Self-assessed Quality Research Articles

Assessment of Grade of Dysphonia and Correlation With Quality of Life Protocol

The main objective of this study is to check the correlation between vocal self-assessment and results of the Voice-Related Quality of Life (V-RQOL) protocol, and whether there is a correlation between perceptual vocal assessment made by voice therapists and the results from the V-RQOL protocol. The study included 245 subjects with vocal complaints. This was a prospective analytical clinical study. Vocal perceptual assessment of each subject with dysphonia was made by three voice therapists, followed by self-assessment made by the subjects themselves, and the application of the V-RQOL protocol. The results have shown poor level of agreement between vocal assessment made by the voice therapists and self-assessment made by the subjects. The statistical analysis indicated that the results of V-RQOL protocol showed significant correlation with the vocal assessment made by the voice therapists and the self-assessment by the subjects. The agreement between the assessments was low and variable; age, gender, professional voice use, and clinical laryngoscopic diagnosis did not influence the agreement level. Protocol V-RQOL is sensitive to vocal assessment made by the voice therapists and self-assessment made by the patient.

Ten years results of the Canadian breast intensity modulated radiation therapy (IMRT) randomized controlled trial

Background and purposeWe report the long-term outcomes in patients enrolled in a multicenter randomized controlled trial comparing Intensity Modulated Radiation Therapy (IMRT) with standard wedge radiotherapy. Materials and methodsTrial participants were assessed to compare long-term side effects between treatment arms. The primary endpoint was chronic breast pain assessed by trained observers blinded to treatment allocation. Secondary endpoints included cosmesis and quality of life measures. ResultsMedian follow-up time was 9.8years and 241 patients were available for assessment. There was no significant difference in chronic pain between treatment arms (OR=0.74, range 0.432–1.271). There were also no differences for the secondary endpoints. Univariate and multivariate analyses identified young age (p=0.013) and pain during RT (p<0.001) to be associated with chronic pain. Acute moist desquamation was associated with late subcutaneous fibrosis (p=0.003) and telangiectasia (p=0.039). Pain during RT was associated with a long-term poorer self-assessed cosmetic outcome (p<0.001) and quality of life (p<0.001). ConclusionsBreast IMRT cannot be recommended for all patients to reduce long-term side effects. However, late toxicities were significantly correlated with acute side effects, which are increased in patients having poor dose distribution. Breast IMRT may hence be useful for selected patients.

European Society of Gynaecologic Oncology Quality Indicators for Advanced Ovarian Cancer Surgery.

The surgical management of advanced ovarian cancer involves complex surgery. Implementation of a quality management program has a major impact on survival. The goal of this work was to develop a list of quality indicators (QIs) for advanced ovarian cancer surgery that can be used to audit and improve the clinical practice. This task has been carried out under the auspices of the European Society of Gynaecologic Oncology (ESGO). Quality indicators were based on scientific evidence and/or expert consensus. A 4-step evaluation process included a systematic literature search for the identification of potential QIs and the documentation of scientific evidence, physical meetings of an ad hoc multidisciplinarity International Development Group, an internal validation of the targets and scoring system, and an external review process involving physicians and patients. Ten structural, process, or outcome indicators were selected. Quality indicators 1 to 3 are related to achievement of complete cytoreduction, caseload in the center, training, and experience of the surgeon. Quality indicators 4 to 6 are related to the overall management, including active participation to clinical research, decision-making process within a structured multidisciplinary team, and preoperative workup. Quality indicator 7 addresses the high value of adequate perioperative management. Quality indicators 8 to 10 highlight the need of recording pertinent information relevant to improvement of quality. An ESGO-approved template for the operative report has been designed. Quality indicators were described using a structured format specifying what the indicator is measuring, measurability specifications, and targets. Each QI was associated with a score, and an assessment form was built. The ESGO quality criteria can be used for self-assessment, for institutional or governmental quality assurance programs, and for the certification of centers. Quality indicators and corresponding targets give practitioners and health administrators a quantitative basis for improving care and organizational processes in the surgical management of advanced ovarian cancer.

Strategic Vision Excellence in the Use of Information Technology

The self-assessment of quality plays a strategic role when it comes to direct or govern the use of Information Technology (IT) in a telecommunications organization. Due to its importance, it is essential to start out from a relational determination between models to suit it to the organizational reality. This work of exploratory and documentary research addresses the quality in the use of IT from the perspective of the Iberoamerican excellence model and the ISO 38500 standard, based on the knowledge about the high use that IT represents in the organization strategy.

Use of a Self-Reflection Tool to Enhance Resident Learning on an Adolescent Medicine Rotation

PurposeAdolescent Medicine (AM) educators in pediatric residency programs are seeking new ways to engage learners in adolescent health. This mixed-methods study presents a novel self-reflection tool and addresses whether self-reflection enhanced residents' perception of the value of an adolescent rotation, in particular, its relevance to their future practice. MethodsThe self-reflection tool included 17 Likert scale items on residents' comfort with the essential tasks of adolescent care and open-ended questions that promoted self-reflection and goal setting. Semi-structured, postrotation interviews encouraged residents to discuss their experiences. Likert scale data were analyzed using descriptive statistics, and interview notes and written comments on the self-reflection tool were combined for qualitative data analysis. ResultsResidents' pre–to post–self-evaluations showed statistically significant increases in comfort with most of the adolescent health care tasks. Four major themes emerged from our qualitative analysis: (1) the value of observing skilled attendings as role models; (2) the comfort gained through broad and frequent adolescent care experiences; (3) the career relevance of AM; and (4) the ability to set personally meaningful goals for the rotation. ConclusionsResidents used the self-reflection tool to mindfully set goals and found their AM education valuable and relevant to their future careers. Our tool helped make explicit to residents the norms, values, and beliefs of the hidden curriculum applied to the care of adolescents and helped them to improve the self-assessed quality of their rapport and communications with adolescents. We conclude that a structured self-reflection exercise can enhance residents' experiences on an AM rotation.

Coping, uncertainty and health-related quality of life as determinants of anxiety and depression on a sample of hospitalized cardiac patients in Southern Italy.

Being hospitalized often causes psychological distress and compromises patients' psychological well-being, thereby augmenting the burden of illness. The aim of this paper is to investigate two possible determinants of anxiety and depression among hospitalized cardiac patients, namely uncertainty in illness, and coping strategies, controlling for the perceived health-related quality of life, and distinguishing between borderline and pathological levels of anxiety and depression. Data on anxiety, depression, coping style, uncertainty in illness and self-assessed quality of life concerning 200 cardiac inpatients from a university hospital were collected through validated questionnaires. A biprobit analysis, whose dependent variables are hospital anxiety and depression, was carried out. Uncertainty in illness has a significant impact on the possibility of crossing the borderline level of both anxiety and depression. The coping strategy of Positive Reappraisal and Growth is inversely and significantly correlated to anxiety and depression, be it borderline or pathological; the Restraint Coping strategy is positively and significantly related to borderline anxiety. The reduction of uncertainty in illness and the development of adequate coping strategies should be promoted in order to decrease the patients' risk of crossing the borderline threshold of anxiety and depression.

Customer's self-audit to improve the technical quality of maternity care in Tabriz: a community trial.

Pregnant women have a major role to play in assessing and improving their own quality of care. This study in Tabriz, Islamic Republic of Iran, aimed to assess the effectiveness of an intervention for pregnant women-based on education and support groups and involvement in quality assessment activities-in order to improve the technical quality of public maternity care at public health centres. The intervention phase began in September 2011 and lasted 8 months. The outcome measure was health-care providers' degree of adherence to the Iranian maternity care standards. An intervention group of 92 pregnant women from 10 health centres was compared with a control group of 93 pregnant women from 11 centres. Logistic regression analysis showed that the self-assessed technical quality of maternity care received by the women was significantly better in the intervention that the control group for several of the standards concerning clinical examinations, maternal education and vitamin and mineral supplements.

An explorative study from the Norwegian Quality Register Gastronet comparing self-estimated versus registered quality in colonoscopy performance.

Background and study aims: The value of a colonoscopy quality assurance (QA) register may be questioned if it brings no new information on which to act for quality improvement, e. g. if self-assessed quality of colonoscopy performance correlates perfectly with registered performance. Patients and methods: In this explorative study, 39 (33 Norwegian and 6 Swedish) out of 99 new endoscopists joining the Norwegian QA register Gastronet from 2008 to 2013 responded to an invitation to fill in a questionnaire for self-assessment of cecal intubation rate, polyp detection rate for polyps ≥ 5 mm (PDR-5 mm), withdrawal time, total examination time, and rates for severely painful and pain-free colonoscopies before receiving their first-time feedback of actually registered results from Gastronet. A linear regression analysis was applied to explore the correlation between experience level and quality of estimation. Results: We included 2654 colonoscopies in our study. Endoscopists underestimated their cecal intubation rate (estimated 88.8 %, registered 93.1 %, P < 0.001), total procedure time (estimated 31.7 minutes, registered 37.2 minutes, P = 0.014), withdrawal time (estimated 9.8 minutes, registered 14.4 minutes, P = 0.006) and the rate of pain-free procedures (estimated 18.3 %, registered 24.5 %, P = 0.001). Pre-study colonoscopy experience was not correlated with estimated quality for any of the indicators. Conclusions: Apart from overestimation of severely painful examinations, endoscopists most often underestimated their colonoscopy performance. Self-assessed quality of colonoscopy performance may not be a satisfactory substitute for systematic registration of quality and not sufficiently valid to be acted upon.

Doskonalenie jakości samooceny audytu wewnętrznego w jednostkach sektora finansów publicznych

Cel – Prezentacja wybranych aspektów doskonalenia jakości funkcjonowania audytu wewnętrznego w jednostkach sektora finansów publicznych. Metodologia badania – Przyjęte metody badań: analiza literatury, badania ankietowe w jednostkach sektora finansów publicznych, analiza wyników i wnioskowanie. Wynik – W artykule zaprezentowano wyniki badań ankietowych, które przeprowadzono w wybranych jednostkach sektora finansów publicznych w województwie wielkopolskim w 2016 roku. Oryginalność/wartość – Zaprezentowano zagadnienia dotyczące potrzeby doskonalenia jakości audytu wewnętrznego na podstawie opinii kierownictwa jednostek sektora finansów publicznych.

Sleep Beliefs And Circadian Typology Of Helping Professions Students

The aim of this study was to evaluate sleep beliefs in students of helping professions and to explore differences in sleep beliefs considering circadian typology. We have also investigated the relationship between sleep beliefs, self-assessment of awareness of healthy sleep recommendations and self-assessment of sleep quality. Moreover we have investigated the relationship of circadian typology with assessment of awareness of recommendations for healthy sleep and assessment of one's own sleep quality. This study was conducted online among 563 students from seven different study programmes of helping professions at the University of Zagreb, Croatia. Sleep beliefs were examined with Sleep Beliefs Scale (Adan et al., 2006) and circadian typology with Composite Scale of Morningness (Smith et al., 1989). The average percentage of correct sleep beliefs in helping professions students was 61%. The results showed low positive correlation between correctness of sleep beliefs and one's own assessment of awareness of healthy sleep recommendations. Greater self assessed sleep quality was associated with greater tendency toward morningness. The differences in the accuracy of sleep beliefs between students of different circadian typology was not found, neither was the correlation between accuracy of sleep beliefs and assessment of one's own sleep quality, nor the correlation between circadian typology dimension and assessment of awareness of healthy sleep recommendations. The results of our study implicate that university students, even those with some formal education on sleep physiology and psychology, could benefit from sleep hygiene education programs, both personally and professionally.

Self-assessment of noise-induced hearing impairment in traffic police and bus drivers: Questionnaire-based study

Background and Objectives: Noise-induced hearing loss is a major preventable occupational hazard. The ill effect of noise exposure is well evidenced by researchers. This study was done to study the self-assessment of hearing quality, annoyance evaluation, noise-related attitude and knowledge in traffic police, and bus drivers on Indian population in a growing city. Subjects and Methods: The study was done on 60 nonsmokers, male traffic police, and 80 long route bus drivers in the age range of 30–50 years. There were 15 questions related to self-assessment administered on these individuals. Results: The results revealed that in spite of regular noise exposure, around 60% individuals rated excellent hearing. Further, surprisingly all individuals rated no knowledge of any ear protection devices available. Nearly, 30–50% individuals related to poor quality of sleep due to noise exposure in both groups. The result also revealed strong association between the responses of most of the questions asked from bus drivers and traffic police. Conclusion: The negative consequences of noise exposure are well reflected as an outcome of this questionnaire-based study which shows these individuals are having signs of hearing-related problems. Hence, there is a need to educate these professionals about hazardous effect of noise exposure.

REGULATORY-ADAPTIVE STATE IN EVALUATION OF BISOPROLOL AND NEBIVOLOL THERAPY EFFECTIVENESS FOR VENTRICULAR ARRHYTHMIA

Aim. To compare efficacy of bisoprolol and nebivolol treatment in ventricular arrhythmias patients (VA) and arterial hypertension (AH) and/ or ischemic heart disease (IHD) taken its influence on regulatoryadaptive state (RAS). Material and methods. Totally, 60 patients participated with VA of Lown I-IV grades, Bigger II-III grades, at the background of AH II-III stage and/or IHD, who were randomized to 2 groups of treatment: bisoprolol 6,5±1,8 mg daily or nebivolol 6,5±2,1 mg daily. As combination therapy, lisinopril was used 12,3±4,0 mg daily and 13,7±4,5 mg/daily, acetylsalicylic acid 92,3±18,8 mg/daily and 92,9±18,2 mg/daily, atorvastatin 16,3±4,8 mg/daily and 16,5±4,7 mg daily together with bisprolol or nebivolol, respectively. At baseline and in 6 months of therapy we performed: quantitative RAS assessment via the test of cardio-respiratory synchronicity, echocardiography, triplex scanning of brachocephalic arteries, tredmill, six minute walking test, 24-hour blood pressure monitoring and ECG monitoring, self-assessed life quality. Results. Both regimens of combination therapy comparably same improved structural and functional state of the heart, decreased blood pressure, effectively suppressed ventricular arrhythmia. However, only nebvolol positively influenced RAS, better improved exercise tolerance and improved life quality. Conclusion. In VA patients with AH of II-III stages and/or IHD, usage of nebivolol, comparing to bisoprolol, as combination therapy, might be more preferrable due to positive influence on RAS.

Measuring severity of acne vulgaris and impairment in quality of life of its patients and aiming for their concomitant reduction facilitates comprehensive management

Some of the adolescent patients of chronic acne, some women aged 25–40 years, and particularly, patients with psychiatric diseases (primary or secondary to acne) have disproportionately severe acne and its attendant psychosocial distress. Although no consensual clinical gold standard regarding the severity of acne exists despite abundance of scales developed over six decades, global acne grading system is used most commonly. The “subjective” psychosocial consequences of acne can be better evaluated by self-assessed health-related quality of life (QoL) tools than the traditional clinical assessment by the physician. The correct interpretation of these tools such as health status surveys (generic and specific) and preference-based measures, requires adherence to the rules regarding reliability, validity, sensitivity, and complete transcultural adaptation. The Cardiff Acne Disability Index is the most commonly employed specific health state survey for acne. Comprehensive therapy addressing the severity of acne as well as the resultant impaired QoL concomitantly can, fortunately, mitigate negative mental symptoms; this mitigation may even be proportional to the clinical remission. In addition, the routinely integrated practice of these twin measures may also speed up patient encounters by inculcating perspicacity in the treating physician.

An Environment to Co-develop Informational Systems for IR in Japan

Most universities around the world must be accredited in order to assure and enhance the quality of education. Japanese universities also are under accreditation by the government as well. They must undergo certified evaluation and accreditation periodically, which is conducted by organizations certified by the Japanese Minister of Education. Accreditation committees evaluate every university based on the Standards for Evaluation and Accreditation by reviewing the self-assessment reports. That is why it is important for universities to pursuit their advantages and to create high quality self-assessment report. To present some advantages in the report, the university staffs have to obtain the evidences demonstrating some effects or outcomes. Moreover, Institutional Research (IR) is one of the important tools to obtain these evidences. Some systems for IR have been developed individually, but few of them were shared or co-developed with other universities. If many universities in Japan can utilize such systems, we can obtain various knowledges newly. In this paper, we explain not only some advantages of sharing or co-developing systems but also some problems.

A Study of Enhancing Reliability of Classroom Self-Assessment in University

The usefulness of self-assessment for evaluation purposes has been controversial among language testers and teachers, pointing to the long-held psychometric concerns of its low-leveled reliability for assessment. This study aimed at exploring the possibility of enhancing the reliability of self-assessment used in a college English classroom (n=32) by diagnosing a cause of deteriorating the reliability quality of self-assessment and seeking measures to offset the negative factor for future use. In order to achieve the goals of the study, internal consistency reliabilities were obtained before and after an improvement was made in the self-assessment. Students’ feedback on the self-assessment was sought through a focus-group interview. Next, a multiple regression analysis was conducted to see if self-assessment can be a significant predictor in students’ final grades in the course. The independent variables used for this study were final exam, midterm exam, and five self-assessments. The results of the analyses are as follows: 1) from the focus-group interview on the 6th week of semester, a subjectivity problem of self-assessments was found and a new set of items in a quiz format were added for its modified version, 2) Cronbach’s α’s of self-assessments have drastically gone up from its original ones (.514-.546) to modified ones (.614-.850), and 3) four variables were included in the final model predicting students’ final grades: final exam, midterm exam, third and second self-assessments. Based on the findings, a new perspective on reliability issues in self-assessment was proposed.

P-224: Self-assessment of the quality of the management of high blood pressure in Tunisian diabetic

Objectifs Le diabete est un probleme majeur de sante publique. Sa prise en charge doit etre precoce, globale portant aussi bien sur le diabete que sur les facteurs de risque associees. L'association Diabete hypertension arterielle (HTA) est frequente, elle augmente le risque cardio-vasculaire et accelere la survenue de complications degeneratives. L'objectif de notre etude est d'evaluer la qualite du suivi des diabetiques hypertendus pris en charge en ambulatoire en se referant aux recommandations actuelles des societes savantes. Methodes Ce travail a comporte deux parties : une enquete observationnelle aupres de 200 patients tires au sort, repondant a une grille d'evaluation comportant 6 items, et une partie retrospective analysant les donnees fournies par les dossiers medicaux. Resultats Les patients etaient repartis en 21,5 diabetique type 1 et 78,5 % diabetique type 2. L'âge moyen des patients etait de 52,08 ans. L'etude a porte sur 82 hommes et 118 femmes avec un sexe ratio egal a 0,69. 34,9 des diabetiques de type 1 et 56,7 des diabetiques de type 2 etaient suivis pour une HTA. L'anciennete de l'HTA etait de 7,2 + /- 6,3 ans. La PAS moyenne chez tous les diabetiques vus ce jour a la consultation etait de 136 mmHg. La PAD moyenne de 78,3 +/- 10,1 mmHg. Parmi les patients qui ont beneficie d'une prise en charge de la PA, 65,5 % avaient une PAS Conclusion Ce travail souligne qu'outre une prescription medicale conforme aux recommandations, les regles hyigieno-dietetiques ainsi qu'une bonne organisation des soins sont a considerer dans la prise en charge des diabetiques tunisiens hypertendus.

Effect of T4 endoscopic thoracic sympathicotomy on life quality in patients with primary palmar hyperhidrosis

To assess the quality of life in patients with primary palmar hyperhidrosis before and after T4 endoscopic thoracic sympathicotomy (ETS) using the modified rating scales system for life quality. Between June, 2009 and May, 2014, forty-eight patients with primary palmar hyperhidrosis received ETS at the thoracic level T4. Patients completed self assessment of life quality by the modified rating scales system before and after the surgery. Follow-up data including effectiveness of operation, patient satisfaction and life quality were obtained at 1 and 6 months after the surgery. ETS at the thoracic level T4 was performed successfully for all cases. No mortality or serious complications were observed. No one needed thoracotomy in the period of surgery. Mild or moderate compensatory sweating was appeared in 38 cases (79.1%) or 1 case (2.1%), respectively. None severe case was observed after T4 ETS. About 97.9% of the patients were very satisfied with the result of the operation and no patient regretted the surgical procedure. All patients answered the quality of life (QoL) questionnaire and showed the improvement of QoL after the procedure (F=763.67, P<0.001). Primary palmar hyperhidrosis led to the reduction of life quality. ETS at T4 level could reduce sweating production and improve QoL in patients with primary palmar hyperhidrosis.

Cross-cultural adaptation and validation of the Nijmegen Cochlear Implant Questionnaire into Italian.

The NCIQ is a quantifiable self-assessment health-related quality of life instrument specific for cochlear implant users. The aim of this study was to culturally adapt the NCIQ into Italian (I-NCIQ). A prospective instrument validation study was conducted. Cross-cultural adaptation and validation were accomplished. Cronbach α was used to test internal consistency in 51 CI users and in a control group composed by 38 post-lingual deaf adult on a waiting list for a CI. ICC test was used for test-retest reliability analysis. Kruskal-Wallis test with Mann-Whitney post hoc were used to compare the I-NCIQ scores in CI users before and after the cochlear implantation and in control patients. I-NCIQ scores obtained in CI users were compared with the results of Italian version of disyllabic testing without lip-reading and without masking. Good internal consistency and good test-retest reliability were found. I-NCIQ scores obtained in the 51 CI users after implantation were consistently higher than those obtained before implantation and in the control group. Moreover, no differences were found in the results of I-NCIQ obtained in the group of 51 CI users before implantation and in the group of control patients on post hoc Mann-Whitney analysis. Positive correlations between I-NCIQ scores and the results of disyllabic testing without lip-reading and without masking were found. The I-NCIQ is a reliable, valid, self-administered questionnaire for the measurement of QOL in CI users; its application is recommended.

Qualité des données de vaccination chez les enfants de 0 à 11 mois en Côte d’Ivoire

In order to guide the decisions of programme managers, an immunization Data Quality Self-Assessment was performed in Côte d’Ivoire in 2012. This study was designed to assess the accuracy of immunization data and the quality of the immunization tracking system with this tool. A descriptive cross-sectional study was conducted in 88 randomly selected immunization facilities from 30 health districts. These structures were included in the study based on the number of children aged 0-11 months who received three doses of vaccine against Diphtheria, Tetanus, Pertussis, Hepatitis B Viral and Haemophilus Influenzae b on the one hand and measles vaccine coverage on the other. This assessment focused on two criteria in particular: accuracy of immunization data measured by the verification factor (VF) and the quality of the immunization tracking system. The accuracy of immunization data was satisfactory at the district level (VF=95%), but not for the health centre level (VF=81%), as 73% of health districts and health centres obtained a satisfactory factor (≥95%).The number of children aged 0-11 months vaccinated differed from one level of the health system to another and from one document to another.The mean quality index was not satisfactory for both the district and health centre levels (64% vs 50%). Only one health district and one health centre obtained a quality index greater than 80%. Furthermore, 93% of health districts and 50% of health centres obtained quality indices ranging from 50% and 80%, respectively.The weakest components at both levels were “supervision and monitoring” and “analysis and use of data”. The deficiencies in data reporting and the quality of the immunization monitoring system need to be improved by supportive supervision.

Self-perception, complaints and vocal quality among undergraduate students enrolled in a Pedagogy course.

To compare the vocal self-perception and vocal complaints reported by two groups of students of the pedagogy course (freshmen and graduates); to relate the vocal self-perception to the vocal complaints for these groups; and to compare the voice quality of the students from these groups through perceptual auditory assessment and acoustic analysis. Initially, 89 students from the pedagogy course answered a questionnaire about self-perceived voice quality and vocal complaints. In a second phase, auditory-perceptual evaluation and acoustic analyses of 48 participants were made through voice recordings of sustained vowel emission and poem reading. The most reported vocal complaints were fatigue while using the voice, sore throat, effort to speak, irritation or burning in the throat, hoarseness, tightness in the neck, and variations of voice throughout the day. There was a higher occurrence of complaints from graduates than from freshmen, with significant differences for four of the nine complaints. It was also possible to observe the relationship between vocal self-perception and complaints reported by these students. No significant differences were observed in the results of auditory-perceptual evaluation; however, some graduates had their voices evaluated with higher severity of deviation of normalcy. During acoustic analysis no difference was observed between groups. The increase in vocal demand by the graduates may have caused the greatest number and diversity of vocal complaints, and several of them are related to the self-assessment of voice quality. The auditory-perceptual evaluation and acoustic analysis showed no deviations in their voice.