Patient Satisfaction Research Articles

Effect of surgical timing on postoperative outcomes in patients with acute cholecystitis after delayed percutaneous transhepatic gallbladder drainage

BACKGROUND To date, the optimal timing for percutaneous transhepatic gallbladder drainage (PTGBD), particularly for patients who have missed the optimal window for emergency laparoscopic cholecystectomy (LC) (within 72 hours of symptom onset) has not been determined. AIM To study the effects of LC timing on outcomes of grade II/III acute cholecystitis (AC) in patients with delayed PTGBD. METHODS Data of patients diagnosed with Tokyo Guidelines 2018 grade II or III AC who underwent delayed PTGBD followed by LC at a single hospital between 2018 and 2022 were retrospectively studied. According to the interval between gallbladder drainage and cholecystectomy, the patients were divided into early and delayed LC groups. Outcomes including surgery time, postoperative complications and hospital stay, and patient satisfaction were analyzed and compared between the two groups using t - and χ 2 tests. RESULTS There were no significant differences between the two groups in intraoperative blood loss, postoperative abdominal drainage tube placement time, pain index, or total disease duration (all P > 0.05). Compared with those of the early LC group, the delayed group showed significant decreases in the length of procedure (surgery time), conversion rate to open surgery, degree of adhesions, surgical complications, postoperative hospital stay, and total treatment costs, and increased patient satisfaction despite a longer interval before PTGBD (all P < 0.05). CONCLUSION For patients with grade II/III AC with delayed PTGBD, LC should be performed 2 weeks after PTGBD to decrease postoperative complications and hospital stays and improve patient satisfaction.

Narrative nursing for negative emotions in patients with acute pancreatitis: Based on model construction and application

BACKGROUND Acute pancreatitis (AP), as a common acute abdomen disease, has a high incidence rate worldwide and is often accompanied by severe complications. Negative emotions lead to increased secretion of stress hormones, elevated blood sugar levels, and enhanced insulin resistance, which in turn increases the risk of AP and significantly affects the patient's quality of life. Therefore, exploring the intervention effects of narrative nursing programs on the negative emotions of patients with AP is not only helpful in alleviating psychological stress and improving quality of life but also has significant implications for improving disease outcomes and prognosis. AIM To construct a narrative nursing model for negative emotions in patients with AP and verify its efficacy in application. METHODS Through Delphi expert consultation, a narrative nursing model for negative emotions in patients with AP was constructed. A non-randomized quasi-experimental study design was used in this study. A total of 92 patients with AP with negative emotions admitted to a tertiary hospital in Nantong City of Jiangsu Province, China from September 2022 to August 2023 were recruited by convenience sampling, among whom 46 patients admitted from September 2022 to February 2023 were included in the observation group, and 46 patients from March to August 2023 were selected as control group. The observation group received narrative nursing plan, while the control group was given with routine nursing. Self-rating anxiety scale (SAS), self-rating depression scale (SDS), positive and negative affect scale (PANAS), caring behavior scale, patient satisfaction scale and 36-item short form health survey questionnaire (SF-36) were used to evaluate their emotions, satisfaction and caring behaviors in the two groups on the day of discharge, 1-and 3-month following discharge. RESULTS According to the inclusion and exclusion criteria, a total of 45 cases in the intervention group and 44 cases in the control group eventually recruited and completed in the study. On the day of discharge, the intervention group showed significantly lower scores of SAS, SDS and negative emotion (28.57 ± 4.52 vs 17.4 ± 4.44, P < 0.001), whereas evidently higher outcomes in the positive emotion score, Caring behavior scale score and satisfaction score compared to the control group (P < 0.05). Repeated measurement analysis of variance showed that significant between-group differences were found in time effect, inter-group effect and interaction effect of SAS and PANAS scores as well as in time effect and inter-group effect of SF-36 scores (P < 0.05); the SF-36 scores of two groups at 3 months after discharge were higher than those at 1 month after discharge (P < 0.05). CONCLUSION The application of narrative nursing protocols has demonstrated significant effectiveness in alleviating anxiety, ameliorating negative emotions, and enhancing satisfaction among patients with AP.

The protocol for BROWSE-P (breast reconstruction outcomes with Strattice™ or Artia™ – pre-pectoral): a cohort study to assess long-term outcomes of immediate pre-pectoral implant based breast reconstruction with Strattice™ or Artia™

Introduction: Techniques in implant-based breast reconstruction (IBBR) have evolved over the last 15 years due to the introduction of mesh or acellular dermal matrices (ADMs). Traditionally, total submuscular coverage progressed to upper pole muscle cover with lower pole ADM and now total or anterior ADM cover in the pre-pectoral plane. Data is scarce to support the pre-pectoral technique but, it is suggested to result in less postoperative pain, more natural cosmesis and avoidance of animation deformity. The BROWSE study concluded that subpectoral with Strattice™ IBBR resulted in better cosmesis and lower rates of capsular contracture when compared to the total submuscular technique. The BROWSE-P study aims to assess the safety profile of Artia™ a porcine derived ADM and review the long-term outcomes of pre-pectoral IBBR with Strattice™ and Artia™. Methods and analysis: BROWSE-P is a single center cohort study. Consecutive patients who have undergone immediate pre-pectoral IBBR with Strattice™ or Artia™ from January 2017 to December 2022 will be included. Demographic, operative, oncology, complication, and further surgery data with be collected to assess the rate of revision surgery and safety profile of Artia™. Those who have their implant reconstruction in situ will be invited for clinical assessment to assess for capsular contracture. Participants will also be asked to complete a BREAST-Q post-reconstruction module, to assess patient satisfaction and quality of life, and have medical photographs taken for an assessment of aesthetic outcome by a blinded panel using the 10-point Visser scale. We aim to collect data on 500 reconstructions and complete clinical assessment, patient reported outcomes and aesthetic assessment for 250 patients.

Comparative Analysis of Full Endoscopic Interlaminar Lumbar Discectomy and Lumbar Microdiscectomy

Study Design: Retrospective clinical study. Objectives: The aim is to assess and contrast the results of full endoscopic lumbar discectomy (FELD) and lumbar microdiscectomy (LMD) for L5–S1 disc herniation, with a specific emphasis on postoperative pain reduction and surgical effectiveness. Background: Although minimally invasive spine operations are becoming more popular, there is still little research on the comparative effectiveness of FELD and LMD. Materials and Methods: The research had a total of 50 patients who received surgical intervention for L5–S1 disc herniation, with 25 patients getting full endoscopic interlaminar discectomy and the other 25 patients undergoing LMD. Clinical outcomes were assessed using the Visual Analog Scale for low back and leg pain, collected preoperatively and at the end of 1 week, 3 months, and 6 months postsurgery. Patient satisfaction was evaluated using Odoms criteria at the same intervals. Results: The study included 50 patients (26 men, 24 women), with a mean age of 51.11 ± 13.76 years. The groups had no significant differences in demographic data. Back and leg pain Visual Analog Scale scores decreased more significantly in the FELD group after 1 week of surgery (P < 0.001), although the declines at 3 months and 6 months were not significantly different between the two groups. According to Odoms criteria, patient satisfaction was favorable in both groups and significantly better in the FELD group than in the LMD group at 1 week postoperatively [excellent in 20 patients (80%) in the FELD group vs 9 patients (36%) in the LMD group (P = 0.025)]. However, patient satisfaction at 3 months and 6 months did not differ between the groups. Conclusion: This study demonstrates that FELD offers significant early postoperative advantages over LMD at the L5–S1 level when compared with pain and satisfaction scales. Level of Evidence Level III.

A Novel Technique for Top Surgery in Small-Breasted Individuals Who Experience Gender Dysphoria – Concentric Periareolar Mastectomy, Interlocking Suture and Waterjet-Assisted-Liposuction

Background: In small-breasted individuals, who experience gender dysphoria, the concentric periareolar approach is typically the preferred method for mastectomy. However, this method carries a notable risk of hypertrophic scars and changes in the areolar dimensions. This study introduces the periareolar interlocking suture (PIS) as a new scar-minimizing procedure, with a low complication rate and high patient satisfaction. Patients and Methods: We performed a concentric periareolar mastectomy (CPM) combined with PIS and waterjet-assisted liposuction (WAL) in patients with small breasts (A to B-Cup) and good skin quality/elasticity. Outcome measures included complication rates, patient satisfaction (assessed via the BODY-Q Chest and Nipples Scale and scar appearance), nipple sensitivity, and the rate of surgical corrections. Results: Between April 2017 and December 2023, we conducted 2312 mastectomies in 1156 people who experience gender dysphoria, with 410 breasts treated using CPM combined with PIS and WAL. The mean patient age was 23 years, mean hospital stay was 4 days, and mean operation time was 96.1 minutes. The overall complication rate was 7.8%, with acute hematomas occurring in 4.6% of the cases. Secondary revisions were necessary in only 2.2% of cases. Patient satisfaction, measured using the BODY-Q scale, was statistically significant and very high. Conclusion: Individuals with gender dysphoria are well-informed and increasingly demand aesthetic outcomes. Whenever feasible, procedures with minimal scarring are preferred. The technique presented here resulted in very high patient satisfaction, preserved nipple sensitivity, and a low rate of complications and secondary aesthetic corrections in a carefully selected cohort of patients with small breasts.

Photodynamic Therapy in Acne Vulgaris: A Systematic Review

Acne is a multifactorial disorder of the pilosebaceous unit. Photodynamic therapy (PDT) is an energy-based treatment shown to be safe in acne vulgaris, although the mechanism of action of PDT in acne is incompletely understood. This review summarizes the clinical features of and treatment efficacy in acne patients treated with PDT. A systematic review of Medline, Embase, and the Cochrane Database of Systematic Reviews was conducted. Title, abstract, full-text screening, and data extraction were completed using Covidence. Studies reporting the use of PDT in patients with acne were included while clinical features and treatment responses were extracted. Treatment outcomes were scored as complete response, partial response, and no response. After screening a total of 1122 studies, 82 studies met the inclusion criteria, representing 56 prospective studies, 25 randomized controlled trials, and 1 retrospective study. Results representing 4340 patients with acne (mean age 24.4 years; 52% females) treated with PDT are summarized. Overall, 2154 (50%) participants underwent aminolevulinic acid PDT, 452 (10%) participants underwent methyl aminolevulinate PDT, 28 (<1%) participants underwent daylight PDT, and 1706 (39%) underwent other modalities of PDT. The average follow-up period after study completion was 3 months, ranging from 2 weeks to 13 months. A partial response was observed in treated patients with outcome measures including clinical response, lesion count, pain, recurrence, and patient satisfaction. This systematic review provides preliminary data summarizing the clinical features and treatment efficacy in patients with acne treated with PDT. Our results suggest a partial clinical response when using PDT to manage acne. Future studies should focus on standardizing study protocols and drawing direct comparisons between PDT and other modalities for acne treatment.

Dupilumab Improves Patient-Reported Outcomes as Early as 1 Month among Adults with Prurigo Nodularis in Clinical Practice: Initial Results from the RELIEVE-PN Study

Introduction: Dupilumab is a monoclonal antibody approved in the United States (US) for patients aged ≥18 years with prurigo nodularis (PN). This analysis evaluated the real-world initial impact of dupilumab therapy on symptoms and treatment satisfaction among US adults with PN. Methods: RELIEVE-PN is an ongoing longitudinal prospective patient survey study assessing the real-world effectiveness of dupilumab in the treatment of adult patients with PN. Adults with PN were recruited through the US dupilumab patient support program and surveyed before (baseline) and 1 month after dupilumab initiation. PN symptoms over the last 7 days were assessed using the worst-itch numeric rating scale (WI-NRS), average-itch NRS, skin pain NRS, and skin burning or stinging/tingling NRS (range 0 [no symptom] to 10 [most severe symptom] for all). Treatment satisfaction with current therapy was evaluated using a 7-point Likert scale from “extremely satisfied” to “extremely dissatisfied”. Results: Of 84 patients (mean age, 57.5 years; 79.8% female; 83.3% White) completing the baseline survey and initiating dupilumab, 62 (mean age, 56.4 years; 77.4% female; 83.9% White) completed the Month 1 survey. At baseline, mean (SD) WI-NRS, average itch NRS, skin pain NRS, and skin burning/tingling NRS were 7.70 (2.24), 6.45 (2.25), 5.06 (2.87), and 5.51 (3.02), respectively. By month 1, mean (SD) WI-NRS, average itch NRS, skin pain NRS, and skin burning or stinging/tingling NRS improved to 5.56 (2.89), 4.35 (2.23), 3.40 (2.46), and 3.76 (2.60), respectively (p<0.001 for all). Additionally, significantly more patients reported they were satisfied with current PN treatment(s) at 1 month after dupilumab treatment initiation vs prior to starting dupilumab (77.4% vs 13.1%; p<0.001). Conclusion: Early results from the RELIEVE-PN study demonstrate improvement in symptoms and patient satisfaction with therapy as early as 1-month from treatment initiation of dupilumab. Further comparative research is needed to confirm these findings. Acknowledgment: Research was funded by Sanofi and Regeneron Pharmaceuticals Inc.

The Efficacy of Topical Cosmetic Containing Alpha‐Arbutin 5% and Kojic Acid 2% Compared With Triple Combination Cream for the Treatment of Melasma: A Split‐Face, Evaluator‐Blinded Randomized Pilot Study

ABSTRACTBackgroundWhile the gold standard treatment for melasma is triple combination cream (TCC), arbutin and kojic acid demonstrate their benefits and may be used as an alternative.AimsTo investigate the efficacy of cream containing alpha‐arbutin 5% and kojic acid 2% (AAK) compared with TCC for melasma treatment.Patients/MethodsA split‐faced, randomized study was conducted among 30 participants with melasma, and all were randomized to receive AAK or TCC on each side of their face for 12‐week along with 4‐week follow‐up period. The melanin index (MI), modified Melasma Area Severity Index (mMASI), and physician global assessment (PGA) scores were used to measure the effectiveness of interventions. Recurrence of melasma after treatment discontinuation was evaluated by MI and mMASI. Patient satisfactions and adverse effects were also evaluated. In the analysis, the mean difference (MD) was used for MI and mMASI, while Wilcoxon signed‐rank test was for the PGA scores, adverse effects, and patient satisfaction.ResultsThe MD of MI and mMASI scores were not different between groups (mMASI [p = 0.344] and MI [p = 0.268]). The PGA scores only showed improvement on the TCC‐treated side (p = 0.032). Compared to the AKK group, the subjects with TCC showed higher severity of recurrence (MI [p = 0.004] and mMASI [p = 0.045]). No difference in patient satisfaction score between the groups, but erythema and stinging were higher in the TCC group.ConclusionsThe AAK cream appeared to be effective for melasma treatment, highlighting a lower recurrent rate and fewer adverse events than standard therapy.Trial Registration: thaiclinicaltrials.org: TCTR20230124004

Safety and Efficacy of Photodynamic Therapy with ALA 10% Topical Gel Activated by Red Light versus ALA 20% Topical Solution Activated by Blue Light for the Treatment of Actinic Keratosis on the Upper Extremities: A Blinded Randomized Study

Background: Actinic keratosis (AKs) is a pre-cancerous skin neoplasm that can appear as erythematous to pink scaly plaques at sites of ultraviolet light damage. Photodynamic therapy (PDT) using aminolaevulinic acid (ALA) 10% gel activated by red light is approved by the FDA for the treatment of AKs on the face and scalp, and ALA 20% solution activated by blue light is approved for PDT treatment of AKs on the face, scalp, and upper extremities. While both options have been proven to an effective treatment on the upper extremity, there has been no direct side-by-side comparison. This study aimed to compare the safety and efficacy of both PDT on the upper extremities. Design: This was a prospective, single-center, split-arm randomized clinical trial with 20 adult subjects presenting with 4-17 clinically confirmed mild-moderate AKs (Olsen grading) on each distal upper extremity. Subjects were treated with ALA 10% gel/red light and ALA 20% solution/blue light PDT on respective randomly selected upper extremities. Lesion complete clearance rate (LCCR) served as the primary endpoint. Secondary endpoints included complete clearance per patient side (PatCR), LCCR of moderate lesions, LCCR 12 weeks after PDT-1, PatCR 12 weeks after PDT-1, overall cosmetic outcome assessed by the investigator, and patient satisfaction. Results: The LCCR was significantly greater for ALA10% vs. ALA20% at Day 120; no significant differences were observed at the other observed time points. 30 patients were enrolled in the study and received their first treatment (PDT1). LCCRs after PDT1 were 65.4% and 58.4% for ALA10% and ALA 20%, respectively. 25 patients received a second treatment (PDT2), resulting in LCCRs of 88.2% and 72.1% respectively. 22 patients returned for follow-up 6 months after their last PDT treatment (PDT1 or PDT2), with LCCR of 83.7% (ALA10%) and 79.3% (ALA20%). 17 patients returned for follow-up 12 months after the last PDT treatment, with LCCRs of 81.5% (ALA10%) and 87.6% (ALA20%). There were no statistical differences between ALA10% and ALA20% for subject-reported pain or satisfaction ratings. ALA10% was rated as significantly easier to apply compared to ALA20% by the investigator. Conclusion: Both ALA10% and ALA20% appear to be safe and effective for PDT treatment of AKs on the upper extremities. There is a trend for increased efficacy with ALA10%, and it may be easier to apply. Additional data is in the process of being collected as the study continues.

Correlation between blepharospasm and psychological diseases: the anxiety, depression and sleep disorder study

AIM: To investigate the relationship between benign essential blepharospasm (BEB) symptoms and depression/anxiety/sleep disorder in a prospective manner and to determine whether treatment the BEB with botulinum toxin type A (BoNT/A) can impact psychological symptoms. METHODS: This prospective interventional case series recruited 61 adults with evidence of BEB. Patients were administered the Jankovic Rating Scale (JRS), the Blepharospasm Disability Index (BSDI), Personal Health Questionnaire Depression Scale (PHQ-8), Generalized Anxiety Disorder 7-item scale (GAD-7) and the Athens insomnia scale (AIS) to evaluate the severity of BEB symptoms, depression, anxiety and sleep disorder before and 1wk, 1, 3mo after the BoNTA treatment. Statistical analysis was performed to assess the relationships between changes in the survey scores. RESULTS: The mean score for JRS, BSDI, PHQ-8, and GAD-7 improved significantly (P<0.0001), respectively, compared to the initial visit at follow-up. At baseline, worse BSDI scores were correlated with worse GAD-7 and PHQ-8, but not with worse AIS. At 1mo follow-up visit, there was no correlation between change in BSDI and PHQ-8/AIS, the change in GAD-7 showed a mild association with change in BSDI. The change in BSDI was correlated with the change in both PHQ-8 and GAD-7 in the subgroup of patients without a prior diagnosis of depression or anxiety. Patient satisfaction with BoNT/A treatment reached the highest at 1mo of follow-up (83.6%, 51/61). CONCLUSION: BEB may lead to psychological diseases. BoNT/A can significantly improve motor and non-motor symptoms of BEB, which emphasize the effectiveness of BoNT/A and therefore pave the way for its use in the field of psychiatry. However, further research is needed to confirm these findings and understand the underlying mechanisms.

What is the Impact of Leaders with Emotional Intelligence on Proxy Performance Metrics in 21st Century Healthcare?—A Systematic Literature Review

Emotional intelligence (EQ) in healthcare leadership has been a subject of debate regarding its significance in enhancing job performance and patient-centred care. This systematic review investigates the impact of EQ on organisational performance metrics in healthcare leaders. Eleven studies meeting the inclusion criteria were identified through a comprehensive database search. The findings suggest that EQ positively influences job satisfaction, with emotionally intelligent leaders fostering a positive work environment and commitment among employees. Moreover, EQ correlates negatively with emotional exhaustion, indicating its potential in mitigating burnout rates among healthcare professionals. EQ fosters teamwork, organisational culture and enhances job performance, with higher EQ levels in leaders associated with increased team empowerment and proactivity. Despite the compelling evidence, limitations in the study methodologies and heterogeneity in the reported outcomes challenge the establishment of definitive conclusions. Nevertheless, the findings underscore the importance of EQ in healthcare leadership and its potential to improve organisational dynamics and employee wellbeing. This review highlights the need for further research on EQ’s impact on patient satisfaction and calls for the development of EQ training programmes tailored for healthcare leaders.

Factors Influencing Outcome After Shoulder Arthroplasty (FINOSA Study): Protocol of a Prospective Longitudinal Study With Randomized Group Allocation

Background There is an increasing need for evidence-based postoperative rehabilitation strategies to optimize patient outcome. Knowledge of potential prognostic factors could steer the development of rehabilitation protocols and could result in better treatment outcomes and higher patient satisfaction. Objective This study aimed to investigate which potential prognostic factors predict baseline shoulder pain and function and its evolution in the first 2 years following surgery, in patients with total shoulder arthroplasty. The secondary objective is to investigate which potential prognostic factors predict baseline quality of life and its evolution in the first two years following surgery. Methods To reach the aims of this project, a prospective longitudinal study, running from January 2020 to March 2025, will be carried out with a follow-up of 48 months. Patients will be randomized based on sling wear. We will study factors such as shoulder function, patient expectations, psychosocial factors, lifestyle factors, sling wear, soft tissue integrity, and physiotherapy treatment. Test moments will take place preoperatively, at 6 weeks, 12 weeks, 6 months, 12 months, and 24 months. Descriptive statistics will be used to describe the patient population characteristics. Based on literature review, expert opinion, and univariate analyses, potential prognostic factors will be chosen as covariates. A mixed regression model for repeated measures will be used to assess both the evolution of the Shoulder Pain and Disability Index within persons from baseline over time and the differences in evolution between participants. Correlation analyses will be used to investigate associations between the other outcome measures such as the Constant and Murley Score, shoulder range of motion, shoulder muscle strength, and proprioception, and the primary outcome measure, the Shoulder Pain and Disability Index score. Potential prognostic factors not included in the model will be presented in a descriptive manner. Results Data collection started in January 2020. In April 2023 the sample size was reached. Data collection will end in April 2025. Analyses will follow when data collection is completed. Conclusions Knowledge of potential prognostic factors will have implications toward better rehabilitation strategies of patients after total shoulder arthroplasty. Trial Registration ClinicalTrials.gov NCT04258267; https://clinicaltrials.gov/study/NCT04258267 International Registered Report Identifier (IRRID) DERR1-10.2196/56522

The Impact of Language-Discordant Care Upon the Patient Family Experience in Pediatric Plastic Surgery

Background: Patient satisfaction surveys usually overlook differences in patient family experience (PFE) for families whose spoken language is different from that of the treating physician. This study examines the relationship between language-discordant care and patient experience. Methods: A retrospective review of deidentified pediatric plastic surgery PFE survey responses from 2018 to 2021 was performed with permission from Lurie Children’s Hospital’s PFE Team. Results: A total of 443 pediatric plastic surgery patients were included. The race breakdown was White (49%), Other (23.9%), Black (8.8%), and Asian (5.9%). Ethnic distribution included “Not Hispanic/Latino” (58.2%) and “Hispanic/Latino” (31.4%). Languages spoken were English (80.4%), Spanish (18.1%), and Other (2.3%). Eighty-seven (19.64%) patients were language-discordant with their providers; out of this group, 68 (78.2%) preferred interpreter services. Methods of interpreter services included in-person (54.4%), over-the-phone (27.9%), video (1.5%), and no services (16.2%). The language-discordant group was less likely to give the highest ranking to “provider courtesy and respect” [odds ratio (OR)=0.200, P<0.001], “provider listened carefully” (OR=0.202, P<0.001), and “knowing what to do with subsequent questions following visit” (OR=0.435, P<0.01). No differences in PFE ratings existed for: “enough information provided,” overall provider rating, and whether they would recommend the facility. There were no significant differences in provider ratings by interpreter service method. Conclusions: Patient/provider language discordance results in significantly lower PFE ratings in areas involving patient teaching and perceptions of provider respect, courtesy, and careful listening. This underscores the importance of providers better accommodating families with limited English proficiency.

Construction and Application Effect Analysis of Orthopedic Pain Care Ward under Multi-Disciplinary Cooperation Model

Aims/Background A multidisciplinary team (MDT) approach is a nurse-led pain management method that involves collaboration with staff from other departments. The purpose of this paper was to discuss the construction and application effect of a pain care ward in orthopedics utilizing the MDT approach. Methods A retrospective analysis of case data was conducted, selecting 90 patients with hip joint fractures who underwent hip replacement arthroplasty (HRA) at our hospital between February 2021 and February 2024. The patients were divided into two groups based on the nursing methods: a control group (n = 43), which received a conventional analgesic management program, and an intervention group (n = 47), which received the same conventional analgesic management program along with the implementation of an orthopedic pain care ward under the MDT approach. The study compared the pain knowledge and attitudes of the responsible nurses in both groups through questionnaires. Additionally, the accuracy of pain assessments and the awareness rates of patients’ pain-related health education were evaluated and compared between the two groups. Furthermore, the effectiveness of pain intervention, range of motion (ROM), and Hospital for Special Surgery (HSS) scores before and after the intervention were analyzed. The incidence of complications and overall nursing satisfaction were also compared between the two groups. Results The general knowledge, pain assessment, drug analgesia, comprehensive application, and total scores of nurses in the intervention group were significantly higher than those in the control group (p < 0.05). The accuracy rate of nurses’ pain assessments and the awareness rate of patients’ pain health education in the intervention group were 91.49% and 93.62%, respectively, both significantly higher than the 72.09% and 79.07% observed in the control group (p < 0.05). The total effective rate of pain intervention in the intervention group was 74.47%, significantly higher than the 53.49% in the control group (p < 0.05). After the intervention, both the ROM and HSS scores in the intervention group were significantly higher than those in the control group (p < 0.05). The overall incidence of complications in the intervention group was 6.38%, significantly lower than the 20.93% in the control group (p < 0.05). Finally, the total satisfaction rate with nursing care in the intervention group was 91.49%, significantly higher than the 74.42% in the control group (p < 0.05). Conclusion The construction and application of an MDT pain care ward can effectively enhance the accuracy of nurses’ pain assessments, increase patients’ awareness of pain-related health education, and improve the efficiency of pain interventions. Additionally, it can lead to better joint mobility and improved hip function, promoting the sustainable development of the pain care ward. These improvements contribute to higher patient satisfaction and enrich the quality of nursing services.

Patient and Parent/Caregiver Satisfaction with Efficacy and Cosmetic Elegance of Tapinarof Cream 1% Once Daily in a Long-term Extension Trial in Adults and Children Down to Age 2 Years with Atopic Dermatitis

Introduction: Patients with atopic dermatitis (AD) report low satisfaction with currently available topical therapies. Satisfaction and patient preference are closely linked to treatment adherence, and understanding preferences may contribute to improving the quality of AD care and adherence. In the pivotal 8-week, phase 3 ADORING 1 and 2 trials, tapinarof cream 1% (VTAMA®, Dermavant Sciences, Inc.) once daily (QD) demonstrated superior efficacy versus vehicle and was well tolerated in adults and children down to age 2 years with AD. We report Patient Satisfaction Questionnaire© (PSQ) results from ADORING 3, a 48-week, open-label extension trial. Methods: In ADORING 3, eligible patients from ADORING 1 and 2, from a 4-week maximal usage pharmacokinetics trial, and tapinarof-naive patients with mild AD, or moderate or severe AD, that did not meet inclusion criteria for ADORING 1 or 2, were followed for up to 48 weeks. The PSQ was completed at Week 48 or at early termination visit and assessed patient or parent/caregiver satisfaction with tapinarof efficacy, cosmetic elegance (look and feel of tapinarof cream), application ease, impact on daily life, and preference for tapinarof versus prior AD therapies. Patients aged ≥16 years self-completed the PSQ; parents/caregivers completed for children aged 2 to 15 years. Results: 505 patients or parents/caregivers completed the questionnaire. Respondents consistently reported high rates of satisfaction across all parameters. Most patients or parents/caregivers strongly agreed or agreed with PSQ questions assessing satisfaction with cosmetic elegance (91.5%), quick absorption (89.5%), application ease (97.6%), impact on daily life (94.3%), efficacy (92.3%), and confidence in tapinarof (92.7%). For patients or parents/caregivers who reported prior use of other topical therapies to treat AD, most strongly agreed or agreed that tapinarof was more effective (86.3%), easier to use (68.6%), and that they preferred tapinarof to prior topicals (88.0%). Compared with systemic drugs used previously for AD, most strongly agreed or agreed that tapinarof was more effective (84.6%), easier to use (77.6%), and that they preferred tapinarof to prior systemic drugs (85.9%). Conclusion: Patient or parent/caregiver satisfaction data from ADORING 3 showed a consistent and highly positive perception of long-term use of tapinarof cream across all parameters, including satisfaction with tapinarof efficacy, cosmetic elegance, application ease, impact on daily life, and preference for tapinarof compared with prior AD therapies. Satisfaction with tapinarof is likely to contribute to long-term adherence and improved outcomes for patients with AD.

Participant acceptability and clinician satisfaction of cognitive behavioural therapy and medication management algorithm compared with enhanced standard care for treatment of depression among youth with HIV.

Background: Primary results of the International Maternal Pediatric Adolescent AIDS Clinical Trials Network (IMPAACT) 2002 trial showed that cognitive behavioural therapy (CBT) and medication management algorithm (MMA) (COMB-R) significantly improved depression in youth with HIV (YWH) compared with enhanced standard care (ESC). Acceptability and satisfaction were examined among study participants and clinicians.Method: Between March 2017 and March 2019, 13 U.S. sites enrolled YWH, aged 12-24, diagnosed with nonpsychotic depression. Sites were randomised to either COMB-R (CBT by a therapist and licensed prescriber) or ESC (standard psychotherapy and medication management). After the intervention (week 24), participants, prescribers, and therapists rated acceptability and satisfaction. We compared site-level means using Wilcoxon tests.Results: Both COMB-R (n = 69) and ESC (n = 71) participants had a mean age of 21.4 years, with 53% female, and 54% having acquired HIV perinatally. Baseline age, sex, depression levels, RNA viral load, and CD4 count were comparable between arms. The distribution of site-level mean participant acceptability was greater in COMB-R compared with ESC (p = 0.04). The distribution of site-level mean prescriber satisfaction was greater in COMB-R (p = 0.01). The was no evidence that the site-level mean therapist satisfaction did not differ between arms (p = 0.52).Discussion: Acceptability and satisfaction for participants and licensed prescribers were higher at COMB-R sites compared with standard of care, indicating that this tailored, manual-guided, collaborative, measured care intervention was less burdensome in terms of the number of visits. Patient and medication provider satisfaction rates were higher than standard of care.Conclusion: While these results support the use of CBT and MMA in treating depression among YWH, further research is required to determine generalisability.

The Impact of Telemedicine on Chronic Disease Management: A Post-Pandemic Analysis of Patient Outcomes and Accessibility

This study explores the impact of telemedicine on chronic disease management, focusing on patient outcomes and healthcare accessibility in the post-pandemic context. Using a qualitative research approach, the study examines how telemedicine has transformed the management of chronic conditions, especially for patients facing geographical or mobility barriers. Data were collected through in-depth interviews with patients, healthcare providers, and policy experts to gain insights into the experiences and challenges associated with telemedicine for chronic care. The findings reveal that telemedicine has improved patient accessibility to healthcare services, enabling consistent monitoring and timely interventions, which positively impact patient health outcomes. However, the study also identifies challenges, including technological barriers and limitations in patient-provider communication, that may affect care quality and patient satisfaction. Despite these issues, telemedicine is seen as a valuable supplement to traditional healthcare, enhancing healthcare access, especially for underserved populations. This research provides key insights for healthcare policymakers and practitioners in improving telemedicine practices, ensuring that they address accessibility gaps without compromising quality. The study concludes that, with strategic improvements, telemedicine holds significant potential to transform chronic disease management and make healthcare more equitable.

On-site physiotherapy in older emergency department patients following a fall: a randomized controlled trial.

Greater fear of falling (FOF) is associated with an increased risk of falling in patients aged 65 and older. This study aims to assess the impact of physiotherapy on FOF in older patients and investigates the feasibility of such an intervention in the emergency department (ED) setting. All patients aged 65 or older, who presented to the ED of the University Hospital Basel after a fall between January 2022 and June 2023 were screened for inclusion. Participants were assigned to an intervention or control group depending on the randomized presence or absence of a physiotherapist at inclusion. Both groups received the same fall prevention booklet. Physiotherapists instructed and performed exercises with patients in the intervention group. The primary outcome was the difference in FOF between groups 7days post inclusion, assessed by short Falls Efficacy Scale International(sFES-I). Secondary outcomes included feasibility, overall reduction of FOF, patient satisfaction, the occurrence of falls post inclusion and the use of medical resources. Of the 1204 patients screened for inclusion, 104 older adults with a recent fall were enrolled (intervention: n = 44, control: n = 60); median age was 81years and 59.1% were female. There was no between-group difference in FOF as measured by sFES-I within a week of inclusion (p = 0.663, effect size = 0.012 [95% confidence interval (CI) - 0.377 to 0.593]). Despite the intervention being deemed feasible from the physiotherapist's perspective, the study encountered challenges, such as low recruitment (with the planned sample size not being reached) and a notable dropout rate before the first follow-up. A physiotherapy intervention in the ED showed no improvement in FOFwhen compared to a control group. Trial registration number and date NCT05156944, 01.12.2021.

Virtual reality for patient informed consent in skull base tumors and intracranial vascular pathologies: A pilot study.

With the growing demand for shared decision-making and patient-centered care, optimal informed consent (IC) has gained relevance. Virtual reality (VR) has seen significant technological advancements, and its medical applications currently include surgical planning and medical education. This pilot study investigates the feasibility of VR-enhanced informed consent (VR-IC) in neurosurgery to improve preoperative IC and patient satisfaction. We included patients aged 18 to 75years who were scheduled for skull base meningioma or brain aneurysm surgery between May and December 2023. Exclusion criteria were visual/auditory impairments and severe cognitive/psychiatric disorders. Patients received standard IC followed by VR-IC using patient-specific VR models of their pathology. After an initial demonstration by the surgeon, the patients used the VR station independently. A questionnaire with 18 questions on a 5-point Likert scale assessed the subjective impression of VR-IC. Ten patients participated in the study, with six (60%) undergoing aneurysm clipping and four (40%) undergoing skull base meningioma resection. The mean age of the participants was 58years (± 15, range 27 to 75years), with four female patients (40%). Patients overall rated the VR-informed consent (VR-IC) positively with a mean of 4.22 (± 0.84). There was a better understanding of their pathology (mean 4.30 ± 0.92) and the planned procedure (mean 3.95 ± 1.04). Trust in the surgeon was rated with a mean of 3.47 (± 0.94). Only minimal side effects from the VR experience including dizziness or discomfort were noted (mean 4.60 ± 0.22). None of the participants dropped out of the study. VR-enhanced informed consent is feasible and improves patient understanding and satisfaction without significant side effects. These findings will guide the planning of a randomized controlled trial to validate the benefits of VR-IC in neurosurgery further.

Study on the Analgesic Efficacy of Femoral Nerve Block for Post-Hip Arthroscopy Pain.

Postoperative pain management is challenging for hip arthroscopy, and the effectiveness and specific protocols of femoral nerve block (FNB) in hip surgeries remain insufficient. Therefore, we designed this study to investigate the analgesic efficacy and optimal drug concentrations of FNB after hip arthroscopy. A total of 148 patients undergoing hip arthroscopy were included and randomly divided into three groups: 0.3% ropivacaine FNB group, 0.4% ropivacaine FNB group, and 0.4% ropivacaine intra-articular injection (IAI) group (positive control). The main outcomes included dynamic and static visual analog scale (VAS) scores at various time points postoperatively, total intraoperative remifentanil consumption, and cumulative consumption of morphine within 24h postoperatively. Secondary outcomes included total intraoperative dexmedetomidine consumption, RASMAY sedation scores, and patients' satisfaction scores postoperatively. Both FNB and IAI anesthesia were shown to be safe for post-hip arthroscopy analgesia. Compared with IAI anesthesia, FNB showed no significant differences in analgesic effect within 12h postoperatively but had a better analgesic effect after 24h and lower remifentanil consumption intraoperatively. Group 0.4% ropivacaine showed lower dynamic VAS scores within the first 12h compared with 0.3% ropivacaine for FNB, however, there were no significant differences in patient satisfaction and sedation, and postoperative ambulation was delayed, indicating that the higher concentration of ropivacaine correlated with a longer time to ambulation. The IAI group had greater intraoperative opioid consumption and more side effects. Compared with IAI anesthesia, FNB can better alleviate post-hip arthroscopy pain and reduce opioid consumption. However, it requires specialized equipment and technical support and carries a certain risk of puncture. Chinese Clinical Trials Registry (ChiCTR2400091579).