Level Of Patient Satisfaction Research Articles

Reverse Shoulder Prosthesis for Proximal Humeral Fractures: Primary Treatment vs. Salvage Procedure

Background: The optimal treatment for complex proximal humerus fractures (PHFs) lacks consensus, with reverse total shoulder arthroplasty (RTSA) often being a final resort rather than a primary approach. This study aimed to compare outcomes and satisfaction rates of primary RTSA for PHFs versus salvage RTSA for previously unsuccessful treatments. We hypothesized that primary RTSA would yield superior clinical outcomes, functional scores, and patient satisfaction. Methods: A retrospective analysis of RSA procedures between 2011 and 2021 was conducted, focusing on primary RTSA for PHFs or salvage RTSA for failed osteosynthesis. Patients meeting inclusion criteria underwent clinical and radiological follow-up for at least two years. Demographic characteristics, outcomes scores, and range of motion (ROM) were assessed. Results: Of 63 patients, 42 underwent primary RTSA and 21 underwent salvage RTSA. The median follow-up was 50 months. Statistically significant differences favored primary RTSA in forward flexion, abduction, internal rotation, and Constant shoulder score. Patient satisfaction levels did not significantly differ between groups. Complications occurred in 7.15% of primary RTSA cases and 14.28% of salvage RTSA cases. Conclusions: Primary RTSA may yield slightly better outcomes and lower complication rates compared to salvage RTSA. Further prospective studies are necessary to validate these findings.

Patient satisfaction among Saudi academic hospitals: a systematic review

PurposeTo systematically review the patient’s satisfaction (PS) levels within academic hospitals in Saudi Arabia from January 2012 to the end of October 2022.Data sourcesArticles were gathered from PubMed, ProQuest, Google...

OVERVIEW OF THE LEVEL OF SATISFACTION OF THE PATIENT'S FAMILY AT THE CHILDREN'S POLY OF INDRAMAYU HOSPITAL

Success in providing hospital services is measured by the level of patient satisfaction and patient family, satisfaction is a person's feeling of pleasure or disappointment with the impression obtained when or after receiving services. The purpose of the study was to determine the picture of the level of satisfaction of the patient's family at the children's poly of RSUD Indramayu. This research uses quantitative research methods with a descriptive approach. The population in this study was the families of patients in the children's poly, for the sampling technique using accidental sampling as many as 85 respondents. Research instruments using questionnaires and data analysis using univariate. The results of this study found that as many as 48 respondents (56.5%) of patients' families were satisfied and 37 respondents (43.5%) of patients' families were dissatisfied, with dimensions tangible 65 respondents (76.5%) patient families are satisfied, reliability dimensions 68 respondents (80%) patient families are satisfied, responsiveness dimensions 68 respondents (80%) patient families feel dissatisfied, assurance dimensions 53 respondents (62.4%) and empathy dimensions 85 respondents (100%) patient families feel satisfied. The conclusion of this study illustrates the level of satisfaction of the patient's family at the children's poly of Indramayu Hospital, the results were obtained in the satisfied category of as many as 48 respondents (56.5%) and did not meet the minimum hospital service standards determined by the Ministry of Health of the Republic of Indonesia, which is ≥90%. It is recommended that medical personnel be able to make efforts or efforts in improving the health services provided.

Surgical Removal of Fat Nodules Formed in the Tear Trough After Autologous Fat Grafting.

Autologous fat grafting is a common treatment for tear trough deformities. This procedure involves a potential complication of fat nodule formation, leading to abnormal bulging of the lower eyelid. However, limited information exists about this complication, and an effective treatment is lacking. The present study aimed to present a novel surgical approach for the removal of fat nodules caused by autologous fat grafting in the tear trough. This retrospective study included 33 patients who underwent surgery for the removal of fat nodules formed after autologous fat grafting. The procedure was performed using a conjunctival approach, allowing exposure and removal of all fat nodules in the anterior septal space, with the method adapted according to the severity of the deformity. A total of 66 eyelids were treated surgically, including 30 (45.45%) with mild nodular deformity, 23 (34.85%) with moderate nodular deformity, and 13 (10.70%) with severe nodular deformity. A second surgical procedure was required on 3 eyelids (4.56%). The main complications of the surgery were conjunctival congestion (21.21%), and localized depression (18.18%), bruising (12.12%). Among the patients, 29 (87.88%) were satisfied and 4 (12.12%) were dissatisfied with the treatment results. Conjunctival approach surgery is an effective method of removing fat nodules formed after autologous fat grafting in the tear trough, with good results and high levels of patient satisfaction. This approach enables the effective management of a common complication of autologous fat grafting and may enable the wider application of autologous fat grafting in the periorbital region. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Correction of the Tuberous Breast with Fat Grafting and Implant: Techniques, Evaluation with BREAST-Q, and Preliminary Results.

The correction of tuberous breast deformity with fat grafting has gained popularity in recent years, but it remains unclear whether this new technique can produce patient satisfaction levels comparable to those achieved with implant-based correction. This study aimed to compare patients' satisfaction and quality of life using the BREAST-Q questionnaire after correction of tuberous breast deformity with fat grafting and implants. Twenty-four patients (36 breasts) were included in our study. Thirteen patients (15 breasts) had a correction with lipofilling (mean 2.67 interventions) and 11 patients (21 breasts) had an implant-based correction (mean 1 intervention). Both fat and implant treatments showed statistically significant improvements in breast satisfaction (p value=0.001, 0.002, respectively), psychosocial (p value=0.003, 0.003, respectively), and sexual satisfaction (p value=0.008, 0.002, respectively) between the pre-treatment and post-treatment stages. However, the only statistically significant differences between the treatments were observed in the physical condition pre-treatment (p value=0.008) and sexual condition post-treatment (p value=0.030). The outcome of both treatments was not statistically different. Furthermore, the outcome exhibited a statistically significant positive linear relationship with breast satisfaction for both treatments. This study suggests that lipofilling can achieve breast and outcome satisfaction comparable to that of implants, although this parity in results comes at the cost of more interventions. These preliminary results lend support to the notion that, as surgeons have access to two equally effective techniques, it is crucial to provide appropriate guidance to patients to ensure their satisfaction. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Contemporary Advances in Cardiac Remote Monitoring: A Comprehensive, Updated Mini-Review

Over the past decade, remote monitoring (RM) has become an increasingly popular way to improve healthcare and health outcomes. Modern cardiac implantable electronic devices (CIEDs) are capable of recording an increasing amount of data related to CIED function, arrhythmias, physiological status and hemodynamic parameters, providing in-depth and updated information on patient cardiovascular function. The extensive use of RM for patients with CIED allows for early diagnosis and rapid assessment of relevant issues, both clinical and technical, as well as replacing outpatient follow-up improving overall management without compromise safety. This approach is recommended by current guidelines for all eligible patients affected by different chronic cardiac conditions including either brady- and tachy-arrhythmias and heart failure. Beyond to clinical advantages, RM has demonstrated cost-effectiveness and is associated with elevated levels of patient satisfaction. Future perspectives include improving security, interoperability and diagnostic power as well as to engage patients with digital health technology. This review aims to update existing data concerning clinical outcomes in patients managed with RM in the wide spectrum of cardiac arrhythmias and Hear Failure (HF), disclosing also about safety, effectiveness, patient satisfaction and cost-saving.

Patient Satisfaction Survey in Traditional Medicine Units in Bhutan, 2023: a cross-sectional survey

Background: Assessing patient satisfaction is a vital component of any robust health service. In this study, we assessed the level of patient satisfaction with the TM services across health facilities in Bhutan in 2023. Methods: This study was a cross-sectional study conducted among adults availing TM services between March and April 2023. Patient satisfaction was scored against given statements on a Likert scale. Data were analysed to examine the overall levels of satisfaction with TM services. Results: There were 353 respondents surveyed across 46 TM units. Patients reported high satisfaction scores on the cleanliness of the health facility and its toilets, availability of sitting facilities in waiting rooms, clarity of direction and signage in the hospitals, and good communication skills of receptionists and TM practitioners. High scores were also recorded on the time provided by TM practitioners to patients and the ability to receive timely care. However, patients reported lower scores on the availability of all amenities for the drungtshos to provide the desired services to the patient. However, only 44.41% of participants reported adequate satisfaction with the services. The domain-wise satisfaction scores: satisfaction (44.19%), Physical environment (31.44%), Courtesy (52.12%), Quality of care (48.48%), Interpersonal (56.37%), Communication (56.37%), Time spent with health professionals (28.61%) and Accessibility and convenience (37.68%). Conclusions: Only four in every ten participants were highly satisfied with Traditional Medicine services at various public health facilities in Bhutan. Such patient satisfaction surveys serve as a benchmark for quality improvement initiatives.

Patient Satisfaction: The Role of Artificial Intelligence in Healthcare

Applications of artificial intelligence (AI) can be seen in almost every aspect of the healthcare system, as it has potential to affect almost every facet of the healthcare, from detection of ailments and serious or complex chronic diseases to their control, prevention and cure. With technological innovations, upgradation and adoption in the field of healthcare, healthcare professionals are required to be well prepared to accept the continuously evolving technology and its application to provide best healthcare facilities, which gave rise to the various studies on the role of the machine learning (ML), AI, deep learning (DL), etc., in the field of healthcare. Similarly, the rise in digitalised hospitals, medical facilities, records and data has resulted in the improvisation in the field of healthcare, which in turn has increased the need of experts, professionals, experienced and digitally literate workforce teams in the field of entire healthcare system. Understanding the roles of these advanced technologies, impacts being created on the health, lifestyle and the entire healthcare system, along with the perception of the patients towards it, will shape the way for the improvements and the applications of AI and its outcomes to be achieved, resulting in healthier world for the patients and the society. The objective of the study is to create a patient satisfaction model and validate it with respect to factors influencing patient satisfaction of several patients undergoing AI treatment factors. In the study, the United States, Canada, Australia, UAE and China were chosen as a place of survey, as these are advanced countries and the use of AI is highest in these countries compared to other countries, and survey was done with the help of structured questionnaire. In our earlier study, exploratory factor analysis (EFA) was performed for initial knowledge development on the construct of patients undergoing AI treatment. Patient satisfaction rests on six broad dimensions: First factor is personal touch (PT), second factor is comprehensive gap (CG), third factor is answerability (AB), fourth factor is nerve racking (NR), fifth factor is wrong reporting (WR) and sixth factor is enlightened (EL). With the help of confirmatory factor analysis (CFA) and structured equation modelling (SEM), it has emerged from the study that patient satisfaction level of the construct suggests that PT will have a greater impact on patient satisfaction, and it is the most significant factor of patient satisfaction compared to other constructs. Thus, we can conclude that PT still remains the most important factor in the minds of patients before undergoing AI treatment.

Can narrow-diameter implants enhance patient-reported outcomes for mandibular implant-retained overdentures?

A systematic review and meta-analysis. To evaluate and compare stability and functionality between narrow and standard implant-retained mandibular overdentures in edentulous patients from multiple perspectives. Assessments included clinical parameters [survival rate (SR) and marginal bone loss (MBL)], along with patient-reported outcome measures (PROMs) including patient satisfaction and oral health-related quality of life (OHRQoL). The study protocol followed PRISMA criteria for reporting reviews and meta-analyses. Using appropriate keywords, electronic search was conducted in each of the following databases: Medline, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus, up to July 22, 2022. There were no restrictions based on language, publication type, or publication date. Additionally, ongoing studies were explored in ClinicalTrials.gov and WHO ICTRP, while cross-references in each selected study were manually examined. The eligible studies were randomized controlled trials (RCTs) or controlled clinical trials (CCTs) comparing narrow implants (diameter ≤ 3.5 mm) to standard implants (diameter > 3.5-4.5 mm) retaining mandibular overdentures in edentulous patients. Excluded were studies with unclear implant diameter information, fewer than 5 patients per group, observational studies, reviews, and laboratory studies. Two authors independently conducted study selection, data collection, and analysis, resolving any discrepancies through discussion with a third author. Methodological quality was assessed using RoB-2 and ROBINS-I tools. Implant SR and MBL measurements at final follow-up were recorded, while patient satisfaction and OHRQoL were evaluated using visual analogue scale (VAS-100) and oral health impact profile (OHIP) questionnaire, respectively. After duplicate removal, 782 publications and 83 registered clinical trials were identified, of which 26 were eligible for full-text assessment. Ultimately, the quantitative evaluation included 12 publications from 8 independent studies: 4 parallel design RCTs and 4 CCTs. Risk of bias assessment revealed variations among the studies, with only one study being rated as having low risk. The follow-up periods ranged from 1 to 3 years. Meta-analysis showed no significant difference in SR and MBL between narrow and standard implant groups (p = 0.29 and p = 0.93, respectively), with considerable heterogeneity (I2 = 100% and I2 = 78%, respectively). Regarding PROMs, the narrow implant group showed significantly higher levels of patient satisfaction (mean difference (MD): 8.18; 95% CI: 5.83 to 10.53; p < 0.00001; I2 = 36%) and exhibited a significant improvement in OHRQoL (MD: -4.36; 95% CI: -6.83 to -1.89; p < 0.001; I2 = 55%) compared to the standard implant group. For implant-retained mandibular overdentures, the use of narrow implants is associated with comparable SR and MBL, along with higher patient satisfaction and better OHRQoL improvement as compared to standard implants, offering a viable alternative option for patients with diminished alveolar bone width.

From Awareness to Action: Clinicians and the Health Care of Deaf Patients

High levels of patient satisfaction are critical in health care and allow patients to feel more satisfied with their care and be more compliant overall. This idea is even more important in traditionally disenfranchised groups of people, such as Deaf patients, because satisfaction with medical encounters can translate into better health outcomes. This community possesses its own traditions, language, and culture, and health disparities here are apparent and often significant. Clearer communication in clinical encounters allows for more accessible health care. Barriers to effective communication are a major factor accounting for poorer health outcomes for Deaf individuals.

Immediate versus early loading of immediately placed bone-level tapered dental implants with hydrophilic surface in full arch maxillary rehabilitation: A pilot randomized clinical trial with 2-year follow-up.

This study aimed to compare implant stabilities between the immediate and early loaded, immediately placed bone-level tapered dental implants in the maxilla and to evaluate marginal bone loss (MBL), oral health-related quality of life (OHRQoL), and patient satisfaction at a 2-year follow-up. A pilot, prospective, randomized, controlled clinical trial was conducted on 24 maxillary failing dentition patients. The bone-level tapered implants of 12 patients were immediately loaded with temporary restorations, while the other 12 patients did not receive any kind of temporization. Implant-supported screw-retained complete porcelain-fused-to-metal prostheses were delivered to all patients in the seventh postoperative week. The insertion torque values of implants assigned to the immediate and early loading groups were 33.0 ± 4.87 and 29.26 ± 8.31 Ncm, respectively. The dynamics of implant stability changes from implant placement up to a 2-year follow-up were similar for both groups (Penguin®, p = 0.268; Ostell®, p = 0.552), while the MBL was at submillimeter level. The cumulative implant survival rate was 91.80% for immediately loaded implants and 97.22% for early loaded implants, without significant difference (p = 0.162). The total score on the Oral Health Impact Profile questionnaire significantly decreased over time in both groups, indicating improvement in OHRQoL (p < 0.001), and the high level of patient satisfaction remained after 2 years of function regardless of a loading protocol. Both loading protocols, immediate and early, of six immediately placed bone-level tapered dental implants are an adequate treatment choice for fixed rehabilitation of the maxillary failing dentition.

The Application of Reverse Z-Plasty Design in Medial Canthal Skin Redundancy Reconstruction Surgery.

To investigate the clinical outcomes of reverse Z-plasty in the reconstruction of epicanthal fold. We conducted a retrospective analysis on clinical data from patients who underwent medial canthal skin redundancy reconstruction surgery from September 2019 to January 2023. The surgical procedure involved a preoperative design for the incision line, suborbicularis oculi dissection to create a muscle flap, and the use of a reverse Z-flap for the reconstruction of the lateral canthal fold. Postoperative follow-up assessments focused on the intercanthal distance, positional changes of the medial canthus point, alterations in the medial canthus angle, and patient satisfaction levels. The statistical evaluation was carried out utilizing paired t-tests, with a P-value of less than 0.05 denoting statistical significance. Postsurgery, the lacrimal prominences were less exposed, and inner canthal angles naturally reshaped. Inconspicuous scarring with diminished reverse Z-plasty marks was noted within 3 months. The average ICD has increased by 3 to 6mm, corresponding to elongation ratios of 9.09% to 28.30%. Preoperatively, the ICD averaged 31.25±2.32mm, expanding postoperatively to 35.19±2.26mm. The canthal angle enlarged significantly from 49.031±6.627 to 62.188±6.662. Inner canthal points shifted notably postsurgery, with a decrease in x-value and an increase in y-value, signalling a movement upwards and away from the nose. Patient satisfaction is high. The reverse Z-plasty technique has proven to be an effective approach for reconstructing the epicanthal fold. The clarity and precision of the incision design, coupled with the stability of postoperative results, demonstrate that this method can reliably achieve successful epicanthal fold reconstruction.

Comparison of recurrence rate of primary pterygium using conjunctival autograft with sutures versus suture-free approach.

Objective: To compare the recurrence rate of primary pterygium treated with conjunctival autograft (CAG) using sutures versus a suture-free approach. Methodology: From July 2022 to December 2022, a quasi-experimental study was carried out at the Institute of Ophthalmology, Liaquat University of Medical &amp; Health Sciences Jamshoro. A total of 110 patients with primary pterygium underwent treatment with conjunctival autograft using sutures or a suture-less/glue-free approach, under local anaesthesia. The patients were monitored for 12 months after surgery to assess recurrence and complications, and all procedures were performed by a single surgeon. Data was collected and analyzed on SPSS version 22. Result: The study included 110 patients with pterygium, mostly males (71.81%) and from rural areas, with the nasal location being the most common. Group A had 3 recurrences at 3 and 6 months, while Group B had 4 recurrences at similar intervals. Group A had fewer complications, including graft oedema, retraction, granuloma, and giant papillary conjunctivitis, while Group B had three cases of retraction. The recurrence rate was found to be 5.08% and 7.70% with and without sutures (P value ≥ 0.53) respectively. Conclusion: The excision of primary pterygium using conjunctival autograft with sutures or suture-free/glue-free methods are safe and uncomplicated procedure that results in lower levels of induced astigmatism, improved cosmetic appearance, no tissue loss, reduced recurrence of pterygium, and decreased risk of, scleral thinning, granuloma formation. Suture-free conjunctival autograft results in less postoperative manifestation like discomfort foreign body sensation, shorter surgery time, and high levels of patient satisfaction compared to conjunctival autograft with sutures. Key words: Primary pterygium, autograft and pterygium. recurrence rate of pterygium, suture with pterygium.

Influence of pain duration and severity on oral health-related quality of life and patient satisfaction during adult treatment with clear aligners

BackgroundThis study aims to compare the impact of pain on quality of life and patient satisfaction during treatment with aligners.MethodsNinety-four subjects in active treatment were invited to answer self-reported questions concerning pain severity and duration, occurrence of other signs and symptoms, and level of satisfaction with their treatment. Also, the OHIP-14 questionnaire was applied to assess patients’ OHRQoL.ResultsNinety-four patients (49 women and 45 men) answered the survey. Pain duration of 1–3 days was reported by 69.1% of patients (n = 60). For those who reported pain (n = 84), it was considered mild severity by 42.9% and moderate by 52.4%. Almost sixty-four percent of the sample were very satisfied with the aligner’s aesthetics (n = 60) and forty-nine percent were satisfied with treatment in general (n = 46). Mean OHIP-14 score was 3.36 ± 2.54. OHRQoL was significantly associated with pain severity, whereas patients who reported having experienced moderate pain presented a significantly higher mean OHIP-14 score than those who reported having experienced mild pain (3.92 ± 1.93 and 2.69 ± 2.83, respectively; p = 0.036). The “psychological discomfort” OHIP-14’s domain was the most influenced by the level of pain.ConclusionPain severity significantly influenced OHRQoL, in adult patients under treatment with clear aligners. However, high levels of patient satisfaction were reported, regardless of pain duration or severity.

Electromyographic Evaluation of Masseter and Temporalis Muscle Activity in Distal Extension Edentulous Patients After Replacing with Implants—A Prospective Clinical Trial

Aim: To assess the changes in muscle activity after replacing the missing teeth or teeth with implants in distal extension edentulous patients and to evaluate the patient’s satisfaction levels. Materials and Methods: This was a single-group experimental study, based on convenience sampling with a sample size of 40 patients. Only unilateral mandibular distal extension edentulous sites were included and endo-osseous dental implants were placed in delayed protocol. Electrical activities of the masseter and temporalis muscles were recorded at rest and clench before, immediately, and one month after the cementation using electromyography. Patient satisfaction was analyzed through a questionnaire. Descriptive statistics an inferential statistics with repeated measures of ANOVA followed by the Bonferroni post hoc test were done to analyze the study data. P value &lt; .05 would be considered statistically significant for all the analyses. Results: Right temporalis showed significantly higher surface electromyography (sEMG) activity at one-month post cementation than baseline at rest and clench. Similarly, the left temporalis has shown significant sEMG activity at one-month post cementation than baseline at clench. However, there was no statistical difference with the right and left masseter. The implant-supported prosthesis was well received by the majority of patients. Conclusion: Definitive improvement in the electrical activity of the temporalis before and after the replacement of prosthesis was noticed with positive patient satisfaction levels with implant-supported prosthesis.

Integrating Spatial and Non-Spatial Dimensions to Evaluate Access to Rural Primary Healthcare Service: A Case Study of Songzi, China

Access to rural primary healthcare services has been broadly studied in the past few decades. However, most earlier studies that focused on examining access to rural healthcare services have conventionally treated spatial and non-spatial access as separate factors. This research aims to measure access to primary healthcare services in rural areas with the consideration of both spatial and non-spatial dimensions. The methodology of study is threefold. First, the Gaussian two-step floating catchment area (G-2SFCA) method was adopted to measure spatial access to primary healthcare services. Then, a questionnaire survey was conducted to investigate non-spatial access factors, including demographic condition, patient’s household income, healthcare insurance, education level, and patient satisfaction level with the services. After that, a comprehensive evaluation index system was employed to integrate both spatial and non-spatial access. The empirical study showed a remarkable disparity in spatial access to primary healthcare services. In total, 78 villages with 185,137 local people had a “low” or “very low” level of spatial access to both clinics and hospitals. For the non-spatial dimension, the results depicted that Songzi had significant inequalities in socioeconomic status (e.g., income, education) and patient satisfaction level for medical service. When integrating both spatial and non-spatial factors, the disadvantaged areas were mainly located in the eastern and middle parts. In addition, this study found that comprehensively considering the spatial and non-spatial access had a significant impact on results in healthcare access. In conclusion, this study calls for policymakers to pay more attention to primary healthcare inequalities within rural areas. The spatial and non-spatial access should be considered comprehensively when the long-term rural medical support policy is designated.

ANALYSIS OF THE DIMENSIONS OF HEALTH SERVICE QUALITY ON PATIENT SATISFACTION AT ROYAL PRIMA MARELAN HOSPITAL IN 2024

One indicator of quality in health services is patient satisfaction, where high-quality health services will generally create a high level of patient satisfaction, leading to loyalty to health services. The study aimed to analyze the dimensions of Health Service Quality toward Patient Satisfaction at Royal Prima Marelan Hospital in 2024. The method used in this research is quantitative non-experimental with a descriptive approach (cross-sectional survey) and associative analysis. The population was 318 people, and the sample determination used Slovin so that the sample size was 197, rounded up to 200 samples, with incidental sampling technique-data analysis using univariate, bivariate (Chi-Square), multivariate (multiple logistic regression Enter method). The results of the Chi-Square analysis obtained the variables of Physical Evidence (p-value 0.004), reliability (p-value 0.006), Responsiveness (p-value 0.008), assurance (p-value 0.004), empathy (p-value 0.002) have a p-value ≤ 0.05 with a significant level of 0.05. It is concluded that the most influential variable is the empathy variable, with a p-value of 0.000 &lt;0.05. The OR value obtained is 10.224, meaning that ease of relationship, good communication, and understanding of the needs of patients have an opportunity of 10.224 times to increase patient satisfaction at Royal Prima Marelan Hospital in 2024. KEYWORDS: quality, satisfaction, patient, empathy

P056 Patient Satisfaction Survey of a Newly Set-Up Fast Track Giant Cell Arteritis Service in a District General Hospital

Abstract Background/Aims Giant Cell Arteritis (GCA) is a multisystem, large and medium artery vasculitis, which results in significant comorbidity, even mortality. Prompt diagnosis is a pivotal first step in its effective management. To that effect, we set up a fast track service in Eastbourne District General Hospital (EDGH) for a one-stop-shop assessment of GCA referrals with Ultrasound Doppler. Fifteen months from service commencement, we embarked on assessing patient satisfaction of our service users. This exercise could provide vital insight into the effectiveness of our new service, and thus drive improvement. Furthermore, it is well established that patient satisfaction is associated with improved outcomes in patient care, be it due to improved compliance, engagement with the service, or overall better understanding of the underlying condition. Aims 1. To assess overall level of patient satisfaction of our new fast track GCA service against a number of internally set criteria; 2. To improve the effectiveness of the service based on feedback from the actual service users; 3. To improve the level of satisfaction of patients coming through the GCA service. Methods We set up a dedicated GCA clinic aiming to see patients within five days of referral. In order to assess overall patient satisfaction of the service, we formulated a questionnaire-based survey that was posted to 99 service users. We assessed five areas overall: appointment allocation process; staff attitude; information supplied; advice line effectiveness; overall satisfaction. Data were collected and analysed on Microsoft Excell. No patient identifiable details were collected. Results Out of the 99 feedback forms that were sent out, 51 were returned completed within the survey period. The appointment allocation process was assessed as “excellent” by 95% of responders, and “satisfactory” by 5%. Staff received 98% “excellent” rating. Information provided to the patient was assessed as 91% “excellent”, 8% “satisfactory”, and 1% “poor”. Response to advice line inquiries received 54% “excellent”, 18% “satisfactory”, and 2% “poor” rating (26% of responders answered “non-applicable”). Finally, overall satisfaction was rated at 93%, with, crucially, no service user providing a “poor” rating. Conclusion We conducted a patient survey to assess overall satisfaction of our new fast track GCA pathway, ultimately aiming at improving our service. The overwhelming majority of the feedback was positive, but we focused and acted on suggestions. Following the survey, we have a) designed a GCA “passport” with useful information for newly diagnosed patients; b) revisited the advice line with a modified information leaflet for this service; c) endeavoured to optimise the referrals process via education sessions on GCA for Hospital and Primary Care clinicians. Following a period of intervention, we will be reassessing patient satisfaction, aiming to continue improving our service. Disclosure A. Hall: None. P. Kamperidis: None. H. Perera: None. S. Panthakalam: None.

Application and effect of tension-reducing suture in surgical treatment of hypertrophic scar

PurposeTo investigate the application and effectiveness of tension-reducing suture in the repair of hypertrophic scars.MethodsA retrospective analysis of clinical data was conducted on 82 patients with hypertrophic scars treated at the Department of Burns and Plastic Surgery of Nanjing Drum Tower Hospital from September 2021 to December 2022. Patients were operated with combination of heart-shaped tension-reducing suturing technique and looped, broad, and deep buried (LBD) suturing technique or conventional suture method. Outcomes of surgical treatment were assessed before and 6 months after surgery using the Patient and Observer Scar Assessment Scale (POSAS) and the Vancouver Scar Scale (VSS).ResultsImprovements were achieved on scar quality compared to that preoperatively, with a reduction in scar width (1.7 ± 0.6 cm vs. 0.7 ± 0.2 cm, P < 0.001). Assessment using the POSAS and VSS scales showed significant improvements in each single parameter and total score compared to preoperative values (P < 0.05). The Combination method group achieved better score in total score of VSS scale, in color, stiffness, thickness and overall opinion of PSAS scale, and in vascularity, thickness, pliability and overall opinion of OSAS scale.ConclusionThe amalgamation of the heart-shaped tension-reducing suturing technique and the LBD suturing technique has shown promising outcomes, garnering notably high levels of patient satisfaction in the context of hypertrophic scar repair. Patients have exhibited favorable postoperative recoveries, underscoring the clinical merit and the prospective broader applicability of this approach in the realm of hypertrophic scar management.

Minimally invasive sacroiliac joint fusion secondary to lumbosacral fusion: clinical and functional results at 2 years of follow-up

Introduction: Degenerative sacroiliac (SI) joint syndrome is known to be more common after lumbosacral fusion. While this diagnosis is suspected based on various clinical criteria and diagnostic tests, it is confirmed with a diagnostic nerve block. If conservative treatment fails, SI joint fusion through a minimally invasive approach is a useful palliative approach for patients at a treatment crossroads. The aim of this study was to evaluate the clinical and functional results at 2 years postoperative after minimally invasive SI joint fusion in patients with SI joint syndrome following lumbosacral fusion.Materials and Methods: We carried out a single-center retrospective study of patients operated between June 2017 and October 2020. Included were patients who had a confirmed diagnosis of SI joint syndrome after lumbosacral fusion surgery, who underwent SI joint fusion and had at least 2 years’ follow-up. The primary outcome was the improvement in lumbar and radicular pain on a numerical rating scale (NRS). The secondary outcomes were the functional scores (Oswestry and SF-12) along with the level of patient satisfaction. Our study population consisted of 54 patients (41 women, 13 men) with a mean age of 59 years (27–88). Thirty-one of these patients were operated on both sides (85 fusions in all). The patients had undergone a mean of 3 lumbar surgeries (1–7) before the SI fusion.Results: The lumbar and radicular NRS were 8.4 (7-10) and 5.1 (2-10) preoperatively and 5.2 (0-8) and 3.0 (0-8) at 2 years postoperatively, which was a reduction of 37% and 42% (p<0.001), respectively. The Oswestry score went from 69.4 (52-86) preoperatively to 45.6 (29-70) at 2 years, which was a 33% improvement (p < 0.001). Eighty-six percent of patients were satisfied or very satisfied with the surgery.Discussion: After minimally invasive SI joint fusion, the patients in this study had clear clinical and functional improvements. Previous publications analyzing the results of SI joint fusion found even more improvement, but those patients were relatively heterogenous; in our study, only patients who had a history of lumbosacral fusion were included.Conclusion: Minimally invasive SI joint fusion helped patients who developed SI joint syndrome after lumbosacral fusion to improve clinically and functionally.Level of evidence: IV, Retrospective study