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.

Conservative 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. Review 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). There 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; I 2 = 15.83%); tumor location [central (OR 1.28; 95% CI 0.06-27.49; I 2 = 17.63%); lower (OR 0.75; 95% CI 0.21-2.65; I 2 = 2.21%); superior (OR 0.67; 95% CI 0.26-1.74; I 2 = 0.00%] and tumor size (OR 8.73; 95% CI -11.82-29.28; I 2 = 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. The 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.

Tingkat Kepuasan Pasien Terhadap Pelayanan Kefarmasian di Apotek Parviz Kota Palangka Raya

Pharmaceutical services involve direct and responsible care for patients related to pharmaceutical preparations, aiming to achieve definite results that enhance patients' quality of life. One indicator of healthcare quality is measuring user satisfaction. Apotek Parviz provides pharmaceutical services to the surrounding community, offering dual healthcare services—doctor diagnosis and pharmaceutical care—thus improving the health and quality of life for residents of Palangka Raya City. This study aims to determine patient satisfaction levels with pharmaceutical services at Apotek Parviz in Palangka Raya City, based on five dimensions: tangibility, reliability, responsiveness, assurance, and empathy. This descriptive study used a questionnaire with a sample size of 86 respondents selected through accidental sampling. The research results showed that the satisfaction percentages for each dimension were: 87.43% for tangibility, 81.16% for reliability, 83.25% for responsiveness, 84.49% for assurance, and 83.25% for empathy. The overall average satisfaction across the five dimensions, according to the Likert scale, was 84.18%, indicating that patients are very satisfied with the pharmaceutical services at Apotek Parviz in Palangka Raya City.

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.

A Comparative Study on Aesthetic and Pain Outcomes in Flap Versus Implant Breast Reconstruction After Mastectomy.

Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death among women worldwide. Surgical treatments, including mastectomy and subsequent breast reconstruction, are critical components of breast cancer management. This systematic review compares the outcomes of flap versus implant reconstruction post-mastectomy, focusing on aesthetic differences, pain, recovery, and psychological adaptation. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA) 2020 guidelines, we conducted a comprehensive literature search across PubMed, Cochrane, and ScienceDirect databases. Inclusion criteria targeted studies comparing aesthetic outcomes, pain, recovery costs, duration, and psychological adaptation between flap and implant breast reconstructions. We excluded non-English and non-Spanish studies, case reports, and those without full-text availability. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). From an initial pool of 25,881 articles, 16 high-quality studies involving 14,196 participants were selected for synthesis. Flap reconstruction was associated with higher patient satisfaction regarding aesthetic outcomes and psychological well-being but also had higher complication rates, including infections and wound dehiscence. Implant reconstruction showed fewer complications but did not achieve the same level of patient satisfaction. Flap reconstruction, despite its higher complication rates, tends to provide superior aesthetic and psychological outcomes compared to implant reconstruction. These findings highlight the importance of personalized treatment plans considering individual patient needs and preferences. Future research should focus on long-term randomized controlled trials (RCTs) and standardized outcome measures to further delineate the comparative effectiveness of these reconstruction techniques. Personalized care and ongoing research are essential to improving the quality of life for breast cancer survivors undergoing reconstruction.

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.

Patient Satisfaction Following Orthodontic Treatment: A Systematic Review.

Patient-reported outcome measures (PROMs) have become increasingly important in orthodontic treatment as they reflect patients' perceptions of treatment outcomes. Understanding patient satisfaction with orthodontic treatment is crucial for improving healthcare delivery and patient-centered care. This systematic review aimed to critically appraise the evidence regarding patient satisfaction after orthodontic treatment, exploring the effects of different treatment types, patient demographics, and other factors on satisfaction levels. Eight electronic bibliographic databases were searched without publication time or language restrictions, including PubMed®, Scopus®, the Cochrane Central Register of Controlled Trials, Web of Science™, Embase®, Google™ Scholar, Trip, and OpenGrey. A manual search was conducted on the references in the included papers. Eligibility criteria were established based on the Population, Intervention, Comparison, Outcomes, and Study (PICOS) framework. Studies were included if they reported patient satisfaction levels following orthodontic treatment using standardized questionnaires. Two reviewers independently collected and analyzed the data. The risk of bias was assessed usingCochrane's risk of bias tool (RoB2) for randomized clinical trials, and the methodologic quality for cohort and cross-sectional studies was assessed using the modified version of the Newcastle-Ottawa scale. Fourteen studies employed various questionnaires and timings to gauge post-orthodontic treatment satisfaction. Patient satisfaction levels were generally high, with most studies reporting satisfaction rates above 91%. Fixed orthodontic appliances were associated with higher satisfaction levels compared to removable appliances. While age and gender did not significantly influence satisfaction, the quality of care and doctor-patient relationships were crucial factors in patient satisfaction. This systematic review proves that patient satisfaction with orthodontic treatment is generally high, with fixed appliances and positive doctor-patient relationships contributing to higher satisfaction levels. However, the quality of the evidence was moderate to low, highlighting the need for further high-quality clinical studies in this area.

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.].

Assessing the efficacy of anticoagulation therapy in the management of atrial fibrillation: An observational study

Background: Atrial fibrillation (AF) substantially elevates stroke risk. Managing AF with anticoagulation therapy is crucial to reduce this risk, yet assessing the balance between its efficacy in preventing strokes and the potential for bleeding complications is essential. Aims and Objectives: The aim of this study is to evaluate the efficacy and safety of anticoagulation therapy in the management of AF. Materials and Methods: This observational study followed 100 AF patients at a government general hospital over 8 months to evaluate the efficacy and safety of anticoagulation therapy. We analyzed stroke occurrence, bleeding complications, treatment adherence, patient satisfaction, and improvements in quality of life (QoL). In addition, we recorded patient demographics and baseline characteristics, such as body mass index, smoking status, and CHA2DS2-VASc scores. Results: The study population was at a moderate-to-high risk of stroke, with an average CHA2DS2-VASc score of 2.9. The efficacy of stroke prevention was confirmed, with a 2% incidence of stroke events. Bleeding complications included major bleeding in 4% of the patients, with minor bleeding predominantly occurring in the first 3 months of therapy. Treatment adherence was noteworthy, with 75% of patients not missing any doses. High levels of patient satisfaction were observed, with 90% of participants reporting being satisfied or very satisfied with their treatment. QoL, measured through the AF-QoL questionnaire, showed significant improvement from a baseline score of 58–76. Conclusion: Anticoagulation therapy in AF patients was effective in stroke prevention with a manageable risk of bleeding. High treatment adherence and patient satisfaction further support the therapeutic value of anticoagulation in AF management.

[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.

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 .

Ultrasound Assessment of Facial and Neck Aging: A Noninvasive Approach to a Minimally Invasive Treatment

Abstract This technical note explores the diagnostic potential of ultrasound in assessing age-related changes in the soft tissues of the lower face and neck, with a primary focus on identifying causes of contour deformities and guiding minimally invasive rejuvenation procedures. Seventeen clinical patients with various age-related soft-tissue changes were subjected to ultrasound assessments, targeting issues such as soft-tissue sagging, supra- and subplatysmal adipose tissue excess, platysma thickness, and localization of ptotic platysma strands. The ultrasound examinations successfully identified specific anatomical features contributing to age-related soft-tissue changes in all 17 patients. This information guided tailored treatment plans, resulting in remarkable esthetic improvements in each case. The discussion emphasizes ultrasound’s invaluable role as a diagnostic tool for precisely identifying soft-tissue alterations in the lower face and neck. The noninvasive nature and high spatial resolution of ultrasound make it particularly effective for this purpose. The corrective methods guided by ultrasound findings proved to be minimally invasive and yielded successful outcomes in all cases, promoting high levels of patient satisfaction. The study highlights the underutilization of ultrasound’s diagnostic potential in clinical practice and highlights the importance of its incorporation into routine assessments. Ultrasound emerges as a cost-effective, noninvasive, and accessible means of accurately diagnosing age-related soft-tissue changes, empowering clinicians to tailor rejuvenation procedures to each patient’s unique needs. The hope is that by emphasizing its utility, this study encourages the broader adoption of ultrasound in clinical practice.

Effect of Various Vital Bleaching Systems on Clinical Outcomes and Patient Satisfaction.

Objective To evaluate the clinical behavior of different bleaching products - the hydrogen peroxide (H2O2), carbamide peroxide (CP), and titanium dioxide bleaching systems. Methods Three bleaching systems with different concentrations (H2O2 15%, 38%, CP 15%, 35%, and titanium dioxide 20% H2O2) were used. Sixty participants with discolored teeth were enrolled and equally divided into six groups. Each group was rendered the assigned bleaching protocol against the control group, which received plain dentifrice polishing.Each case was evaluated immediately, two weeks, three months, six months, and one year after the bleaching treatment. The clinical evaluation was made for color change by (shade guide and digital images with L*a*b* parameters), tooth sensitivity, gingival irritation, and participants' satisfaction. Results All bleaching systems showed color improvement after bleaching regimens with significant effect showed by in-office titanium dioxide 20% H2O2 followed by 38% H2O2 with Δ=10.26 and Δ=6.52, respectively, when compared to other bleaching techniques. Higher sensitivity was recorded in group III with 50% of the participants reporting postoperative sensitivity. Higher gingival irritation was recorded in group IV (15% CP) where 60% of the patients reported gingival irritation. Thirty-five of the 60 participants (58.5%) recorded that the treatment whitened their teeth "moderately" and "a lot" while seven participants recorded "a slight" difference. There was a highly significant difference in participants' satisfaction between all bleaching groups (p < 0.05). Conclusion It is evident that there is a development of dental sensitivity and gingival irritation irrespective of the bleaching system used. The color assessment showed that the desired result can be achieved with variable levels of patientsatisfaction with excellent overall results with the titanium dioxide system.

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

Influence of nursing services and facilities on the satisfaction level of BPJS Patients in the inpatient ward of Wajo health Center

Overview: The research conducted at the Wajo Health Center in Baubau City in 2023 aims to evaluate the impact of nursing services and facilities on the satisfaction of BPJS patients. Using an analytical cross-sectional approach, this study involved 42 patients selected through accidental sampling. Primary data were collected through survey questionnaires, while secondary data were obtained from the health center's medical records. Body of Knowledge: This study evaluates the influence of nursing services and health facilities on BPJS patient satisfaction as a key indicator of the effectiveness of the National Health Insurance. The research highlights the importance of improving service quality and health infrastructure to achieve equitable health coverage in line with the WHO's Universal Health Coverage goals. Methods: The study employed an analytical cross-sectional design at the Wajo Health Center in Baubau City from May to June 2023. Out of a population of 55 patients, 42 were selected via accidental sampling. Primary data were gathered through questionnaires and analyzed using univariate, bivariate, and Chi-Square statistical methods. Ethical considerations were maintained by ensuring informed consent, anonymity, and data confidentiality. Results: The majority of respondents were female (81%), predominantly aged 20-29 years (54.8%), and had a high school education (57.1%). Most were housewives (66.7%). There was a high level of satisfaction with nursing care (71.4%) and health facilities (81%). Bivariate analysis showed a significant relationship between satisfaction with nursing services (X² = 10.438, p = 0.005) and health facilities (X² = 12.101, p = 0.003) and BPJS patient satisfaction. Recommendation: It is recommended to enhance service quality through regular training for medical personnel to improve interpersonal and clinical skills. Periodic evaluations of health infrastructure are necessary to ensure reliability. Continuous support from management is required for ongoing improvements, ensuring that health service standards meet BPJS patient expectations.