Evaluation of the relationship between patient expectation, patient expectation coverage rates and patient satisfaction in open primary septorhinoplasty surgery: a prospective randomized study

SUMMARY The positive impact on patient comprehension and improved procedural outcomes when multimedia is utilized to convey instructions preprocedurally has been previously shown for gastrointestinal procedures such as colonoscopy. However, in gastroesophageal reflux testing (GERD), we continue to utilize verbal and written instructions to establish this diagnosis when we use BRAVO pH testing. This is arguably a more complex procedure involving stopping medications, placement of a device, and maintaining an accurate diary for the duration of the testing. We hypothesize that by utilizing multimedia to relay complex textual information, patients will have improved comprehension of periprocedural instructions thereby improving data entry and satisfaction of expectations during the procedure. Prospective randomized study of 120 patients undergoing endoscopic placement of the BRAVO pH monitoring capsule for evaluation of GERD receive either written preoperative instructions (control) or written plus video instructions (video group). A composite comprehension score was calculated using procedure-specific parameters of data entry over the 48-hour monitoring period. Patient satisfaction was evaluated on the basis of a five-point Likert scale. Extent of patient satisfaction was defined by the fulfillment of patient expectations. Exclusion criteria included patients who did not have access to the video or did not complete follow-up. Seventy-eight patients completed all follow-up evaluations. The video group (n = 44) had a significantly higher mean comprehension score when compared to the control group (n = 34) (9.6 ± 1.4 vs. 7.4 ± 2.0, P = 0.01). Overall satisfaction with instructions was significantly higher in the intervention group (91% vs. 47%, p 0.01). We detected no significant difference in comprehension or satisfaction scores in subgroup analyses of the video group comparing patients <65 and ≥65 years of age and by education level. Compared to standard written instructions, video instructions improved patient comprehension based on data evaluation, and satisfaction. Therefore, clinicians should consider incorporation of multimedia instructions to enhance patient periprocedural expectations and understanding of reflux pH testing using the BRAVO procedure.

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A Prospective Randomized Study of Endoscopic versus Conventional Harvesting of the Radial Artery

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0000000000000386 ◽

2017 ◽

Vol 12 (4) ◽

pp. 231-238 ◽

Cited By ~ 6

Author(s):

Bob B. Kiaii ◽

Stuart A. Swinamer ◽

Stephanie A. Fox ◽

Larry Stitt ◽

Mackenzie A. Quantz ◽

...

Keyword(s):

Patient Satisfaction ◽

Wound Infection ◽

Radial Artery ◽

Artery Bypass ◽

Randomized Study ◽

Open Group ◽

Prospective Randomized Study ◽

Harvesting Technique ◽

Endoscopic Group

Objective The aims of the study were to determine whether endoscopic harvesting of the radial artery (RA) reduces morbidity due to pain, infection, and disability with improvement in satisfaction and cosmesis compared to the conventional technique and (2) to compare the 6-month angiographic patency of the RA harvested conventionally and endoscopically. Methods In a prospective randomized study, 119 patients undergoing coronary artery bypass grafting using the RA were randomized to have RA harvested either conventionally (n = 59) or endoscopically (n = 60). Results Radial artery harvest time (open wound time) was significantly reduced in the endoscopic group (36.5 ± 9.4 vs 57.7 ± 9.4 minutes, P < 0.001). Only one patient developed wound infection (1.6%) in the endoscopic group compared with six patients (10.2%), P = 0.061, in the conventional group. Although this was not statistically significant, clinically this was relevant in terms of reduction in postoperative morbidity. Postoperative pain in the arm incision was significantly lower in the endoscopic group at postoperative day 2 ( P < 0.001) and at discharge ( P < 0.001) and similar to the conventional open group at 6 weeks’ follow-up ( P = 0.103). Overall patient satisfaction and cosmesis were significantly better in the endoscopic group at postoperative day 2 ( P < 0.001), at discharge ( P < 0.001), and at 6 weeks’ follow-up ( P < 0.001). There was no difference in the arm disability postoperatively ( P = 0.505) between the two groups. Six-month angiographic assessment of 23 patients (12 endoscopic and 11 open) revealed no difference in the patency rate (10/12 in endoscopic and 9/11 in open group). Conclusions Endoscopic RA harvesting reduced the incidence of postoperative wound infection and wound pain and improved patient satisfaction and cosmesis compared with conventional harvesting technique. There was no difference in the 6-month angiographic patency of the RA harvested conventionally and endoscopically.

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The Relationship Between Circulating Bone Morphogenetic Protein-4 and Inflammation Cytokines in Patients Undergoing Thoracic Surgery: A Prospective Randomized Study

Journal of Inflammation Research ◽

10.2147/jir.s324775 ◽

2021 ◽

Vol Volume 14 ◽

pp. 4069-4077

Author(s):

Xu Zhao ◽

Jitao Zhang ◽

Wenjuan Zhang ◽

Ruping Dai ◽

Junmei Xu ◽

...

Keyword(s):

Thoracic Surgery ◽

Bone Morphogenetic Protein ◽

Randomized Study ◽

Prospective Randomized Study ◽

Bone Morphogenetic Protein 4 ◽

Morphogenetic Protein ◽

The Relationship ◽

Inflammation Cytokines

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Comparison between the Efficacy of 5% Imiquimod Cream and Intralesional Triamcinolone Acetonide in the Prevention of Recurrence of Excised Ear Keloid: A Prospective Randomized Study

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2020.05.10222 ◽

2020 ◽

Vol 103 (5) ◽

pp. 423-427

Keyword(s):

Patient Satisfaction ◽

Triamcinolone Acetonide ◽

Recurrence Rate ◽

Randomized Study ◽

Surgical Excision ◽

Prospective Randomized Study ◽

Imiquimod Cream ◽

Non Invasive ◽

One Year ◽

Injection Materials

ackground: Ear keloid scars represents an abnormal, exaggerated healing response after skin injury. In addition to cosmetic concern, scars may cause pain, pruritus, or contractures. Nowadays, topical therapies have increased because they are easy to use, comfortable, and non-invasive. The 5% imiquimod cream has been reported as effective to prevent the recurrence of ear keloid after surgical excision. Objective: To evaluate the efficacy of 5% imiquimod cream in decreasing the recurrence rate of keloid after surgical excision, when compared with triamcinolone acetonide injection. Materials and Methods: Thirty patients, which included 6.67% male and 93.33% female, enrolled in a prospective-randomized study. Sixteen patients were informed to use triamcinolone injection (10 mg/mL) and 14 patients were informed to apply 5% imiquimod cream (nightly every other day) for 12 weeks after the ear keloid was excised and the stitches removed. Results: The 30 patients were examined of recurrence of ear keloids on their ears for 48 weeks after surgical excision. The overall mean of Vancouver Scar Scale at one year for evaluating the effectiveness of imiquimod to decrease recurrence rate when compared with triamcinolone acetonide injection showed at 6.50 and 4.25 respectively. The patient satisfaction was slightly higher in triamcinolone group. However, the two outcomes, the Vancouver Scar Scale (p=0.389) and the patient satisfaction (p=0.833), were not statistically significant. No serious local and systemic adverse event was detected in either groups of patients. Conclusion: Treatment of surgical excision ear keloids with triamcinolone acetonide injection might be a better selection as compared to imiquimod cream for effectiveness in term of lower recurrence rate and higher patient satisfaction. A limitation of the present study is the number of the patients. Keywords: Keloid, Imiquimod, Triamcinolone acetate, Recurrence of ear keloid

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Endoscopic Plantar Fascia Release versus Cryosurgery for the Treatment of Chronic Plantar Fasciitis: A Prospective Randomized Study

Journal of the American Podiatric Medical Association ◽

10.7547/18-082 ◽

2019 ◽

Vol 110 (5) ◽

Author(s):

Bilgehan Çatal ◽

Ali Bilge ◽

Ragıp Gökhan Ulusoy

Keyword(s):

Patient Satisfaction ◽

Plantar Fasciitis ◽

Outcome Measurement ◽

Randomized Study ◽

Surgical Techniques ◽

Plantar Fascia ◽

Prospective Randomized Study ◽

American Orthopaedic ◽

Plantar Fascia Release

Background In a prospective randomized study, we compared two different surgical techniques used in plantar fasciitis surgery. Methods Forty-eight patients diagnosed as having plantar fasciitis and treated for at least 6 months with no response to conservative modalities were included in this study. The patients were randomly assigned to receive endoscopic plantar fascia release (EPFR) or cryosurgery (CS). Patients were evaluated using the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS-AHS) as a primary outcome measurement at baseline and 3 weeks and 3, 6, and 12 months after surgery. At the final follow-up visit, the Roles-Maudsley score was used to determine patient satisfaction. Results Five patients did not complete the 1-year follow-up examination (one in the EPFR group and four in the CS group). Thus, the study group included 43 patients. Although both groups showed significant improvement at the final evaluation, the patients in the EPFR group had significantly better AOFAS-AHS scores at 3 months. The success rate (Roles-Maudsley scores of excellent and good) in the EPFR group at 12 months was 87% and in the CS group was 65%. Conclusions Both EPFR and CS were associated with statistically significant improvements at 1-year follow-up. At 3-month follow-up, EPFR was associated with better results and a higher patient satisfaction rate compared with CS.

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