Degree Of Patient Satisfaction Research Articles

Spinal cord epidural stimulation for motor and autonomic function recovery after chronic spinal cord injury: A case series and technical note.

Traumatic spinal cord injury (tSCI) is a debilitating condition, leading to chronic morbidity and mortality. In recent peer-reviewed studies, spinal cord epidural stimulation (scES) enabled voluntary movement and return of over-ground walking in a small number of patients with motor complete SCI. Using the most extensive case series (n = 25) for chronic SCI, the present report describes our motor and cardiovascular and functional outcomes, surgical and training complication rates, quality of life (QOL) improvements, and patient satisfaction results after scES. This prospective study occurred at the University of Louisville from 2009 to 2020. scES interventions began 2-3 weeks after surgical implantation of the scES device. Perioperative complications were recorded as well as long-term complications during training and device related events. QOL outcomes and patient satisfaction were evaluated using the impairment domains model and a global patient satisfaction scale, respectively. Twenty-five patients (80% male, mean age of 30.9 ± 9.4 years) with chronic motor complete tSCI underwent scES using an epidural paddle electrode and internal pulse generator. The interval from SCI to scES implantation was 5.9 ± 3.4 years. Two participants (8%) developed infections, and three additional patients required washouts (12%). All participants achieved voluntary movement after implantation. A total of 17 research participants (85%) reported that the procedure either met (n = 9) or exceeded (n = 8) their expectations, and 100% would undergo the operation again. scES in this series was safe and achieved numerous benefits on motor and cardiovascular regulation and improved patient-reported QOL in multiple domains, with a high degree of patient satisfaction. The multiple previously unreported benefits beyond improvements in motor function render scES a promising option for improving QOL after motor complete SCI. Further studies may quantify these other benefits and clarify scES's role in SCI patients.

Intradermal suture post-surgical scar in external dacryocystorhinostomy: technique and patient satisfaction survey

Purpose: Dacryocystorhinostomy surgery may result in significant postoperative scarring. Although other surgical techniques have been developed that achieve a better aesthetic result, the ab externo technique remains the gold standard for this procedure. We developed a telephone survey to evaluate the visual impact of postoperative skin scars associated with ab externo dacryocystorhinostomy. Methods: 470 patients underwent uncomplicated external dacryocystorhinostomy surgery by two consultant surgeons from January 2014 to December 2021. Skin incisions were closed using intradermic continuous suture with prolene 6.0. The exclusion criteria were cases of dacryo-phlegmon and lacrimal sac fistulae with skin maceration. The visual effect of the postoperative scar was evaluated, and the degree of patient satisfaction was measured by a questionnaire with four subjective perceptions of the scar (very good, good, bad, very bad) given by a physician in the first postoperative month. The survey responses were used as the basis for a literature review. Results: The survey received 470 responses (100%) Very good perception of the scar was achieved in 75,8% of patients. There were no other post-operative complications noted from medical records review. Conclusions: Given the small percentage of patients who complained of marked scarring, it should not be the main reason for deciding on the procedure for dacryocystorhinostomy, especially in elderly patients. Therefore, the surgical technique should be considered as a surgically acceptable choice if cosmetic results were selection criteria in the case of total stenosis of the nasolacrimal duct.

A High-Efficiency Consultation Improves Urological Diagnosis in Patients with Complex LUTS-A Pilot Study.

(1) Background: The diagnosis of moderate-severe lower urinary tract symptoms (LUTS) is not easy due to the complexity of the micturition act. Sequential diagnostic tests can be time consuming due to waiting lists. Thus, we developed a diagnostic model combining all the tests in a single one-stop consultation. (2) Methods: In a prospective pilot study in patients with complex LUTS, they received all diagnostic tests (ultrasound, uroflowmetry, cystoscopy, pressure-flow study) in a single consultation and by the same doctor. Patients' results were compared with those from a 2021 paired cohort that underwent the classical sequential diagnostic pathway. (3) Results: Per patient, the high-efficiency consultation saved: 175 days of waiting, 60 min doctor time and 120 nursing assistant time and over 300 euros on average. The intervention also saved 120 patient journeys to the hospital, lowering the total carbon footprint by 145.86 kg CO2. In one-third of the patients, performing all the tests within the same consultation contributed to reaching a more appropriate diagnosis and thus more effective treatment. Patients' satisfaction was high, with good tolerability. (4) Conclusions: The high-efficiency urology consultation improves waiting times, therapeutic decisions and the degree of patient satisfaction while optimizing the use of resources and generating savings for the health system.

Efficacy and Satisfaction of Low Doses UVA1 Phototherapy: A Spanish Experience from a Single Centre.

UVA1 phototherapy is a treatment used for multiple dermatological conditions. The optimal therapeutic regimens and dosing of UVA1 are a matter of debate. The dosages used vary widely between published studies and there are no evidence-based protocols that provide data on dosage, duration, or the role of maintenance therapy. The purpose of this study is to evaluate the experience in our medical center regarding treatment with UVA1, as well as the degree of patient satisfaction with the treatment according to their pathology. We present a retrospective evaluation of outcomes, treatment tolerability, and satisfaction in adult patients using a low dose of UVA1 phototherapy, administered in our dermatologic service between 2019 and 2022. A total of 78 patients were treated with UVA1, of whom 46 patients (59%) were over 18 years old, completed treatment, and gave their consent. The overall objective clinical response rate was 91.30% (42/46), achieving a complete response in 17 (36.96%) patients, partial response in 25 (54.34%), and no response in 4 (8.70%). The complete response rates recorded were high in morphea, scleredema, or chronic hand eczema. In terms of the level of satisfaction objectively measured by TSQM-9 version 1.4, highlighting high scores obtained in mastocytosis, systemic sclerosis, morphea, scleredema, chronic hand eczema, or prurigo nodularis (over 65 points). We present a review of treatment with UVA1 phototherapy at low doses with good response in a wide variety of dermatological pathologies.

Patient dissatisfaction associated with physician-patient linguistic discordance in California clinics: an analytical cross-sectional study

BackgroundPatient satisfaction is considered as a product of two psychological processes, a cognitive one, including expectations and perceptions, and an emotional one resulting from the congruence between expectation and subjective perception of the user. The objective was to identify the factors associated with the level of perceived satisfaction in patients treated in 36 nonprofit health clinics that offer comprehensive health care services in four counties in the state of California, United States.MethodsCross-sectional analytical study in 14 clinics in four California counties. It consisted of the application of a 30-item questionnaire to determine the degree of patient satisfaction with the clinic. The factorial composition of the quality of care and clinic quality components was analyzed and two factors with an Eigen value greater than 1 were obtained.ResultsA total of 846 responses were registered. Factor analysis identified two underlying dimensions: Physician Attitude and Empathy. It was found that the discordance in language between the physician and the patient generates a difference in the perception of satisfaction. Patients who prefer to speak English have better satisfaction than those who speak Spanish. Spanish speakers who do not have interpreter have lower satisfaction than those who do (p < 0,01).ConclusionsThe most important sociodemographic cofactor was language. Satisfaction decreased in Spanish-speaking patients who were not proficient in the use of English since they expressed fewer comments and doubts.

Non-surgical rhinoplasty technique: An innovative approach for nasal reshaping with hyaluronic acid fillers.

Nonsurgical rhinoplasty has become increasingly popular among patients who want to improve the aesthetic aspects of their nose and do not accept the risks and/ or cost of surgical rhinoplasty. The main goal of the current paper was to present the preliminary aesthetic and clinical outcomes of an innovative injection technique for nose sculpturing with hyaluronic acid (HA) filler. Retrospective analysis of a prospective clinical registry of patients who attended one of the study centers and were candidates for non-surgical nose reshaping between October 2019 and November 2020. A 25 mg/mL HA filler was administered, in all the cases, by using a syringe with a fixed microneedle (30G/8mm). All patients were injected at three key nose points with the following order: (1) Tip (maximum HA injected 0.2mL); (2) columella (maximum HA injected 0.3mL); and (3) Radix and Dorsum (maximum HA injected 0.3mL). Degree of patient satisfaction with the treatment was assessed by using a five-points Likert scale. The primary endpoint was the degree of patients' satisfaction 12 months after treatment. One-hundred-and-one patients (91 women) were included in the study. Fifty-six (56%) patients underwent a unique treatment-session and 44 (44%) subjects needed an additional touch-up. Eighty-five (84.2%) patients were very satisfied with the treatment results. Six (5.9%) patients reported moderate adverse events, which were successfully controlled with medical therapy. Our nose sculpturing technique, by using hyaluronic acid filler, was an effective, predictable, and relatively safe procedure, that obtained a high degree of patient satisfaction.

Minimally invasive 1,444-nm Nd:YAG laser treatment for axillary bromhidrosis.

Axillary bromhidrosis is an apocrine glands hyperactivity disease. A total of 24 patients (15 men and 9 women) with axillary bromhidrosis underwent a laser procedure with a 1,444-nm Nd:YAG laser. Parameters evaluated in this study were as follows: the degree of malodor (T0, baseline; T30, after 1 month; and T180, after 6 months), postoperative pain, short-term decreased mobility (T1, after 1 day; T7, after 7 days; and T30, after 1 month), and overall satisfaction (T30, after 1 month and T180, after 6 months). A visual analog scale (VAS), from 0 to 10, was used to assess pain and decreased mobility, with lower values denoting less severity. A total of 24 patients were followed up for 6 months after laser treatment. At baseline, all patients (100%) complained of a strong axillary malodor (mean degree of malodor at T0 = 2.0 ± 0.00). It decreased to 0.50 ± 0.64 at T30. At T180, the degree of malodor was 0.54 ± 0.57. Both T30 and T180 degrees of malodor significantly decreased from the baseline value (p < 0.01). The mean degree of patient satisfaction at T30 was 1.75 ± 0.52, and at T180, it was 1.67 ± 0.21. Among the 24 patients, eight complained of moderated pain 1 day after treatment. The pain subsided on day 7, except for two patients, with VAS = 1. Pain and mobility restrictions were in any case resolved within T30. Treatment with a 1,444-nm Nd:YAG laser for subdermal interstitial coagulation could be a less invasive and more effective option treatment for axillary bromhidrosis.

Satisfaction of patients with health care services in tertiary care facilities of Riyadh, Saudi Arabia: A cross-sectional approach.

As part of Saudi Vision 2030, the country's healthcare system is undergoing a significant makeover, with accessibility and effectiveness serving as the benchmarks for measuring patient care quality. This study's goal was to ascertain the degree of patient satisfaction with the medical care and services received in Riyadh's tertiary care facilities. The PSQ-18 (Patient Satisfaction Questionnaire-18), a standardized validated questionnaire including areas of "overall satisfaction," "technical quality," "interpersonal aspect," "communication," "financial aspect," "time spent with the doctor," and "accessibility and convenience," was used in this cross-sectional study on 384 patients of two tertiary care facilities in Riyadh, Saudi Arabia, over a 6-month period. The degree to which sociodemographic characteristics and components of patient satisfaction are correlated was assessed using binary and multiple regression analysis. When the P-value was < 0.05, the results were considered significant and were presented as adjusted odds ratios (AOR). To ascertain how each PSQ-18 subscale affected other subscales, a Pearson Correlation analysis was conducted. The overall degree of satisfaction with all 18 items was 73.77%. The financial component received a rating of 81% compared to 77% for general satisfaction. Technical quality (75%) was followed by accessibility and convenience (73.5%), communication (73%), and interpersonal elements (72%). At 68%, the time spent in the doctor's domain received the lowest rating. The odds of satisfaction were increased by 3.87 times, 3.45 times, and 3.36 times among those who are employed, qualified by university education, and married compared to unemployed (P-value = 0.018), less qualified (P-value = 0.015) and singles (P-value = 0.026), respectively. The younger age group also made 1.78 times more of a difference in higher satisfaction ratings. The general satisfaction domain showed a positive association with other areas. Participants who were satisfied with the communication and accessibility and convenience domains of healthcare providers were the only ones who were typically satisfied with the domain of doctor time spent. The study's findings could act as a benchmark for Saudi Arabia's healthcare services as well as a starting point for quality assurance procedures.

Patient-Reported Satisfaction with Using a Rechargeable 10 kHz Spinal Cord Stimulation Device

Chronic pain is a common clinical condition and is frequently treated with a variety of medications, but pharmacotherapy is oftentimes not the optimal long-term treatment option. Safe and effective long-term pain relief for trunk and limb pain is available using high-frequency spinal cord stimulation at 10 kHz (10 kHz SCS), which is delivered using a rechargeable implantable pulse generator (IPG). Although rechargeable devices have been shown to reduce patient risk and overall cost by eliminating the need for periodic surgeries to replace depleted non-rechargeable IPGs, there is little published evidence that rechargeable technology is practical and convenient for patients, especially in the context of 10 kHz SCS. This analysis of real-world patients implanted with 10 kHz SCS devices was undertaken using patient data from an industry-maintained database to investigate whether there was a substantial burden associated with rechargeable SCS and the degree of patient satisfaction or dissatisfaction with 10 kHz SCS. This study included 10,391 men and women who were implanted with 10 kHz SCS devices to treat chronic pain of the trunk and/or limbs. They received stimulation for a median of 361 days (180-1550 days), and 65.48% had previous spine surgery. In this patient sample, most patients were satisfied with the efficacy of 10 kHz SCS, including 77% who would repeat the procedure and 71% who would recommend it to other patients with similar pain. In regards to IPG recharging, 70% were satisfied or very satisfied and 19% were neutral, and a majority of patients recharged their device daily for 30 to 60 minutes. These results indicate most patients do not find IPG recharging inconvenient or burdensome. In addition, IPG recharging is not a barrier to the majority of patients benefitting from 10 kHz SCS for long-term pain relief.

Patient experience, overall satisfaction, and its associated factors after general emergency surgery

Background: The level of patient satisfaction is an essential health outcome used to determine the quality of care provided. Unfortunately, studies need to be more comprehensive regarding patient satisfaction and its associated factors after general emergency surgery in Saudi Arabia. Therefore, this study aims to measure the level of patient satisfaction after general emergency surgery and determine the factors that influence it. Methods: A cross-sectional study was conducted among patients who underwent general emergency surgery in the Qassim region from June to July 2022 after applying inclusion and exclusion criteria. A validated online Arabic Patient-Reported Experience Measures questionnaire was distributed through multiple social networking applications. Bivariable and multivariable logistic analyses determine the variables linked to satisfaction with the care provided and assess patient experience, overall satisfaction, and its associated factors after general emergency surgery. p = 0.05 with a 95% CI was considered as the statistical significance level. Results: Patient satisfaction with the general emergency surgery was high. Confidence and trust in doctors and nurses responsible for the care, the absence of nighttime noise from staff and other patients, the perception of sufficient privacy for both clinical discussions and examinations, explanation of the purpose of discharge medication and how to take it, and information are given for whom to contact if concerned, were associated with significantly high patient satisfaction and good experience. Conclusion: Many associated factors were found to influence the attitude, experience, and degree of patient satisfaction with the medical/non-medical services rendered by the general emergency surgery unit staff.

Design, implementation and evaluation of a service for Medication compliance aids (MCAs) in an institutional Pharmacy in the city of Córdoba

The Pharmaceutical Service (PS) for the provision of Medication compliance aids (MCAs) consists of reconditioning and unifying, in a protocolized manner and in multi-compartment devices, the medications used by a patient, ordering them according to their dosage guideline. The objective was to design, implement and evaluate an PS of MCAs in an institutional pharmacy in the city of Córdoba. Observational, descriptive and longitudinal study. A Standard Operating Procedure (SOP) was developed from for PS of MCAs and applied to a sample of 20 patients. Adherence was analyzed by: tablet count and Morisky-Green test. A validated service satisfaction questionnaire was applied and a cost analysis was performed considering the initial investment and the times involved. A 98.0% adherence was obtained by counting the tablets and by the Morisky-Green test: 5.0% at the start of the service and 55.0% at 3 months. The patients expressed in the satisfaction questionnaire: 90.0% very satisfied and 10.0% satisfied. Regarding the cost analysis, the initial investment was USD 1,670.44. A value of US $ 4.29 was calculated for the first interview, and the monthly cost of preparation ranged from US $ 16.02, for 7-30 weekly takings, to US $ 28.73 for more than 121 takings. It was possible to develop and implement an SOP for the PS of SPD, with significant improvements in adherence. A high degree of patient satisfaction was observed and were obtained minimal operating costs to achieve sustainability.

Estudio descriptivo sobre la satisfacción de las usuarias de Implanon® y los motivos para su retirada

IntroductionImplanon® is a subdermal contraceptive implant that is inserted on an outpatient basis. It contains 68mg of etonogestrel, and is a long-acting reversible contraception method. MethodologyLongitudinal and retrospective descriptive study of the patients who had Implanon® inserted in our centre between 2015 and 2016. The variables analysed were age, reasons for insertion and removal, time until removal, degree of patient satisfaction, and unwanted pregnancy during the period of use. ResultsIn 97.3% of the cases, the reason for insertion was contraception, but there was one case of insertion to control heavy menstrual bleeding. The mean age of insertion was 27.2 years. The percentage continuing with the method after 3 years of follow-up was 43.6%. The most frequent reasons for requesting removal were frequent uterine bleeding (16.2%) and gestational desire (13.5%). Regarding satisfaction, overall 75.7% of the users were satisfied with the method. No pregnancy occurred in the users. ConclusionsImplanon® is a highly effective contraceptive method, mainly used by patients around the third decade of life. The most frequent side effects observed relate to alterations in the menstrual bleeding pattern, and are among the most frequent reasons for requesting removal of the device.

Esplorhem Study Design and Progress: Evaluation of Spanish Experience of Using Florio® Heamo, Digital Medical Device for Treatment Monitoring in Hemophilia Patients

Background: The use of electronic diaries (eDiaries) has been implemented as a promising strategy to improve the follow-up of diseases such as hemophilia, both for clinicians and for the patients themselves. In particular, standard treatment of hemophilia patients is mainly based on infusion of factor concentrates and is performed at home by patients or caregivers. This practice involves a thorough recording of infusions, bleedings, and other adverse events, which is usually carried out on paper and is deficient in most cases, making it very difficult to follow up and optimize patient treatment. Florio® HAEMO is a cell phone application (app) designed for hemophilia patients, where they can record bleeding and infusion details and share them with their physician in real time. The implementation of this app in the clinical routine of hemophilia patients promises to improve patient follow-up, enabling treatment at home in a more controlled and autonomous manner. Methods: eSPLORHEM (Evaluation of Spanish experience of using florio HAEMO ediary) is a bispective, observational and multicenter study designed to evaluate the national experience on the use of florio HAEMO for treatment monitoring in hemophilia patients. Hemophilia A and B patients with factor levels <5%, with no other hemostasis problems and who are not participating in a phase 1-3 clinical trial will be included. The effect of the use of the app on adherence to treatment and the annual bleeding rate will be evaluated. Adherence to treatment will be calculated based on the prescribed treatment and concentrates collected at the pharmacy by the patient and ABR will be calculated by the number of bleedings for one year. Quality of life survey data will also be collected through the EQ-5D-5L questionnaire and at the end of the study a survey will be conducted with both patients and clinicians to assess the degree of satisfaction with the use of florio HAEMO. The quality of the documentation recorded in the app will be assessed by comparing the drug stock that the patient picks up at the pharmacy against the number of infusions and the stock recorded. Results: To date, a total of 12 Spanish centers have confirmed their participation and it is estimated that a total of approximately 100 patients will be included. The protocol was approved by the competent authorities in January 2022 and is being implemented in all collaborating centers. The recruitment phase will be open until the end of August 2022, including a retrospective phase since May 2020 in order to include the experience of patients who have already started using the app. The follow-up period will end in August 2023, so that patients will complete a minimum follow-up period of 12 months. Final analysis report is expected to be available in November 2023. Conclusion: The results of this study will provide objective evidence of the effect of the use of florio HAEMO, through clinical parameters such as treatment adherence and ABR, as well as the degree of patient and clinician satisfaction. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Clinical Effect of Application of Interventional Treatment Models for Improvement of Quality of Postoperative Recovery in Elderly Patients with Total Hip Arthroplasty.

To investigate the application value of the interventional treatment model for improving the recovery of elderly patients after total hip arthroplasty (THA). A total of 50 patients who received THA were randomly divided into the control group (25 cases) undergoing traditional treatment and the experimental group (25 cases) undergoing intervention of cognition, emotion, environment, education, nutrition, and sleep. The mini-mental state examination (MMSE) score, the incidence and duration of postoperative cognitive dysfunction (POCD), the out-of-bed activity time, hospital stays, and the satisfaction degree of patients were compared between the two groups. There was no statistically significant difference in basic information between the two groups. On days 7 and 14 after surgery, the MMSE score of the control group was significantly lower than that of the experimental group (P <0.05). The incidence of POCD in the experimental group was lower and its duration was shorter than in the control group but without statistical significance. Besides, the significantly decreased out-of-bed activity time, the reduced length of hospital stay, and the higher satisfaction degree were observed in the experimental group (P <0.05). Interventional treatment model could significantly increase the MMSE score, accelerate the recovery of elderly patients after THA, and increase their satisfaction degree.

The impact of Parkinson's disease on results of primary total knee arthroplasty.

Parkinson's disease (PD) is a common neurodegenerative disorder. When patients with PD undergo total knee arthroplasty (TKA) for knee osteoarthritis, poorer knee function and poorer quality of life are obtained than in matched cohorts (MCs). However, the degree of patient satisfaction is usually high. The mean length of stay is 6.5% longer in patients with PD than in MCs. Compared with MCs, patients with PD undergoing TKA have a 44% higher risk of complications. In patients with PD, the overall complication rate is 26.3% compared with 10.5% in MCs; the periprosthetic joint infection rate is 6.5% in patients with PD vs 1.7% in MCs; and the periprosthetic fracture rate is 2.1% in patients with PD vs 1.7% in MCs. The 90-day readmission rate is 16.29% in patients with PD vs 12.66% in MCs. More flexion contractures occur in patients with PD. The rate of medical complications is 4.21% in patients with PD vs 1.24% in MCs, and the rate of implant-related complications is 5.09% in patients with PD vs 3.15% in MCs. At 5.3 years' mean follow-up, the need for revision surgery is 23.6%. The 10-year implant survival, taking revision of any of the components as an endpoint, is 89.7% in patients with PD vs 98.3% in MCs.

Effectiveness and Safety of Treating Negative Emotions after PCI from the Perspective of Qi and Blood: A Systematic Review and Meta-Analysis.

Background Many patients undergoing PCI have been reported to suffer from psychological distress and negative emotions. Several lines of evidence have indicated that PCI patients with negative emotions are particularly vulnerable to myocardial reperfusion injury when they face psychological challenges. As proven by clinical trials and research, traditional Chinese medicine (TCM) has certain advantages in alleviating psychological symptoms in PCI patients. The level of evidence for TCM is not yet high. There is no existing systematic review to evaluate the effectiveness and safety of TCM in post-PCI patients. Methods PubMed, EMBASE, Cochrane Library, Web of Science, CNKI, VIP, Wanfang Database, and CBM were searched to identify randomized controlled trials (RCTs) that treated negative emotions after PCI using qi and blood cotherapy. The search period was from database inception to March 1, 2022. After applying the inclusion and exclusion criteria to the RCTs, research quality evaluation and data extraction were conducted, and a meta-analysis of the articles was performed using Revman 5.3 and Stata 12.1. Results A total of 14 RCTs involving 1314 patients were included. Meta-analysis results indicated that compared with the anti-anxiety and depression medications group, the qi-blood harmony group was more effective in clinical outcomes (RR = 1.19, 95% CI (1.13, 1.25), P < 0.00001), maintaining the stability of angina pectoris (SMD = 0.65, 95% CI (0.29, 1.01), P=0.0004), increasing the degree of patients' satisfaction (SMD = 0.95, 95% CI (0.25, 1.65), P=0.008), reducing the frequency of attacks (SMD = 0.64, 95% CI (0.11, 1.18), P=0.02), and the incidence of adverse reactions (RR = 0.54, 95% CI (0.43, 0.68), P < 0.00001). The HAMA and HAMD scores were significantly lower after treatment, and there was no significant difference between the two groups (HAMA: RR = 1.03, 95% CI (0.95, 1.12), P=0.4). The efficacy of the two groups was comparable. In terms of reduction of the HAMD score, after sensitivity analysis, the literature by Liang was found to be significantly influencing the results, and after excluding the results of Liang, the qi-blood harmony group was superior to the Western medicine group for reducing the HAMD score (RR = 1.12, 95% CI (1.01, 1.24), P < 0.05), which was significantly different. The results of this review, combined with the grade evaluation, suggest that the HAMA posttreatment score reduction, the efficacy of TCM treatment, and the incidence of adverse reactions were supported by moderate evidence, and the HAMD posttreatment score reduction and the SAQ score were supported by low-quality evidence. Conclusion Treating negative emotions after PCI based on the idea of “harmonization of qi and blood” can effectively improve the clinical efficacy, the stability of angina pectoris and the degree of patient satisfaction, and can reduce the frequency of angina attacks and the incidence of adverse events. There was no significant difference between the two groups for reductions in the HAMA and HAMD scores. However, more high-quality, large sample, multicentre RCTs are still needed for further verification. PROSPERO Registration Number: PROSPERO CRD42022313169.

Определение направлений совершенствования качества медицинских услуг с использованием методик SERVQUAL и IPA

Assessing patients’ expectations and perceptions of health care delivery is challenging. To understand the quality of health care delivery, a study was conducted related to how patients assess the expected and perceived quality of health care delivery in a district hospital. Modern methods of measuring patient satisfaction and its interpretation using statistical analysis methods allow solving problems of this type. P u r p o s e : development of approach to improvement of quality of medical services provision using results of measurement of satisfaction with quality of medical services provided to patients in inpatient conditions of regional level, using SERVQUAL technique; substantiation on built regression model of influence of certain aspects of patients’ perception of quality satisfaction. M a t e r i a l s a n d m e t h o d s . The materials of the study are presented in the form of the results of a medical and sociological study of 418 patients who received medical services in one of the medical organizations at the regional level. Methods of statistical analysis of patient questionnaire results, factor, regression analysis, Importance-Performance Analysis (IPA) were used. R e s u l t s . An analysis of the data showed that 54.3% of patients were quite satisfied with the services. A regression equation is constructed to calculate the degree of patient satisfaction depending on a number of aspects of health care delivery. According to the IPA method, a schedule of four-quadrant distributions of patient assessments has been drawn up, on the basis of which it is possible to form measures to increase patient satisfaction with medical services. F i n d i n g s . The use of the SERVQUAL technique allows you to measure satisfaction with the quality of medical services, and the use of the IPA technique allows you to interpret it and obtain useful information regarding the quality of medical services as an element of patient feedback in the quality management system of a medical organization.

An Investigation into Patient Satisfaction from the Healthcare System in Saudi Arabia: Survey and Analysis of the Major Determinants in the Qassim Region

The main aim of this empirical study is to investigate and assess the degree of patient satisfaction in hospitals in the Al-Qassim region of Saudi Arabia and the primary causes that may contribute to satisfaction or dissatisfaction with the healthcare system. Primary data were acquired from a sample consisting of 292 patients in the Kingdom of Saudi Arabia's Al-Qassim region. The level of patient satisfaction with the healthcare system in Al-Qassim region was investigated using a self-administered questionnaire. The main determinants of patient satisfaction in the healthcare system included patient demographics, expectations, perceptions, and experiences. In Al-Qassim region patient experiences and expectations were the most important elements in influencing their satisfaction level. Further, demographics factors have favorable and substantial effects on people's perceptions and behavior regarding their satisfaction level with healthcare services in the Al-Qassim region. This research will aid healthcare administrators, policymakers, paramedical staff, and physicians in identifying the reasons for patient dissatisfaction and considering viable options to improve patient satisfaction levels in the health care system.

Less invasive turn-down flap tendinoplasty in chronic Achilles tendon rupture

Bridging the defect in chronic ruptures of the Achilles tendon via aturn-down flap of the aponeurosis sparing the skin of the rupture zone. Chronic Achilles tendon rupture with adefect distance ≤ 6 cm. Extended Achilles tendon defect interval ≥ 7 cm, chronic wounds or infections near the surgical approach, higher degrees of arterial or venous malperfusion, complex regional pain syndrome. Dorsomedial surgical approach proximal to the rupture zone, splitting of the crural fascia, loading of the distal Achilles tendon stump with anonresorbable augmentation suture using the Dresden instrument, preparation of the turn-down flap of the aponeurosis securing the turning point with acatching suture. Transfer of the turn-down tendon flap under the skin bridge and suture to the distal tendon stump tying the augmentation suture under adequate pretension simultaneously closing the gap in the aponeurosis. Alternative technique: free advancement of the autologous tendon graft. Anterior splint in 20°of plantar flexion, consecutive mobilization and rehabilitation similar to the percutaneous technique in acute Achilles tendon rupture with the Dresden instrument. Lower leg orthosis with 20°of plantarflexion for 8weeks, then stepwise reduction of the heel height. Physiotherapy beginning from the 2ndpostoperative week, active full-range of ankle motion from 6weeks after surgery. In general, worse results than in percutaneous reconstruction of acute Achilles tendon injuries. Despite this, high degrees of patient satisfaction with alow rate of postsurgical complications and good functional outcome with admittedly poor data availability. Relevant increase of plantar flexion strength depending on the amount of degeneration of the triceps surae muscle.

The process of transition from pediatric to adult healthcare services for nephrological patients: Recommendations vs. reality-A single center experience.

Transitional care is an essential step for patients with kidney disease, and it is supported by policy documents in the United Kingdom and United States. We have previously described the heterogeneous situation currently found in Europe regarding certain aspects of transitional care: the written transition plan, the educational program, the timing of transfer to adult services, the presence of a coordinator and a dedicated off-site transition clinic. In line with the transition protocol “RISE to transition,” the objective of this paper is to describe the experience of the Bologna center in defining a protocol for the management of chronic kidney disease and the difficulties encountered in implementing it. We apply this model to various chronic diseases along the process of transfer to adult services. It begins when the patient is 14 years old and is complete by the time they reach 18. The family is continuously involved and all the patients in transitional care receive continuous medical care and psychological support. We identified a series of tests designed to measure various criteria: medical condition, psychological state, quality of life, and degree of patient satisfaction, which are repeated at set intervals during the transition process. The organization of the service provided an adequate setting for taking charge of the patients in the long term. The transition program implemented by the adult and pediatric nephrology services of the Bologna center has lowered the risk of discontinuity of care and greatly improved the patients’ awareness of responsibility for their own healthy lifestyle choices.