scholarly journals Patients’ perspective on supposedly patient-relevant process and outcome parameters: a cross-sectional survey within the ‘PRO patients study’

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Christine Kersting ◽  
Julia Hülsmann ◽  
Klaus Weckbecker ◽  
Achim Mortsiefer
Keyword(s):  
Scoping Review ◽  
Care Process ◽  
Free Text ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Outcome Parameters ◽  
Processes Of Care ◽  
Age Related ◽  
Process And Outcome ◽  
Patients Perspective

Abstract Background To be able to make informed choices based on their individual preferences, patients need to be adequately informed about treatment options and their potential outcomes. This implies that studies measure the effects of care based on parameters that are relevant to patients. In a previous scoping review, we found a wide variety of supposedly patient-relevant parameters that equally addressed processes and outcomes of care. We were unable to identify a consistent understanding of patient relevance and therefore aimed to develop an empirically based concept including a generic set of patient-relevant parameters. As a first step we evaluated the process and outcome parameters identified in the scoping review from the patients’ perspective. Methods We conducted a cross-sectional survey among German general practice patients. Ten research practices of Witten/Herdecke University supported the study. During a two-week period in the fall of 2020, patients willing to participate self-administered a short questionnaire. It evaluated the relevance of the 32 parameters identified in the scoping review on a 5-point Likert scale and offered a free-text field for additional parameters. These free-text answers were inductively categorized by two researchers. Quantitative data were analyzed using descriptive statistics. Bivariate analyses were performed to determine whether there are any correlations between rating a parameter as highly relevant and patients’ characteristics. Results Data from 299 patients were eligible for analysis. All outcomes except ‘sexuality’ and ‘frequency of healthcare service utilization’ were rated important. ‘Confidence in therapy’ was rated most important, followed by ‘prevention of comorbidity’ and ‘mobility’. Relevance ratings of five parameters were associated with patients’ age and gender, but not with their chronic status. The free-text analysis revealed 15 additional parameters, 12 of which addressed processes of care, i.e., ‘enough time in physician consultation’. Conclusion Patients attach great value to parameters addressing processes of care. It appears as though the way in which patients experience the care process is not less relevant than what comes of it. Relevance ratings were not associated with chronic status, but few parameters were gender- and age-related. Trial registration Core Outcome Measures in Effectiveness Trials Initiative, registration number: 1685.

scholarly journals Perioperative nutrition care and dietetic practices in the scope of bariatric surgery in Saudi Arabia using adapted protocols for evaluation

2021 ◽  
Vol 9 ◽  
pp. 205031212110361
Author(s):  
Elham Abbas Aljaaly
Keyword(s):  
Bariatric Surgery ◽  
Saudi Arabia ◽  
Care Process ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Nutrition Risk ◽  
Nutrition Care ◽  
Management Protocol ◽  
Perioperative Nutrition

Objectives: This study evaluates the availability of perioperative nutritional care protocols and the practices of bariatric registered dietitians in Saudi Arabia. The primary outcomes of the study were conducted using an adapted American survey “with permission.” Methods: A cross-sectional survey of a selected 32 dietitians providing bariatric services completed a self-administered online questionnaire from 12 hospitals in Jeddah, Saudi Arabia. Results: All surveyed dietitians were females, mainly Saudi nationals (93.9%, n = 30), and accredited by the Saudi Commission for Health Specialties (93.8%, n = 30). Only 37.5% (n = 6) of the dietitians were specialized in bariatric surgery. Perioperative common practices of dietitians included a conduct of screening for nutrition risk before (44%, n = 14) and after surgery (62.5%, n = 20) and applied a nutrition management protocol that is mainly based on the application of nutrition care process (62.5%, n = 20). Dietitians (81%, n = 26) reported the importance of having standardized protocols for nutritional management of patients undoing bariatric surgery, where 69% (n = 22) confirmed the availability of pre-operative written protocols in hospitals and 75% (n = 24) confirmed the existence of post-operative protocols. Pre-operative practices included using approaches for weight loss before surgery, for example, very low and low-calorie diet. Dietitians (25%, n = 8) see two to ten patients per month. The sleeve gastrectomy procedure is the most often performed surgery. Conclusion: This is the first study to evaluate the perioperative nutrition care protocols and practices related to bariatric surgery in Saudi Arabia. Perioperative bariatric protocols are available, but some dietitians are not aware of their availability and contents. Researchers emphasize the importance of creating national protocols by the Saudi Credentials Body to standardize practices within the field.

Side effects following COVID-19 vaccination: A cross-sectional survey with age-related outcomes in Saudi Arabia

2021 ◽  
Vol 11 (3) ◽  
pp. 119-125
Author(s):  
Ahlam Alghamdi ◽  
Alnada Ibrahim ◽  
Mohammed Alraey ◽  
Afrah Alkazemi ◽  
Isra Alghamdi ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Side Effects ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Age Related

scholarly journals Cross-sectional survey of the undergraduate rheumatology curriculum in European medical schools: a EULAR School of Rheumatology initiative

RMD Open ◽  
2018 ◽  
Vol 4 (2) ◽  
pp. e000743 ◽  
Author(s):  
Abhishek Abhishek ◽  
Annamaria Iagnocco ◽  
J W J Bijlsma ◽  
Michael Doherty ◽  
Frédéric Lioté
Keyword(s):  
Musculoskeletal Diseases ◽  
Site Response ◽  
Joint Infection ◽  
Medical Schools ◽  
Calcium Pyrophosphate ◽  
Free Text ◽  
Curriculum Content ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Additional Information

ObjectivesTo survey the undergraduate rheumatic and musculoskeletal diseases (RMDs) curriculum content in a sample of medical schools across Europe.MethodsThe undergraduate musculoskeletal diseases and disability curriculum of University of Nottingham, UK, was used as a template to develop a questionnaire on curriculum content. The questionnaire elicited binary (yes/no) responses and included the option to provide additional information as free text. The survey was mailed to members of the European League Against Rheumatism (EULAR) School of Rheumatology (Undergraduate Classroom) and to EULAR Standing Committee on Education and Training members in January 2017, with a reminder in February 2017.ResultsResponses were received from 21 schools belonging to 11 countries. Assessment of gait, hyperalgesic tender site response and hypermobility were not included in many curricula. Similarly, interpretation of investigations undertaken on synovial fluid was taught in only 16 schools. While disease-modifying anti-rheumatic drugs and biological agents, and urate-lowering treatment were included in the curricula of 20 and 21 institutions, respectively, only curricula from 18 schools included core non-pharmacological interventions. Osteoarthritis, gout, rheumatoid arthritis, spondyloarthropathy, polymyalgia rheumatica and lupus were included in the curriculum of all institutions. However, common RMDs such as calcium pyrophosphate deposition, fibromyalgia, giant cell arteritis and bone and joint infection were included in 19 curricula.ConclusionThis survey highlights areas of similarities and differences in undergraduate curricula across Europe. It is hoped that the results of this survey will catalyse the development and agreement of a minimum core European Curriculum for undergraduate education in RMDs.

Benefits and Challenges of Using Virtual Primary Care During the COVID-19 Pandemic: An International Cross-sectional Survey Study (Preprint)

2021 ◽  
Author(s):  
Edmond Li ◽  
Rosy Tsopra ◽  
Geronimo Jimenez ◽  
Alice Serafini ◽  
Gustavo Gusso ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Delivery ◽  
Lessons Learned ◽  
Survey Study ◽  
Free Text ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Face To Face ◽  
Remote Care

BACKGROUND With the onset of COVID-19, general practitioners (GPs) and patients worldwide swiftly transitioned from face-to-face to digital remote consultations. There is a need to evaluate how this global shift has impacted patient care, healthcare providers, patient and carer experience, and health systems. OBJECTIVE We explored GPs’ perspectives on the main benefits and challenges of using digital remote care. METHODS GPs across 20 countries completed an online questionnaire between June – September 2020. GPs’ perceptions on main barriers and challenges were explored using free-text questions. Thematic analysis was used to analyse the data. RESULTS A total of 1,605 respondents participated in our survey. The benefits identified included reducing COVID-19 transmission risks, guaranteeing access and continuity of care, improved efficiency, faster access to care, improved convenience and communication with patients, greater work flexibility for providers, and hastening the digital transformation of primary care and accompanying legal frameworks. Main challenges included patient’s preference for face-to-face consultations, digital exclusion, lack of physical examinations, clinical uncertainty, delays in diagnosis and treatment, overuse and misuse of digital remote care, and unsuitability for certain types of consultations. Other challenges include the lack of formal guidance, higher workloads, remuneration issues, organisational culture, technical difficulties, implementation and financial issues, and regulatory weaknesses. CONCLUSIONS At the frontline of care delivery, GPs can provide important insights on what worked well, why, and how during the pandemic. Lessons learned can be used to inform the adoption of improved virtual care solutions, and support the long-term development of platforms that are more technologically robust, secure. INTERNATIONAL REGISTERED REPORT RR2-10.2196/30099

scholarly journals Complexities in consultations in case of euthanasia or physician-assisted suicide: a survey among SCEN physicians

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Tessa D. Bergman ◽  
H. Roeline W. Pasman ◽  
Bregje D. Onwuteaka-Philipsen
Keyword(s):  
Psychiatric Disorders ◽  
Assisted Suicide ◽  
Public Debate ◽  
Main Diagnosis ◽  
Physician Assisted Suicide ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Age Related ◽  
Attending Physician ◽  
Complex Cases

Abstract Background In the Netherlands, euthanasia or physician-assisted suicide (EAS) is allowed if due care criteria are met. One criterion is consultation of a second independent physician, often SCEN physicians. The public debate about EAS focuses on patients with psychiatric disorders, dementia, and tired of living, as complex cases. What complexities SCEN physicians perceive during consultation is unknown. This study aims to assess the frequency of EAS consultations that are perceived difficult by SCEN physicians, to explore what complexities are perceived by SCEN physicians during consultation, and to assess what characteristics are associated with difficult consultations. Methods Data from 2015 to 2017 from an annual cross-sectional survey among SCEN physicians was used. In 2015, the survey focused on the most difficult consultation that year and in 2016/2017 on the most recent consultation. Frequencies of coded answers to an open-ended question were done to explore what complexities SCEN physicians perceived during their most difficult consultation. Univariable and multivariable logistic regression analyses were used to assess what characteristics were associated with difficult consultations. Results 21.6% of cases consulted by SCEN physicians is perceived difficult. Complexities that SCEN physicians perceive were mainly in contact with patients (79.7%) and in the assessment of due care criteria (41.0%). Characteristics that were associated with a higher likelihood of a consultation being difficult are the attending physician being less certain to perform the EAS, patients staying in the hospital, main diagnosis heart failure/CVA, and accumulation of age-related health problems/psychiatry/dementia, and the presence of a psychiatric disorder, or psychosocial or existential problems besides the main diagnosis. Characteristics that were associated with a lower likelihood of a consultation being difficult are high patient’s age and physical suffering as reason to request EAS. Conclusion Complexities perceived by SCEN physicians in EAS consultations are not limited to the ‘complex’ cases present in the current public debate about EAS, e.g. patients with psychiatric disorders, dementia, and tired of living. Attention for these complexities in intervision could indicate if there is a need among SCEN physicians to enhance knowledge and skills in training and to receive specific support in intervision on these complexities.

scholarly journals Age-related factors influence HIV testing within subpopulations: a cross-sectional survey of MSM within the Celtic nations

2019 ◽  
Vol 95 (5) ◽  
pp. 351-357
Author(s):  
Jenny Dalrymple ◽  
Kareena McAloney-Kocaman ◽  
Paul Flowers ◽  
Lisa M McDaid ◽  
Jamie Scott Frankis
Keyword(s):  
Hiv Testing ◽  
Online Survey ◽  
Future Research ◽  
Sociocultural Factors ◽  
Health Improvement ◽  
Cross Sectional Survey ◽  
Related Factors ◽  
Cross Sectional ◽  
Factors Influencing ◽  
Age Related

ObjectivesDespite a recent fall in the incidence of HIV within the UK, men who have sex with men (MSM) continue to be disproportionately affected. As biomedical prevention technologies including pre-exposure prophylaxis are increasingly taken up to reduce transmission, the role of HIV testing has become central to the management of risk. Against a background of lower testing rates among older MSM, this study aimed to identify age-related factors influencing recent (≤12 months) HIV testing.MethodsCross-sectional subpopulation data from an online survey of sexually active MSM in the Celtic nations—Scotland, Wales, Northern Ireland and Ireland (n=2436)—were analysed to compare demographic, behavioural and sociocultural factors influencing HIV testing between MSM aged 16–25 (n=447), 26–45 (n=1092) and ≥46 (n=897).ResultsMultivariate logistic regression demonstrated that for men aged ≥46, not identifying as gay (OR 0.62, CI 0.41 to 0.95), location (Wales) (OR 0.49, CI 0.32 to 0.76) and scoring higher on the personalised Stigma Scale (OR 0.97, CI 0.94 to 1.00) significantly reduced the odds for HIV testing in the preceding year. Men aged 26–45 who did not identify as gay (OR 0.61, CI 0.41 to 0.92) were also significantly less likely to have recently tested for HIV. For men aged 16–25, not having a degree (OR 0.48, CI 0.29 to 0.79), location (Republic of Ireland) (OR 0.55, CI 0.30 to 1.00) and scoring higher on emotional competence (OR 0.57, CI 0.42 to 0.77) were also significantly associated with not having recently tested for HIV.ConclusionKey differences in age-related factors influencing HIV testing suggest health improvement interventions should accommodate the wide diversities among MSM populations across the life course. Future research should seek to identify barriers and enablers to HIV testing among the oldest and youngest MSM, with specific focus on education and stigma.

scholarly journals Patient-Reported Use of the After Visit Summary in a Primary Care Internal Medicine Practice

2019 ◽  
Vol 7 (5) ◽  
pp. 703-707
Author(s):  
Sarita Pathak ◽  
Gregory Summerville ◽  
Celia P Kaplan ◽  
Sarah S Nouri ◽  
Leah S Karliner
Keyword(s):  
Primary Care ◽  
Multivariable Analysis ◽  
Free Text ◽  
Primary Care Visit ◽  
Communication Tool ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Visit ◽  
Patient Reported ◽  
Communication Errors

Participants completed a cross-sectional survey about their use of the after visit summary (AVS) at a previous primary care visit. Of 355 participants, 294 (82.8%) recalled receiving it, 67.4% consulted it, 45.9% consulted it more than once, and 31.6% shared the AVS. In multivariable analysis, higher education and older age were associated with AVS consultation. Among the subset of 133 patients recalling personalized free-text instructions, 96% found them easy to understand and 94.4% found them useful. Our findings suggest that the AVS is a useful communication tool and improvement efforts should emphasize clarity for those most vulnerable to communication errors.

Reconsidering the HbA1c Cutoff for Diabetes Diagnosis Based on a Large Chinese Cohort

2019 ◽  
Author(s):  
Jiying Qi ◽  
Yang Su ◽  
Qianqian Song ◽  
Zhaojun Ding ◽  
Min Cao ◽  
...  
Keyword(s):  
Positive Association ◽  
Diabetes Diagnosis ◽  
Middle Aged ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Aged Population ◽  
Diagnosis And Management ◽  
Age Related ◽  
The Difference ◽  
Hba1c Levels

Abstract Introduction The HbA1c has been considered as the ‘gold standard’ in diabetes diagnosis and management, however, age, gender and body mass index (BMI) might have certain effects on HbA1c. We are aiming to further investigate the correlation between age and HbA1c, and whether it was affected by gender and BMI. Methods A cross-sectional survey including 135,893 nondiabetic individuals who took the physical examination between 2013 and 2017 was conducted. The subjects were grouped by gender, age and BMI, and the interactive and independent effects of the 3 factors on the HbA1c were detected. The median and 95% confidence interval (CI) of HbA1c levels were calculated. Results The HbA1c levels gradually increased along with age, both in female and male, and there is a positive association between BMI and the HbA1c. The difference on HbA1c in gender was associated with both age and BMI, the age-related increase in HbAlc was accentuated in the subgroup with higher BMI, and there was a marked accentuation of the positive association between BMI and HbA1c as age increased. In almost all the young and middle-aged (aged 20–59) subgroups, the 97.5th percentiles of HbA1c levels were lower than 6.5%, suggesting that the single HbA1c cutoff value is probably not applicable to the young and middle-aged population. Conclusions We recommend that the effects of age, gender and BMI should be taken into consideration when using HbA1c for the diagnosis and management of diabetes, especially in the young and middle-aged population.

576 Firefighter Post-injury Return to Work: A Balance of Dedication and Obligation

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S130-S130
Author(s):  
Lauren B Nosanov ◽  
Kathleen S Romanowski
Keyword(s):  
Return To Work ◽  
Burn Injury ◽  
Organizational Level ◽  
Free Text ◽  
Cross Sectional Survey ◽  
Post Injury ◽  
Cross Sectional ◽  
Burn Center ◽  
Medical Evaluation ◽  
The Individual

Abstract Introduction Over the duration of firefighters’ careers there exists a high probability of sustaining burn injuries necessitating medical evaluation and treatment. While many are minor and do not significantly affect the ability to work in full capacity, there exists risk for both short and long-term incapacitation. It is not uncommon for firefighters to push for earlier return to work than is medically advisable. However, there are additional external factors which drive premature return to duty. Methods An online cross-sectional survey was sent to firefighters who were members of a statewide Professional Firefighters’ Union. A multiple-choice format was used to assess demographics, injury details, medical care received and return to work. Free text format allowed for elaboration regarding factors influencing decisions to return to work. Results The survey was sent to 30,000 firefighters, with 413 (1.4%) responses received. Excluding those with incomplete data, 354 remained for analysis. Of these, 132 (37.3%) reported a burn injury which required medical evaluation. The majority were sustained during active duty, with 90.7% using protective gear at the time. Most burns were small and affected the head (50.8%) and upper extremities (48.3%). The majority were not treated at a Burn Center. While 12 (16.2%) reported returning to work prematurely themselves, nearly half indicated that they knew a colleague whom they felt had returned to work too soon. Factors cited include firefighter culture, finances, limitations of workman’s compensation, pressure from peers and employers, dislike of light duty and a driving desire to get back to work. Conclusions While many cite love of the job and a culture of pride and camaraderie that is “in our DNA”, firefighters’ decisions to return to work after burn injury are equally driven external pressures and obligations. Additional education is needed at both the individual and organizational level, which may best be facilitated by evaluation and treatment at a Burn Center. Applicability of Research to Practice Improved understanding of factors driving firefighters’ views on returning to duty after injury may help establish support systems and improve education regarding risks of premature return to work, particularly with regard to reinjury.

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