Academic literature on the topic 'Patient satisfaction – Research'
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Journal articles on the topic "Patient satisfaction – Research"
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Steele, Joseph Rodgers, Ryan Kristopher Clarke, and Stowe Shoemaker. "Measuring patient satisfaction in oncology." Journal of Clinical Oncology 30, no. 34_suppl (December 1, 2012): 236. http://dx.doi.org/10.1200/jco.2012.30.34_suppl.236.
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236 Background: Improving the patient experience has been an increasingly important quality improvement goal for most health care institutions; however, all patients are not equal. Within the oncology community exist a host of unique needs that must be identified, measured, and addressed. Commercially available questionnaires are too general and often non-diagnostic. The goal of our study was to develop a method to better identify, quantify, and address the needs of this population. Methods: Over 60 hours of in-depth qualitative interviews were conducted with a diverse population of patients (n=68), physicians (n=28), nurses. and technologists (n=33) at UT MD Anderson Cancer Center. A customized patient-experience questionnaire was created from the qualitative data obtained. A balanced incomplete block design was used so each patient answered only 60 questions, while the questionnaire contained over 85 questions. The questionnaire was administered via email to approximately 30,000 patients over one week time period. Results: A total of 4,179 patients completed the survey with average completion time of 24 minutes. A total of 6,909 opened the email invitation, 6,007 began the survey (a 69% completed/began response rate). Non-response bias was monitored via a short survey completed by 2,094 patients. Analysis revealed little difference between respondents and non-respondents. The survey results showed the following: (1) when relevant, a patient will complete a lengthy survey (2) a patient’s perception of their experience is directly related to how they perceive themselves (a number, customer, patient, or loved family member) (3) higher satisfaction is correlated with perception of a “unique” interaction or service (e.g. a visit with a sub-specialty oncologist versus one with a parking attendant). Conclusions: Proper survey techniques are necessary to identify, measure, and address the needs of oncology patients. Contrary to popular belief, patients are willing to complete lengthy questionnaires with little survey fatigue. Positive patient experiences correlate with patient perceptions of provider empathy, caring, and treatment similar to that of a “loved family member” as well as unique, health care services.
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Henderson, Amanda, Gideon Caplan, and Ann Daniel. "Patient satisfaction: the Australian patient perspective." Australian Health Review 27, no. 1 (2004): 73. http://dx.doi.org/10.1071/ah042710073.
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The literature reveals little Australian academic study of the phenomenon of patient satisfaction and identifies severalproblems in current research practice. A theoretical discussion about the phenomenon of 'patient satisfaction' is for themost part absent, the rigour in the methods applied is often dubious, a definition of patient satisfaction is not agreedand the patient experience is often not the focus of research. To address some of these issues inductive research wasconducted with Australian patients to explore what they considered important for patient satisfaction to exist. A seriesof 52 interviews were conducted with twenty elective surgery patients in an Australian teaching hospital. Patients wereinterviewed on admission to hospital, within one week of discharge from hospital and between six and eight weeksafter discharge. Research with patients identified 16 themes that were important to make a patient's hospital staysatisfactory. Qualitative data have provided a foundation to better understand what 'patient satisfaction' means in itseveryday use. Such an approach is faithful to the concerns and priorities of the patients who are the users of healthcare services.
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Ghosh, Manimay. "Measuring patient satisfaction." Leadership in Health Services 27, no. 3 (July 1, 2014): 240–54. http://dx.doi.org/10.1108/lhs-06-2013-0027.
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Purpose – The purpose of this study was to understand the different dimensions patients staying in a hospital perceived as important for satisfaction and how those dimensions affected their overall satisfaction levels. Design/methodology/approach – A scale comprising 21 items to measure patient experience in a hospital was developed based on literature review. After purification of the scale, a field survey was administered to patients who were discharged in the recent past from a public or a private hospital in the city. The data collected were analyzed using multivariate techniques. Findings – The data analysis highlighted four important dimensions of patient satisfaction. The four dimensions significantly and positively affected patient’s overall satisfaction level. Research limitations/implications – This research study was conducted in one of the four major metropolitan cities of India. Nonetheless, the study provides valuable insights into the patient satisfaction dimensions in an Indian context and how those dimensions affected patient’s overall satisfaction. Practical implications – Hospitals, in general, can use the study findings to measure and improve their operational performance. Originality/value – This study was not limited to one or few hospitals, but covered many hospitals in one of the four metropolitan cities of India. It provides a comprehensive picture of how many hospitals in the city fared in terms of satisfying their patients.
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Andrew, G. H. Thompson. "The Practical Implications of Patient Satisfaction Research." Health Services Management Research 1, no. 2 (July 1988): 112–19. http://dx.doi.org/10.1177/095148488800100205.
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Greeneich, Diane Sturdy, Carol Olson Long, and Barbara Kemp Miller. "Patient satisfaction update: Research applied to practice." Applied Nursing Research 5, no. 1 (February 1992): 43–48. http://dx.doi.org/10.1016/s0897-1897(05)80085-0.
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Afrashtehfar, Kelvin I., Mansour K. A. Assery, and S. Ross Bryant. "Patient Satisfaction in Medicine and Dentistry." International Journal of Dentistry 2020 (December 29, 2020): 1–10. http://dx.doi.org/10.1155/2020/6621848.
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Health professionals, such as medical and dental clinicians, have scant understanding of patients’ experiences and perceptions of satisfaction. Nevertheless, implementing a patient-reported outcome measures (PROMs) research practice in surgical sciences is necessary. Hence, the objective of this article was to better understand patients’ satisfaction with their medical and dental care. The methods of the current article are based on a narrative review of the literature strategy. A literature review was conducted using both EMBASE and Medline databases up to July 12, 2020, by combining keywords and terms related to “satisfaction theories” and “patient satisfaction,” and “medicine” or “dentistry/stomatology/odontology.” Patient satisfaction’s multidimensional nature has been established since the perceived reasons for satisfaction varied widely among patients. Many aspects of treatment influence participant satisfaction at different stages of the intervention process. An improved understanding of the basis for managing patients’ expectations with information reiteratively and efficiently may ultimately reduce patients’ potential for negative feelings toward the medical and dental treatment experience. Lastly, the consumerist method may misrepresent the still undertheorized concept of satisfaction in health service.
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Wiggers, John H., Kathleen O. Donovan, Selina Redman, and Rob W. Sanson-Fisher. "Cancer patient satisfaction with care." Cancer 66, no. 3 (August 1, 1990): 610–16. http://dx.doi.org/10.1002/1097-0142(19900801)66:3<610::aid-cncr2820660335>3.0.co;2-t.
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Ramli, Abdul Haeba. "PATIENT SERVICE AND SATISFACTION SYSTEMS." Business and Entrepreneurial Review 15, no. 2 (June 18, 2019): 189. http://dx.doi.org/10.25105/ber.v15i2.4633.
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<p>The objective the research is to analyze abo the influence of service delivery system to patient satisfaction. This analysis data used Structural Equation Modeling (SEM) to observe about interrelatedness between some variable. The population in this study is 225 persons of hospital medical patient in type C hospital in Makassar and spread to 75 hospital patients in Stella Maris hospital, 75 hospital patients in Akademis Jaury Yusuf Putra hospital, and 75 hospital patients in Grestelina hospital. The research result shows that service delivery system composed of physical support and contact personal are significant and positive influence on patient satisfaction</p>
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Rahman, Muhammad Sabbir, and Aahad M. Osmangani. "Patient satisfaction constructs." International Journal of Health Care Quality Assurance 28, no. 8 (October 12, 2015): 841–54. http://dx.doi.org/10.1108/ijhcqa-05-2015-0056.
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Purpose – The purpose of this paper is to examine the five-factor structure of patients’ satisfaction constructs toward private healthcare service providers. Design/methodology/approach – This research is a cross-sectional study. A questionnaire-based survey was conducted with previous and current Bangladeshi patients. Exploratory factor analysis was employed to extract the underlying constructs. Findings – Five underlying dimensions that play a significant role in structuring the satisfaction perceived by Bangladeshi private healthcare patients are identified in this study. Practical implications – The main contribution of this study is identifying the dimensions of satisfaction perceived by Bangladeshi patients regarding private healthcare service providers. Originality/value – Healthcare managers adopt the five identified underlying construct items in their business practices to improve their respective healthcare efficiency while ensuring overall customer satisfaction.
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Fadhilah, Humaira, Nurlita Nurlita, and Ida Listiana. "Tingkat Kepuasan Pasien Terhadap Pelayanan Kefarmasian Di Instalasi Farmasi Rawat Jalan Rumah Sakit Bhineka Bakti Husada." Edu Masda Journal 4, no. 2 (September 30, 2020): 121. http://dx.doi.org/10.52118/edumasda.v4i2.103.
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Pharmacy service in the hospital must be prioritised to patient safety which is based on the paradigm of patient oriented, where pharmacist has a role not only focusing on medicine but also on patients. The good quality of pharmacy service can be seen from patients satisfaction. The objective of this research is to determine patient satisfactions level of outpatient pharmacy installation in Bhineka Bakti Husada Hosiptal. The research used non-experimental research design by descriptive. The number of sampel taken in this research was 100 respondent. The patients satisfactions level was calculated by the result of questionnaires which assessed from 5 dimentions. The satisfactions level analysis was conducted through calculation on the average of performance and expectancy.The research showed that deployment of service given in the installation pharmacy outpatient Bhineka Bakti Husada Hospital with level of conformity satisfaction and expectations > 75% of dimensions 91,6% reliability, 91,5% responsiveness, 92,57% assurance, 89,68% emphaty and 90,27% tangible. The results of this research show that patients are satisfied with the service provided in the installation pharmacy outpatient Bhineka Bakti Husada Hospital.
Dissertations / Theses on the topic "Patient satisfaction – Research"
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Fox, Jessica M. "The Effect of Patient Expectations on Patient Satisfaction." Youngstown State University / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ysu1560350332980685.
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Fitzpatrick, Raymond Michael. "Conceptual, methodological and policy issues in patient satisfaction research." Thesis, Royal Holloway, University of London, 1988. http://repository.royalholloway.ac.uk/items/cf6fd5a1-5b74-448d-88b6-06cfca7352bb/1/.
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This thesis is concerned with current debates as to the value of patient satisfaction research. The thesis reports two surveys by means of which the scope of patient satisfaction research is considered. Conceptual and methodological problems in this field of research and alternative theories of the social process whereby patients evaluate health care are reviewed. The two surveys are presented in terms of an introduction to the particular field of medicine involved, the methods of enquiry used, survey responses and discussion of results. The first survey is of patients attending outpatient neurological clinics presenting with headache. This study was conducted with intensive interviews, one before the neurological consultation and a second at home, one month later. The problems of making sense of patients' accounts in terms of 'expectations' and 'satisfaction' are outlined. Instead different perceptions of the value of clinic visits are related to four different concerns felt by patients in relation to their headaches, concerns for reassurance, explanation, prevention and symptomatic treatment. The second survey is of patient satisfaction with outpatient care in a department of genito-urinary medicine. This survey was conducted with two questionnaires: one completed whilst patients waited in the clinic for theirconsultation, and a second which was mailed to patients one month later. Survey results are used to examine an interactionist model of patient satisfaction developed by Ben Sira. The data is examined by various methods to suggest limitations of and modifications to the original model. Finally the thesis assesses the contribution of the two surveys to an understanding of how patients evaluate medical care. Alternative models of patient satisfaction are reexamined. It is argued that some perspectives have too restricted a view of patients' abilities. The implications of the two surveys are reviewed in terms of the different interests researchers may have in surveying patients' views.
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Wu, Ning. "Measurement issues in evaluating provider performance in health services research /." View online version; access limited to Brown University users, 2005. http://wwwlib.umi.com/dissertations/fullcit/3174695.
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Collins, Karen A. "The meaning of patient satisfaction : re-assessing a qualitative psychological research methodology." Thesis, University of Sheffield, 2002. http://etheses.whiterose.ac.uk/2961/.
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In a move towards a more informed understanding of the concept of satisfaction, this study aims to explore how thirty dermatology patients describe what it means to be satisfied with their healthcare. This was undertaken by adopting a qualitative research approach, using an in-depth semi-structured interview methodology. It was conducted within the context of a randomised controlled trial of telemedicine in dermatology (RCT). A secondary aim was to evaluate the extent to which the methodological approach of the study (interpretative phenomenological analysis) was successful in eliciting such descriptions. The findings reveal patient satisfaction as being a complex and fluid construct underpinned by a range of values, beliefs, attitudes and experiences. Individual participant descriptions of satisfaction emphasise the importance of 1) receiving a diagnosis treatment and cure, 2) minimum waiting time for appointments and treatment 3) the need to receive adequate information and explanations 4) receiving individualised personal care and 5) the need for participants to feel as though they were being taken seriously and 6) the importance of practitioner characteristics/good communication. Perhaps the most significant observation was the sequential nature of satisfaction, which was defined, redefined and re-evaluated by participants throughout the interview process. This study also identified a continuum of satisfaction across patients' definitions of being 'satisfied' as opposed to 'very satisfied' with healthcare. The method of data analysis (interpretative phenomenological analysis-IPA) was a useful approach to guide the analysis identifying and exploring themes relevant to eliciting the meaning of satisfaction. However, limitations to this methodology were apparent over the course of the study, and alternative methodology, contextualised interpretative phenomenological analysis has been postulated. It is suggested that the journey for a definitive notion of patient satisfaction, can only be meaningfully directed by accepting some form of refinement of phenomenological methods as a means of adding sophistication to existing quantitative studies.
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Bjørngaard, Johan Håkon. "Patient satisfaction with outpatient mental health services - the influence of organizational factors." Doctoral thesis, Norges teknisk-naturvitenskapelige universitet, Det medisinske fakultet, 2008. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-2227.
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Pasienttilfredshet med polikliniske tilbud i det psykiske helsevernet – betydningen av organisatoriske faktorer Pasientenes opplevelse og tilfredshet med behandlingstilbudet har i økende grad blitt vektlagt ved evaluering av tjenester til mennesker med psykiske lidelser. Systematiske målinger av brukererfaringer i det psykiske helsevernet skal inngå som en av flere kvalitetsindikatorer for spesialisttjenesten. Dette skal blant annet gi brukerne beslutningsgrunnlag for å kunne velge hvor man ønsker å behandles, fagfolkene innspill til egen kvalitetsutvikling og staten nødvendig styringsinformasjon. Hensikten med avhandlingen var å undersøke i hvilken grad organisatoriske forhold har betydning for pasientenes tilfredshet med behandlingstilbudet. Resultatene i avhandlingen bygger på analyser av data fra flere større undersøkelser med spørreskjema til pasienter om deres erfaringer med det psykiske helsevernet. Samlet sett viser resultatene at misnøye eller tilfredshet med tjenestetilbudet i liten grad var avhengig av hvor behandlingen fant sted. Det vil si at pasientene var fornøyd eller misfornøyd relativt uavhengig av hvor de ble behandlet. For eksempel blant pasienter i poliklinikker for voksne kunne bare om lag to prosent av variansen i tilfredshet knyttes til hvilken behandlingsenhet som sto for behandlingen. Resultatene viste også at ulike mål på den psykiske lidelsens alvorlighet var assosiert med pasienttilfredshet, noe som vil ha betydning ved sammenlikning av behandlingsenheter med til dels ulike behandlingsoppgaver. Avhandlingen viser at aggregerte mål for pasienttilfredshet har klare begrensninger som indikator på organisatorisk kvalitet. Det er grunn til å tvile på om gjennomsnittlig tilfredshet ved for eksempel en poliklinikk er egnet som styringsinformasjon. Det synes som om metoden i liten grad er egnet til å identifisere poliklinikker med dårlig kvalitet og det er også usikkert om de poliklinikkene som metoden beskriver som dårlige, faktisk er dårlige. Kandidat: Johan Håkon Bjørngaard, Institutt for samfunnsmedisin Veiledere: Jon Magnussen, Torleif Ruud og Svein Friis Finansieringskilde: Rådet for psykisk helse og Stiftelsen Helse og Rehabilitering
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Vietmeier, Anna C. "The Effects of Patient Expectation on Patient Perception." Youngstown State University / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ysu156034912164728.
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Grammer, Kyndal. "Rurality as a Moderator of Perception of Need for Medical Care and Patient Satisfaction." Digital Commons @ East Tennessee State University, 2021. https://dc.etsu.edu/etd/3866.
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Many individuals experience barriers to accessing medical care, especially in rural areas. Some barriers are attitudinal and represent perceptions of quality care. Patient satisfaction and perceived need for medical care are two such attitudinal barriers related to health care utilization, yet the relationship between these variables has not been explored. Using data from an online survey, the current study examined the association between these variables, and further, whether rurality status moderated this association. Results indicated a significant correlation between patient satisfaction and perception of need. Although the overall moderation model was significant, perception of need was not significantly associated with patient satisfaction, and rurality status did not significantly moderate the relationship. However, the covariates of sexual orientation and income did significantly predict patient satisfaction. This study highlights the complex associations of patient satisfaction, as well as the importance of social determinants of health in patients’ perceptions of quality of care.
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Jordan, Joanne Emma. "Conceptualising and measuring health literacy from the patient perspective." Connect to thesis, 2009. http://repository.unimelb.edu.au/10187/6776.
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The current patient-centred healthcare approach encourages individuals to assume greater roles in decisions about their health. The premise is that patients who are well informed about healthcare options are more likely to adhere to prescribed treatments and achieve better health outcomes. This approach assumes that patients have an adequate level of health literacy. While a range of definitions exist, health literacy is commonly defined as an individual’s ability to seek, understand and utilise health information to make appropriate health decisions.Health literacy is increasingly recognised as a complex multi-dimensional concept which involves interactions between individual abilities and broader environmental factors. However across definitions, there has been little consultation with patients to understand what is important to effectively seek, understand and utilise health information. The lack of a consensual understanding has led to debate as to what health literacy represents and how it should be measured. A range of measures exist with the predominant approach being the testing of individual literacy abilities. However measures do not assess the range of attributes described in definitions. Thus a considerable gap exists between how health literacy is defined and how it is measured. This thesis focused on addressing this gap. The objectives were to: (i) critically appraise existing health literacy measures (ii) develop a conceptual framework from the patient perspective and (iii) use this framework to develop a comprehensive measure of health literacy.
A multi-method qualitative and quantitative approach was used:
(1) Systematic review and appraisal of the content, development and psychometric properties of health literacy measures.
(2) In-depth consultations with patients across healthcare and disease continuums to develop a conceptual framework.
(3) Development of a new health literacy measure based on the conceptual framework using a classical test theory approach.
A critical appraisal of the literature revealed that the majority of health literacy measures are not based on a conceptual framework and none appeared to adequately measure a person’s ability to seek, understand and utilise health information. Content focussed primarily on reading, comprehension and numeracy skills and scoring was poorly defined. Only five of the 19 measures had evidence of acceptable reliability.
The conceptual framework of health literacy from the patient perspective identified 17 key elements: six individual abilities and 11 broader contextual factors that are important to seek, understand and utilise health information and expanded previous conceptualisations of health literacy. This informed the development of the Health Literacy Management Scale (HeLMS) which measures six generic and potentially modifiable abilities and three specific broader social factors. Overall the HeLMS measures an individual’s ability to seek, understand and utilise health information within the healthcare setting. The HeLMS consists of 29 items across eight domains. Rigorous psychometric testing demonstrates that it possesses strong construct validity and high reliability (coefficient α >0.80 for all eight domains).
This research provides unique contributions to the conceptualisation and measurement of health literacy. Limitations in the content and psychometric properties of previously developed measures have been identified through a systematic process. A conceptual framework derived from the patient perspective identifies a range of components that provide new insight into: (i) constructs that should be incorporated to measure health literacy and (ii) areas that need to be addressed to improve health literacy. The development of the HeLMS now allows for a more comprehensive assessment of health literacy. Information from the conceptual framework and the HeLMS are likely to be useful tools to inform the development of public health initiatives to enhance patient participation in the management of their health.
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Oliveira, Acacia Maria Lima de. "Satisfação do paciente com os cuidados de enfermagem : adaptação cultural e validação do Patient Satisfaction Instrument." [s.n.], 2004. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308893.
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Orientador: Edineis de Brito GuirardelloDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
Made available in DSpace on 2018-08-04T03:23:24Z (GMT). No. of bitstreams: 1 Oliveira_AcaciaMariaLimade_M.pdf: 5400295 bytes, checksum: 9cdb377799ce85db56adcce9afe05b04 (MD5) Previous issue date: 2004
Resumo: Resumo o processo de hospitalização pode acarretar para o paciente um distanciamento do seu convívio familiar. O fato de permanecer, mesmo que temporariamente, em um ambiente estranho ao seu convívio, com normas e rotinas a que não está habituado e a expectativa com relação ao tratamento, podem gerar sentimentos de insatisfação com relação ao cuidado recebido. A satisfação do paciente com o cuidado de enfermagem, foi definida por RISSER (1975) como sendo o grau de congruência entre as expectativas do paciente e sua percepção sobre o cuidado recebido. Estudos sobre satisfação do paciente na cultura brasileira utilizam-se de uma abordagem genérica, de modo a não valorizar a satisfação do paciente com a assistência de enfermagem. Sendo assim, é importante utilizar instrumentos de medida específicos para avaliar a satisfação do paciente quanto aos cuidados de enfermagem. Considerando a inexistência de instrumentos para este fim, o presente estudo teve por objetivo traduzir e validar o Patient Satisfaction Instrument (PSI), desenvolvido por Hinshaw e Atwood (1982), para a cultura brasileira. É um instrumento composto de 25 itens que aborda situações do cuidado de enfermagem, agrupados em três domínios: Educacional, Profissional e Confiança. O procedimento metodológico de adaptação utilizado seguiu as etapas de: a) tradução do instrumento para a língua portuguesa; b) tradução de volta para a língua original; c) julgamento por um comitê de juízes e d) pré-teste da versão final do instrumento, o qual denominou-se Instrumento de Satisfação do Paciente (ISP). Participaram do estudo 211 pacientes, internados em clínicas médicocirúrgicas de dois hospitais do município de São Paulo. Na análise da confiabilidade do instrumento, obteve-se alta consistência interna para todos os itens do instrumento (a= 0,88) e para os domínios Educacional (a= 0,66) e Confiança a= 0,79). Apenas para o domínio Profissional, obteve-se um coeficiente alfa de Cronbach de 0,62. Quanto a validade de constructo, a análise de fator exploratória mostrou que, apesar da medida de adequação da amostra ter sido estatisticamente significante, (MSA= 0,84), o critério utilizado para selecionar fatores com auto valor maior que 1 demonstrou sete fatores que explicaram 62% variância total. Os resultados da análise de fator confirmatória mostraram que apenas o RMR, obteve valores aceitáveis (0,10). Os resultados desse estudo indicam que o PSI traduzido para a nossa cultura pode ser utilizado para medir satisfação do paciente. Entretanto, é necessário que este instrumento seja aplicado em outras populações com características semelhantes para testar os itens que não foram consistentes na amostra estudada
Abstract: The hospitalization process may keep the patient distant from their family. The fact of being in an unfamiliar setting, even for a short period, with established rules and routines that they are not used to and the expectations concerning the treatment, may bring about dissatisfactions. Patient Satisfaction with nursing care was defined by RISSER (1975) as the congruence degree between the patient expectations and their perception concerning the care provided. Studies on patient satisfaction in Brazil adopt a generic approach and do not give value to patient satisfaction with the nursing care. Based on that, it is important to use specific measurement instruments in order to assess the patient satisfaction with the nursing care. As there are no instruments with this purpose, the present study aimed at translating and validating the Patient Satisfaction Instrument (PSI) developed by Hinshaw and Atwood (1982) to the Brazilian culture. The PSI is constituted of 25 items that cover situations related to the nursing care grouped in three domains: Educational, Professional and Trust. The methodological procedure used were a) translation of the instrument into Portuguese; b) back-translation to English c) committee review; d) test of the pre-final version. 211 patients admitted in medical-surgical clinics in two hospitais in São Paulo city made part of the study. The analysis of its reliability scored high internal consistence in ali items (a=0.88), and for Educational domains (oc=0.66); and Trust (oc=0.79). Only for the Professional domain it scored Cronbach's alfa (oc=0.62). In relation to construct validity, the exploratory factor analysis showed that besides the adequacy measure of the sampling been statistically significant (MSA=0,84), the criteria used to select the factors with an eigenvalue of 1.00 or above demonstrate seven factors that explained 62% of the total variance. The results of confirmatory factor analisys showed that only the root mean-squared residual (RMR), met the criteria standards (0.10). The results of this study indicate that the PSI translated to Brazilian culture can be used to measure patient'satisfaction. However, it is necessary to point out that it is important to apply this instrument to other populations with characteristics similar to the ones in the present study in order to review the items which were not consistent in the studied samples
Mestrado
Enfermagem e Trabalho
Mestre em Enfermagem
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Sjöström, Malin. "Internet-based treatment of stress urinary incontinence : treatment outcome, patient satisfaction, and cost-effectiveness." Doctoral thesis, Umeå universitet, Allmänmedicin, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-84405.
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Background Stress urinary incontinence (SUI) is the leakage of urine when coughing, sneezing, or on exertion. It affects 10-35% of women, and can impair quality of life (QOL). First-line treatment is pelvic floor muscle training (PFMT). However, access barriers and embarrassment may prevent women from seeking care. There is a need for new, easily accessible ways to provide treatment. Aim To evaluate the treatment outcome, patient satisfaction, and cost-effectiveness of an Internet- based treatment programme for SUI. Methods We recruited 250 community-dwelling women aged 18-70 years, with SUI ≥1/week via our website. Participants were randomised to 3 months of PFMT with either an Internet-based programme (n=124), or a programme sent by post (n=126). We had no-face-to face contact with the participants, but the Internet group received individually tailored e-mail support from an urotherapist. Treatment outcome was evaluated after 4 months with intention-to-treat analysis. After treatment, we telephoned a strategic selection of participants (Internet n=13, postal n=8) to interview them about their experiences, and analysed the results according to grounded theory principles. We also performed a cost-utility analysis with a 1-year societal perspective, comparing the treatment programmes with each other and with a no-treatment alternative. To scrutinize our measure of QOL, we performed a reliability study of the ICIQ-LUTSqol questionnaire. Results Participants in both intervention groups achieved highly significant improvements (p<0.001) with large effect sizes (>0.8) in the primary outcomes symptom score (ICIQ-UI SF: mean change Internet 3.4 [SD 3.4], postal 2.9 [3.1]), and condition-specific QOL (ICIQ-LUTSqol: mean change Internet 4.8 [SD 6.1], postal 4.6 [SD 6.7]); however, the differences between the groups were not significant. Compared with the postal group, more participants in the Internet group perceived they were much or very much improved after treatment (40.9%, vs. 26.5%, p=0.01), reduced their use of incontinence aids (59.5% vs. 41.4%, p=0.02), and indicated satisfaction with the treatment programme (84.8% vs. 62.9%, p<0.001). Results from the interviews fell into three categories: about life with SUI and barriers to seeking care; about the treatments and the patient-provider relationship; about the sense of empowerment many women experienced. A core category emerged: “Acknowledged but not exposed.” The extra cost per quality-adjusted life year (QALY) gained through use of the Internet-based programme compared with the postal programme was €200. The extra cost per QALY for the Internet-based programme compared with no treatment was €30,935. The condition-specific questionnaire ICIQ-LUTSqol is reliable in women with SUI, with high degrees of agreement between overall scores (Intraclass correlation coefficient 0.95, p<0.001). Conclusion Internet-based treatment for SUI is a new, effective, and patient-appreciated treatment alternative, which can increase access to care in a sustainable way.
Books on the topic "Patient satisfaction – Research"
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Krowinski, William J. Measuring and managing patient satisfaction. 2nd ed. Chicago, Ill: American Hospital Pub., 1996.
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J, Krowinski William, ed. Measuring and managing patient satisfaction. Chicago, Ill: American Hospital Pub., 1990.
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The nurse practitioner: Real-world research in A&E. London: Whurr, 2000.
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Quality of life: From nursing and patient perspectives : theory, research, practice. Sudbury, MA: Jones & Bartlett Learning, 2011.
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K, Andres Nicole, Dobson Allen, and American Nurses' Association, eds. Nursing quality indicators: Definitions and implications. Washington, D.C: American Nurses Pub., 1996.
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Northern Health and Social Services Council (Northern Ireland). Ambulance patient care service: Consumer satisfaction study : research carried out by the Northern Health and Social Services Council, in conjunction with the Northern Ireland Ambulance Service. Ballymena: NHSSC, 1998.
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D, Horn Susan, Hopkins David S. 1921-, Huber Michael, Nerenz David R, Zajac Barry M, Moskowitz Daniel B, and Aydin Carolyn E, eds. Faulkner & Gray's medical outcomes and practice guidelines library. Washington, DC: Faulkner & Gray's Healthcare Information Center, 1994.
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She hui zhi chi, wu ming yu xu qiu man zu: Ai zi gu er jiu zhu xing shi de bi jiao yan jiu = Social support, stigma and need satisfaction : a comparative research on the assistance to HIV/AIDS orphans. Beijing Shi: She hui ke xue wen xian chu ban she, 2011.
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(Editor), Jennifer Burr, and Paula Nicolson (Editor), eds. Consumer Health Care Research. Palgrave Macmillan, 2004.
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(Editor), Jennifer Burr, and Paula Nicolson (Editor), eds. Consumer Health Care Research. Palgrave Macmillan, 2004.
Find full textBook chapters on the topic "Patient satisfaction – Research"
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Chow, Andre, Erik Mayer, Lord Ara Darzi, and Thanos Athanasiou. "Patient Satisfaction in Surgery." In Key Topics in Surgical Research and Methodology, 165–73. Berlin, Heidelberg: Springer Berlin Heidelberg, 2010. http://dx.doi.org/10.1007/978-3-540-71915-1_14.
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Ceylan, Cemil. "Research on the Interaction Between Patient Satisfaction, Service Quality, Organizational Image and Trust in a Training and Research Hospital." In Lecture Notes in Management and Industrial Engineering, 313–27. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-42416-9_28.
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Alharethi, Salman, Abdullah Gani, and Mohd Khalit Othman. "Emergency Departments." In Advances in Intelligent Systems and Computing, 341–58. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-030-03405-4_23.
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Abstract Emergency services are essential and any person may require these services at some point in their lives. Emergency services are run by complex management and consist of many different parts. It is essential to establish effective procedures to ensure that patients are treated in a timely fashion. By obtaining real-time information, it is expected that intelligent decisions would be made. Hence, thorough analytics of problems concerning appropriate operational effective management, would help prevent patient dissatisfaction in the future. Mapping studies are utilized to configure and explore a research theme, whereas systematic reviews are utilized to combine proofs. The use of improvement strategies and quality measurements of the health care industry, specifically in emergency departments, are essential to value patients’ level of satisfaction and the quality of the service provided based on patients’ experience. This paper explores and creates momentum with all the methodologies utilized by researchers from 2010 and beyond with the stress on patient fulfillment in the emergency services segment.
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Shoemaker, Laura, and Susan McInnes. "Starting a Palliative Care Program at a Cancer Center." In The Comprehensive Cancer Center, 107–20. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-82052-7_12.
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AbstractPalliative care is now considered an integral component in the provision of comprehensive cancer care services, from diagnosis to treatment to ultimate recovery or death. High-quality evidence in the setting of both solid tumors and hematologic malignancies suggests that incorporation of palliative care is associated with higher quality care, greater patient and family satisfaction, improved clinician experience, more appropriate healthcare resource utilization, and better patient outcomes, including survival. Strategic investment, staffing, and support for a palliative care program also makes cancer care patient-centric and cost-effective. This chapter provides pragmatic guidance on setting up a palliative care program within a cancer center and discusses strategies and opportunities for early and late planning, launch of the program and its integration within other cancer services, making it sustainable, monitoring outcomes and quality, and using it as a platform for research.
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Akkus, Yeliz. "Sexual Satisfaction in Rheumatoid Arthritis Patients." In Encyclopedia of Quality of Life and Well-Being Research, 5926–31. Dordrecht: Springer Netherlands, 2014. http://dx.doi.org/10.1007/978-94-007-0753-5_4220.
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Borgnis, Francesca, Lucia Pigini, Marina Ramella, Claudia Salatino, Maurizio Saruggia, Chiara Folini, and Rosa Maria Converti. "Assessing the Outcome of Mobility Assistive Technology (OMAT) in Daily Living: Preliminary Results in an Italian Sample." In Lecture Notes in Computer Science, 534–41. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-08645-8_63.
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AbstractThe World Health Organization has defined assistive technologies (AT) as the fourth pillar of global health and supported identifying AT outcomes among the five top priorities in AT research. In this framework, the research study OMAT (Outcomes of Mobility Assistive Technology in rehabilitation pathways) was developed by Fondazione Don Carlo Gnocchi. The OMAT study aims to develop and test the applicability of a model of rehabilitation pathway related to prosthetic interventions in the field of mobility: a multidisciplinary assessment of patients’ needs and expectations was made at baseline and after an adequate period of use of the prescribed assistive devices in everyday settings. To date, the study is ongoing. The present work aims to show the preliminary results of the OMAT research study, in particular its primary outcomes. Specifically, OMAT AT outcome assessment consists of 1) perceived effectiveness of assistive mobility products, 2) satisfaction of the intervention and 3) possible changes in quality of life. Among the recruited subjects (N = 32), most patients (87.5%) received only one mobility assistive product, especially bimanual self-propelled wheelchairs. Patients used the received mobility assistive products for 3–6 months, with a good frequency (few-days/ week) and moderate support. Preliminary results showed a positive impact of assistive mobility products in terms of perceived effectiveness, intervention satisfaction, and quality of life. Interestingly, patients showed improved quality of life, showing a significant decrease of the severity degree in problems identified at baseline evaluation. Further studies will be conducted to replicate these promising results in a larger sample.
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Cleophas, Ton J., and Aeilko H. Zwinderman. "Effect of Treatment Modality, Counseling, and Satisfaction with Doctor on Quality of Life, 450 Patients, Traditional Regressions vs Kernel Ridge Regression." In Kernel Ridge Regression in Clinical Research, 163–73. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-10717-7_16.
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"Patient Satisfaction." In Encyclopedia of Quality of Life and Well-Being Research, 4661. Dordrecht: Springer Netherlands, 2014. http://dx.doi.org/10.1007/978-94-007-0753-5_102936.
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Gilligan, Colin, and Robin Lowe. "Patient satisfaction and the role of marketing research." In Marketing and General Practice, 33–42. CRC Press, 2018. http://dx.doi.org/10.1201/9781315377278-4.
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Peršolja, Melita. "Congruence of Nurse Staffing and Activities with Patient Needs." In Medical Education for the 21st Century [Working Title]. IntechOpen, 2021. http://dx.doi.org/10.5772/intechopen.96589.
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This study aimed to discover the correlation between patient satisfaction with nursing care activities and staffing patterns. The research was conducted at the medical ward of a secondary care regional hospital in Slovenia over one month. Data was collected with regard to the following: (1) patients cared for daily and number of hours/patients day at the ward level, (2) patient needs (using a classification system), (3) nurse activities as observed at 10-minute intervals, and (4) the Patient Perception of Hospital Experience with Nursing tool. A total of 218 patients were involved, and their satisfaction with nursing care was found to be high. Patient satisfaction was negatively correlated with the number of patients cared for at the unit daily, but positively with the number of care hours per patient day, the proportion of registered nurses in the nursing team, the realized percentage of the registered nurse personnel requirements, and with some direct care activities. The correlation also revealed three process items (undivided attention, explanation, and things are done without asking) being the special strengths of nursing care activities. The results show that nurse-staffing and process patterns affect patient experience. It is thus recommended to increase the amount of nursing care offered by registered nurses, while nurses’ competences can affect the process of care, and thus patient satisfaction.
Conference papers on the topic "Patient satisfaction – Research"
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Al-Ramahi, Mohammad, Abdullah Wahbeh, and Cherie Noteboome. "Features Related to Patient Portal User Satisfaction." In SIGMIS-CPR '18: 2018 Computers and People Research Conference. New York, NY, USA: ACM, 2018. http://dx.doi.org/10.1145/3209626.3209729.
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Lv, Jie. "Research of Hospitalization Patient Satisfaction Based on Path Analysis." In 2011 International Conference on Information Management, Innovation Management and Industrial Engineering (ICIII). IEEE, 2011. http://dx.doi.org/10.1109/iciii.2011.256.
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FRANCI, A., and M. CORSI. "QUALITY IN HOME CARE: A METHODOLOGICAL PROPOSAL TO MEASURE PATIENT SATISFACTION." In Proceedings of the 24th Meeting of the European Working Group on Operational Research Applied to Health Services. WORLD SCIENTIFIC, 1999. http://dx.doi.org/10.1142/9789812817839_0009.
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Hakim, Lukman, Ah Yusuf, and Purwaningsih. "The Effect of Case Manager's Role to Patient Satisfaction - A Systematic Review." In The 9th International Nursing Conference: Nurses at The Forefront Transforming Care, Science and Research. SCITEPRESS - Science and Technology Publications, 2018. http://dx.doi.org/10.5220/0008325203550360.
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Özcan, Selami, Kerim Baş, and H. Yunus Taş. "Effects of Health Sector Information Asymmetry on Patient Satisfaction: An Appilication on Yalova Oral and Dental Care Centre." In International Conference on Eurasian Economies. Eurasian Economists Association, 2013. http://dx.doi.org/10.36880/c04.00673.
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Effects of excessive information level difference between providers and receivers of health care services on patients will be presented with this work. Fundamental concepts like health care service, information asymmetry and it’s effects will be explained. Information levels of attempts and treatments that were put in practice to the patients, surgical operations and billing will be studied and the outputs of the information level difference between the provider and the receiver will be determined. In this research, it will be revealed if the practical applications and the concepts in the literature overlap each other and developing a new method towards evaluating the information level difference will be attempted. Patients who received a certain number of treatments will be targeted. Survey questions that will be asked to the patients will try to reveal the amount of information on the procedure they have undertaken and the between this level of information and the their satisfaction. SPSS software is used for the analysis of the data. Resolving of the relation between patient satisfaction themeasured percentage of level of information about the procedure the subject have undertaken will be attempted during the evaluation of the survey results. The effects of gender, age and education on level of information-customer satisfaction will also be investigated while determining the patients level of information with this survey.
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Abd al Hadi, Samah Ahmad, Amal Abousaad, and Mujahed Shraim. "Improving Waiting Times in Hand Surgery Clinic at Rumailah Hospital, Qatar." In Qatar University Annual Research Forum & Exhibition. Qatar University Press, 2020. http://dx.doi.org/10.29117/quarfe.2020.0183.
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Background: The quality and efficiency of healthcare delivery are key drivers that influence hospital quality as well as patient satisfaction. The patient waiting time is the period of time that passes between patients first seeking medical treatment from the healthcare system and their admittance for consultation and diagnosis. The hand surgery clinic at Rumailah Hospital (RH) in Qatar has seen that only 12% of new patients who had been referred for urgent treatment from the accident and emergency department had received an appointment within 14 days. Aim: To increase the percentage of patients with new, urgent referrals to the hand surgery clinic at Rumailah Hospital from the accident and emergency department to be seen within 14 days from the current 12% to 20% by the end of October 2019 and from 20% to 60% by the end of April 2020. Methodology: This is a Quality improvement Project used the Institute for Healthcare Improvement model for improvement, the team used the root cause analysis to identify the bottleneck in the process, the Plan- Do - Study - Act (PDSA) cycles facilitates testing the selected changes: increase capacity, triage acciedent and emergency referrals, and clear the back log. Results: After implementing the changes, we observed increase in the proportion of patients who received appointments within 14 days of the referral, from 22% in July to 26% in August and 40% in September and October, 2019. Conclusion: The project team did extensive research in understanding the complex process of OPD appointment and clinic consultation. The project team tested three change ideas that yielded to manage the percentage of patients who received appointments within 14 days. The team is planning to test the next change idea to improve the triaging process by implementing electronic triaging, which is expected to reduce the waiting time for an appointment in the clinic.
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Siyoto, Sandu, and Elya Irawan Putri. "Analysis of Patient Satisfaction and Interest of Patient on Doctor Servicing Health Care Provider in the Healthcare and Social Security Agency." In 8th International Nursing Conference on Education, Practice and Research Development in Nursing (INC 2017). Paris, France: Atlantis Press, 2017. http://dx.doi.org/10.2991/inc-17.2017.54.
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Chen Lihua, Hou Kaihu, Sun Shaopeng, and Ji Yunhai. "Research on the comprehensive evaluation of patient satisfaction based on the attribute reduction and AHP." In 2012 9th International Conference on Service Systems and Service Management (ICSSSM 2012). IEEE, 2012. http://dx.doi.org/10.1109/icsssm.2012.6252261.
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Utama, Yofa, Hema Malini, and Vetty Priscilla. "The Patient Satisfaction to Nursing Round Implementation “Matrons Round” in A Hospital, Palembang." In Proceedings of the 1st EAI International Conference on Medical And Health Research, ICoMHER November 13-14th 2018, Padang, West Sumatera, Indonesia. EAI, 2019. http://dx.doi.org/10.4108/eai.13-11-2018.2283699.
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Sarikadarwati, Henny Yulsiati, Sandrayati, and Susi Ardiani. "The Effect of Patient Satisfaction Levels on Competency and Facilities at Siti Khadijah Islamic Hospital, Palembang City." In 4th Forum in Research, Science, and Technology (FIRST-T3-20). Paris, France: Atlantis Press, 2021. http://dx.doi.org/10.2991/ahsseh.k.210122.016.
Full textReports on the topic "Patient satisfaction – Research"
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Dy, Sydney M., Julie M. Waldfogel, Danetta H. Sloan, Valerie Cotter, Susan Hannum, JaAlah-Ai Heughan, Linda Chyr, et al. Integrating Palliative Care in Ambulatory Care of Noncancer Serious Chronic Illness: A Systematic Review. Agency for Healthcare Research and Quality (AHRQ), February 2020. http://dx.doi.org/10.23970/ahrqepccer237.
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Objectives. To evaluate availability, effectiveness, and implementation of interventions for integrating palliative care into ambulatory care for U.S.-based adults with serious life-threatening chronic illness or conditions other than cancer and their caregivers We evaluated interventions addressing identification of patients, patient and caregiver education, shared decision-making tools, clinician education, and models of care. Data sources. We searched key U.S. national websites (March 2020) and PubMed®, CINAHL®, and the Cochrane Central Register of Controlled Trials (through May 2020). We also engaged Key Informants. Review methods. We completed a mixed-methods review; we sought, synthesized, and integrated Web resources; quantitative, qualitative and mixed-methods studies; and input from patient/caregiver and clinician/stakeholder Key Informants. Two reviewers screened websites and search results, abstracted data, assessed risk of bias or study quality, and graded strength of evidence (SOE) for key outcomes: health-related quality of life, patient overall symptom burden, patient depressive symptom scores, patient and caregiver satisfaction, and advance directive documentation. We performed meta-analyses when appropriate. Results. We included 46 Web resources, 20 quantitative effectiveness studies, and 16 qualitative implementation studies across primary care and specialty populations. Various prediction models, tools, and triggers to identify patients are available, but none were evaluated for effectiveness or implementation. Numerous patient and caregiver education tools are available, but none were evaluated for effectiveness or implementation. All of the shared decision-making tools addressed advance care planning; these tools may increase patient satisfaction and advance directive documentation compared with usual care (SOE: low). Patients and caregivers prefer advance care planning discussions grounded in patient and caregiver experiences with individualized timing. Although numerous education and training resources for nonpalliative care clinicians are available, we were unable to draw conclusions about implementation, and none have been evaluated for effectiveness. The models evaluated for integrating palliative care were not more effective than usual care for improving health-related quality of life or patient depressive symptom scores (SOE: moderate) and may have little to no effect on increasing patient satisfaction or decreasing overall symptom burden (SOE: low), but models for integrating palliative care were effective for increasing advance directive documentation (SOE: moderate). Multimodal interventions may have little to no effect on increasing advance directive documentation (SOE: low) and other graded outcomes were not assessed. For utilization, models for integrating palliative care were not found to be more effective than usual care for decreasing hospitalizations; we were unable to draw conclusions about most other aspects of utilization or cost and resource use. We were unable to draw conclusions about caregiver satisfaction or specific characteristics of models for integrating palliative care. Patient preferences for appropriate timing of palliative care varied; costs, additional visits, and travel were seen as barriers to implementation. Conclusions. For integrating palliative care into ambulatory care for serious illness and conditions other than cancer, advance care planning shared decision-making tools and palliative care models were the most widely evaluated interventions and may be effective for improving only a few outcomes. More research is needed, particularly on identification of patients for these interventions; education for patients, caregivers, and clinicians; shared decision-making tools beyond advance care planning and advance directive completion; and specific components, characteristics, and implementation factors in models for integrating palliative care into ambulatory care.
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Tipton, Kelley, Brian F. Leas, Nikhil K. Mull, Shazia M. Siddique, S. Ryan Greysen, Meghan B. Lane-Fall, and Amy Y. Tsou. Interventions To Decrease Hospital Length of Stay. Agency for Healthcare Research and Quality (AHRQ), September 2021. http://dx.doi.org/10.23970/ahrqepctb40.
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Background. Timely discharge of hospitalized patients can prevent patient harm, improve patient satisfaction and quality of life, and reduce costs. Numerous strategies have been tested to improve the efficiency and safety of patient recovery and discharge, but hospitals continue to face challenges. Purpose. This Technical Brief aimed to identify and synthesize current knowledge and emerging concepts regarding systematic strategies that hospitals and health systems can implement to reduce length of stay (LOS), with emphasis on medically complex or vulnerable patients at high risk for prolonged LOS due to clinical, social, or economic barriers to timely discharge. Methods. We conducted a structured search for published and unpublished studies and conducted interviews with Key Informants representing vulnerable patients, hospitals, health systems, and clinicians. The interviews provided guidance on our research protocol, search strategy, and analysis. Due to the large and diverse evidence base, we limited our evaluation to systematic reviews of interventions to decrease hospital LOS for patients at potentially higher risk for delayed discharge; primary research studies were not included, and searches were restricted to reviews published since 2010. We cataloged the characteristics of relevant interventions and assessed evidence of their effectiveness. Findings. Our searches yielded 4,364 potential studies. After screening, we included 19 systematic reviews reported in 20 articles. The reviews described eight strategies for reducing LOS: discharge planning; geriatric assessment or consultation; medication management; clinical pathways; inter- or multidisciplinary care; case management; hospitalist services; and telehealth. All reviews included adult patients, and two reviews also included children. Interventions were frequently designed for older (often frail) patients or patients with chronic illness. One review included pregnant women at high risk for premature delivery. No reviews focused on factors linking patient vulnerability with social determinants of health. The reviews reported few details about hospital setting, context, or resources associated with the interventions studied. Evidence for effectiveness of interventions was generally not robust and often inconsistent—for example, we identified six reviews of discharge planning; three found no effect on LOS, two found LOS decreased, and one reported an increase. Many reviews also reported patient readmission rates and mortality but with similarly inconsistent results. Conclusions. A broad range of strategies have been employed to reduce LOS, but rigorous systematic reviews have not consistently demonstrated effectiveness within medically complex, high-risk, and vulnerable populations. Health system leaders, researchers, and policymakers must collaborate to address these needs.
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Saldanha, Ian J., Wangnan Cao, Justin M. Broyles, Gaelen P. Adam, Monika Reddy Bhuma, Shivani Mehta, Laura S. Dominici, Andrea L. Pusic, and Ethan M. Balk. Breast Reconstruction After Mastectomy: A Systematic Review and Meta-Analysis. Agency for Healthcare Research and Quality (AHRQ), July 2021. http://dx.doi.org/10.23970/ahrqepccer245.
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Objectives. This systematic review evaluates breast reconstruction options for women after mastectomy for breast cancer (or breast cancer prophylaxis). We addressed six Key Questions (KQs): (1) implant-based reconstruction (IBR) versus autologous reconstruction (AR), (2) timing of IBR and AR in relation to chemotherapy and radiation therapy, (3) comparisons of implant materials, (4) comparisons of anatomic planes for IBR, (5) use versus nonuse of human acellular dermal matrices (ADMs) during IBR, and (6) comparisons of AR flap types. Data sources and review methods. We searched Medline®, Embase®, Cochrane CENTRAL, CINAHL®, and ClinicalTrials.gov from inception to March 23, 2021, to identify comparative and single group studies. We extracted study data into the Systematic Review Data Repository Plus (SRDR+). We assessed the risk of bias and evaluated the strength of evidence (SoE) using standard methods. The protocol was registered in PROSPERO (registration number CRD42020193183). Results. We found 8 randomized controlled trials, 83 nonrandomized comparative studies, and 69 single group studies. Risk of bias was moderate to high for most studies. KQ1: Compared with IBR, AR is probably associated with clinically better patient satisfaction with breasts and sexual well-being but comparable general quality of life and psychosocial well-being (moderate SoE, all outcomes). AR probably poses a greater risk of deep vein thrombosis or pulmonary embolism (moderate SoE), but IBR probably poses a greater risk of reconstructive failure in the long term (1.5 to 4 years) (moderate SoE) and may pose a greater risk of breast seroma (low SoE). KQ 2: Conducting IBR either before or after radiation therapy may result in comparable physical well-being, psychosocial well-being, sexual well-being, and patient satisfaction with breasts (all low SoE), and probably results in comparable risks of implant failure/loss or need for explant surgery (moderate SoE). We found no evidence addressing timing of IBR or AR in relation to chemotherapy or timing of AR in relation to radiation therapy. KQ 3: Silicone and saline implants may result in clinically comparable patient satisfaction with breasts (low SoE). There is insufficient evidence regarding double lumen implants. KQ 4: Whether the implant is placed in the prepectoral or total submuscular plane may not be associated with risk of infections that are not explicitly implant related (low SoE). There is insufficient evidence addressing the comparisons between prepectoral and partial submuscular and between partial and total submuscular planes. KQ 5: The evidence is inconsistent regarding whether human ADM use during IBR impacts physical well-being, psychosocial well-being, or satisfaction with breasts. However, ADM use probably increases the risk of implant failure/loss or need for explant surgery (moderate SoE) and may increase the risk of infections not explicitly implant related (low SoE). Whether or not ADM is used probably is associated with comparable risks of seroma and unplanned repeat surgeries for revision (moderate SoE for both), and possibly necrosis (low SoE). KQ 6: AR with either transverse rectus abdominis (TRAM) or deep inferior epigastric perforator (DIEP) flaps may result in comparable patient satisfaction with breasts (low SoE), but TRAM flaps probably increase the risk of harms to the area of flap harvest (moderate SoE). AR with either DIEP or latissimus dorsi flaps may result in comparable patient satisfaction with breasts (low SoE), but there is insufficient evidence regarding thromboembolic events and no evidence regarding other surgical complications. Conclusion. Evidence regarding surgical breast reconstruction options is largely insufficient or of only low or moderate SoE. New high-quality research is needed, especially for timing of IBR and AR in relation to chemotherapy and radiation therapy, for comparisons of implant materials, and for comparisons of anatomic planes of implant placement.
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Treadwell, Jonathan R., James T. Reston, Benjamin Rouse, Joann Fontanarosa, Neha Patel, and Nikhil K. Mull. Automated-Entry Patient-Generated Health Data for Chronic Conditions: The Evidence on Health Outcomes. Agency for Healthcare Research and Quality (AHRQ), March 2021. http://dx.doi.org/10.23970/ahrqepctb38.
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Background. Automated-entry consumer devices that collect and transmit patient-generated health data (PGHD) are being evaluated as potential tools to aid in the management of chronic diseases. The need exists to evaluate the evidence regarding consumer PGHD technologies, particularly for devices that have not gone through Food and Drug Administration evaluation. Purpose. To summarize the research related to automated-entry consumer health technologies that provide PGHD for the prevention or management of 11 chronic diseases. Methods. The project scope was determined through discussions with Key Informants. We searched MEDLINE and EMBASE (via EMBASE.com), In-Process MEDLINE and PubMed unique content (via PubMed.gov), and the Cochrane Database of Systematic Reviews for systematic reviews or controlled trials. We also searched ClinicalTrials.gov for ongoing studies. We assessed risk of bias and extracted data on health outcomes, surrogate outcomes, usability, sustainability, cost-effectiveness outcomes (quantifying the tradeoffs between health effects and cost), process outcomes, and other characteristics related to PGHD technologies. For isolated effects on health outcomes, we classified the results in one of four categories: (1) likely no effect, (2) unclear, (3) possible positive effect, or (4) likely positive effect. When we categorized the data as “unclear” based solely on health outcomes, we then examined and classified surrogate outcomes for that particular clinical condition. Findings. We identified 114 unique studies that met inclusion criteria. The largest number of studies addressed patients with hypertension (51 studies) and obesity (43 studies). Eighty-four trials used a single PGHD device, 23 used 2 PGHD devices, and the other 7 used 3 or more PGHD devices. Pedometers, blood pressure (BP) monitors, and scales were commonly used in the same studies. Overall, we found a “possible positive effect” of PGHD interventions on health outcomes for coronary artery disease, heart failure, and asthma. For obesity, we rated the health outcomes as unclear, and the surrogate outcomes (body mass index/weight) as likely no effect. For hypertension, we rated the health outcomes as unclear, and the surrogate outcomes (systolic BP/diastolic BP) as possible positive effect. For cardiac arrhythmias or conduction abnormalities we rated the health outcomes as unclear and the surrogate outcome (time to arrhythmia detection) as likely positive effect. The findings were “unclear” regarding PGHD interventions for diabetes prevention, sleep apnea, stroke, Parkinson’s disease, and chronic obstructive pulmonary disease. Most studies did not report harms related to PGHD interventions; the relatively few harms reported were minor and transient, with event rates usually comparable to harms in the control groups. Few studies reported cost-effectiveness analyses, and only for PGHD interventions for hypertension, coronary artery disease, and chronic obstructive pulmonary disease; the findings were variable across different chronic conditions and devices. Patient adherence to PGHD interventions was highly variable across studies, but patient acceptance/satisfaction and usability was generally fair to good. However, device engineers independently evaluated consumer wearable and handheld BP monitors and considered the user experience to be poor, while their assessment of smartphone-based electrocardiogram monitors found the user experience to be good. Student volunteers involved in device usability testing of the Weight Watchers Online app found it well-designed and relatively easy to use. Implications. Multiple randomized controlled trials (RCTs) have evaluated some PGHD technologies (e.g., pedometers, scales, BP monitors), particularly for obesity and hypertension, but health outcomes were generally underreported. We found evidence suggesting a possible positive effect of PGHD interventions on health outcomes for four chronic conditions. Lack of reporting of health outcomes and insufficient statistical power to assess these outcomes were the main reasons for “unclear” ratings. The majority of studies on PGHD technologies still focus on non-health-related outcomes. Future RCTs should focus on measurement of health outcomes. Furthermore, future RCTs should be designed to isolate the effect of the PGHD intervention from other components in a multicomponent intervention.