Free Counseling Chatbot in a Communication Application For Improving Patient Satisfaction with Indwelling Ureteric Stents After Ureterorenoscopic Lithotripsy: A Retrospective Study (Preprint)

2021 ◽  
Author(s):  
Weiming Cheng ◽  
Yi-Chun Chiu ◽  
Fan-Yu Hua ◽  
Chi-Chia Chi ◽  
Chang-Chi Chang ◽  
...  
Keyword(s):  
Higher Education ◽  
Patient Satisfaction ◽  
Medical Staff ◽  
Odds Ratio ◽  
Free Module ◽  
Education Level ◽  
Gross Hematuria ◽  
Exact Test ◽  
Ureteric Stents ◽  
Associated Symptoms

BACKGROUND Health education is important for improving patients’ adherence to treatment, thereby reducing morbidity. Face-to-face communication is not sufficient nowadays, and online interaction can improve patient–physician communication and education. OBJECTIVE We designed a chatbot for patients who received indwelling double-J ureteric stents (DJs) after ureterorenoscopic lithotripsy (URSL) and evaluated the efficacy of this chatbot in improving patient satisfaction in clinical practice. METHODS We designed a chatbot, based on the free module provided by the communication application Line©, which described the associated symptoms with DJs and the self-care of DJs after discharge and emphasized the importance of timely DJ removal. Patients could interact with the chatbot for any concerns regarding their DJs after discharge. We prospectively included patients who received indwelling DJs after URSL at our hospital from August 1st, 2019 to November 30th, 2019. Patient education on DJ-related information was conducted either by medical staff before discharge or by using the chatbot, based on patients’ preference. Patients were asked to rate the severity of their DJ-related symptoms and their satisfaction with using the free chatbot on a five-point scale before DJ removal. Fisher’s exact test was used to evaluate the effect of the chatbot on the severity of DJ-related symptoms and the possible factors associated with the satisfaction with this chatbot. RESULTS A total of 70 patients were included. Twenty patients received routine education by medical staff while 50 patients elected to have additional interaction through the chatbot. The patients in the chatbot group were significantly younger (age <60 years: 74% versus 15%, P < .001), had a higher education level (40% versus 5%, P = .004), and reported more severe gross hematuria (66% versus 15%, P < .001) than those in the medical-staff group. No differences were observed for other DJ-associated symptoms. On multivariate analysis, severe gross hematuria was significantly associated with age younger than 60 years (odds ratio 6.704, P = .003, 95% CI 1.898–23.673) and the use of the chatbot (odds ratio 6.63, P = .02, 95% 1.374–31.989). All 50 patients in the chatbot group reported being satisfied (32%) or very satisfied (68%) with the chatbot tool. Patients older than 60 years were significantly more satisfied with the chatbot (35.5% versus 6.3%, P = .04). Education level, the severity of DJ-associated symptoms, and the recognition of the necessity of DJ removal were not significantly associated with the degree of satisfaction. CONCLUSIONS The use of a chatbot resulted in high satisfaction of the patients, especially elderly patients. Younger patients with higher education levels were more likely to adopt this new form of communication, which helped improve their knowledge of DJ-associated symptoms.

Spatial Distribution and Determinants of Household Iodized Salt Utilization in Ethiopia: A Spatial and Multilevel Analysis of Ethiopian Demographic and Health Survey

2020 ◽  
Author(s):  
Yigizie Yeshaw ◽  
Adugnaw Zeleke Alem ◽  
Getayeneh Antehunegn Tesema ◽  
Achamyeleh Birhanu Teshale ◽  
Alemneh Mekuriaw Liyew ◽  
...  
Keyword(s):  
Higher Education ◽  
Spatial Distribution ◽  
Health Survey ◽  
Odds Ratio ◽  
Media Exposure ◽  
Wealth Index ◽  
Education Level ◽  
Iodized Salt ◽  
P Value ◽  
Community Media

Abstract Background: Iodine deficiency disorder is a significant public health problem, affecting both developed and developing nations worldwide. It is associated with poor body growth and irreversible mental retardation. However, little is known about the spatial distribution and determinants of household iodized salt utilization in Ethiopia. Therefore, this study aimed to explore the spatial distribution and determinants of iodized salt utilization at national level. Methods : Ethiopian Demographic and Health Survey 2016 data was used to investigate the spatial distribution and determinants of household iodized salt utilization in Ethiopia. ArcGIS 10.6 and SaTScan™ version 9.6 software were used to explore the spatial distribution and detect significant clusters, respectively. We used STATA version 14 software to analyze the determinants of household iodized salt utilization. The odds ratio with its 95% confidence interval (CI) was determined for potential determinants included in the multivariable multilevel logistic regression model and the corresponding p-value ≤ 0.05 was employed to declare the statistically significant variables. Results : Household iodized salt utilization was spatially clustered in Ethiopia (Moran’s Index = 0.076, p-value= 0.01). The significant hotspot areas with high iodized salt utilization were located in Benishangul, Amhara, Gambella, Tigray and Northwest Oromia regions. Those households with higher education level ((Adjusted Odds Ratio [AOR] =1.49, 95% CI =1.14-1.93), high community level education (AOR=1.51, 95% CI=1.03-2.20), middle wealth index (AOR=1.31, 95% CI=1.04-1.65) and high community media exposure (AOR=1.52, 95% CI=1.07-2.17) had higher odds of iodized salt utilization. Conclusions : Household iodized salt utilization had significant spatial variation across the country . The significant hotspot areas with high iodized salt utilization were located in Benishangul, Amhara, Gambella, Tigray and Northwest Oromia regions. Households with higher education level, high community level education and high community media exposure and middle wealth index had higher odds of iodized salt utilization. Increasing education level, wealth status and community media exposure is recommended to increase iodized salt utilization. A targeted intervention is also needed for those regions with low household iodized salt utilization.

Epistemologi Pendidikan Islam: Melacak Metodologi Pengetahuan Perguruan Tinggi Islam Klasik

1970 ◽  
Vol 13 (3) ◽  
pp. 453-473
Author(s):  
Musnur Hery
Keyword(s):  
Higher Education ◽  
Learning Process ◽  
Education Level ◽  
Formal Institutions ◽  
Islamic History ◽  
Formal Institution

Islamic higher college not only limited to higher education that famous at Islamic history like madrasah (e.g. Nizamiyah), and al-Jami’ah (e.g. al-Azhar). Yet, Islamic higher college is the implementation of learning process that can be categorized in higher education stage, that being practiced in Moslem society, even still in non-formal or informal form before madrasah existence. Several epistemologies branch indeed take place at formal institution, while some epistemologies branch theoretically applied at formal institution, but it’s practiced at non-formal institutions. These non-formal institutions were still reflecting Islamic higher education level. 

To Investigate the Critical Influencing Factors for Decision Making Process of Students Who Want to Study Abroad

2019 ◽  
Vol 118 (11) ◽  
pp. 619-624
Author(s):  
JueJueMyint Toe ◽  
Ali Abdulbaqi Ameen ◽  
Sui Reng Liana ◽  
Amiya Bhaumik
Keyword(s):  
Higher Education ◽  
Decision Making ◽  
Study Abroad ◽  
Education Level ◽  
Decision Making Process ◽  
International Level ◽  
Continuing Higher Education ◽  
Clear Trend ◽  
The People ◽  
Study Overseas

Myanmar is the developing country and its education system is not yet to international level. Hence, most of the young adults, who like to upgrade their knowledge global wide and to gain international recognized higher educational certificates, choose to study overseas rather than continuing higher education after their high education nowadays, that becomes the trend of young people to study overseas since the competency among the people is getting intense based on the education level in every industry. The purpose of this research is to understand that students’ decision making process of selecting university. The study will be conducted to see clear trend of Myanmar students’ decision making of studying in abroad. This research will cover the context of what is Myanmar students’ perception of abroad, how they consider among other countries and explaining those factors which determine Myanmar students’ choice and how they decide to study abroad.

Awareness, Attitude and Health Practices Among Parents of Children with Ear Infection: A National Study in Saudi Arabia (Preprint)

2018 ◽  
Author(s):  
Saleh Saad Algamdi ◽  
Mutasim Hussain Alkhalifah ◽  
Mohammed H. Shawosh ◽  
Khalid Ali Alshehri ◽  
Hajar Fahad Alghamdi ◽  
...  
Keyword(s):  
Higher Education ◽  
Saudi Arabia ◽  
Otitis Media ◽  
Acute Otitis Media ◽  
Education Level ◽  
National Study ◽  
Health Practices ◽  
Monthly Income ◽  
Health Seeking ◽  
Ear Infection

BACKGROUND Otitis media (OM) is a very common childhood problem. It is inflammation of the middle ear usually caused by viral or bacterial infection. Otitis media is a main cause of antibiotic use in children. The primary treatment for acute otitis media (AOM) is watchful waiting: 80% of cases resolve without intervention. Southeast Asia, the Western Pacific region, and Africa have the highest prevalence of OM. Prevalence studies on OM are scant in Saudi Arabia. Only a few studies have been conducted in some cities. OBJECTIVE The aim of this study was to determine the knowledge, attitude, and health-seeking practices of parents with regard to OM. METHODS A national study was conducted September 19, 2018–October 9, 2018 in the Kingdom of Saudi Arabia. Data were collected using an electronic online questionnaire. It was culturally adopted, validated, and translated into Arabic. Items on the questionnaire included demographics, knowledge, attitude, and health practices about ear infection among parents of children <5 years old. The calculated representative sample size of the Saudi population was 9600 individuals (95% confidence interval and 1% margin of error). The aim was for 10,000 responses. Stratified sampling was used with each administrative area considered as independent strata. Statistical analysis was conducted using Excel software (Microsoft, Redmond, WA). Data were coded, grouped, arranged, and cleaned. Statistical Package for Social Sciences (version 23.0; Armonk, NY: IBM Corporation) was used for data analysis. RESULTS This study included 10,004 participants. Most were females. The mean age was 37.93 years (standard deviation, 10.20 years). Overall, 81.9% of parents were knowledgeable about ear infection. Parents who were knowledgeable about ear infections were significantly older (P = .005), female (P < .001), had a higher education level (P < .001), were married (P < .001), had a monthly income of 10,000–20,000 Saudi riyals (P < .001), and lived in the Al-Baha region (P < .001). The scores of 90.0% of parents indicated they had a good attitude about ear infection; and 58.6% of parents believed that ignorance is why children do not go to a healthcare facility for ear infection treatment. Parents with positive overall health practices represent 81.2%. Parents with good health practices were significantly associated with female sex (P = .009), higher education level (P < .001), being married (P < .001), a monthly income of 5000–1000 Saudi riyals (SR; P < .001), and living in the Al-Baha region (P < .001). CONCLUSIONS Knowledge, attitude, and health-seeking practices in Saudi Arabia were overall adequate. However, more integrated educational materials are needed for the general population. The development of a broad national awareness program, especially in low socioeconomic areas, could significantly contribute to the early detection and management of OM.

scholarly journals COVD-26. TELEPHONE CONSULTATIONS IN NEURO-ONCOLOGY DURING THE COVID-19 PANDEMIC: LEVELS OF PATIENT SATISFACTION AND COMPARISON WITH TRADITIONAL FACE-TO-FACE CONSULTATIONS

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii26-ii26
Author(s):  
Emma Toman ◽  
Claire Goddard ◽  
Frederick Berki ◽  
William Garratt ◽  
Teresa Scott ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
University Hospitals ◽  
Health Crisis ◽  
Patient Satisfaction Questionnaire ◽  
Telephone Consultation ◽  
Exact Test ◽  
Face To Face ◽  
Significant Difference ◽  
The Face ◽  
The University

Abstract INTRODUCTION Controversy exists as to whether telephone clinics are appropriate in neurosurgical-oncology. The COVID-19 pandemic forced neuro-oncology services worldwide to re-design and at the University Hospitals Birmingham UK, telephone clinics were quickly implemented in select patients to limit numbers of patients attending hospital. It was important to determine how these changes were perceived by patients. METHODS A 20-question patient satisfaction questionnaire was distributed to patients who attended neuro-oncology clinic in person (“face-to-face”), or via the telephone. Fisher’s exact test was used to determine significance, which was set at p&lt; 0.05. RESULTS Eighty questionnaires were distributed between June 2020 and August 2020. Overall, 50% (n=40) of patients returned the questionnaire, 50% (n=23) of face-to-face and 50% (n=17) telephone patients. Of those who received telephone consultations, 88% (n=15) felt the consultation was convenient, 88% (n=15) were satisfied with their consultation and 18% (n=3) felt they would have preferred to have a face-to-face appointment. Of those who attended clinic in person, 96% (n=22) felt their consultation was convenient, 100% (n=23) were satisfied with their consultation and 13% (n=3) would have preferred a telephone consultation. Within the face-to-face clinic attendees, only 13% (n=3) were concerned regarding the COVID risk associated with attending hospital. There was no significant difference in patient convenience or satisfaction (p=0.565 and p=0.174 respectively) between face-to-face and telephone clinics. There was no significant difference in whether patients would’ve preferred the alternative method of consultation (p &gt; 0.999). CONCLUSION Our study suggests that careful patient selection for neuro-oncology telephone clinic is not inferior to face-to-face clinic. Telephone clinic during COVID-19 pandemic proved to be convenient, safe and effective. This global health crisis has transformed telephone neuro-oncology consultations from an experimental innovation into established practice and should be continued beyond the pandemic in select cases.

scholarly journals Post hoc patient satisfaction with the choice of valve prosthesis for aortic valve replacement: results of a single-centre survey

2021 ◽  
Author(s):  
Laure Bryssinck ◽  
Siel De Vlieger ◽  
Katrien François ◽  
Thierry Bové
Keyword(s):  
Patient Satisfaction ◽  
Aortic Valve ◽  
Confidence Interval ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Odds Ratio ◽  
Mechanical Valve ◽  
Decisional Conflict ◽  
Valve Prosthesis ◽  
Post Hoc

Abstract OBJECTIVES Our goal was to examine post hoc patient satisfaction and the decision-making process of choosing a prosthesis for aortic valve replacement (AVR). METHODS We surveyed 113 patients who were operated on for AVR at 60–70 years of age, including 74 patients with a mechanical valve (MECH) and 39 with a bioprosthesis (BIO). The study focused on quality of life and the decision pathway in relation to prosthesis choice and valve-related complications. Decisional conflict was defined as the post hoc uncertainty perceived by patients regarding their choice of prosthesis. RESULTS The survey was performed at a median of 5.2 (3.2–8.1) years after the AVR. Patients with a biological valve were older (BIO: 68.4 years [66.2–69.4] vs MECH: 63.9 [61.9–66.7]; P &lt; 0.001). Global post hoc satisfaction with prosthesis choice was high in both groups (MECH: 95.9%; BIO: 100%), and 85.1% (MECH) and 92.3% (BIO) of them would repeat their choice. Conflict about their decision was equal (MECH: 30.3%; BIO: 32.6%) for different reasons: MECH patients experienced more anticoagulation-related inconvenience (25.9% vs 0%), fear of bleeding (31.1% vs 0%) and prosthesis noise (26.2% vs 0%), whereas more BIO patients feared prosthesis failure (39.7% vs 17.4%) or reoperation (43.5% vs 18.1%). Active involvement in the decision (odds ratio 0.37, 95% confidence interval 0.16–0.85; P = 0.029) and adequate information about the prosthesis (odds ratio 0.34, 95% confidence interval 0.14–0.86; P = 0.020) decreased the risk of conflict about the decision. CONCLUSIONS Although 30% of the responders showed a decisional conflict related to prosthesis-specific interferences, global patient satisfaction with the prosthesis choice for AVR is excellent. Increasing the patient’s involvement in the prosthesis choice through shared accountability and improved information is recommended to decrease the choice-related uncertainty.

scholarly journals 22. Patient Satisfaction Remains Unchanged Following Implementation of an Antibiotic Stewardship Intervention in Primary Care

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S11-S12
Author(s):  
Zachary Hostetler ◽  
Keith W Hamilton ◽  
Leigh Cressman ◽  
McWelling H Todman ◽  
Ebbing Lautenbach ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Satisfaction ◽  
Odds Ratio ◽  
Logistic Regression Model ◽  
Adjusted Odds Ratio ◽  
Primary Care Providers ◽  
Mixed Effects ◽  
Antibiotic Prescribing ◽  
Care Providers ◽  
Targeted Intervention

Abstract Background Inappropriate prescription of antibiotics for respiratory tract infections (RTIs) in ambulatory care settings is common, increasing the risk of adverse health outcomes. Behavioral and educational interventions targeting primary care providers (PCPs) have shown promise in reducing inappropriate antibiotic prescribing for RTIs. While one perceived barrier to such interventions is the concern that these adversely impact patient satisfaction, few data exist in this area. Here, we examine whether a recent PCP-targeted intervention that significantly reduced antibiotic prescribing for RTIs was associated with a change in patient satisfaction. Methods The PCP-targeted intervention involved monthly education sessions and peer benchmarking reports delivered to 31 clinics within an academic health system, and was previously shown to reduce antibiotic prescribing. Here, we performed a retrospective, secondary analysis of Press Ganey (PG) surveys associated with the outpatient encounters in the pre- and post-intervention periods. We evaluated the impact on patient perceptions of PCPs based on provider exposure to the intervention using a mixed effects logistic regression model. Results There were 17,416 out of 197,744 encounters (8.8%) with associated PG surveys for the study time period (July 2016 to September 2018). In the multivariate model, patient satisfaction with PCPs was most strongly associated with patient-level characteristics (age, race, health status, education status) and survey-level characteristics (survey response time, patient’s usual provider) (Figure 1). Satisfaction with PCPs did not change following delivery of the provider-based intervention even after adjusting for patient- and survey-level characteristics [adjusted odds ratio (95% CI): 1.005 (0.928, 1.087)]. However, a small increase in satisfaction associated with receiving antibiotics during the entire study period was seen [adjusted odds ratio (95% CI): 1.146 (1.06, 1.244)]. Figure 1: Association of a provider-targeted intervention as well as patient, provider, and practice characteristics with patient satisfaction in a multivariable mixed effects logistic regression model Conclusion Patient perceptions of PCPs remain unchanged following the delivery of a behavioral and educational intervention to primary care providers that resulted in observable decreases in antibiotic prescribing practices for RTIs. Disclosures All Authors: No reported disclosures

scholarly journals Noncommunicable diseases and the use of health services: analysis of the National Health Survey in Brazil

2017 ◽  
Vol 51 (suppl 1) ◽  
Author(s):  
Deborah Carvalho Malta ◽  
Regina Tomie Ivata Bernal ◽  
Margareth Guimarães Lima ◽  
Silvânia Suely Caribé de Araújo ◽  
Marta Maria Alves da Silva ◽  
...  
Keyword(s):  
Higher Education ◽  
Health Insurance ◽  
Health Services ◽  
Sex Education ◽  
National Health ◽  
Health Survey ◽  
National Health Survey ◽  
Education Level ◽  
Noncommunicable Diseases ◽  
Use Of Health Services

ABSTRACT OBJECTIVE To assess whether sex, education level, and health insurance affect the use of health services among the adult Brazilian population with chronic noncommunicable diseases (NCD). METHODS Data from a cross-sectional survey were analyzed, the National Health Survey (PNS). Frequency of use of services in the population that referred at least one NCD were compared with the frequency from a population that did not report NCD, according to sex, education level, health insurance, and NCD number (1, 2, 3, 4, or more). The prevalence and prevalence ratios were calculated crude and adjusted for sex, age, region, and 95% confidence intervals. RESULTS The presence of a noncommunicable disease was associated with increase in hospitalizations in the last 12 months, in 1.7 times (95%CI 1.53–1.9). Failing to perform usual activities in the last two weeks for health reasons was 3.1 times higher in NCD carriers (95%CI 2.78–3.46); while the prevalence of medical consultation in the last 12 months was 1.26 times higher (95%CI 1.24–1.28). NCD carriers make more use of health services, as well as women, people with higher number of comorbidities, with health insurance, and higher education level. CONCLUSIONS NCD carriers make more use of health services, as well as women, people with higher number of comorbidities, with health insurance, and higher education level.

The Ability to Use Epinephrine Autoinjector in Patients Who Receive Prescription Immediately after Anaphylaxis

2021 ◽  
pp. 1-6
Author(s):  
Saša Kadivec ◽  
Mitja Košnik
Keyword(s):  
Higher Education ◽  
Shelf Life ◽  
Anaphylactic Reaction ◽  
Family Physician ◽  
Fatal Outcome ◽  
Education Level ◽  
Adult Patients ◽  
Prescription Rate ◽  
Training Device ◽  
Epinephrine Autoinjector

<b><i>Background:</i></b> Epinephrine autoinjector (EAI) is prescribed to prevent a fatal outcome in the case of a repeated anaphylactic reactions. We wanted to determine how adult patients who received their first prescription as part of an urgent treatment of an anaphylactic reaction or at their family physician were instructed on the use of EAI. <b><i>Methods:</i></b> Nurses assessing patients’ knowledge asked the patient to demonstrate how to use the EAI training device. Patients who performed the critical steps correctly in 1 min were labelled as competent. <b><i>Results:</i></b> Forty-one patients (24% women, 46 ± 5 years) came for the allergy examination 116 ± 145 days after receiving a prescription for EAI. When prescribing, the doctor or nurse explained the instructions for the use of EAI to 63.4% patients, and 31.7 patients practiced the use of EAI using a training device. At the pharmacy, 22% received explanation and 7% also practiced using a training device. Fifty-four percent of patients were able to effectively administer EAI adrenaline within 1 min. Higher education level was associated with sufficient knowledge about the use of EAI (<i>p</i> = 0.026). At the time of the visit to the allergy specialist clinic, 61% of patients had EAI with them. The shelf life of EAI was known to 63% of patients. <b><i>Conclusions:</i></b> The activities to increase the prescription rate of EAI immediately after treatment of anaphylactic episode are not sufficient to prevent severe outcome after the repeated episodes of anaphylaxis as nearly a half of patients are not able to use EAI correctly.

Employee Engagement: A Study on Perception of Teachers in Higher Education

2021 ◽  
pp. 286-290
Author(s):  
Ashwini Kundar ◽  
Pakkeerappa P.
Keyword(s):  
Higher Education ◽  
Employee Engagement ◽  
Service Sector ◽  
Education Level ◽  
Faculty Members ◽  
Primary Sources ◽  
Business Strategies ◽  
Know How ◽  
Overall Performance

Employee engagement is an important factor to be considered while developing any kind of business strategies and it plays an important role in improving overall performance of an organisation. As the importance of employee engagement in service sector has increased to a great extent now, it becomes necessary to know how it works for the benefit of organisation and how it contributes for the success of the organisation. The main objective of the study is to know the commitment and engagement of teachers at higher education level. It is very much important to know the level of commitment and engagement of teachers or faculty members that leads to development of the students and also the institution. The study is empirical in nature and the data is collected from primary sources. The findings suggest that there is a higher-level engagement and commitment among the faculty members for the organisations they work for. Higher level of engagement leads to the development of the institution.

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