How do patients respond to safety problems in ambulatory care? Results of a retrospective cross-sectional telephone survey

ObjectivesPatients in German ambulatory care frequently report patient safety problems (PSP). It is unclear whether patients report PSP back to their general practitioner (GP) or specialist in charge. This study reports on how patients respond to experienced PSP.DesignRetrospective cross-sectional study.SettingComputer-assisted telephone interviews (CATI) with randomly recruited citizens aged ≥40 years in Germany.Participants10 037 citizens ≥40 years. About 52% of the interviewees were female, 38% were between 60 and 79 years old and about 47% reported that they were chronically ill. A total of 2589 PSPs was reported.Primary and secondary measures/ResultsAccording to the respondents (n=1422, 77%, 95% CI: 74.7 to 79.1), 72% (95% CI: 70.2 to 73.7) of PSP were reported back to the GP in charge or to another GP/specialist. Further reactions were taken by 65% (95% CI: 62.5 to 67.5) of the interviewees: around 63% (95% CI: 62.5 to 66.2) of the reported PSP led to a loss of faith in the physician or to complaints. χ2 and binary logistic regression analyses show significant associations between the (a) reporting and (b) reaction behaviour and determinants like ‘medical treatment area’ ((a) χ2=17.13, p=0.009/(b) χ2=97.58, p=0.000), ‘PSP with/without harm’ ((a) χ2=111.84, p=0.000/(b) χ2=265.39, p=0.000) and sociodemographic characteristics when respondents are aged between 40 and 59 years ((a) OR 2.57/(b) OR 2.60) or have chronic illnesses ((a) OR 2.16/(b) OR 2.14).ConclusionThe data suggest that PSPs are frequently reported back to the GP or specialist in charge and have a significant serious impact on the physician–patient relationship. Much could be learnt from the patient reporting and reacting behaviour to prevent PSPs in ambulatory care.

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Falsified Drugs in the Opinion of Patients Diagnosed with Cardiovascular Diseases—Nationwide and Cross-Sectional Study on the Example of EU-Member Country

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18073823 ◽

2021 ◽

Vol 18 (7) ◽

pp. 3823

Author(s):

Damian Świeczkowski ◽

Szymon Zdanowski ◽

Piotr Merks ◽

Miłosz Jaguszewski

Keyword(s):

Cardiovascular Diseases ◽

Chronically Ill ◽

Cross Sectional Study ◽

Control Group ◽

Computer Assisted ◽

Study Group ◽

Sectional Study ◽

Cross Sectional ◽

Telephone Interviews ◽

Falsified Medicines

Background: In light of a falsified medications pandemic, understanding the patient perspective on falsified medicines is warranted. Our study aimed to investigate the perspectives regarding falsified medicines among patients with cardiovascular diseases. Methods: Computer-assisted telephone interviews were conducted based on a questionnaire: (i) Respondents suffering from cardiovascular diseases and (ii) respondents not being chronically ill. Only participants below 50 years of age were included. Results: We enrolled 1200 respondents total, 800 in the study group and 400 in the control group (in cooperation with a professional public opinion research center). The vast majority of participants agreed that community pharmacies are the only place that ensures the secure purchasing of non-falsified drugs (67.01% study group and 65.25% control group; p < 0.01). The majority of respondents were convinced that purchasing medications on the Internet is associated with a higher risk of receiving falsified drugs. Patients diagnosed with cardiovascular diseases and those with “non-satisfactory financial situation” had significantly decreased likelihoods of obtaining a high score in general knowledge on falsified medications (OR = 0.64 and OR = 0.58, respectively). Conclusions: Awareness of the risks associated with falsified drugs among patients with cardiovascular diseases remains high but still insufficient.

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Patient safety in ambulatory care from the patient's perspective: a retrospective, representative telephone survey

BMJ Open ◽

10.1136/bmjopen-2019-034617 ◽

2020 ◽

Vol 10 (2) ◽

pp. e034617

Author(s):

Max Geraedts ◽

Svenja Krause ◽

Michael Schneider ◽

Annette Ortwein ◽

Johannes Leinert ◽

...

Keyword(s):

Patient Safety ◽

Medical Treatment ◽

Ambulatory Care ◽

Outpatient Surgery ◽

Diagnostic Procedures ◽

Cross Sectional Study ◽

Patient Experiences ◽

Additional Treatment ◽

Computer Assisted ◽

Cross Sectional

ObjectivesData on patient safety problems (PSPs) in ambulatory care are scarce. The aim of the study was to record the frequency, type, severity and point of origin of PSPs in ambulatory care in Germany.DesignRetrospective cross-sectional study.SettingComputer-assisted telephone interviews with randomly recruited citizens aged ≥40 years in Germany who were asked about their experiences with PSPs in ambulatory care.Participants10 037 citizens ≥40 years.MeasuresA new questionnaire was developed to record patient experiences with PSPs in ambulatory care. The study reported here targets patient experiences in the last 12 months. The questionnaire focuses on PSPs in seven areas of medical treatment: anamnesis/diagnostic procedures; medication; vaccination, injection, infusion; aftercare; outpatient surgery; office administration; other areas. For each PSP reported, detailed questions were asked about the specialist group concerned, and, on the most serious harm, the severity of the harm and its consequences. The target parameters are presented as proportions with 95% CIs.Results1422 of the respondents (14%) reported 2589 PSPs. The areas most frequently affected by PSPs were anamnesis/diagnostic procedures (61%) and medication (15%). General practitioners accounted for 44% of PSPs, orthopaedists for 15% and internists for 10%. 75% of PSPs were associated with harm, especially unnecessarily prolonged pain or deterioration of health; 35% of PSPs led to permanent harm. 804 PSPs (32%) prompted patients to see another doctor for additional treatment; 255 PSPs (10%) required inpatient treatment.ConclusionPSPs experienced by patients are widespread in ambulatory care in Germany. The study reveals in which areas of medical treatment efforts to prevent PSPs could make the greatest contribution to improving patient safety. It also demonstrates the valuable contribution of patient reports to the analysis of PSPs.

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Is there a relationship between gestational diabetes and postpartum depression?

Current Women s Health Reviews ◽

10.2174/1573404816999200918115133 ◽

2020 ◽

Vol 16 ◽

Author(s):

Salman Khazaei ◽

Erfan Ayubi ◽

Saeid Bashirian ◽

Ronak Hamzehei ◽

Ensiyeh Jenabi

Keyword(s):

Gestational Diabetes ◽

Postpartum Depression ◽

Odds Ratio ◽

Depression Scale ◽

Binary Logistic Regression ◽

Cross Sectional Study ◽

University Education ◽

P Value ◽

Cross Sectional ◽

The Relationship

Background: The relationship between gestational diabetes and postpartum depression (PPD) is poorly understood and seldom studied. Objective: In an effort to explore this issue, the present study investigated the relationship between gestational diabetes and PPD. Methods: The present cross-sectional study was performed with 342 women who were referred to four urban health centers of Hamadan city, west of Iran. We used convenience sampling as a method to recruit women in each health center. We used a researcher-made checklist for gathering data on socio-demographic characteristics and potential risk factors of PPD. The Persian validated version of the Edinburgh Postnatal Depression Scale (EPDS) was used to assess PPD. Univariate and multivariable binary logistic regression was applied to estimate the odds ratio (OR) (95% confidence interval [CI]). Results: Gestational diabetes was identified as the most important risk factor for PPD with OR (95% CI) of 2.19 (1.11, 4.31); P-value=0.02 after adjusting for other variables. Moreover, the adjusted odds ratio showed that PPD among lesseducated women (primary school) was 3.5 times higher compared to women with a university education (OR=3.54, 95% CI: 1.27, 9.84; P-value=0.01). Conclusion: Our findings suggested that PPD is more likely among women with gestational diabetes and those who were less educated. Interventional and educational activities for reducing the risk of PPD can be targeted for use with this population.

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Hubungan Budaya Organisasi dengan Intensi Turnover di Rumah Sakit Awal Bros Batam

Jurnal Endurance ◽

10.22216/jen.v4i3.4609 ◽

2019 ◽

Vol 4 (3) ◽

pp. 464

Author(s):

Endang Sulastri ◽

Yulastri Arif ◽

Utari Christhya Wardhani

Keyword(s):

Organizational Culture ◽

Interpersonal Relationships ◽

Turnover Intention ◽

Random Sampling ◽

Binary Logistic Regression ◽

Cross Sectional Study ◽

Sectional Study ◽

Chi Square ◽

Cross Sectional ◽

Good Communication

Intensi turnover pada institusi pelayanan kesehatan merupakan masalah serius dan harus segera ditindaklanjuti, karena akan berdampak terhadap kualitas sumber daya manusia yang dapat mempengaruhi dalam pemberian pelayanan kesehatan kepada pasien. Intensi turnover di Rumah Sakit Awal Bros Batam sejak lima tahun terakhir diatas standar rata-rata turnover dan Rumah Sakit belum mempunyai stategi yang efektif untuk mencegahnya. Tujuan penelitian ini untuk menganalisis hubungan budaya organisasi dengan risiko intensi turnover di Rumah Sakit Awal Bros Batam. Metode penelitian menggunakan desain kuantitatif dengan cross sectional study. Pengambilan sampel kuantitatif menggunakan kuesioner berdasarkan proposional random sampling, Chi Square dan Uji Regresi Logistic Berganda (Binary Logistic). Hasil penelitian menunjukkan bahwa budaya organisasi di Rumah Sakit Awal Bros Batam mempunyai hubungan yang bermakna dengan intensi turnover dengan nilai pValue 0.005. Saran yang dapat diberikan peneliti adalah menciptakan suasana kerja yang kondusif dengan menjaga hubungan interpersonal dan komunikasi yang baik antar karyawan maupun atasan. The intention of turnover in health care institutions is a serious problem and must be followed up immediately, because it will have an impact on the quality of human resources that can affect the delivery of health services to patients. The intention of the turnover in Batam Awal Bros Hospital since the last five years is above the average turnover standard and the Hospital does not yet have an effective strategy to prevent it. The purpose of this study was to analyze the relationship between organizational culture and risk of turnover intention at Awal Bros Batam Hospital. The research method uses quantitative design with cross sectional study. Quantitative sampling using a questionnaire based on proportional random sampling, data processing using the mean, Chi Square and Binary Logistic Regression Test. The results showed that the organizational culture in Batam Awal Bros Hospital had a significant relationship with turnover intention with a pValue 0.005. Suggestions that can be given by researchers is establish a conducive work atmosphere by maintaining interpersonal relationships and good communication between employees and superiors

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The number of household members as a risk factor for peptic ulcer disease

Scientific Reports ◽

10.1038/s41598-021-84892-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Mi Hong Yim ◽

Keun Ho Kim ◽

Bum Ju Lee

Keyword(s):

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Binary Logistic Regression ◽

Cross Sectional Study ◽

Living Alone ◽

Cross Sectional ◽

Ulcer Disease ◽

Logistic Regression Models ◽

Household Members ◽

H Pylori

AbstractPeptic ulcer disease (PUD) is caused by many sociodemographic and economic risk factors other than H. pylori infection. However, no studies reported an association between PUD and the number of household members. We showed the number of family members affected by PUD based on sex in a Korean population. This cross-sectional study used 1998–2009 data from the Korea National Health and Nutrition Examination Survey of the Korea Centers for Disease Control and Prevention. Multiple binary logistic regression models adjusted for confounders were constructed to analyze the association of PUD with the number of household members. The number of household members was associated with PUD, age, body mass index (BMI), waist circumference, systolic blood pressure, hemoglobin, glucose, location (urban/rural), income, education level, stress, current drinking, and smoking in both sexes. Men with other household members had a higher PUD risk compared to men or women living alone (reference), and the opposite was observed for women. Men with 4 household members had a higher PUD risk than men living alone in the model adjusted for age, BMI, income, location, education, and stress (OR = 2.04 [95% CI 1.28–3.27], p value = .003). Women with more than 6 household members had a lower PUD risk than women living alone in the adjusted model (OR = 0.50 [0.33–0.75], p value = .001). Women with more household members had a lower PUD risk. However, more men had PUD than women regardless of the number of household members.

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Timely Initiation of Breast Feeding and Associated Factors among Caesarian Section Delivered Mothers in Health Facilities of Dessie City Administration, North Eastern Ethiopia

Pediatric Reports ◽

10.3390/pediatric13010001 ◽

2020 ◽

Vol 13 (1) ◽

pp. 1-8

Author(s):

Roza Shiferaw ◽

Sisay Eshete Tadesse ◽

Tefera Chane Mekonnen ◽

Aregash Abebayehu Zerga

Keyword(s):

Cesarean Section ◽

Breast Feeding ◽

Associated Factors ◽

Statistical Significance ◽

Data Entry ◽

Binary Logistic Regression ◽

Cross Sectional Study ◽

Cross Sectional ◽

Timely Initiation ◽

Eastern Ethiopia

Objective: To assess the magnitude and associated factors of timely initiation of breastfeeding among cesarean section delivered mothers. Methods: A health facility-based cross-sectional study was employed among 421 systematically selected mothers from February to June, 2017. Data were collected by a structured questionnaire. Data entry and analysis was done using Epi Data and SPSS version 24. Binary logistic regression was computed to identify factors. Adjusted odds ratio with a 95% confidence interval was used to declare statistical significance. Result: The magnitude of timely initiation of breast feeding (among mothers who gave birth by cesarean section was 57%. Counseling during antenatal care (AOR = 3.32; 95% CI: 1.80, 6.13), facility where cesarean section (CS) was performed (AOR = 2.55; 95% CI: 1.57, 4.14), and post-CS counseling (AOR = 6.93; 95% CI: 3.99, 12.02) were factors that contributed for the practice of timely initiation among cesarean section delivered mothers. Conclusions: The magnitude of TIBF was good. Counseling during ANC, the facility where CS was performed and post-natal advice were factors associated with TIBF. Implementation of baby-friendly hospital initiatives should be strengthened in order to promote timely initiation of breast feeding.

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Predictors of COVID-19-Related Perceived Improvements in Dietary Health: Results from a US Cross-Sectional Study

Nutrients ◽

10.3390/nu13062097 ◽

2021 ◽

Vol 13 (6) ◽

pp. 2097

Author(s):

Kelly Cosgrove ◽

Christopher Wharton

Keyword(s):

Dietary Habits ◽

Eating Habits ◽

Binary Logistic Regression ◽

Cross Sectional Study ◽

Lifestyle Changes ◽

Income Loss ◽

Cross Sectional ◽

Healthy Eating Habits ◽

Health Related ◽

Survey Responses

The COVID-19 pandemic resulted in substantial lifestyle changes. No US study has identified predictors of perceived dietary healthfulness changes during the pandemic period. This study included analyses of lifestyle and dietary healthfulness changes using 958 survey responses from US primary household food purchasers. Information was collected related to demographics, COVID-19-related household changes, and health-related habits before and during the pandemic. Binary logistic regression identified predictors of perceived increase in dietary healthfulness during the pandemic period. Overall, 59.8%, 16.4%, and 23.4% of participants reported that their eating habits likely changed, may have changed, and likely did not change, respectively. Of the participants whose dietary habits likely or may have changed, 64.1%, 16.8%, and 19% reported healthier, neither healthier nor less healthy, and less healthy eating habits, respectively. COVID-19-related income loss, more meals consumed with household members in front of the television, an increase in food advertisement exposure, increased perceived stress, and better perceived current health were significant predictors of a perceived increase in dietary healthfulness. Overall, dietary habits were perceived to become healthier during the pandemic. The predictors of perceived improvement in dietary healthfulness were surprising and indicate the need for further study of these factors in crisis and noncrisis situations.

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Women’s perceptions of factors influencing their food shopping choices and how supermarkets can support them to make healthier choices

BMC Public Health ◽

10.1186/s12889-021-11112-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Preeti Dhuria ◽

Wendy Lawrence ◽

Sarah Crozier ◽

Cyrus Cooper ◽

Janis Baird ◽

...

Keyword(s):

Healthy Eating ◽

Personal Responsibility ◽

Food Preferences ◽

Food Choices ◽

Cross Sectional Study ◽

Future Research ◽

Cross Sectional ◽

Telephone Interviews ◽

Food Shopping ◽

Women’S Perceptions

Abstract Objectives To examine women’s perceptions of factors that influence their food shopping choices, particularly in relation to store layout, and their views on ways that supermarkets could support healthier choices. Design This qualitative cross-sectional study used semi-structured telephone interviews to ask participants the reasons for their choice of supermarket and factors in-store that prompted their food selections. The actions supermarkets, governments and customers could take to encourage healthier food choices were explored with women. Thematic analysis was conducted to identify key themes. Setting Six supermarkets across England. Participants Twenty women customers aged 18–45 years. Results Participants had a median age of 39.5 years (IQR: 35.1, 42.3), a median weekly grocery spend of £70 (IQR: 50, 88), and 44% had left school aged 16 years. Women reported that achieving value for money, feeling hungry, tired, or stressed, and meeting family members’ food preferences influenced their food shopping choices. The physical environment was important, including product quality and variety, plus ease of accessing the store or products in-store. Many participants described how they made unintended food selections as a result of prominent placement of unhealthy products in supermarkets, even if they adopted more conscious approaches to food shopping (i.e. written or mental lists). Participants described healthy eating as a personal responsibility, but some stated that governments and supermarkets could be more supportive. Conclusions This study highlighted that in-store environments can undermine intentions to purchase and consume healthy foods. Creating healthier supermarket environments could reduce the burden of personal responsibility for healthy eating, by making healthier choices easier. Future research could explore the interplay of personal, societal and commercial responsibility for food choices and health status.

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Antibiotic Prescriptions among China Ambulatory Care Visits of Pregnant Women: A Nationwide Cross-Sectional Study

Antibiotics ◽

10.3390/antibiotics10050601 ◽

2021 ◽

Vol 10 (5) ◽

pp. 601

Author(s):

Houyu Zhao ◽

Mei Zhang ◽

Jiaming Bian ◽

Siyan Zhan

Keyword(s):

Pregnant Women ◽

Ambulatory Care ◽

National Level ◽

Mainland China ◽

Antibiotic Use ◽

First Trimester ◽

Cross Sectional Study ◽

Cross Sectional ◽

Fetal Safety ◽

First Trimester Of Pregnancy

Background: Antibiotic use in pregnant women at the national level has rarely been reported in China. Objectives: We aimed to investigate antibiotic prescriptions during pregnancy in ambulatory care settings in China. Methods: Data of 4,574,961 ambulatory care visits of pregnant women from October 2014 to April 2018 were analyzed. Percentages of Antibiotic prescriptions by different subgroups and various diagnosis categories and proportions of inappropriate antibiotic prescriptions for different subgroups were estimated. Food and Drug Administration (FDA) pregnancy categories were used to describe the antibiotic prescription patterns. The 95% confidence intervals (CIs) were estimated using the Clopper––Pearson method or Goodman method. Results: Among the 4,574,961 outpatient visits during pregnancy, 2.0% (92,514 visits; 95% CI, 2.0–2.0%) were prescribed at least one antibiotic. The percentage of antibiotic prescriptions for pregnant women aged >40 years was 4.9% (95% CI, 4.7–5.0%), whereas that for pregnant women aged 26–30 years was 1.5% (95% CI, 1.4–1.5%). In addition, percentages of antibiotic prescriptions varied among different trimesters of pregnancy, which were 5.4% (95% CI, 5.3–5.4%) for the visits in the first trimester of pregnancy and 0.5% (95% CI, 0.4–0.5%) in the third trimester of pregnancy. Furthermore, the percentages of antibiotic prescriptions substantially varied among different diagnosis categories and nearly three-quarters of antibiotic prescriptions had no clear indications and thus might be inappropriate. In total, 130,308 individual antibiotics were prescribed; among these, 60.4% (95% CI, 60.0–60.8%) belonged to FDA category B, 2.7% (95% CI, 2.1–3.5%) were classified as FDA category D and 16.8% (95% CI, 16.2–17.4%) were not assigned any FDA pregnancy category. Conclusions: Antibiotic prescriptions in ambulatory care during pregnancy were not highly prevalent in mainland China. However, a substantial proportion of antibiotics might have been prescribed without adequate indications. Antibiotics whose fetal safety has not been sufficiently illustrated were widely used in pregnant women.

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