Subjective Experience Of Patients Research Articles

#443 LEVIL evaluates the impact of HDx on HR-QoL and symptoms, including durability-of-effect and variability

Abstract Background and Aims Current hemodialysis (HD), utilizing conventional high-flux dialyzers, is handicapped by clearance limitations (larger-sized uremic toxins), which contribute to poor health-related quality-of-life (HR-QoL) and symptom-burden. Recent international consensus and guideline-setting efforts have explicitly prioritized identification and management of symptoms and subjective experience, whilst also acknowledging the lack of tools available to fully appreciate and continuously monitor these challenges. This study aimed to utilize dynamic patient-reported-outcome-measurement tool (PROM), London Evaluation of Illness (LEVIL-developed in-house), to iteratively interrogate patient-experience and to confirm previously reported HR-QoL benefits of the use of expanded hemodialysis (HDx) using medium cut-off dialyzer (extending the spectrum of uremic toxins being addressed). Furthermore, this study aimed to extend appreciation of effects on patient subjective experience to include durability-of-effects, variability of symptom-measures and impact of HDx withdrawal. Methods We conducted a multi-centre interventional study in 47 patients established on conventional thrice weekly centre-based HD in Ontario, Canada. Study protocol was 15-months in length with five phases 1) one-month observation (high-flux-HD), 2) three-months HDx 3) two-month wash-out (high-flux-HD), 4) six-months HDx, 5) three-month wash-out (high-flux-HD). HR-QoL and symptom-burden were evaluated using LEVIL throughout study. Results HDx-therapy improved HR-QoL [p 0.0006 (19% from baseline)] and a variety of symptoms including general wellbeing [p 0.005 (23%)], energy [p 0.004 (33%)], sleep-quality [p 0.001 (33%)], pruritus [0.003 (30%)], pain [p 0.01 (19%)], restless leg syndrome [p 0.0006 (15%)], mood [p 0.02 (12%)], appetite [ p 0.03 (9%)], breathlessness [p 0.001 (9%)], and HD-recovery [p 0.004 (26%)]. Response was more pronounced in those with poorer HR-QoL and higher symptom-burden. Improvements were durable over time with continued use with less symptom-variability (range 10-35% improvement). Improvements diminished gradually with return to high-flux-HD. The drivers of poor HR-QoL were largely general-wellbeing, energy, sleep-quality, pruritus, and bodily pain. Conclusion Use of a dynamic PROM effectively allowed appreciation of HR-QoL burden in HD-patients. Use of HDx-therapy results in improved patient subjective outcomes that are durable and associated with significantly lower variation in important symptom-domains than patients experience with receiving conventional high-flux-HD.

Subjective Experiences of Spanish-Speaking Patients Residing in the United States With Low English Proficiency Learning to Manage Their Diabetes: A Qualitative Study.

Language discordance is a known barrier to diabetes care in patients with type 2 diabetes. This study aimed to better understand the subjective experiences of a group of Spanish-speaking study participants with low English proficiency who were learning to manage their diabetes using a language-concordant health coaching intervention. This qualitative exploratory study used structured interview data to understand subjective experiences among participants. Thematic content analysis was conducted from a subset of health coaching phone transcripts (n = 17) performed during a language-concordant health coaching intervention study. Among the 17 participants included in the study, even with language-concordant coaching, participants had challenges in managing their diabetes care. Participants described internal and external factors, such as socioeconomic instability, that complicated their behavior changes and self-management abilities. A health coaching intervention in patients with low English proficiency can help to improve health outcomes. Findings from this study can guide the development of health care services and the management of chronic diseases in diverse populations.

Practice Standards in International Medical Departments of Public Academic Hospitals in China: Cross-Sectional Study.

Improving health care in cities with a diverse, international population is crucial for ensuring health equity, particularly for foreigners facing challenges due to cultural and language barriers. This situation is especially relevant in China, a major destination for expatriates and travelers, where optimizing health care services and incorporating international standards in the public sector are vital. Achieving this involves understanding the operational details, cultural and linguistic nuances, and advancing medical digitalization. A strategic approach focusing on cultural competence and awareness of health care systems is essential for effectively navigating health care for foreigners and expatriates in China. The aim of this study was to perform an in-depth analysis of the subjective and objective experiences of local and international patients in public hospitals in China to provide a basis for enhancing the medical experience of all patients. A structured questionnaire was provided to patients at an international outpatient service of a top-tier university hospital in China. Qualitative analysis of the survey responses was performed to methodically categorize and analyze medical treatment, focusing on patient demand and satisfaction across four main category elements ("high demand, high satisfaction"; "high demand, low satisfaction"; "low demand, high satisfaction"; and "low demand, low satisfaction"), enabling a detailed cross-sectional analysis to identify areas for improvement. Elements falling under "high demand, high satisfaction" for both Chinese and international patients were primarily in the realms of medical quality and treatment processes. In contrast, elements identified as "high demand, low satisfaction" were significantly different between the two patient groups. The findings highlight the importance of systematic, objective research in advancing the quality of international health care services within China's leading academic medical centers. Key to this improvement is rigorous quality control involving both patients and providers. This study highlights the necessity of certifying such centers and emphasizes the role of digital platforms in disseminating information about medical services. This strategy is expected to cater to diverse patient needs, enhancing the overall patient experience. Furthermore, by developing comprehensive diagnosis and treatment services and highlighting the superior quality and costs associated with international health care, these efforts aim to foster a sense of belonging among international patients and increase the attractiveness of China's medical services for this demographic.

Financial Toxicity Experiences of Patients With Cancer in Indonesia: An Interpretive Phenomenological Analysis

ObjectivesFinancial toxicity (FT) is an important adverse effect of cancer. Recent systematic reviews have shown that FT may lead to treatment nonadherence and impaired health-related quality of life, both of which may adversely influence the survival rates of patients. However, less is known about how patients endure FT, particularly in low- and middle-income countries. The purpose of this study was to explore how patients with cancer experience and cope with FT in Indonesia. MethodsSemistructured in-depth interviews were conducted to explore the experiences of Indonesian patients with cancer. Qualitative data were analyzed using interpretive phenomenological analysis approach. We purposefully recruited 8 patients undergoing active treatment (aged 27-69 years) who had been diagnosed of cancer over 5 years before and possessed health insurance at the time of diagnosis. ResultsWe identified 2 main themes: (1) the experienced financial burden, with subthemes underinsurance, out-of-pocket nonhealthcare cancer-related costs, and negative income effect from employment disruption, and (2) the financial coping strategies, with subthemes reallocating household budget, seeking family support, rationalizing treatment decisions, and topping up insurance for family members. ConclusionsThis is the first interpretive phenomenological study on FT in the literature and the first qualitative FT study in Indonesia. Our findings provide insight into the occurrence of FT and coping strategies used by Indonesian patients with cancer. The subjective experiences of patients may be considered to further improve oncology care, support the need for measurement of FT, and provide mitigation programs for patients.

Criteria for evaluating the effectiveness of psychiatric home care-mobile team: A systematic review of the literature.

To explore criteria evaluating the effectiveness of psychiatric home care-mobile team practices, that have been developed widely in the last decades. Systematic review of the literature. We included 24 studies published between January 2010 and October 2023. CINAHL, APA PsycInfo, Embase, Scopus and PubMed. The evaluation criteria differed according to the studies: impact on hospital stay, symptomatic clinical impact, repercussions on functioning, quality of life, analysis of profitability, safety, therapeutic alliance and finally, cooperation network. The variability of the criteria used to judge the effectiveness of psychiatric home care-mobile team practices shows their richness and diversity, and the absence of standardisation. The variability of the criteria used to judge the effectiveness of psychiatric home care-mobile team practices supports a qualitative and multidisciplinary approach, with enhanced teamwork. Psychiatric home care-mobile team practice have widely developed in the last years and their effectiveness need to be evaluated. Our main finding is that there is a rich variety of practices and that evaluation criteria are very diverse, thus not standardised. We suggest using a mixed-method approach to capture the subjective experience of patients and caregivers. These findings also highlight the significance of institutional cooperative work and call for a redefinition of team construction. The authors adhered to PRISMA guidelines. No patient or public contribution.

A Delphi Method Comfort Status Scale for Patients With Lung Cancer After Thoracoscopic Surgery

ObjectiveTo construct the comfort status scale for patients with lung cancer after thoracoscopic surgery. MethodsOn the basis of the comfort status scale and the subjective experience and objective symptoms of patients with lung cancer after thoracoscopic surgery, the relevant literature was consulted, semi-structured interviews and group discussions were conducted, the pool of items of the postoperative comfort status scale for patients with lung cancer was initially formed, and the postoperative comfort status scale for patients with lung cancer was finally established by Delphi method inquiry to 15 clinical and nursing experts. ResultsThe positive coefficient of experts was 100%, the coefficient of authority (CR) was 0.92 and 0.93, and the Kendal's W was 0. 257 and 0. 298, the degree of coordination of expert opinions was statistically significant (p < 0.05). Finally, a total of 28 items in 4 dimensions were formed to assess the postoperative comfort status of patients with lung cancer after thoracoscopic surgery. ConclusionThe Delphi method-based comfort status scale for patients with lung cancer after thoracoscopic surgery is scientific and reliable, and can provide a quantitative basis for the evaluation of the comfort status of patients after lung cancer thoracoscopic surgery, to further provide individual comfort care measures.

Clinical benefits of novel non-nucleoside reverse transcriptase inhibitors: A prospective cohort study.

The efficacy and safety of ainuovirine+lamivudine+tenofovir (ANV+3TC+TDF) and efavirenz+lamivudine+tenofovir (EFV+3TC+TDF) have been confirmed in previous clinical trials; however, there are no related studies on patient-reported outcomes. This study aimed to evaluate the effectiveness and safety of these 2 antiretroviral therapy regimens and to understand the patient's symptom experience and subjective experience of sleep quality through patient-reported outcomes. This is a single-center prospective cohort study with 243 patients evaluated from October 1, 2021 to June 30, 2022. Virological effectiveness and patient-reported outcomes results were analyzed. The primary endpoint was the proportion of HIV viral load <50 copies/mL (virological suppression rate) at 48 weeks and the changes in the HIV symptom index and Pittsburgh sleep quality index. The virological suppression rates in the ANV+3TC+TDF and EFV+3TC+TDF groups were 83.6% (102/122) and 87.6% (106/121), respectively, at 48 weeks. In the ANV+3TC+TDF group, the scores of HIV symptom index and pittsburgh sleep quality index in the 48th week were lower than the baseline level (p < 0.05). Logistic regression results showed that the baseline regimen EFV+3TC+TDF was a risk factor for dizziness/lightheadedness (odds ratio = 3.153, 95% confidence interval: 1.473-6.748, p = 0.003), sadness/depression odds ratio = 2.404, 95% confidence interval:1.188-4.871, p = 0.015), and difficulty sleeping (odds ratio = 2.802, 95% confidence interval: 1.437-5.463, p = 0.002) at 48 weeks. Both regimens showed good virological effectiveness; however, compared with ANV+3TC+TDF, the EFV+3TC+TDF regimen reduced the prevalence of HIV-related symptoms.

Modern methodological approach to the assessment of the individual quality of life of HIV-infected patients

Introduction. The study of the quality of life (QOL) of HIV-infected patients in the system of personalized and specialized pharmaceutical care is a fundamentally new method that allows us to study the multidimensional picture of the patient's subjective experiences caused by the disease. Integral information about the physical, psychological, spiritual and social aspects of the disease makes it possible to identify individual characteristics of the patient's reaction to the disease, evaluate the effectiveness of treatment in a particular patient according to individual monitoring data and use these data to correct the treatment and prevention program. Objective: development of modern methodological approaches to assessing the individual quality of life of HIV–infected patients to determine the effectiveness of treatment of a particular patient with subsequent correction of the therapy and prevention program. Material and methods. The object of the study is HIV-infected patients undergoing treatment at the State Medical Institution “Kuzbass Center for Prevention and Control of AIDS” (n=250). The QL research methodology includes key components: selection of a research tool; collection and formation of a database; scaling of questionnaire data; statistical processing of collected information; analysis and interpretation of results. Results. A modern modified method for assessing the individual quality of life of HIV-infected patients based on the use of relationship type indices has been developed. Each indicator represents the ratio of satisfaction with a certain aspect of life to the corresponding level of psychological claims. The sum of the index values is an indicator of quality of life. Conclusion. A modified widely used method has been developed to assess the individual quality of life of HIV–infected patients in the system of specialized pharmaceutical care to determine the effectiveness of treatment of a particular patient with subsequent correction of the therapy and prevention program. It has been established that one of the main factors determining the quality of life of HIV–infected patients is a subjective assessment of health, which proves the importance of assessing quality of life as an integral indicator closely related to health.

Os lunatum reconstruction with autogenous bone graft from the medial condyle of the femur for Kienböck's disease: a case report

This case report outlines the management of a 43-year-old man suffering from chronic wrist pain due to Kienböck's disease. In 2019, the patient underwent os lunatum reconstruction surgery at Hospital of Traumatology and Orthopedics (TOS), utilizing a femur medial condyle autologous bone graft-a rarely reported techinque. Four years postoperatively patient underwent a follow-up visit, the patient exhibited substantial improvements in pain relief and functionality, evidenced by a QuickDASH score of 2 points, indicating minimal disability. Despite these positive outcomes, nuanced limitations in specific wrist movements and a subtle decrease in grip strength were noted. Notably, the patient reported discomfort in the left knee, the donor site for the autologous graft. This case contributes valuable insights into the feasibility and challenges associated with the femur medial condyle autologous bone graft technique for Kienböck's disease. The findings underscore the need for ongoing refinements and long-term monitoring, considering the patient's subjective experiences and the impact on both the wrist and the donor site. The study adds to the limited body of literature on unconventional surgical approaches for Kienböck's disease, guiding future research endeavors and refining the application of femur medial condyle autologous bone grafts in orthopedic practice.

Real-World Data on Faricimab Switching in Treatment-Refractory Neovascular Age-Related Macular Degeneration.

Faricimab is a newly approved bispecific antibody for neovascular age-related macular degeneration (nAMD). Our study aims to evaluate clinical outcomes of faricimab switching in patients with treatment-refractory nAMD; determine parameters that predict these outcomes; and obtain patient subjective experience on this new injection. This is a retrospective case review with clinical and imaging data from a tertiary referral unit (Birmingham and Midland Eye Centre, UK), involving patients who were switched to faricimab between 1 January and 1 December 2023. In all, 63 eyes (54 patients) with a mean age of 79.2 ± 7.8 and mean of 41.5 ± 22.4 previous anti-VEGF injections were analysed. With a mean of 4.81 ± 1.16 faricimab injections over 6.98 ± 1.75 months, post-treatment visual acuity was logMAR 0.49 ± 0.36 and central macular thickness (CMT) was 320.3 ± 97.9 µm. After first dose, 39.1% achieved complete dryness and 89.1% had anatomical improvement. Presence of subretinal fluid was a predictor of better functional outcomes (p = 0.001, β = -0.182), while initial CMT predicted better anatomical outcomes (p = 0.001, β = 0.688). Compared to their experiences of previous anti-VEGF injections, 89% of patients reported no more discomfort and 87.0% experienced no more floaters, photopsia, or bubbles post-injection. Faricimab switching has anatomical efficacy but limited functional improvement in treatment-refractory AMD. Patient experiences of faricimab compared to previous injections were overall positive.

Subjective evaluation of monopolar radiofrequency treatment by patients in aesthetic rejuvenation.

To assess the subjective experiences of patients following monopolar radiofrequency (RF) treatment for facial rejuvenation and anti-aging purposes. A study involving 50 female patients (aged 30-70years, Fitzpatrick skin type III and IV) who received a single session of RF treatment. Exclusion criteria comprised active infections, skin diseases, pregnancy, or history of recent anti-aging treatments. Thirty-four patients completed a 10-question questionnaire after 3months of treatment. Among the respondents, 82% expressed satisfaction with the RF treatment, reporting significant improvements primarily in the mid and lower face, and eyelids. Mainly, patients noted improvements in skin laxity (52.9%), skin texture (17.6%), and skin tone (11.7%). Notably, 73.5% noticed changes within 1-2months post-treatment, with the peak effect observed at 1-2months. Mild complications (swelling and erythema) were reported, usually resolving within a week. The mean pain score was 1.94 (±0.66), indicating mild to moderate discomfort. Monopolar RF devices, apply high-frequency electric currents generating heat, stimulating collagen production for skin tightening. This study's unique focus on detailed subjective patient experiences provides insights valuable in clinical settings, aiding clinicians in managing patient expectations and achieving optimal results. The satisfaction rates align with previous findings, emphasizing RF treatment's efficacy in addressing facial laxity, especially in the mid and lower face. Positive feedback extended beyond skin tightening, encompassing skin texture and tone improvements. While the study's observation period was 3months post-treatment, longer-term studies are warranted for comprehensive assessments. The study underscores the efficacy of monopolar RF device, as a non-invasive and effective anti-aging treatment. The findings contribute to diversifying the RF market, potentially aiding clinicians in optimizing patient care. Considering the growing complexity of patient demands and treatment responses, this study serves as a valuable reference for clinicians engaging in RF treatments.

N18 The experience of the IBD patients with a permanent or temporary stoma: update of the literature

Abstract Background Surgery is indicated in selected patients with inflammatory bowel disease (IBD).Annually, 2000 (0.66%) of these individuals in the UK and an estimated 24,000 (1.5%) in the USA undergo surgery resulting in a permanent or temporary stoma. The audience of patients undergoing a stoma surgery is very broad and consists of not only elderly people, but also young adults, fertile or pregnant women.Fear of having a stoma is a major concern for people with IBD. And this aspect goes beyond the simple therapeutic aspect but it encroaches upon the psychological, occupational, relational, educational, financial and domestic area.This study aims to analyze the Quality of Life (QoL) outcomes of IBD patients with temporary or permanent stoma Methods To identify, evaluate and synthesis the lived experiences of IBD patients having a stoma, a meta-synthesis has been performed following the Sandelowski and Barroso guidelines (2007).Studies included: primary studies in English language, conducted using qualitative methodology that explore the subjective experience of IBD patients having a temporary or permanent stoma; studies that debated the experiences lived during the period of having a stoma; studies published from January 2013 to October 2023. The instrument Critical Appraisal Skills Program (CASP) has been used for the qualitative evaluation of the included studies (Image 1) Results Sixteen studies have been analyzed and the most of them involved more than one medical or research institution. The included studies described different areas of the perceived experience of 3046 IBD patients with a stoma. A total of 30 labels have been classified into 12 sub-themes, grouped in a total of five themes. (a) Surgery is a trigger for possible psychological disorders such as PTSD and (b) the positive perception of the stoma as an effective therapy in the management of IBD symptoms are the most frequent labels in the studies (Table 1) Conclusion The results of this study contributed to provide evidence about the experience of stoma-bearing IBD patients.Healthcare providers should offer improved interdisciplinary counselling earlier in the course of IBD so as to inform and enpower the patient and allow for shared decision-making. Patient information, education and support groups are crucial when managing IBD patients and optimizing patient-reported outcomes.This counts especially for young subjects that would be less prone to accept a stoma.Taken together, these findings provide further proof of the complex interplay between various psychological aspects.Our findings are consistent with previous research, which suggest, in terms of direction for psychological operations,that an increased focus in the educational and management of the disease is crucial

Quality of YouTube Videos Regarding Anterior Cruciate Ligament Reconstruction Using Quadriceps Tendon Autograft Is Unsatisfactory

PurposeThis study aimed to assess the validity and informational value of teaching material regarding anterior cruciate ligament reconstruction (ACL-R) using quadriceps tendon (QT) autograft provided on the YouTubeTM video platform. MethodsAn extensive systematic search of the YouTubeTM video platform was performed, and all videos that met the criteria were included in the analysis. The analysis of the video content was performed using the DISCERN instrument, Journal of American Medical Association (JAMA) benchmark criteria and Global Quality Score (GQS). The duration of the videos, the date of publication, and the number of likes and views were recorded. Furthermore, videos were categorized based on the source (physicians, companies, patients), the subject (surgical technique, patient experience and overview [overview videos were videos in which multiple aspects were analyzed]) and the type of content (educational or subjective patient experience). ResultsA total of 88 videos were included in the analysis. Seventy-one (80.7%) videos were published by physicians, 15 (17.0%) by patients and 2 (2.3%) by companies. The majority of the videos described various surgical techniques (59 – 67.0%), 80.7% of the videos (72 – 81.8%) had an educational nature, and the remaining 18.2% described patient experiences. The mean length of the videos was 8.21 ±7.88 minutes. The mean number of views was 3988.51 ±9792.98 (range: 9-56047), while the mean numbers of comments and likes were 30.07±70.07 (range: 0-493) and 4.48 ±14.22 (range: 0-82), respectively. The mean DISCERN score, JAMA score, and GQS were 27.43 ±11.56 (95% CI: 25.01–29.85; range: 17-68), 1.22 ±0.85 (95% CI: 1.04–1.40; range: 0-3), and 1.82 ±0.93 (95% CI: 1.63–2.01; range: 1-4), respectively. For all scores, videos published by physicians had higher quality (DISCERN score, JAMA score, and GQS) (p<0.05). Among all of the analyzed videos, overview videos were of the highest quality (p<0.05). ConclusionsYouTube™ is a fast and open-access source of mass information. The overall quality of the videos on ACL reconstruction performed using QT autograft was unsatisfactory, demonstrating low educational quality and reliability. Currently, YouTube™ cannot be recommended as a reliable source of information on ACL reconstruction with the quadriceps tendon.

Severity, interference, qualities, and correlates of severe pain: Descriptive cross-sectional study on pain experience of cancer patients in Sri Lanka.

Pain is the most debilitating and subjective experience of cancer patients. This study examines the severity, interference, characteristics, and associations of severe pain in Sri Lankan cancer patients. A descriptive study was conducted in Sri Lanka on 384 patients at age 18 or older who had cancer pain for 3 months or more due to the initial lesion, secondaries, radiation, or chemotherapy. Patients with non-cancerous pain or brain metastases were excluded. Data was collected using a validated Sinhala version of the Short-Form Brief Pain Inventory and the Short-Form McGill Pain Questionnaire-2. Logistic regression was used to identify severe pain correlations. The mean of the "worst pain" experience was 7.97, and 73.2% reported their "worst pain" as severe. The "normal works" (62.5%) and "sleep" (58.3%) were severely influenced by pain. "Aching pain," was the most reported pain quality. A statistically significant association was shown between severe pain and male gender (adjusted odds ratio (AOR) = 1.723), being in marriage (AOR = 1.947), absence of family commitments (AOR = 1.8), and pain of 3 months or more duration (AOR = 1.76). The experiences of cancer pain vary, with the majority suffering from severe pain.

German version of the Northoff scale for subjective experience in catatonia (NSSC-dv) : A validated instrument for examination of the subjective experience in catatonia

Patients with catatonia often show serious motor, affective and behavioral symptoms, behind which the subjective experience often remains hidden. Therefore, this study disseminates our own systematic empirical investigation of the subjective experience of catatonia patients to aGerman-speaking audience of clinicians and researchers. Based on current evidence and the clinical experience of the authors, the self-report questionnaire Northoff Scale for Subjective Experience in Catatonia (NSSC) was modified, extended and validated and now consists of 26items capturing the subjective experience of catatonia in its clinical diversity. A total of 46patients with catatonia according to the International Classification of Diseases(11th revision, ICD-11) were asked about their subjective experience during the acute phase of the disease using the NSSC. The NSSC showed high internal consistency (Cronbach's alpha = 0.91). The NSSC total score was significantly associated with the Northoff Catatonia Rating Scale (NCRS; r = 0.46; p < 0.05), the total score of the Positive and Negative Syndrome Scale (PANSS; r = 0.30; p < 0.05), the Brief Psychiatric Rating Scale (BPRS; r = 0.33; p < 0.05), and Trait Anxiety (STAI; r = 0.64; p < 0.01), supporting its validity. Preliminary validation of the NSSC revealed good psychometric properties. The NSSC is auseful instrument for routine clinical use to assess the subjective experience of patients with catatonia in order to provide tailored psychotherapeutic interventions.

Qualitative study of COVID-19 patient experiences with non-invasive ventilation and pronation: strategies to enhance treatment adherence

IntroductionNon-invasive ventilation (NIV) treatment combined with pronation in patients with COVID-19 respiratory failure has been shown to be effective in improving respiratory function and better patient outcomes. These patients may...

Influence of psychosocial characteristics of patients and opinions of their relatives on indication for surgical treatment of pectus excavatum.

To assess the subjective experience of patients and their parents or relatives about the existing pectus excavatum deformity and to contribute to the definition of indications for surgical treatment of this deformity. The initial sample of psychosocial characteristics consisted of self-assessments and observations of patients (and parents) regarding their health, self-image, health care, possible environmental response to their physical appearance, expectations regarding treatment. A modified version of the original Nuss questionnaire on quality of life was used in the psychological part of the examination. The study included a sample of 58 patients aged 10 to 30 years, and a sample of 58 family members of the patient (parents, relatives). The experience of poor emotional status, withdrawals, and bad self-image in patients older than 15 years than younger were significant. The tendency for female patients to have a worse experience is pronounced and significant. The largest percentage of parents have an 'indecisive' or 'weakly expressed' attitude towards surgery. Parents at a significantly higher rate show greater concern for female children. A systematic evaluation of the psychosocial perception of patients and their relatives (who will consent for the operation) may be a useful diagnostic assessment before correcting an anterior chest wall malformation.

Evaluating the accuracy of a cataract surgery simulation video in depicting patient experiences under conscious anesthesia

PurposeTo evaluate the accuracy of a point-of-view cataract surgery simulation video in representing different subjective experiences of patients undergoing the procedure.MethodsOne hundred consecutive post-cataract-surgery patients were shown a short simulation video of the surgery obtained through a porcine eye model during the first postoperative week. Patients then answered a multiple-choice questionnaire regarding their visual and tactile intraoperative experiences and how those experiences matched the simulation.ResultsOf the patients surveyed (n = 100), 78% (n = 78) recalled visual experiences during surgery, 11% recalled pain (n = 11), and 6.4% (n = 5) recalled frightening experiences. Thirty-six percent of patients (n = 36) were interviewed after their second cataract surgery; there was no statistically significant difference between anxiety scores reported before the first eye surgery and second eye surgery (p = 0.147). Among all patients who recalled visual experiences (n = 78), nearly half (47.4%) reported that the video was the same/similar to their experience. Forty-eight percent of the patients recommended future patients to watch the video before their procedures, and more than a third (36%) agreed that watching the video before surgery would have helped them to relax.ConclusionsOur model reflects the wide range of subjective patient experiences during and after surgery. The high percentage of patients who found the video accurate in different ways suggests that, with more development, point-of-view cataract simulation videos could prove useful for educational or clinical use. Further research may be done to confirm the simulation’s utility, by screening the video for subjects before operations.

Conceptualising retention in treatment with long-acting injectable buprenorphine (for opioid use disorder) as a journey: Findings from a longitudinal qualitative study

BackgroundConceptualisations of the ‘patient journey’ are popular within health service research. Patient journeys provide a person-centred approach to health care that typically prioritise subjective patient experience with the aim of improving relevant forms of intervention. This article explores the conceptualisation of retention in treatment for opioid use disorder (OUD) using long-acting injectable buprenorphine (LAIB) as a journey. MethodsData derive from a longitudinal qualitative study, involving semi-structured interviews (held at six time-points), with participants who each initiated LAIB for the first time. Data analysis for this article focuses exclusively upon the experiences of those who had continued with LAIB treatment throughout one year (11 participants). Framework and thematic narrative analyses of 64 interviews with 11 participants sought to identify ‘retention-narratives’ that would indicate a ‘retention journey’ associated with LAIB treatment. FindingsShared treatment experiences consisted of three distinct phases (Withdrawal and Separation, Transformation, and Engagement) that progressed in a linear and intersecting manner through time. Each phase had features that defined treatment experiences at a given time but changed as treatment progressed. All 11 participants experienced multiple features within each of the three treatment phases and all participants reported separation from their respective service provider throughout the first 12 months of treatment. Although some valued the latter separation, most were dissatisfied by reduced levels of contact. ConclusionRetention in treatment for OUD with LAIB, for at least 12-months, can be conceptualised as a journey. This conceptualisation emphasises the benefits (and challenges) clinicians and patients may expect to encounter during the first year of a LAIB treatment programme. An added implication of conceptualising LAIB treatment in this manner is that optimal benefits of the medication (as observed by participants) began to emerge during ‘months 7–12’ of the retention journey.

Feasibility and Utility of a Smartphone Application-Based Longitudinal Cough Monitoring in Chronic Cough Patients in a Real-World Setting.

This study evaluated the feasibility and utility of longitudinal cough frequency monitoring with the Hyfe Cough Tracker, a mobile application equipped with cough-counting artificial intelligence algorithms, in real-world patients with chronic cough. Patients with chronic cough (> 8-week duration) were monitored continuously for cough frequency with the Hyfe app for at least one week. Cough was also evaluated using the Leicester Cough Questionnaire (LCQ) and daily cough severity scoring (0-10). The study analyzed adherence rate, the correlation between objective cough frequency and subjective scores, day-to-day variability, and patient experience. Of 65 subjects consecutively recruited, 43 completed the study. The median cough monitoring duration was 13.9days, with a median adherence of 91%. Study completion was associated with baseline cough severity, and the adherence rate was higher in younger subjects. Cross-sectional correlation analyses showed modest correlations between objective and subjective cough measures at the group level. However, in time series correlation analyses, correlations between objective and subjective measures widely varied across individuals. Cough frequency had greater day-to-day variability than daily cough severity scores in most subjects. A patient experience survey found that 70% of participants found the cough monitoring helpful, 86% considered it acceptable, and 84% felt it was easy to use. Monitoring cough frequency longitudinally for at least one week may be feasible. The substantial day-to-day variability in objective cough frequency highlights the need for continuous monitoring. Grasping the implications of daily cough variability is crucial in both clinical practice and clinical trials.