Level Of Patient Satisfaction Research Articles

Investigating the relationship between individualized care, patient satisfaction and trust in nurses through structural equation modelling.

The aim of this study was to demonstrate the impact of individualized nursing care on patient satisfaction and trust in nurses through structural equation modelling in patients receiving treatment in internal clinics. The study is a descriptive, exploratory and cross-sectional research conducted with patients receiving treatment in the internal admission services of an educational research hospital between January and April 2023. According to sample calculations, it was determined that a minimum of 238 patients needed to be included in the study, and 286 patients who met the inclusion criteria and agreed to participate in the research formed the study sample. Data were collected using the 'Patient Identification Form', 'Individualized Care Scale-Patient Version', 'Newcastle Nursing Care Satisfaction Scale' and the 'Trust in Nurses Scale'. The level of awareness of nursing actions supporting individuality was found to be 2.71 ±0.99, the level of perceiving individuality was 2.88 ±0.99, the average level of nursing care satisfaction measured 77.17 ± 12.67 and the average level of trust in nurses was 21.92 ±3.04. It was determined that as patients' awareness of nursing actions supporting individuality and their perception of individuality in care increased, they remained more satisfied with their care and had greater trust in nurses. Patients who perceived receiving individualized care were found to have higher levels of patient satisfaction and trust in nurses. Additionally, it was observed that as participants' satisfaction with their care increased, their trust in nurses also increased.

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

IntroductionConservative surgery is the gold standard for the treatment of single and small tumors and, combined with the concept of oncoplastic tumors, brings good aesthetic results while maintaining cancer safety. The objective was to comparatively analyze the degree of satisfaction of patients undergoing breast conserving surgery (BCS), with and without oncoplastic surgery (OPS) using level II OPS techniques.MethodsReview with a search in the databases MEDLINE (by PubMed), EMBASE, Clinical Trials, Scopus, Web of Science, BVS and Oppen gray. The meta-analysis of random effects was performed using the Der Simonian-Laird method considering the odds ratio (OR) with a 95% confidence interval (95% CI).ResultsThere was no statistically significant difference in the aesthetic outcome between women who underwent OPS and BCS (OR 0.90; 95% CI 0.62–1.30). The staging (OR 1.93; 95% CI 0.97–3.84; I2 = 15.83%); tumor location [central (OR 1.28; 95% CI 0.06–27.49; I2 = 17.63%); lower (OR 0.75; 95% CI 0.21–2.65; I2 = 2.21%); superior (OR 0.67; 95% CI 0.26–1.74; I2 = 0.00%] and tumor size (OR 8.73; 95% CI −11.82–29.28; I2 = 93.18%) showed no association with the type of BCS performed, with or without OPS. The degree of satisfaction remains even in cases of extreme oncoplasty.ConclusionThe level of patient satisfaction in relation to BCS was similar to that of the group undergoing OPS, highlighting that OPS allows the patient's satisfaction rate to be maintained even in the case of large or multicentric tumors.

Report of the IDEOM Meeting Adjacent to the GRAPPA 2023 Annual Meeting.

The nonprofit organization International Dermatology Outcome Measures (IDEOM) is committed to improving the implementation of patient-centered outcome measures in dermatologic disease. At a conference adjacent to the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) 2023 annual meeting, the IDEOM Psoriatic Disease Workgroup presented updates on recent efforts in outcome measure advancement. Dr. Alice Gottlieb presented the preliminary findings of a study within the Mount Sinai Health System that aims to determine how well the IDEOM musculoskeletal (MSK) symptom framework, which uses the Psoriasis Epidemiology Screening Tool (PEST) and the Psoriatic Arthritis Impact of Disease (PsAID) instruments, functions in clinical settings. Drs. Joseph Merola and Lourdes Perez-Chada updated attendees on the IDEOM MSK-Q, a 9-item patient-reported questionnaire designed to measure the intensity and impact of MSK symptoms on the quality of life in patients with psoriasis (PsO) with or without psoriatic arthritis (PsA). Dr. Vibeke Strand summarized the Outcome Measures in Rheumatology (OMERACT) 2023 conference sessions. Dr. April Armstrong discussed the preliminary findings of a multicentered study designed to validate the 7-item Dermatology Treatment Satisfaction Instrument (DermSat-7) among patients with PsO. She also introduced the Psoriasis and Psoriatic Arthritis Treatment Satisfaction Instrument, a tool that seeks to capture the level of patient satisfaction with current therapy for PsO and PsA. This report summarizes the developments discussed at the IDEOM PsO and PsA research workgroups during the GRAPPA 2023 annual meeting.

Appraisal of Nursing Care Received and it’s Satisfaction: A Case Study of Admitted Patients in Afe Babalola Multisystem Hospital, Ado Ekiti, Ekiti State

Background Patients are the best recruiter of patients if given prompt treatment and comprehensive care. Patient satisfaction with nursing care has been strongly advocated to be an important indicator of the quality of nursing care delivery which raises concerns in many areas, including information communication, privacy, physical and psychological care, availability and accessibility of nurses, and emotional care. The aim of this study centred on identifying the domain of nursing care received by in-patients of Afe Babalola Multisystem Hospital (AMSH) and determining the level of patient satisfaction towards nursing care in AMSH.  Methods A hospital-based cross-sectional, descriptive design was employed. A convenience sampling technique was used to select 102 patients admitted to surgical wards (male and female), Medical wards (male and female), renal wards, accident and emergencies and maternity wards. The Qualipak nursing quality questionnaire (QUALPAC) was used to collect the required data. Data were analysed using SPSS software version 27. Pearson chi-square test and logistic regression analysis was used.  Results Patients received overall moderate nursing care (64.7%) in the framework of physical, communication and psychosocial care. Overall satisfaction with nursing care received was found to be 76.5%. Among the domains of nursing satisfaction, satisfaction towards communication care (89.2%) and physical care (80.4%) showed a high level and satisfaction towards psychosocial care (58.8%) care was lower compared to other dimensions. Respondents’ between the ages of 18-25 years (P< 0.05, Odd ratio- 14.569, CI: 679.461– 0.312), male patients (P< 0.05, Odd ratio- 8.850, CI: 7.477– 0.097), single patients (P< 0.05, Odd ratio- 5.130, CI: 7.569- 0.035), primary education (P< 0.05, Odd ratio- 40.123, CI: 2021.829– 0.076), patients admitted to male renal ward (P< 0.05, Odd ratio- 2.328, CI: 196.160– 0.028) and patients who chose expert doctors as a reason (P< 0.05, Odd ratio- 4.900, CI: 25.509– 0.009) were associated with patient satisfaction. Nursing care received was high among admitted patients in male medical wards, female medical ward and male renal ward.  Conclusion Patientsin this study received moderate nursing care in the three domains of nursing care. A high nursing satisfaction was received. To increase satisfaction with nursing care, greater emphasis should be given to the psychosocial care of patients.

Appraisal of Nursing Care Received and it’s Satisfaction: A Case Study of Admitted Patients in Afe Babalola Multisystem Hospital, Ado Ekiti, Ekiti State

Background Patients are the best recruiter of patients if given prompt treatment and comprehensive care. Patient satisfaction with nursing care has been strongly advocated to be an important indicator of the quality of nursing care delivery which raises concerns in many areas, including information communication, privacy, physical and psychological care, availability and accessibility of nurses, and emotional care. The aim of this study centred on identifying the domain of nursing care received by in-patients of Afe Babalola Multisystem Hospital (AMSH) and determining the level of patient satisfaction towards nursing care in AMSH.  Methods A hospital-based cross-sectional, descriptive design was employed. A convenience sampling technique was used to select 102 patients admitted to surgical wards (male and female), Medical wards (male and female), renal wards, accident and emergencies and maternity wards. The Qualipak nursing quality questionnaire (QUALPAC) was used to collect the required data. Data were analysed using SPSS software version 27. Pearson chi-square test and logistic regression analysis was used.  Results Patients received overall moderate nursing care (64.7%) in the framework of physical, communication and psychosocial care. Overall satisfaction with nursing care received was found to be 76.5%. Among the domains of nursing satisfaction, satisfaction towards communication care (89.2%) and physical care (80.4%) showed a high level and satisfaction towards psychosocial care (58.8%) care was lower compared to other dimensions. Respondents’ between the ages of 18-25 years (P< 0.05, Odd ratio- 14.569, CI: 679.461– 0.312), male patients (P< 0.05, Odd ratio- 8.850, CI: 7.477– 0.097), single patients (P< 0.05, Odd ratio- 5.130, CI: 7.569- 0.035), primary education (P< 0.05, Odd ratio- 40.123, CI: 2021.829– 0.076), patients admitted to male renal ward (P< 0.05, Odd ratio- 2.328, CI: 196.160– 0.028) and patients who chose expert doctors as a reason (P< 0.05, Odd ratio- 4.900, CI: 25.509– 0.009) were associated with patient satisfaction. Nursing care received was high among admitted patients in male medical wards, female medical ward and male renal ward.  Conclusion Patientsin this study received moderate nursing care in the three domains of nursing care. A high nursing satisfaction was received. To increase satisfaction with nursing care, greater emphasis should be given to the psychosocial care of patients.

Level of empowerment of hospitalized patient in Taiwan clinical practice

PurposeIn the health-care system within hospitals, Taiwanese patients usually play the role of passively cooperating with health-care professionals. Therefore, patients rarely make their own treatment decisions. This study evaluated the level of patient education and patient satisfaction in relation to empowerment level in Taiwan. MethodsA cross-sectional survey by a self-administered structured questionnaire was carried out with 618 inpatients from the four hospitals. Statistical analyses were then conducted. Analysis of covariance and post-hoc comparison was used to compare differences between the level of patient empowerment, age, and education as covariates in the model. ResultsThis study found that 21.2% and 35.6% of participants were highly empowered and well empowered, respectively. Years of education is a significant covariate in the counselling domain of patient education. Even after controlling for age and education level, the counselling, answer question and justifying action, providing information scores remain significant for all levels after adjusting for the effects of degree of patient empowerment. Patients with higher empowerment also having more-sufficient patient education, indicating a tendency toward higher patient satisfaction. Patient education and counselling practices in Taiwan's clinical practice could be improved to enhance patient empowerment and ensure health-care systems are person-centred. ConclusionsTo move more toward highly patient empowerment, we suggest that health-care professionals advocate a patient-empowerment approach and to provide more counselling related to patients’ illnesses and possible treatments.

A New Method for the Follow-Up of Patients with Alopecia Areata.

Background: Teledermatology is the application of information and telecommunication technologies in the field of dermatology to provide remote care services based on the exchange of clinical information within a network of professionals or between professionals and patients. Tele-trichoscopy is a non-invasive, inexpensive, and easy-to-use method that applies the principle of surface microscopy at different magnifications. Alopecia areata is a non-scarring alopecia with a chronic evolution, which often needs a close follow-up. Objectives: The aim of our work was to analyze the possible benefits of telemedicine for the follow-up of patients with alopecia areata. Materials and Methods: We enrolled patients with alopecia areata, identified during the first trichological evaluation, and we divided the patients into two groups. One group was provided with the devices necessary for a telemedicine follow-up. The other group had a conventional follow-up. The total follow-up time was one year. All of the patients' photos were blindly evaluated by a team of expert dermatologists who were asked to indicate the quality of the images. The photos were also evaluated to identify disease markers. During the follow-up period, questionnaires were administered to both groups of patients to assess the quality of the visit, the level of patient satisfaction, and to identify any issues encountered by the patients. Results: There was a high degree of concordance between the images obtained by outpatient trichoscopy and those obtained by telemedicine. The satisfaction levels were the same between the patients followed via telemedicine and those seen in the outpatient clinic. Conclusions: Telemedicine applied to trichology using trichoscopy was proven to be a valid system for managing the follow-up of patients suffering from chronic recurrent scalp diseases and, above all, for maintaining continuity of care.

Providing sexual health care for international students in Australia: a qualitative study of a general practice team approach.

Background Provision of culturally responsive sexual health care for international students is important, given the large numbers of international students in Australia and known lower levels of health literacy among this cohort. Team-based care in general practice has the potential to provide this care. Methods A qualitative study that developed and evaluated a team-based model of care for female, Mandarin-speaking, international students in a university-based general practice. The model involved patients attending a consultation with a Mandarin-speaking nurse with advanced skills in sexual health who provided education and preventive health advice, followed by a consultation with a GP. Evaluation of the model explored patient and healthcare worker experiences using a survey and a focus group of patients, and interviews with healthcare workers. Data were analysed using a general inductive approach. Results The consultation model was evaluated with 12 patients and seven GPs. Five patients participated in a focus group following the consultation. Survey results showed high levels of patient satisfaction with the model. This was confirmed via the focus group findings. Healthcare workers found the model useful for providing sexual health care for this cohort of patients and were satisfied with the team approach to patient care. Conclusions A team-based approach to providing sexual health care for international students was satisfactory to patients, GPs and the practice nurse. The challenge is providing this type of model in Australian general practice under the current funding model.

The role of TENS therapy in reducing the incidence of post-Caesarean section wound infection.

The occurrence of wound infection following a Caesarean section procedure poses a substantial clinical obstacle. Transcutaneous Electrical Nerve Stimulation (TENS) has been identified as a promising supplementary treatment option for improving the healing process and decreasing the incidence of infections. This study assessed the efficacy of TENS therapy in the postoperative care of patients who have had Caesarean section. We randomly assigned a total of 108 women who had Caesarean sections to either a TENS group (n = 54) or control (n = 54). The TENS therapy was provided twice daily for a duration of 30 min for the period of 14 days following the surgery. The main measure of interest in this study was the occurrence of wound infection during 30-day period. Additionally, secondary measures included the rate of wound healing, levels of pain experienced and level of patient satisfaction. In comparison to the control (22.2%, p < 0.05), the TENS group had notably reduced occurrence of wound infection, with the rate of 7.4%. TENS group had superior wound healing results, as measured by REEDA scale, at 7 days (2.1 ± 0.8 vs. 2.5 ± 1.0, p < 0.04), 14 days (1.2 ± 0.5 vs. 1.9 ± 0.7, p < 0.05) and 30 days (0.3 ± 0.5 vs. 0.7 ± 0.6, p < 0.05). Furthermore, TENS group had reduced pain levels on the Visual Analog Scale (VAS) at all evaluation intervals (p < 0.05). TENS group exhibited significantly higher levels of patient satisfaction, as evidenced by 64.8% of participants rating high satisfaction, in contrast to 40.7% in the control group (p < 0.05). The incidence of adverse effects was found to be minor, as indicated by a skin irritation rate of 3.7% and reported discomfort rate of 1.9% at the electrode location. TENS therapy effectively decreased the occurrence of post-Caesarean wound infections, expedited the healing process and enhanced pain control. This treatment was well-received by patients and had little negative consequences. The aforementioned results provided evidence in favour of incorporating TENS into post-Caesarean care regimens, which may have significant consequences for improving patient outcomes and maximizing healthcare resources.

Visual Outcomes and Patient Satisfaction After Bilateral Refractive Lens Exchange With a Trifocal Intraocular Lens in 5,226 Patients With Presbyopia.

To assess visual and refractive outcomes and visual function after bilateral RayOne Trifocal toric and nontoric intraocular lens (IOL) (Rayner) implantation in patients with presbyopia. Charts of patients with presbyopia who underwent refractive lens exchange with bilateral implantation of the RayOne Trifocal IOL (toric and non-toric) were retrospectively reviewed. Visual and refractive outcomes were evaluated at 3 months. Patient satisfaction, spectacle independence, and visual disturbance profile were assessed by questionnaires. A total of 5,226 patients were assigned to one of two groups: 1,010 patients had toric IOL implantation (toric group) and 4,216 patients received the non-toric model (non-toric group). Mean ± standard deviation visual acuity at 3 months for the toric group was binocular uncorrected distance visual acuity (UDVA) of 0.07 ± 0.11 logMAR, monocular corrected distance visual acuity (CDVA) of 0.05 ± 0.07 logMAR, binocular uncorrected near visual acuity (UNVA) at 40 cm of 0.10 ± 0.09 logMAR, binocular uncorrected intermediate visual acuity (UIVA) at 40 cm of 0.13 ± 0.12 logMAR, postoperative spherical equivalent (SE) of -0.21 ± 0.47 diopters (D), and cylinder of -0.34 ± 0.40 D. The non-toric group had binocular UDVA of 0.04 ± 0.08 logMAR, monocular CDVA of 0.05 ± 0.07 logMAR, binocular UNVA of 0.10 ± 0.08 logMAR, binocular UIVA of 0.13 ± 0.11 logMAR, SE of -0.08 ± 0.38 D, and cylinder of -0.28 ± 0.34 D. No statistically significant differences were found in achieving spectacle independence and there were high levels of satisfaction in both groups. In this retrospective analysis with more than 5,000 patients, both the toric and non-toric RayOne Trifocal IOL models provided good visual performance at all distances, resulting in excellent levels of spectacle independence and patient satisfaction. [J Refract Surg. 2024;40(7):e468-e479.].

[Translated article] Medial gastrocnemius proximal fasciotomy in patients with chronic plantar fasciitis: A systematic review

IntroductionPlantar fasciitis is the main cause of heel pain in middle-aged patients. In chronic cases, limited ankle dorsiflexion caused by isolated gastrocnemius contracture is considered the main risk factor for suffering it. Therefore, in recent years the number of patients operated on by proximal fasciotomy of the medial gastrocnemius (FPGM) has increased to treat chronic plantar fasciitis. Material and methodsSystematic review following the PRISMA guidelines. We have carried out a bibliographic search in Pubmed, Science Direct, Cochrane Library and Web of Science databases. One hundred and eighty-four articles were found. Data extraction was performed using the Covidence software, and a quality and risk of bias analysis of the included articles was performed based on the Cochrane risk of bias Tool 2.0. ResultsThree articles were included in the review: two randomised clinical trials and one cohort study with a total of 138 patients. In the analysed studies, patients after proximal fasciotomy of the medial gastrocnemius showed significant improvements in pain and in the AOFAS score with high levels of patient satisfaction. Increases in ankle dorsiflexion angle were found after 12 months of follow-up, with no loss of gastrocnemius strength. The complication rate was low and fewer occurred in the proximal fasciotomy compared to plantar fasciotomy. ConclusionProximal fasciotomy of the medial gastrocnemius provides clinical benefit in patients with chronic plantar fasciitis, with a low probability of complications and high patient satisfaction.

The Relationship of Culture-Based Primary Service with Patient Satisfaction in the Inpatition Room of Hospital X in Pontianak

The aim of this research is to analyze the relationship between culture-based excellent service and patient satisfaction in the inpatient room at Hospital X in Pontianak.The research uses quantitative descriptive methods with a cross-sectional study approach. The total sample is 86 respondents, the measuring instrument is a questionnaire of excellent service and customer satisfaction which was created by the author himself with validation results of calculated r values ranging from 0.40 to 0.887 and reliability of 0.944 and 0.956. The research results showed that almost all of the respondents said it was very good, 68 people or (79.07%), the level of patient satisfaction, the majority of respondents said it was very satisfied, 63 people or (73.26%), the results of the analysis of excellent service relationships based on Culture and patient satisfaction with the Spearman Rank obtained a SIG value = 0.000 (Sig &lt; 0.05), so it can be concluded that there is a very significant relationship between excellent service and patient satisfaction in the Inpatient Room at Hospital X in Pontianak. It is hoped that the results of this research can be used to improve excellent nursing service because of the importance of excellent nursing service in increasing the satisfaction of inpatients at Hospital X in Pontianak.

Tamsulosin off-label use in kidney stones: Review and survey

This study investigates the effectiveness and healthcare perceptions of Tamsulosin, an off-label medication for kidney stone management. Despite the documented benefits, the quest for alternative treatments like Tamsulosin persists, driven by its advantages and patient satisfaction levels. This research includes a literature review and a survey of pharmacy students’ opinions on Tamsulosin, aiming to bridge the knowledge gap. This study, which involved 38 first-year professional pharmacy students, achieved a 92% response rate. The research used questionnaire that collected demographic information and assessed participants' knowledge and opinions using a Likert scale, which was integrated into a drug informatics course. We analyzed the responses using SPSS software, utilizing descriptive and chi-square statistical methods. The survey, completed by 38 participants, revealed discrepancies between current treatment practices and the students' understandings. Despite Tamsulosin's documented efficacy in facilitating stone passage, significant skepticism exists about its use without FDA approval. The research showed varied levels of understanding and skepticism towards off-label use among the students. Moreover, 70.3% of respondents recognized Tamsulosin's potential for managing kidney stones, despite its lack of FDA approval, indicating a cautious yet acknowledging attitude towards non-approved drug use for organ rejection. There's a noted need for improved education and the dissemination of evidence-based guidelines in clinical practice. The study uncovers varied knowledge and perceptions among healthcare professionals and pharmacy students regarding Tamsulosin's use in kidney stone management. The gap between clinical evidence and survey participants' awareness underscores the importance of further research and education to align clinical practices with evidence-based guidelines

Clients’ Satisfaction with the Services of the National Health Insurance Scheme at the Moddibo Adama University Teaching Hospital, Yola, Adamawa State

Background: Worldwide, patient satisfaction is one of the cardinal indices for evaluating the quality of healthcare service delivery and the effectiveness of a healthcare system. As consumers of healthcare services, patients have expectations that need to be met. Objective: To assess clients’ satisfaction with the quality of care rendered through the National Health Insurance Scheme in a Nigerian Specialist Medical facility. Methods: This was a descriptive, cross-sectional study of 403 respondents selected randomly from NHIS enrolees attending the Federal Medical Centre, Yola. The study assessed the enrolee's level of satisfaction at the various service points using a self-administered, semi-structured questionnaire. Results: The overall average satisfaction score was 61.0.%. The satisfaction score on the various aspects of service was as follows: hospital environment/cleanliness (87.9%), doctors’ consultation (74.2%), reception/registration (69.5%), laboratory services (64.3%), waiting time (64.2%), staff attitude (60.5%), and availability of prescribed drugs (48.2%) been the lowest. Conclusion: Overall, patients' satisfaction with the services provided was good, with the hospital environment/cleanliness rated highest and the availability of prescribed drugs the lowest. The current level of patient satisfaction needs to be improved by making drugs more available in the NHIS pharmacy and improving the attitude of staff to work and clients.

Clients’ Satisfaction with the Services of the National Health Insurance Scheme at the Moddibo Adama University Teaching Hospital, Yola, Adamawa State

Background: Worldwide, patient satisfaction is one of the cardinal indices for evaluating the quality of healthcare service delivery and the effectiveness of a healthcare system. As consumers of healthcare services, patients have expectations that need to be met. Objective: To assess clients’ satisfaction with the quality of care rendered through the National Health Insurance Scheme in a Nigerian Specialist Medical facility. Methods: This was a descriptive, cross-sectional study of 403 respondents selected randomly from NHIS enrolees attending the Federal Medical Centre, Yola. The study assessed the enrolee's level of satisfaction at the various service points using a self-administered, semi-structured questionnaire. Results: The overall average satisfaction score was 61.0.%. The satisfaction score on the various aspects of service was as follows: hospital environment/cleanliness (87.9%), doctors’ consultation (74.2%), reception/registration (69.5%), laboratory services (64.3%), waiting time (64.2%), staff attitude (60.5%), and availability of prescribed drugs (48.2%) been the lowest. Conclusion: Overall, patients' satisfaction with the services provided was good, with the hospital environment/cleanliness rated highest and the availability of prescribed drugs the lowest. The current level of patient satisfaction needs to be improved by making drugs more available in the NHIS pharmacy and improving the attitude of staff to work and clients.

Interprofessional care for temporomandibular joint disorders: the patient’s perspective

The Indiana University School of Dentistry TMJ Institute is a multidisciplinary clinic designed to support the management of patients with challenging temporomandibular disorders. Professionals across dentistry, medicine, physical therapy, and social work collaborate to create a customised, interprofessional consensus to patient care. Compared with traditional, siloed healthcare models, are patients diagnosed with TMJ dysfunction satisfied with the quality of care received from an interprofessional approach? The objective of this study is to determine the level of patient satisfaction at the Institute using a 5-Point Likert scale patient questionnaire. A total of 93 questionnaires were distributed and 84 were collected. A total of 43% of patients travelled over 50 miles to be seen at the Institute. ‘Strongly agree’ was the most selected response for each prompt. The exception was whether patients preferred to meet with each clinician individually, to which ‘strongly disagree’ or ‘disagree’ was the most popular response, indicating that an interprofessional approach was preferred. The results and comments provided by patients revealed that most patients diagnosed with TMJ dysfunction were highly satisfied with the interprofessional approach used at the TMJ Institute. Our study suggests that positive patient satisfaction is an important factor in assessing the quality and efficacy of interprofessional, patient-centred clinic models.

Clinical efficacy of a two-piece abutment conforming to the concept of one abutment one time in the posterior region: A clinical pilot study.

To assess the impact of a two-piece abutment workflow on enhancing the stability of the alveolar bone and gingiva surrounding the dental implant, and to determine the level of patient satisfaction. A total of 48 patients with dentition defect in the posterior region were included and divided into two groups: the two-piece abutment workflow (TAW) and the sealing screw with submerged healing workflow (SHW). Marginal bone level (MBL), soft tissue indicators, oral hygiene indicators, and patient satisfaction were assessed and recorded partially at 0, 3, 6, and 12 months after surgery. The primary outcome was the change of MBL in different time periods. A generalized linear mixed model (GLMM) was used to take into account the correlated nature of the data, and adjust for potential confounding factors within inter-group differences. The survival rate of implants and prosthesis reached 100% at 12-month follow-up, with an average decrease of 0.25 mm (SD 0.23 mm) of MBL in the TAW group and 0.48 mm (SD 0.45 mm) in the SHW group. The change of MBL in the TAW group (0.15 ± 0.31 mm) was significantly lower than the SHW group (0.41 ± 0.41 mm) through the analysis of GLMM within 6 months, while no significance was found in 12 months. Moreover, less gingival pain and oppression during prosthesis loading, and less time consumption overall duration were showed in the TAW group through Visual Analogue Scale (VAS, p < 0.05). Within a 6-month period, the two-piece abutment workflow showed superior efficacy in preserving the integrity of the marginal bone level. Furthermore, it streamlined treatment procedures and mitigated discomfort, hence increasing patient satisfaction.

FIVE-YEAR FOLLOW-UP OF THIRD-GENERATION PERCUTANEOUS CHEVRON AND AKIN OSTEOTOMIES (PECA) FOR HALLUX VALGUS

BackgroundRecent large studies of third-generation minimally invasive hallux valgus surgery (MIS) have demonstrated significant improvement in clinical and radiological outcomes. It remains unknown whether these clinical and radiological outcomes are maintained in the medium to long-term. The aim of this study was to investigate the five-year clinical and radiological outcomes following third-generation MIS hallux valgus surgery.MethodsA retrospective observational single surgeon case series of consecutive patients undergoing primary isolated third-generation percutaneous Chevron and Akin osteotomies (PECA) for hallux valgus with a minimum 60 month clinical and radiographic follow up. Primary outcome was radiographic assessment of the hallux valgus angle (HVA) and intermetatarsal angle (IMA) pre-operatively, 6 months and ≥60 months following PECA. Secondary outcomes included the Manchester-Oxford Foot Questionnaire, patient satisfaction, Euroqol-5D Visual Analogue Scale and Visual Analogue Scale for Pain.ResultsBetween 2012 and 2014, 126 consecutive feet underwent isolated third-generation PECA. The mean follow up was 68.8±7.3 (range 60–88) months. There was a significant improvement in radiographic deformity correction; IMA improved from 13.0±3.0 to 6.0±2.6, (p &lt; 0.001) and HVA improved from 27.5±7.6 to 7.8±5.1. There was a statistically significant but not clinically relevant increase of 1.2±2.6° in the HVA between 6 month and ≥60 month radiographs. There was an increase in IMA of 0.1±1.6º between 6 month and ≥60 month radiographs which was not statistically or clinically significant. MOXFQ Index score at ≥follow up was 10.1±17.0. The radiographic recurrence rate was 2.6% at final follow up. The screw removal rate was 4.0%.ConclusionRadiological deformity correction following third-generation PECA is maintained at a mean follow up of 68.8 months with a radiographic recurrence rate of 2.6%. Clinical PROMs and patient satisfaction levels are high and comparable to other third-generation studies with shorter duration of follow up.

Rate of Correct Inhaler Usage and Related Factors in Elderly Patients With Chronic Obstructive Pulmonary Disease

Poor disease control in patients with chronic obstructive pulmonary disease (COPD) is associated with suboptimal inhaler use. This study was designed to explore the accuracy of inhaler use and related factors in elderly patients with COPD. A cross-sectional survey design was used to recruit patients with COPD from a medical centre in southern Taiwan who were over 65 years old and used inhalers regularly. All of the data as well as information on inhaler use accuracy were collected using a self-designed questionnaire and inhaler operation checklist. Multivariable logistic regression was used to analyse significant correlates of correct inhaler operation. The average age of the 150 participants was 75.0 years (SD = 7.5) years. Most used one type of inhaler only (86.0%). The rate of accurate inhaler operation was 40.7% (n = 61) for the sample, with dry powder inhalers associated with the highest accuracy (64%) and pressurized metered-dose inhalers associated with the lowest accuracy (1.6%). Multivariate logistic regression analysis showed that using a soft mist inhaler (adjusted odds ratio, AOR = 23.29; 95% confidence interval, 95% CI [2.84, 191.07]), using a dry powder inhaler (AOR =15.60, 95% CI [1.99, 122.26]), and higher satisfaction with the inhaler were positively and independently associated with accurate inhaler use (AOR = 1.94, 95% CI [1.09, 3.44]). Important factors related to inhaler use accuracy include inhaler type and level of patient satisfaction with their inhaler. Healthcare professionals should regularly confirm that older patients are able to use their inhalers correctly and are satisfied with their inhalers.

Influence of multidisciplinary teams (MDT) on breast satisfaction and sexual well-being in the immediate postoperative phase following breast-conserving surgery (BCS).

e13788 Background: Despite the recognized significance of multidisciplinary team (MDT) on patient satisfaction post-operatively, limited data exists on its overall impact. This study assessed the impact of MDT, including the surgeon, medical oncologist, and office staff, on patient breast satisfaction and sexual well-being among early-stage breast cancer patients. We examine three early time points after breast-conserving surgery (BCS): 2 weeks, 4 weeks, and 3 months. In addition, demographic and socioeconomic factors affecting patient satisfaction were also analyzed. Methods: A survey using BREAST-Q modules was conducted via telephone interviews among early-stage breast cancer patients who had BCS at a university-affiliated community hospital from October 2022 to September 2023. BREAST-Q responses were translated to Rasch scores (0=lowest, 100=highest). Patient-reported concerns were collected with open-ended questions. The correlation between variables was measured using Pearson’s correlation. A comparison of Rasch scores over time was done with repeated measures of ANOVA. SPSS 28.0 was used for statistical analysis, with a p-value&lt;0.05 considered statistically significant. Results: Of 200 patients assessed, 61 met the study criteria, and 30 participated (mean age 66.3 years±9.9). Most were White (90%), married (55%), with stage 1 cancer (63%) and comorbidities (60%). At 2 weeks, the mean breast satisfaction score was 66.8, which increased to 71.0 at 4 weeks and 88.1 at 3 months (p&lt;0.05), while sexual well-being remained stable (69.0 at 2 weeks, 73.1 at 4 weeks, and 68.3 at 3 months, p&gt;0.05). Pain at the surgical site was the most cited concern at 2 and 4 weeks (30% and 41%, respectively), while dry skin (25%) was the top concern at 3 months. High patient satisfaction scores with the surgeon (mean 95.5), medical team (mean 98.3), and office staff (mean 99.3) were noted throughout the three time periods (p&gt;0.05). Satisfaction with the surgeon was associated with better breast satisfaction and higher sexual well-being scores at two weeks after BCS (p&lt;0.05). No other significant correlations were found between the influence of MDT on patient satisfaction at 4 weeks and 3 months. In a univariate analysis, widows reported the highest breast satisfaction at 2 weeks (94.0, p&lt;0.05). White patients had a higher sexual well-being score than Black patients (72.4 vs. 51.5, p&lt;0.05), while alcohol use had lower sexual well-being scores at 2 weeks (62.5 vs. 89.8, p&lt;0.05). In a multivariable analysis, only marital status and alcohol use remained significant at 2 weeks post-BCS (p&lt;0.05). Conclusions: The study highlights the surgeon’s critical role in achieving high level of patient satisfaction with their breasts and sexual well-being after BCS. Additionally, it reveals the significant influence of sociodemographic factors on patient outcomes.