Patient experience with healthcare: Feedback for a Post COVID-19 clinic at a tertiary care center in rural area

Purpose: Post-acute sequelae of SARS-CoV-2 infection(PASC) is a complex condition with multi-system involvement. We assessed patients perspectives and experience with a PASC clinic established at University of Iowa in June 2020. Methods: We conducted a mixed-method survey in June 2021 to ask PASC clinic patients about 1) PASC symptoms and their impact on physical and mental health, and cognition using the PROMIS Global Health and Cognitive Function abilities items, and 2) satisfaction with clinic services and referrals, barriers to care, and recommended support resources. Findings: Ninety-seven patients (97/277, 35% response rate) completed the survey. Most were women(67%, n=65/97), Caucasian(93%, n=90/97) and received outpatient care during acute COVID-19 illness (79%). Fifty percent reported wait time of 1-3 months and 40% traveled >1 hour for the appointment at PASC clinic. The most common symptoms >3 months from initial infection were fatigue (77%), brain fog (73%), exercise intolerance (73%), anxiety (63%), sleep difficulties (56%) and depression (44%). A minority of patients reported significantly reduced functioning (≥1.5 SD below mean) of their physical health (22.5%), mental health (15.9%) and cognitive abilities (17.6%). Qualitative analysis of open-ended answers added valuable context to quantitative results. Satisfaction with clinical services was high though participants identified barriers to care including scheduling delays and financial concerns. Respondents suggested potential strategies for optimizing recovery including continuity of care, a co-located multispecialty clinic and being provided with timely information from emerging research. Conclusion: Our study reports high PASC symptom burden, its impact on health and patient experience with healthcare. It is important that primary healthcare professionals listen to patients with empathy and support them during recovery. Healthcare systems and policymakers should focus on accessible, comprehensive, and patient-centered integrated care.

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Impact of patient characteristics on the Canadian Patient Experiences Survey–Inpatient Care: survey analysis from an academic tertiary care centre

BMJ Open ◽

10.1136/bmjopen-2018-021575 ◽

2018 ◽

Vol 8 (8) ◽

pp. e021575 ◽

Cited By ~ 2

Author(s):

Fraser D Rubens ◽

Diana M Rothwell ◽

Amal Al Zayadi ◽

Sudhir Sundaresan ◽

Tim Ramsay ◽

...

Keyword(s):

Mental Health ◽

Inpatient Care ◽

Tertiary Care ◽

Survey Analysis ◽

Physical And Mental Health ◽

Cross Sectional Survey ◽

Significant Difference ◽

Key Driver ◽

Driver Analysis ◽

Canadian Patient

ObjectiveTo determine the role of patient demographics, care domains and self-perceived health status in the analysis and interpretation of results from the Canadian Patient Experience Survey–Inpatient Care.DesignCross-sectional survey.SettingSingle large Canadian two campus tertiary care academic centre.ParticipantsRandom sampling of hospital patients postdischarge.Intervention and main outcome measuresLogistic regression models were developed to analyse topbox scoring on four questions of global care (rate experience, recommend hospital, rate hospital, overall helped). Means of each composite domain were correlated to the four overall scores at the patient level to determine Spearman’s rank correlation coefficients which were plotted against the overall (hospital) domain score for the key driver analysis.ResultsTopbox scoring was decreased with worse degrees of perceived physical and mental health in all four global questions (p<0.05). Female gender and higher levels of education were associated with worse scoring on rate experience, recommend hospital and rate hospital (p<0.001). Whereas there was a significant difference between hospital departments in unadjusted measures, these differences were no longer evident after adjustment with patient covariates. Key driver analysis identified person-centred care, care transition and the domain related to emergency admission as areas of highest potential for improvement.ConclusionsGlobal measures of overall care are influenced by patient-perceived physical and mental health. Caution should be exercised in using patient-satisfaction surveys to compare performance between different healthcare provision entities, as apparent differences could be explained by variation in patient mix rather than variation in performance.

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From hospital to post-acute care organizations: the relationship between patient experience and health recovery

International Journal for Quality in Health Care ◽

10.1093/intqhc/mzaa095 ◽

2020 ◽

Vol 32 (9) ◽

pp. 585-590

Author(s):

Generosa Do Nascimento ◽

Francisco Guilherme Nunes ◽

Janet E Anderson

Keyword(s):

Mental Health ◽

Health Status ◽

Acute Care ◽

Patient Experience ◽

Short Form ◽

Mental Health Status ◽

Patient Questionnaire ◽

Discharge Process ◽

Physical And Mental Health ◽

Post Acute Care

Abstract Objective To determine to what extent patient health status and recovery in post-acute care organizations (PACO) is related to patient experience of the discharge process from hospital and to patient experience while staying in these facilities. Design Longitudinal study of patients discharged from hospitals to PACO. Setting 12 hospitals and 14 PACO Portuguese organizations. Participants 181 patients participated in the both stages of data gathering. Main Outcome Measures Patients’ physical and mental health status was measured through the 36-item short form health survey scale. The experience of transition from hospital to PACO was measured with the Care Transition Measure. The Picker Adult In-Patient Questionnaire was used to measure patients’ experience in these organizations. Results Patients reporting better physical condition in PACO had a better experience on discharge [b = 0.21, 95% confidence interval, CI (0.10, 0.31)] and perceive fewer problems inside facilities [b = − 0.19, 95% CI (−0.31, 0.08)]. The experience in PACO is significantly related to patients’ mental health status [b = − 0.47, 95% CI (−0.59, − 0.36)]. Patients showing higher levels of physical recovery had a better experience on discharge [b = − 0.18, 95% CI (0.08, 0.28)], while those registering better mental recovery experienced fewer problems during their stay [b = − 0.41, 95% CI (−0.52, − 0.30)]. Conclusions PACO play a key role in maintaining and promoting patients’ health, and this goal is influenced by their experience both in the transition from hospitals to PACO and while staying in these facilities.

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Admission experiences of psychiatric patients in tertiary care: An implication toward Mental Health Care Bill, 2013

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.193527 ◽

2017 ◽

Vol 08 (01) ◽

pp. 089-095 ◽

Cited By ~ 2

Author(s):

Vijayalakshmi Poreddi ◽

Rajalakshmi Ramu ◽

Sugavana Selvi ◽

Sailaxmi Gandhi ◽

Lalitha Krishnasamy ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Psychiatric Hospital ◽

Psychotic Disorders ◽

Psychiatric Patients ◽

Care Center ◽

Tertiary Care ◽

Perceived Coercion ◽

Negative Pressures

ABSTRACT Background: Coercion is not uncommon phenomenon among mental health service users during their admission into psychiatric hospital. Research on perceived coercion of psychiatric patients is limited from India. Aim: To investigate perceived coercion of psychiatric patients during admission into a tertiary care psychiatric hospital. Materials and Methods: This was a cross-sectional descriptive survey carried out among randomly selected psychiatric patients (n = 205) at a tertiary care center. Data were collected through face-to-face interviews using structured questionnaire. Results: Our findings revealed that participants experienced low levels of coercion during their admission process. However, a majority of the participants were threatened with commitment (71.7%) as well as they were sad (67.8%), unpleased (69.7%), confused (73.2%), and frightened (71.2%) with regard to hospitalization into a psychiatric hospital. In addition, the participants expressed higher levels of negative pressures (mean ± standard deviation, 3.76 ± 2.12). Participants those were admitted involuntarily (P > 0.001), diagnosed to be having psychotic disorders (P > 0.003), and unmarried (P > 0.04) perceived higher levels of coercion. Conclusion: The present study showed that more formal coercion was experienced by the patients those got admitted involuntarily. On the contrary, participants with voluntary admission encountered informal coercion (negative pressures). There is an urgent need to modify the Mental Health Care (MHC) Bill so that treatment of persons with mental illness is facilitated. Family member plays an important role in providing MHC; hence, they need to be empowered.

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The pattern of problematic internet use and mental health-related internet use among psychiatric outpatients at a tertiary care center

Tzu Chi Medical Journal ◽

10.4103/tcmj.tcmj_50_19 ◽

2020 ◽

Vol 32 (2) ◽

pp. 198

Author(s):

YatanPal Singh Balhara ◽

Swarndeep Singh ◽

Rachna Bhargava

Keyword(s):

Mental Health ◽

Internet Use ◽

Care Center ◽

Tertiary Care ◽

Problematic Internet Use ◽

Tertiary Care Center ◽

Psychiatric Outpatients ◽

Health Related

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Quality of life among caregivers of thalassaemic children, attending at Thalassaemia control unit of a rural tertiary care hospital, in a sub-Himalayan district of West Bengal

The Journal of Community Health Management ◽

10.18231/j.jchm.2021.037 ◽

2022 ◽

Vol 8 (4) ◽

pp. 163-168

Author(s):

Tushar Kanti Saha ◽

Kallol Bhandari ◽

Eashin Gazi ◽

Arup Jyoti Rout ◽

Samir Dasgupta

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Short Form ◽

Tertiary Care ◽

Control Unit ◽

Abnormal Development ◽

Care Hospital ◽

Physical And Mental Health ◽

Cross Sectional

Thalassaemia is a disease of abnormal development of red blood cells which manifests as anaemia. This chronic disease may cause mental, social, financial burdens on the families, care givers and also on health care system.To assess the quality of life (QOL) of the caregivers of thalassaemic children and to identify the predictors of quality of their physical and mental health.Institution based descriptive cross-sectional study conducted in the Thalassaemia Control Unit (TCU) of North Bengal Medical College (NBMC) from December 2018 to April 2019. Total 136 caregivers of children (≤12 years) with thalassaemia were included by complete enumeration method. Physical and mental health of the caregivers were reported in Short Form-36 (SF-36) Health Survey. Collected data were entered into MS-Excel, analysed with the help of SPSS (Version 22).Mean age of caregivers was 34.3 (SD ± 1.4 years). Most of caregivers were female (89%) and had educational qualification up to Primary school (45.6%). Majority (70.6%) of the caregivers were the mothers of the children. Most of the study participants (60.3%) had favourable Physical health Component Summary (PCS) but 64.7% of the caregivers had unfavourable Mental health component Summary (MCS). Educational status was found to be the predictor for PCS but age and relationship with the child were the predictors for MCS.Counselling, psychotherapy, social support for family members or caregivers of the thalassaemic children and community involvement with their full participation should be emphasized to reduce stigma related to thalassaemia.

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Assessment and comparison of the mental health status of patients seeking psychiatry facilities in prelockdown and postlockdown period of the COVID-19 Pandemic: An ambispective study in a tertiary care center in a Hilly Region of North India

Archives of Medicine and Health Sciences ◽

10.4103/amhs.amhs_64_21 ◽

2021 ◽

Vol 9 (1) ◽

pp. 95

Author(s):

Sunny Garg ◽

Devesh Sharma ◽

Anchal Sharma ◽

DineshDutt Sharma ◽

Nidhi Sharma ◽

...

Keyword(s):

Mental Health ◽

Health Status ◽

Care Center ◽

Tertiary Care ◽

Mental Health Status ◽

North India ◽

Tertiary Care Center ◽

Hilly Region

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Attitude of Non-Mental Health Professionals Towards Mental Illness in a Tertiary Care Center

INDIAN JOURNAL OF MENTAL HEALTH AND NEUROSCIENCES ◽

10.32746/ijmhns.2019.v2.i2.23 ◽

2019 ◽

Vol 2 (02) ◽

pp. 23-28

Author(s):

Nishad P. M. A. ◽

Dilshana N. B. ◽

Anil Kakunje ◽

Ravichandra K. ◽

Kamran Chisty

Keyword(s):

Mental Health ◽

Mental Illness ◽

Mental Health Professionals ◽

Health Professionals ◽

Health Care Professionals ◽

Psychiatric Illness ◽

Positive Attitude ◽

Care Center ◽

Tertiary Care ◽

Primary Objective

BACKGROUND Mental and behavioral disorders are major health problems. Stigma can prevent the care and treatment of the mentally ill. There is a gross underestimation of psychiatric comorbidities among patients by non-mental health professionals. A positive attitude of these health professionals has a crucial role in the treatment of patients suffering from psychiatric illness. The primary objective of the study is to study the attitude of various nonmental health professionals towards mental illness. METHODS It is a crosssectional descriptive study, conducted in a private medical college in Mangalore, Karnataka in India. The study had 76 participants consisting of doctors and nurses. Instruments used were a semi-structured demographic proforma and Mental illness: Clinicians Attitude Scale - Version 4 (MICA-4). MICA-4 is a 16- item scale used for assessing attitude towards mental illness. RESULTS The total number of subjects included was 76 among which doctors constituted 57 and nurses 19. As the experience and age of the participants increased, a shift to the positive attitude towards psychiatric illness was noted. Specialist doctors had a higher positive attitude compared to non-specialist medical graduates and nurses. CONCLUSIONS It is essential to have structured training in psychiatry for all health care professionals.

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Impact of the COVID-19 pandemic on Suicide and Self Harm among Patients Presenting to the Emergency Department of a Teaching Hospital in Nepal

10.1101/2020.10.16.20213769 ◽

2020 ◽

Author(s):

Roshana Shrestha ◽

Shisir Siwakoti ◽

Saumya Singh ◽

Anmol Purna Shrestha

Keyword(s):

Mental Health ◽

Care Center ◽

Tertiary Care ◽

Clinical Profile ◽

Organophosphate Poisoning ◽

P Value ◽

Health Crisis ◽

Period 2 ◽

Self Harm ◽

The Impact

ABSTRACTBackgroundThe COVID-19 pandemic is a global challenge that is not just limited to the physical consequences but also a significant degree of a mental health crisis. Self-harm (SH) and suicide are its extreme effects. The aim of this study was to provide an overview of the impact of the COVID-19 pandemic on the occurrence and clinical profile of suicide and SH in our ED.MethodsThis is a cross-sectional observational study conducted in the ED of a tertiary care center. Records of all fatal and nonfatal SH patients presenting to the ED during the lockdown period (March 24-June 23, 2020; Period1), matching periods in the previous year (March 24-June 23,2019; Period 2) and 3 months period prior (December 24 2019-March 23, 2020; Period 3) was included by searching the electronic medical record (EMR) system. The prevalence and the clinical profile of the patients were compared between these three periods.ResultsA total of 125 (periods 1=55, 2=38, and 3=32) suicide and SH cases were analyzed. The cases of suicide/SH had increased by 44% and 71.9% during the lockdown period in comparison to the period 2 and 3. Organophosphate poisoning was the most common mode. Females were predominant in all three periods with a mean age of 32 (95%CI: 29.3-34.7). There was a significant delay in arrival of the patients in period 1 (p-value=0.045) with increased hospital admission (p-value =0.009) and in-hospital mortality (18.2% vs 2.6 % and 3.1%) (p-value=.001).ConclusionWe found an increase in patients presenting with suicide and SH in our ED during the pandemic which is likely to reflect an increased prevalence of mental illness in the community. We hope that the result will prime all mental health care stakeholders to initiate mental health screening and intervention for the vulnerable population during this period of crisis.

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Attitude of Non-Mental Health Professionals Towards Mental Illness in a Tertiary Care Center

INDIAN JOURNAL OF MENTAL HEALTH AND NEUROSCIENCES ◽

10.32746/10.32746/ijmhns.2019.v2.i2.23 ◽

2019 ◽

Vol 2 (02) ◽

pp. 23-28

Author(s):

Nishad P. M. A. ◽

Dilshana N. B. ◽

Anil Kakunje ◽

Ravichandra K. ◽

Kamran Chisty

Keyword(s):

Mental Health ◽

Mental Illness ◽

Mental Health Professionals ◽

Health Professionals ◽

Health Care Professionals ◽

Psychiatric Illness ◽

Positive Attitude ◽

Care Center ◽

Tertiary Care ◽

Primary Objective

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Characteristics of frequent users of the emergency department with chronic pain

CJEM ◽

10.1017/cem.2019.464 ◽

2020 ◽

Vol 22 (3) ◽

pp. 350-358

Author(s):

Yaadwinder Shergill ◽

Danielle Rice ◽

Catherine Smyth ◽

Steve Tremblay ◽

Jennifer Nelli ◽

...

Keyword(s):

Mental Health ◽

Emergency Department ◽

Chronic Pain ◽

Abdominal Pain ◽

High Frequency ◽

Tertiary Care ◽

Chronic Abdominal Pain ◽

Primary Concern ◽

Physical And Mental Health ◽

Ed Visits

ABSTRACTObjectivesTo identify the proportion of high-frequency users of the emergency department (ED) who have chronic pain.MethodsWe reviewed medical records of adult patients with ≥ 12 visits to a tertiary-care, academic hospital ED in Canada in 2012-2013. We collected the following demographics: 1) patient age and sex; 2) visit details – number of ED visits, inpatient admissions, length of inpatient admissions, diagnosis, and primary location of pain; 3) current and past substance abuse, mental health and medical conditions. Charts were reviewed independently by two reviewers. ED visits were classified as either “chronic pain” or “not chronic pain” related.ResultsWe analyzed 4,646 visits for 247 patients, mean age was 47.2 years (standard deviation = 17.8), and 50.2% were female. This chart review study found 38% of high-frequency users presented with chronic pain to the ED and that women were overrepresented in this group (64.5%). All high-frequency users presented with co-morbidities and/or mental health concerns. High-frequency users with chronic pain had more ED visits than those without and 52.7% were prescribed an opioid. Chronic abdominal pain was the primary concern for 54.8% of high-frequency users presenting with chronic pain.ConclusionsChronic pain, specifically chronic abdominal pain, is a significant driver of ED visits among patients who frequently use the ED. Interventions to support high-frequency users with chronic pain that take into account the complexity of patient's physical and mental health needs will likely achieve better clinical outcomes and reduce ED utilization.

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