Evaluation of the Quality and Readability of Online Sources on the Diagnosis and Management of Osteochondral Lesions of the Ankle

Objective: Patients frequently use the internet as a source to obtain health information. The purpose of this study was to evaluate the quality and readability of online resources on the diagnosis and treatment of ankle osteochondral lesions (OCLs). Design: Three search terms (“ankle cartilage defect,” “cartilage injury,” “ankle cartilage damage”) were entered into 3 search engines (Google, Yahoo, and Bing). The first 20 websites from each search was collected excluding websites intended for health care providers. The quality of the websites were evaluated using the DISCERN instrument, JAMA benchmark, and a Quality rating criteria specific to ankle OCL. The readability was assessed using Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL). Statistical analysis was performed using one-way analysis of variance. Results: A total of 41 websites were reviewed. The mean quality ratings were poor across the assessment tools: DISCERN = 38.5 ± 9.0 (range, 23.7-56.7) out of 80; JAMA = 1.0 ± 1.1 (range, 0-3.3) out of 4; and Quality rating criteria = 11.3 ± 4.6 (range, 4-20.7) out of 24. The mean FRE and FKGL were 40.7 ± 32.0 (range, −152.3 to 60.2) and 13.5 ± 10.8 (range, 8.4-80.7), respectively; higher than the recommended reading level for patients (fifth grade). Conclusions: The quality and readability of credible sources for ankle OCL were poor, which could lead to misinformation. This study should guide the improvement of online information on ankle OCL.

Download Full-text

Quality and Readability of Online Information on In-Office Vocal Fold Injections

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489419887406 ◽

2019 ◽

Vol 129 (3) ◽

pp. 294-300

Author(s):

Grace S. Yi ◽

Amanda Hu

Keyword(s):

Health Care ◽

Patient Education ◽

Health Care Providers ◽

Grade Level ◽

Vocal Fold ◽

Online Information ◽

Care Providers ◽

Vocal Fold Injection ◽

The Mean ◽

Google Search

Objectives: Vocal fold injection augmentations are increasingly being performed in the office setting on awake patients, as opposed to the operating room. These procedures thus require patient cooperation and education. As the Internet is a widely-used resource for patients, our aim was to assess the quality and readability of online resources on in-office awake vocal fold injections. Methods: An online Google search using the terms “office vocal fold injection medialization” and “awake vocal fold injection” was conducted. The first 50 English-language websites were categorized into professional- and patient-targeted, and major and minor sources. They were analyzed using the Flesch Reading Ease Score (FRES), Flesch-Kincaid Grade Level (FKGL) test, and DISCERN quality score. Results: Fifty websites were evaluated, and the overall DISCERN score was 2.60 ± 1.01, the mean FRES was 32.16 ± 19.10, and the mean FKGL was 13.76 ± 4.12. Between the 25 professional-targeted and 25 patient-targeted websites, professional-targeted sites had significantly higher DISCERN ( P < .05) and FKGL ( P < .05) scores, and lower FRES ( P < .05) scores. Between the 30 major and 20 minor websites, major websites had significantly lower FRES ( P < .05) and higher FKGL ( P < .05) scores, and there was a trend toward significance for higher DISCERN scores ( P = .052). Conclusions: Our study shows that half of the top Google results for our topic were not written for patient education, but rather for health care professionals. The reading level of this information exceeds the recommended grade level for patient education materials, and may be less comprehensible than intended. While patient-targeted materials are easier to read than professional-targeted sites, they are of lower quality. The quality of the available online information on this topic is suboptimal for both patients and health care providers. This research highlights the need for more appropriate patient education materials given low health literacy rates.

Download Full-text

Nurses’ knowledge and practices related to pain assessment in critically ill patients in a selected private hospital in Bangladesh

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20183957 ◽

2018 ◽

Vol 5 (10) ◽

pp. 4219 ◽

Cited By ~ 1

Author(s):

Sipra Mondol ◽

Faisal Muhammad ◽

A. B. M. Alauddin Chowdhury

Keyword(s):

Critically Ill ◽

Health Care Providers ◽

Pain Assessment ◽

Subjective Experience ◽

Sampling Technique ◽

Care Providers ◽

Cross Sectional ◽

Management Interventions ◽

The Mean ◽

Nurses Knowledge

Background: Most of the time pain is difficult to assess and manage because of being inherently a subjective experience influenced by multiple factors. The perception and tolerance of pain may vary because of different psychological and social influences of the patient. Therefore it is important for health care providers to assess the pain so that individualized management interventions can be provided. This study was aimed to assess the nurses’ knowledge and practices related to pain assessment in critically ill patients.Methods: A descriptive cross-sectional study was carried out among 200 registered nurses working at different ICU in Square Hospital. The study was conducted within April to August 2017. A non-probability purposive sampling technique was used. The data was collected using pre-tested self-administered semi-structured questionnaire and it was analysed using SPSS 22.0 version.Results: About 81% of the respondents were in the age group 22-32 years and the mean age of the respondents was 27.74±12.06 years. About 79.0% of the respondents were female and 59.5% of the respondents had diploma in nursing. The mean monthly income of the respondents’ was 19450.5 taka. The majority (59.5%) of the respondents had less than 2 years’ service experience. About 85.5% of the respondents said it is important to assess the pain and need for analgesia before, during, and after wound care.Conclusions: Our findings reported that the nurses were reasonably knowledgeable about the principles of pain assessment. More than four-fifths of the respondents had adequate knowledge about pain assessment.

Download Full-text

Nurses’ Knowledge, Attitude, and Performance about Disaster Management: A Case of Iran

The Open Public Health Journal ◽

10.2174/1874944502013010441 ◽

2020 ◽

Vol 13 (1) ◽

pp. 441-446

Author(s):

Sedighe S. T. Far ◽

Milad A. Marzaleh ◽

Nasrin Shokrpour ◽

Ramin Ravangard

Keyword(s):

Disaster Management ◽

Health Care Providers ◽

Work Experience ◽

Three Dimensions ◽

Teaching Hospitals ◽

Care Providers ◽

Medical Sciences ◽

Significant Relationships ◽

The Mean ◽

And Performance

Background: Iran is a disaster-prone country in which many natural and man-made disasters happen every year. Because the health sector is vital due to its nature of treatment and rehabilitation of the injured after the disasters, all health care providers, especially hospital nurses, should be prepared to provide the services they need. Objective: The present study aimed to determine the level of knowledge, attitude, and performance of nurses about disaster management in teaching hospitals affiliated to Iran, Shiraz University of Medical Sciences in 2019. Methods: This cross-sectional and descriptive-analytical study was conducted on a sample of 230 nurses working in the teaching hospitals of Iran, Shiraz University of Medical Sciences, who were selected using the stratified sampling proportional to size and simple random sampling methods. The data were collected using a valid and reliable questionnaire containing 20 questions in three dimensions of knowledge, attitude, and performance. Then, the collected data were analyzed using SPSS 25.0 through independent samples t-test, ANOVA and Tukey tests at the significance level of 5%. Results: The results showed that the highest and lowest mean scores were related to the attitude (2.38±0.19) and knowledge (1.70±0.50) of the nurses, respectively. However, all three dimensions were at a moderate level. The results showed significant relationships between the mean score of performance and the gender, marital status, age, and work experience of the nurses. In addition, statistically significant relationships were found between the mean score of knowledge and their age and work experience (p<0.05). Conclusion: According to the findings, the following suggestions can be made to increase the knowledge and performance of the nurses for being prepared in critical situations: reducing the duration and increasing the quality of training classes and workshops on disaster preparedness; providing some incentives for nurses, especially female, married, older, and more experienced ones to attend these classes; and improving the methods of training materials related to disaster management.

Download Full-text

Job satisfaction and its related factors in health care providers and health workers in Esfarayen

Evidence Based Health Policy Management and Economics ◽

10.18502/jebhpme.v3i2.1221 ◽

2019 ◽

Author(s):

Ahmad Sadeghi ◽

Hasan Jafari ◽

Hossein Rouhani ◽

Akram Zhianifard ◽

Maryam Siavashi

Keyword(s):

Job Satisfaction ◽

Health Care ◽

Health Care Providers ◽

Health Care Organizations ◽

Health Workers ◽

Demographic Variables ◽

Care Providers ◽

Related Factors ◽

Care Workers ◽

The Mean

Introduction: Job Satisfaction in Health care organizations is one of the important pillars of health promotion, due to the role they play in the prevention, care and treatment. The aim of this study was to determine the job satisfaction and its related factors in health workers in Esfarayen. Methods: This descriptive-analytical study was carried out on 140 health care workers in Esfarayen in 2017. Data was collected using Herzberg job satisfaction questionnaire, and data were analyzed using ANOVA and t-test in SPSS21 software. Results: The mean age of participant was 37 ± 8.34. Most of them were female (70%) and married (85.5%). The average of job satisfaction was 61.45 ± 7.65 (out of 100). The highest job satisfaction score was work ability (73.54 ± 1.08) and the lowest score belonged to supervision ( 49.15 ± 5.73). Among the demographic variables, Job satisfaction was significantly associated with Employment Status (P<0.05). Conclusion: Despite employees have job satisfaction, factors that increase job satisfaction of employees should be considered by the relevant authorities. Establishing suitable job standards, fair and reasonable salary, and the creation of facilities in the workplace can lead to improved employee satisfaction and, consequently, improved service quality.

Download Full-text

Perceived Discrimination and Reported Trust and Satisfaction in African Americans: The Jackson Heart Study

Ethnicity & Disease ◽

10.18865/ed.27.3.209 ◽

2017 ◽

Vol 27 (3) ◽

pp. 209 ◽

Cited By ~ 10

Author(s):

LáShauntá M. Glover ◽

Mario Sims ◽

Karen Winters

Keyword(s):

African Americans ◽

Health Care Providers ◽

Perceived Discrimination ◽

Discrimination Score ◽

Care Providers ◽

Jackson Heart Study ◽

Cross Sectional ◽

Heart Study ◽

The Mean ◽

Everyday Discrimination

Objectives: 1) To examine the association of multiple dimensions of discrimination with reported trust and satisfaction with providers; 2) to report within-group differences among African Americans (AAs). Methods: Descriptive cross sectional study. The study population included AAs aged 35 to 84 years from the Jackson Heart Study (JHS) (N=5,301). Poisson regression (PR) was used to quantify the association between perceived discrimination and reported trust and satisfaction with providers before and after controlling for selected characteristics. Main Measures: Measures of perceived discrimination included everyday, lifetime, burden from lifetime discrimination, and stress from discrimination. Outcomes included trust and satisfaction with providers. Results: The mean everyday discrimination score was 2.11 (SD±1.02), and the mean lifetime discrimination score was 2.92 (SD±2.12). High (vs low) levels of everyday discrimination were associated with a 3% reduction in the prevalence of trust in providers (PR .97, 95% CI .96, .99) in all models. In fully-adjusted models, high (vs low) lifetime discrimination was associated with a 4% reduction in the prevalence of trust and satisfaction (PR .96, 95% CI .95, .98). Burden of discrimination was not associated with trust or satisfaction, but stress from discrimination was inversely associated with satisfaction. Conclusions: The significant association between discrimination and mistrust and dissatisfaction suggests that health care providers should be made aware of AA perceptions of discrimination, which likely affects their levels of trust and satisfaction.Ethn Dis. 2017;27(3):209-216; doi:10.18865/ed.27.3.209

Download Full-text

Expert Perspectives on Hereditary Angioedema: Key Areas for Advancements in Care across the Patient Journey

Allergy & Rhinology ◽

10.2500/ar.2016.7.0165 ◽

2016 ◽

Vol 7 (3) ◽

pp. ar.2016.7.0165 ◽

Cited By ~ 7

Author(s):

Aleena Banerji ◽

Murat Baş ◽

Jonathan A. Bernstein ◽

Isabelle Boccon-Gibod ◽

Maria Bova ◽

...

Keyword(s):

Health Care Providers ◽

Hereditary Angioedema ◽

Delayed Diagnosis ◽

Scientific Data ◽

Online Information ◽

Care Providers ◽

C1 Inhibitor Deficiency ◽

Patient Journey ◽

Diagnosis And Management ◽

Awareness Campaigns

Background Published literature documents the substantial burden of hereditary angioedema (HAE) with C1 inhibitor deficiency on the quality of life and work productivity of patients. However, despite advances in the field and the availability of guidelines to advise health care providers (HCP) on the diagnosis and management of HAE, there are still many challenges to overcome. For example, delayed diagnosis and misdiagnosis are common, and treatment practices vary worldwide. Objective An international expert panel was convened to consider opportunities for improvements that would benefit patients with HAE. Methods Based on professional and personal experiences, the experts developed schematics to describe the journey of patients through the following stages: (1) onset of symptoms and initial evaluation; (2) referral/diagnosis; and (3) management of HAE. More importantly, the panel identified key areas in which it was possible to optimize the support provided to patients and HCPs along this journey. Results Overall, this approach highlighted the need for wider dissemination of algorithms and scientific data to more effectively educate HCPs from multiple disciplines and the need for more research to inform appropriate treatment decisions. Furthermore, HAE awareness campaigns, accurate online information, and referral to patient advocacy groups were all considered helpful approaches to support patients. Conclusion More detailed and widespread information on the diagnosis and management of HAE is needed and may lead to advancements in care throughout the journey of the patient with HAE.

Download Full-text

Consumer Behavior in Online Risky Purchase Decisions

International Journal of Online Marketing ◽

10.4018/ijom.2018040101 ◽

2018 ◽

Vol 8 (2) ◽

pp. 1-26 ◽

Cited By ~ 3

Author(s):

Kenneth David Strang

Keyword(s):

Consumer Behavior ◽

Health Care Providers ◽

Information Sources ◽

Financial Institution ◽

Online Marketing ◽

Online Information ◽

Purchase Decisions ◽

Care Providers ◽

Online Social Media ◽

Trust Beliefs

There is very little research about how consumers of different races trust online marketing information from businesses or government when making expensive purchase decisions such as cancer treatment medicine. In this article, a large cross-cultural sample was surveyed to evaluate trust belief levels for common online information sources when making risky purchase decisions. Trust belief levels of online information sources were significantly different across ethnicity and gender when making risky decision. Females across all ethnicities held higher trust beliefs for online information sources, and Asian females in particular had the highest trust beliefs for online data from library research to health care providers. Trust belief levels were lower for online social media and bank/financial institution online information sources for risky purchase decisions. These findings can be used by leaders, political authorities, and consumer behavior marketing managers to segment consumers by demographic characteristics.

Download Full-text

Impact of Health Insurance on Health Care Utilisation and Out-of-Pocket Health Expenditure in Vietnam

BioMed Research International ◽

10.1155/2020/9065287 ◽

2020 ◽

Vol 2020 ◽

pp. 1-16

Author(s):

Nguyen Thi Thu Thuong ◽

Tran Quang Huy ◽

Do Anh Tai ◽

Tran Nhuan Kien

Keyword(s):

Health Care ◽

Health Insurance ◽

Health Care Providers ◽

Health Care Utilisation ◽

Health Coverage ◽

Care Providers ◽

Care Utilisation ◽

The Mean ◽

Number Of Visits ◽

Universal Health

Background. In recent years, health insurance (HI) has been chosen by many low- and middle-income countries to obtain an important health policy target—universal health coverage. Vietnam has recently introduced the Revised Health Insurance Law, and the effects of the voluntary health insurance (VHI) and heavily subsidised health insurance (HSHI) programmes have not yet been analysed. Therefore, this study is aimed at examining the impact of these HI programmes on the utilisation of health care services and out-of-pocket health expenditure (OOP) in general and across different health care providers in particular. Methods. Using the two waves of Vietnam Household Living Standard Surveys 2014 and 2016 and the difference-in-difference method, the impacts of VHI and HSHI on health care utilisation and OOP in Vietnam were estimated. Results. For both the VHI and HSHI groups, we found that HI increased the probability of seeking outpatient care, the mean number of outpatient visits, the total number of visits, and the mean number of visits at the district level of health care providers in the last 12 months. However, there was no evidence that the HSHI programmes increased the mean number of inpatient visits and the number of visits at the provincial hospital. We also found that while the VHI programme reduced OOP for both outpatient and inpatient care, the HSHI scheme did not result in a reduction in OOP for hospitalisation, although HI lowered the total OOP. Similarly, we found that for both groups, HI reduced OOP when the insured visited district and provincial hospitals. However, the statistically significant impact was not demonstrated when the enrolees of HSHI programmes visited provincial hospitals. Conclusion. The study offers evidence that the Vietnamese HI scheme increased health care service utilisation and decreased OOP for the participants of the VHI and HSHI programmes. Therefore, the government should continue to consider improving the HI system as a strategy to achieve universal health coverage.

Download Full-text

What Is the Price and Claimed Efficacy of Platelet-Rich Plasma Injections for the Treatment of Knee Osteoarthritis in the United States?

The Journal of Knee Surgery ◽

10.1055/s-0038-1669953 ◽

2018 ◽

Vol 32 (09) ◽

pp. 879-885 ◽

Cited By ~ 8

Author(s):

Nicolas S. Piuzzi ◽

Mitchell Ng ◽

Ariel Kantor ◽

Kenneth Ng ◽

Stephanie Kha ◽

...

Keyword(s):

United States ◽

Standard Deviation ◽

Knee Osteoarthritis ◽

Clinical Efficacy ◽

Health Care Providers ◽

Platelet Rich Plasma ◽

The United States ◽

Care Providers ◽

Knee Oa ◽

The Mean

AbstractPlatelet-rich plasma (PRP) injections are often used for the treatment of knee osteoarthritis (OA), despite clinical value and cost-effectiveness not being definitely established. PRP injections are considered as a potential means of reducing pain and improving function in patients with knee OA, in the hope of delaying or avoiding the need for surgical intervention. Centers that offer PRP injections usually charge patients out of pocket and directly market services. Therefore, the purpose of this study was to quantify the current (1) prices and (2) marketed clinical efficacy of autologous PRP injections for knee OA. A prospective cross-sectional study was performed based on 286 centers identified in the United States offering PRP injections for knee OA. A total of 179 (73.4%) centers were successfully contacted via e-mail or phone, using a simulated 52-year-old male patient with knee OA. Scripted questions were asked by the simulated patient to determine the current marketed prices and clinical efficacy, either reported as “good results” or “symptomatic improvement,” claimed by each treating center. The mean price for a single unilateral knee same-day PRP injection was $714 with a standard deviation of $144 (95% confidence interval [CI]: $691–737, n = 153). The mean claim of clinical efficacy was 76% with a standard deviation of 11% (95% CI: 73.5–78.3%, n = 84). Out of the 84 clinics, 10 claimed “90 to 100% efficacy,” 27 claimed “80 to 90%,” 29 claimed “70 to 80%,” 9 claimed “60 to 70%,” 8 claimed “50 to 60%,” and 1 claimed “40 to 60%.” These findings provide a unique perspective on the PRP market for the treatment of knee OA that is valuable to physicians and health care providers in providing better education to patients on the associated costs and purported clinical benefits of PRP injections.

Download Full-text

Upper Extremity Surgery in Tetraplegia and the Online Information Void

Hand ◽

10.1177/1558944719878835 ◽

2019 ◽

pp. 155894471987883

Author(s):

Shuting Zhong ◽

Gabriella E. Reed ◽

Loree K. Kalliainen

Keyword(s):

Upper Extremity ◽

Health Care Providers ◽

Key Words And Phrases ◽

Online Information ◽

Care Providers ◽

Online Content ◽

Nerve Transfers ◽

Extremity Function ◽

Surgical Options ◽

Upper Extremity Function

Background: People with tetraplegia lack awareness of, and subsequently underutilize, reconstructive surgery to improve upper extremity function. This is a topic of international discussion. To bridge the information gap, proposed mandates encourage providers to discuss surgical options with all tetraplegic patients. Outside of the clinical setting, little is known about information available to patients and caregivers—particularly online. The purpose of this study is to evaluate online content for surgical options for improved upper extremity function for people with tetraplegia. Methods: A sample of online content was generated using common search engines and 2 categories of key words and phrases, general and specific. Articles on the first 2 search pages were evaluated for content and audience. Results: A total of 76 different search results appeared on the first 2 pages using 8 unique search phrases. Of articles generated from general phrases, only 5% mentioned tendon or nerve transfers in tetraplegia. When more specific key search phrases were used, the number of lay articles increased to 71%. Conclusions: Based on initial results, general online information on the management of tetraplegia largely excludes discussions of upper limb reconstruction and the well-known benefits. Unless patients, their caregivers, and nonsurgical health care providers have baseline knowledge of tendon and/or nerve transfers, they are unlikely to obtain de novo awareness of surgical options with self-initiated searches. Thus, the challenge and opportunity is to revise the online dialogue to include upper extremity surgery as a fundamental tenet of tetraplegia care.

Download Full-text