reached new heights, John faced challenges as he needed to quickly execute a plan to mitigate any risks to his company. The imposed tariffs were putting significant pressure on John’s current business initiatives, financial goals, and could derail is customers’ satisfaction. John knew that he was in safe hands with the support of Jabil’s supply chain and compliance directors. As one of the worlds largest Electronic Manufacturing Service companies, Jabil prides itself with understanding logistics, compliance, and operations competencies to support the growth of current and future business, all while mitigating and avoiding potential risks in the market. With the impact of the imposed tariffs beginning to affect John’s business, he knew that he needed to make a quick decision; either move operations out of China to a non-sanctioned country, continue the operations in China with the hope that the sanctions would end but risk customer satisfaction, or continue manufacturing the products in China and shipping the incomplete goods to another non-sanctioned location for final assembly, ultimately avoiding the tariff impacts. How was John expected to make this decision without understanding the trade uncertainties in the future? John knew that he needed to make his business profitable for him and the customer, but what approach did he need to execute on to keep the business sustainable? All these questions were impactful on the success of the business and could ultimately impact any long-term financial gains and growth with his customer base. John was anxious to come to a resolution, and knew that his next decisions would be critical to his business.

Creating Knowledge Using Seci Model as a Knowledge Management Stage to Improve Nurses’ Ability in Undertaking Parenteral Therapy

Muji Rahayu Hospital is a private hospital with 50 beds. The frequent incidence is phlebitis nosocomial infection in adult in-patient wards at Muji Rahayu Hospital from January to June 2011 as high as 5.19%. According to hospital minimal service standard, in-patient service indicator on the incidence of phlebitis must be below 2%. The result of this study reveals that on the factor of individual nurses: (a) The education level of some respondents (management and nursing staff) is nursing academy; (b) The level of knowledge on nursing care with parenteral therapy, parenteral therapy nursing documentation, correct and safe hand washing, and standard operating procedure before the training is inadequate and after the training is very good; (c) The nurses’ skills in undertaking the nursing documentation with parenteral therapy and parenteral therapy treatment before the training is inadequate and after the training is very good. As for the process of creating knowledge using SECI model, the result reveals that: (a) 70% of the respondents have implemented socialization activities; (b) 30% of the respondents have not implemented the externalization activities; (c) as many as 40% of the respondents have not implemented the combination activities; (d) whereas 40% of the respondents have not implemented the internalization activity. Therefore, the recommendation is to encourage individuals or nurses to learn and share knowledge, to document their experiences and expertise, and to give communication trainings.

AN INTEGRATED HEALTHY BREAKFAST EDUCATION FOR TEACHERS, SCHOOL CHILDREN, AND PARENTS IN WEST JAVA

Both skipping and unhealthy breakfast are frequent among Indonesian school children that may cause by low income and lack of awareness on benefits of healthy breakfast. Previous breakfast educations at school focus on the children. The objective of this community services was to build awareness of teachers, school children, and parents integrated. The method of this program was to train teachers, to educate parents, and to educate school children (3rd-6th grades) about healthy breakfast. A material of teacher training and education includes healthy breakfast, healthy snacks, and supported by comics and “cakram” of healthy breakfast. The material given to the target groups includes healthy breakfast; safe snacks, balanced nutrition, and hand wash through oral communication by example, reading comics and discussion. This community service was held on April 2017-April 2018 in Bandung, Tangerang, and Bogor of West Java in collaboration with PERGIZI PANGAN Indonesia and PT Indofood Sukses Makmur. The results showed healthy breakfast education goes well as planned. As much as 221 teachers, 4713 primary school children, 270 parents were educated on that topics. The trained teachers and parents agree to continue the healthy breakfast education program, once each semester. The children said that the design and the messages on healthy breakfast in the comics were interesting and easily understood.

BUSINESS INTELLIGENCE AND POWER OF KNOWLEDGE

Research carried out in the last few years as the example of companies belonging to the category of medium-size enterprises has shown that, for example, typical enterprises, of the total number of data processed in information of importance for its business, seriously takes into consideration and process only 10% of the observed firms. It is justifiable to ask whether these 10% of the processed and analyzed business information can have an adequate potential or motive power to direct the organization to success that is measured by competitive advantages and on a sustainable basis? Or, the question can be formulated: what happens to the rest, mostly 90% of the information that the enterprise does not transform into a form suitable for business analysis and decision-making. It is precisely the task of business intelligence to find a way to utilize all the data collected and processed in the business decision-making process. In this regard, we can conclude that Business Intelligence is, in fact, the framework title for all tools and / or applications that will enable the collection, processing, analysis, distribution to decision-making bodies in the business system in order to derivate from this information valid business decisions - as the most important and / or most important task of the manager. Of course, from an economic point of view, the best decisions are management decisions that provide a lasting competitive advantage and achieve maximum financial performance. This means that business intelligence actually allows a more complete and / or comprehensive view of the overall business performance of all its parts and subsystems. But the system functions can be measured essential and positive economic and financial performance, as well as the position in the branch of the business to which it belongs, and wider, within the national economy. (Of course, today the boundaries of the national economy have become too crowded for many companies, bearing in mind globalization and competitiveness in the light of organization of work and business function). The advantage of business intelligence as a model, if accepted at the organization level, ensures that each subsystem in the organization receives precisely the information needed to make development decisions, but also decisions regarding operational activities. So, it should be born in mind that business intelligence does not imply that information is shared on some key words, on the contrary, the goal is to look at the context of the business, or in general, and that anyone in the further decision hierarchy can manage exactly the same information that is necessary for achieving excellent business performance. Because, if the insight into the information is not complete, the analysis is based on the description of individual parts, i.e. proving partial performance in the realization of individual information, which can certainly create a space for the loss of the expensive time and energy. Illustratively, if the view, or insight into the information, is not 100%, then all business decision-making is like the song of J.J. Zmaj "Elephant", about an elephant and a blindmen, where everyone feels and act only on the base of the experienced work, and brings judgment on what is what or what can be. As in this song for children, everyone thinks that he touches different animals and when they make claims about what they feel, everyone describes a completely different life. Therefore, business intelligence implies that information is fully considered and it is basically the basis or knowledge base, and therefore the basis of business excellence. In doing so, the main problem is how information is transformed into knowledge and based on it in business decision making. It is precisely in this segment that the main advantage of business intelligence is its contribution to the knowledge and business of the company based on power of knowledge. Therefore, for modern business conditions, it is characteristic that the management of the company is realized on the basis of partial knowledge about stakeholders (buyers, suppliers, competitors, shareholders, governments, institutional framework, legislation), and only a complete overview of managers at the highest level in all these partial interest groups allows managers to have a “boat” called the organization of labor leading a safe hand through the storm, Scile and Haribde threatens to endanger business, towards a calm sea and a safe harbor - called a sustainable competitive advantage based on power and knowledge.

The Safe Hands Study: Implementing aseptic techniques in the operating room: Facilitating mechanisms for contextual negotiation and collective action

Even though hand hygiene and aseptic techniques are essential to provide safe care in the operating room, several studies have found a lack of successful implementation. The aim of this study was to describe facilitative mechanisms supporting the implementation of hand hygiene and aseptic techniques. This study was set in a large operating room suite in a Swedish university hospital. The theory-driven implementation process was informed by the literature on organizational change and dialogue. Data were collected using interviews and participant observations and analyzed using a thematic approach. The normalization process theory served as a frame of interpretation during the analysis. Three facilitating mechanisms were identified: (1) commitment through a sense of urgency, requiring extensive communication between the managers, operating room professionals, and facilitators in building commitment to change and putting the issues on the agenda; (2) dialogue for co-creation, increasing and sustaining commitment and resource mobilization; and (3) tailored management support, including helping managers to develop their leadership role, progressively involving staff, and retaining focus during the implementation process. The facilitating mechanisms can be used in organizing implementation processes. Putting the emphasis on help and support to managers seems to be a crucial condition in complex implementation processes, from preparation of the change process to stabilization of the new practice.

Psychosocial and organizational determinants of safe food handling at retail and food service establishments: a systematic review and meta-analysis

ABSTRACTVarious psychosocial and organizational factors have been investigated as determinants of food handlers’ food safety behaviours. A systematic review and meta-analysis of studies in this area was conducted to identify and synthesize the key behavioural determinants. Standard systematic review steps were followed: comprehensive search strategy; relevance screening; article characterization; risk of bias assessment; data extraction; and random-effects meta-analysis. Sixty-two relevant studies were identified, and knowledge was the most commonly investigated behavioural determinant (n = 51). Increased knowledge was consistently associated with safe food handing behaviours across both correlation (r = 0.30; 95% confidence interval [CI]: 0.12, 0.46; n = 24 studies; I2 = 98%) and odds ratio (OR) measures (adjusted OR = 1.85; 95% CI: 1.27, 2.70; n = 3; I2 = 0%). Seven other behavioural determinant categories were also consistently associated with various food safety behaviour outcomes. In contrast, no association was found between food handler experience and behaviour. The findings can inform the development of targeted training initiatives for food handlers.

“In Safe Hands” – A costly integrated care program with limited benefits in stroke unit care

Given reported favourable outcomes of accountable care unit models of health care delivery (Taylor et al., 2017; Stein et al., 2015; Kara et al., 2015), the Clinical Excellence Commission of NSW has embraced “In Safe Hands” (ISH) to enhance coordination of care. ISH embraces the structured interdisciplinary bedside round (SIBR) component, for which reported outcomes include reduced length of stay (Taylor et al., 2017; Stein et al., 2015; Kara et al., 2015), possible reduction in overall costs of care (Kara et al., 2015), and enhanced patient and staff satisfaction (O’Leary et al., 2011). It is not yet clear whether the benefits of such a model are translatable to the Australian Health Care System (Hunyh et al., 2016) and/or established units with an already strong multi-disciplinary approach to patient care. The purpose of this prospective cohort study of 200 participants was to assess the effect(s) of implementation of ISH in a stroke unit of a tertiary hospital in Sydney, Australia.Data on length of stay, re-admission rates, adverse events, as well as patient and nursing satisfaction, were collected pre and post implementation.There was no significant difference in length of stay in median days (5 (IQR 2–7) versus 4 (IQR 2–6), P = 0.55) or incidence of adverse events (10% versus 12%, P = 0.82). Stroke outcome disability scores were not affected by the intervention. There were no significant differences overall in reported patient and nursing satisfaction. Implementation of the ISH program cost approximately AUD$ 1805/week (USD$ 1365) in wages.The ISH program was a costly intervention of limited benefit in a well-established acute stroke unit. We here discuss potential reasons for the failure of this intervention to achieve its primary aim in this setting.

Safe Bets or Hot Hands? How Status and Celebrity Influence Strategic Alliance Formations by Newly Public Firms

Social approval assets derive their value from favorable stakeholder perceptions. Past research has focused primarily on their role as signals that reduce stakeholders’ perceived uncertainty about ...

Swedish men and smoking: Views on screening-detected abdominal aortic aneurysm.

Abdominal aortic aneurysms (AAA), most common among elderly male smokers, often show no symptoms before rupture. To facilitate better care and counselling targeted to smoking cessation for these patients, more knowledge is required about their views. Therefore, the aim of the present study was to describe the views on AAA and smoking among male smokers with screening-detected AAA. A qualitative approach with individual interviews with 16 men with screening-detected AAA was applied. Three had quit smoking by the time of the interviews. Thematic analysis was performed, and four themes emerged: (i) accepting the course of life; (ii) the elusive AAA: a disturbing experiencing or merely a minor inconvenience?; (iii) being in safe hands; and (iv) smoking as an unexpected topic of discussion. Most of the participants felt they were in "safe hands", although thoughts about death were also evoked. However, the information about smoking cessation was unexpected, and the relationship between AAA and smoking unclear. Presenting the connection between AAA and smoking in a clear manner and motivating smoking cessation in an individually-targeted way are important.

Knee pain in nursing home workers after implementation of a safe resident handling program.

Approximately 25-30% of nursing personnel experience knee pain (KP). We sought to identify physical and psychosocial work exposures, and personal factors related to prevalent, incident, and persistent KP 5-8 years after safe resident handing program (SRHP) implementation in nursing homes. Health and exposure information was obtained from worker surveys 5-6 years ("F5") and 7-8 years ("F6") post-SRHP implementation. Prevalent KP correlates were examined at F5; persistent and incident KP predictors were analyzed at F6, utilizing robust Poisson multivariable regression. F5 KP prevalence (19.7%) was associated with combined physical exposures, and with either high job strain or low social support, in separate models. Two-year persistent KP was similarly associated with these psychosocial exposures. Being overweight was associated with KP in all analyses. The SRHP program did not eliminate knee physical loading, which should be reduced to prevent nursing home worker KP. Workplace psychosocial exposures (high job strain, low social support) also appeared germane.

Chemical composition, nutrient-balancing and biological treatment of hand washing greywater

On-site biological hand washing water treatment can improve global access to safe hand washing water, but requires a thorough understanding of the chemical composition of the water to be treated, and an effective treatment strategy. This study first presents a detailed characterization of the individual inputs to hand washing water. We demonstrate (i) that soap is likely the most significant input in hand washing water, representing ∼90% of mass loading, and (ii) that inputs to hand washing water have low concentrations of biologically-essential macro- and micro-nutrients (nitrogen, phosphorus, potassium, copper, zinc, molybdenum and cobalt) with respect to carbon, which may impair biological carbon removal. This study next formulates a recipe that recreates a representative composition of hand washing water and develops a procedure to identify and supplement nutrients in which this recipe is estimated to be deficient. Batch testing of the nutrient-supplemented hand washing water with an inoculum of planktonic bacteria demonstrated improved assimilable organic carbon removal (99% vs. 86% removal) and produced lower final dissolved organic carbon concentrations (1.7 mgC/L vs. 3.5 mgC/L) compared to realistic (nutrient-deficient) washing water. Supplementing nutrients did promote cell growth (50x higher final total cell count). Full-scale testing in a biologically activated membrane bioreactor (BAMBi) system treating 75 L/day of nutrient-supplemented hand washing water showed that long-term operation (100 days) can deliver effective carbon removal (95%) without detrimental fouling or other disruptions caused by cell growth. This work demonstrates that biological treatment in a BAMBi system, operated with appropriate nutrient-balancing offers an effective solution for decentralized treatment of light greywater.

نوجوانوں میں تعلیم و تربیت کے فقدان کا تدارک اور سد باب سیرت مبارکہ کی روشنی میں

Youth is no doubt the asset of Muslim world. If they are utilized in charitable activities; in the protection of respect and honor; and developmental works, they can prove to be beneficial and a blessing. While if they are taken by destructive elements in their hands they will become source of destruction and harm. By providing proper Islamic education, our future will be in safe hands and will breath in an air of respect among other nations.
 In young age, deterioration in manners and moral corruption are alarming and cause mischief in society. Therefore, the interest taken in the problems of youth will result in a progressive society and ummah. Islam has given a special place to youth and has declared them future architect and leaders of humanity. The holy prophet S.A.W has given much importance to the youth and focused on them during his life time. In Islamic history, Muslim youth has represented the Muslim world in golden words and has spread the message of Islam’s moral height and greatness to the coming generations and nations. Due to the importance of youth problem of the youth in current time regarding lack of education and training are particularly discussed in this article. The research article begins with the detailed study of the research done in the area of education and socialization of youth. Moreover, the importance of education and socialization has been discussed in the light of the teachings of Quran and Hadith. After this, decadence in education, factors responsible for the decadence in education and its worse consequences have been thoroughly discussed in the light of the teachings of Islam. As there are several reasons responsible for the downfall of education like: parents, teachers, education system, society, state, preachers, political parties and media, therefore, responsibility of the remedy of this lack of proper education and socialization also depend on all these stake holders. In the end of the paper, recommendations are given for the cure of decadence in education.

New Layouts of Fiber Reinforcements to Enable Full Finger Motion Assist with Pneumatic Multi-Chamber Elastomer Actuators

Fiber-reinforced fluid-driven elastomer actuators have enabled the production of simple, low-cost and safe hand rehabilitation devices. However, so far, the actuators support only finger flexion-extension, and little has been reported on abduction-adduction, which is essential for manipulation tasks and grasping larger objects. The technical design difficulty of realizing abduction-adduction lies in the suppression of interference effects between the metacarpophalangeal (MCP) joint’s two orthogonal motion axes, caused by the necessary multi-chamber actuator structure and its reinforcements, under strong spatial constraints. This problem has not been solved yet, regardless of research efforts on designing various actuator structures. In this study, our goal was to enable flexion of all three finger joints and abduction-adduction of the MCP joint, while minimizing the interference and realizing required ranges of motion. For this, we propose two new types of fiber reinforcements (separate single loops and two-directional hitching) and their combination to direct a multi-chamber structure’s expansion and strengthen its force output into the wanted directions. The reinforcements’ effects on actuator response were evaluated by attaching prototypes to a dummy finger and measuring its range of motion and related joint torques and forces. Results showed that the single loops provided length extension, while the hitching constrained it from the bottom at the centerline and strengthened flexion. When combined, they could be used to adjust the amount of length extension and flexion along the actuator, without detrimentally affecting the flexion or abduction-adduction functions. In conclusion, the two new reinforcement types have the potential of being a major design factor for fitting the actuators’ response for different users’ finger kinematics.

Being in safe hands: Patients' perceptions of how cancer services may support psychological well-being.

To explore how cancer services may positively promote and support patients' well-being throughout treatment. Specifically to identify components of care that are important to patients and meet their needs. Patients commonly experience stress and uncertainty during their cancer journey which can have a negative impact on their psychological health and quality of life. Comparatively, little is known about how patients may experience positive well-being during their treatment experience. Qualitative study using semi-structured interviews. Interviews were conducted between 2014 - 2015 with a purposive sample of 30 individuals who were at the beginning, middle or end of treatment for lung, colorectal and head and neck cancer. The majority were outpatients and receiving radiotherapy, chemotherapy or a combination of these. The recordings were analysed using thematic analysis. Patients may obtain a range of positive health benefits derived from contact with staff, patients and public. Positive emotional gains were based on "being in safe hands" and part of the collective effort to eradicate cancer. This appeared to assist patients achieve favourable treatment responses, however, a range of factors encouraged and hindered them to express concerns. Interactions with staff, patients and the hospital environment supported well-being in those receiving cancer treatment. Findings demonstrate additional areas for research including the development of interventions to facilitate peer support and the implementation of communication strategies that promote well-being.

Evaluation And Use Of Special Collection Perspective Of KNLS

Users in public libraries’ needs are changing, technology is changing, the economic environment is changing, distribution of information channels are changing and so, Public libraries should change their roles and approaches to achieve its goal by availing of special collection and special services to users. In assisting information users to access and use not only online special information services but also access other websites special collection services the role of public libraries within the information age context is changing from that of information provider to that of service provider and so is the roles of librarians; changing its old-age manual operations of print to print service to that of library networking to facilitate information sharing services and activities fundamentally requires the new dimension of trained and available enabling environment of ICT in public library system in Kenya. Users’ opinion, views and feelings account most in the fulfillment of the core objectives the Public library is established for. This paper, discusses the public library special collection in the format of; rare books, manuscripts, photographs, archives, artifact, historical photos, unique materials and pamphlets. Therefore researcher has surveyed them in all 32(100%) public libraries in Kenya. This research paper is further, intended to help public libraries librarians, managers and management to decide how to integrate ICT resources special collection in such a way that most users can understand them well enough to make productive choices to foster research. It compiles usability test data evaluating special collection and services offered in library public libraries in Kenya. This research paper describes the progress and application of a fundamental comparison typical which allows librarians to quantitatively measure library special collection services apparent quality, satisfaction and constancy with a library as well as the degree to which exact elements of a library’s program, collections and setting donate to those perceptions……Library professional protocol and standards are in safe hands of both users and staff who are skillfully trained in technical, analytical and information management and repackaging skills; to further provide library information services like subject specialists and subject analyst equipped with special skills to deal with children information needs and users with special needs. In this paper special collection and special services offered to special users in Kenya National Library Services (KNLS) via public libraries in Kenya has been discussed.

Iterative co-creation for improved hand hygiene and aseptic techniques in the operating room: experiences from the safe hands study

BackgroundHand hygiene and aseptic techniques are essential preventives in combating hospital-acquired infections. However, implementation of these strategies in the operating room remains suboptimal. There is a paucity of intervention studies providing detailed information on effective methods for change. This study aimed to evaluate the process of implementing a theory-driven knowledge translation program for improved use of hand hygiene and aseptic techniques in the operating room.MethodsThe study was set in an operating department of a university hospital. The intervention was underpinned by theories on organizational learning, culture and person centeredness. Qualitative process data were collected via participant observations and analyzed using a thematic approach.ResultsDoubts that hand-hygiene practices are effective in preventing hospital acquired infections, strong boundaries and distrust between professional groups and a lack of psychological safety were identified as barriers towards change. Facilitated interprofessional dialogue and learning in “safe spaces” worked as mechanisms for motivation and engagement. Allowing for the free expression of different opinions, doubts and viewing resistance as a natural part of any change was effective in engaging all professional categories in co-creation of clinical relevant solutions to improve hand hygiene.ConclusionEnabling nurses and physicians to think and talk differently about hospital acquired infections and hand hygiene requires a shift from the concept of one-way directed compliance towards change and learning as the result of a participatory and meaning-making process. The present study is a part of the Safe Hands project, and is registered with ClinicalTrials.gov (ID: NCT02983136). Date of registration 2016/11/28, retrospectively registered.

The Future is in Safe Hands

The fourth annual Manufacturing Champions Awards brought together some of the best talent from across industry for an afternoon of celebration and recognition of the teams and individuals that make UK factories great

Measuring patient outcomes in chronic heart failure: psychometric properties of the Care-Related Quality of Life survey for Chronic Heart Failure (CaReQoL CHF)

BackgroundThe Care-Related Quality of Life survey for Chronic Heart Failure (CaReQoL CHF) is a newly developed patient-reported outcome measure (PROM) that measures care-related quality of life in patients diagnosed with chronic heart failure. This study describes the psychometric properties of the questionnaire and its relationship with disease severity and global rating of quality of care.MethodInsurance companies selected patients with a recorded diagnosis of chronic heart failure and for whom the hospital submitted a billing statement in the last year. Exploratory factor analysis, Cronbach’s alpha and item-rest correlation were used to construct the CaReQoL CHF. Construct validity was assessed by examining the mean values of the CaReQoL CHF scales for the categories of the widely-used New York Heart Association (NYHA) functional classification and by correlating the global rating of quality of care with the CaReQoL CHF scales.ResultsOne thousand eighteen patients with chronic heart failure filled out the CaReQoL CHF (RR: 35.7%). The CaReQoL CHF consists of 20 items and three scales: social and emotional problems, physical limitations, and being in safe hands. The mean scores of the three scales differed significantly for the NYHA categories, particularly for the social-emotional problems and physical limitation scales. The ‘being in safe hands’ scale showed a moderate positive correlation with the global rating of quality of care.ConclusionsThe CaReQoL CHF is a concise and valid PROM that matches patients’ priorities in healthcare. It adds a new element to existing quality of life questionnaires for patients with chronic heart failure, that is ‘being in safe hands’ scale. This scale is relevant for patients because they experience anxiety and tension about their condition. Future research should determine whether the CaReQoL CHF can help healthcare providers in daily practice to focus treatment on outcomes of care that are relevant to individual patients.