Impact of Inpatient Unit Design Features on Overall Patient Experience and Perceived Room-Level Call Button Response

This study explores the relationship between inpatient unit design and patient experience and how spatial features and visibility impact patients’ perception of staff responsiveness. The first part of this study is a retrospective pre–post and cross-sectional study evaluating the impacts of unit design on patient experience at the unit level. This study compares patient experiences based on Press Ganey and HCAHPS surveys in two orthopedic units (existing unit in Atrium building and new unit in Tower) with differing design features at Rush University Medical Center. The chi-square test results show that when moving from the old orthopedic unit to the new unit, almost all patient survey items related to patient experience showed statistically significant improvements. The second part of this study is a room level on the new unit. The ANOVA and Pearson correlation tests revealed that the visibility measure of metric step depth had significant impacts on patients’ perception of staff’s “promptness in responding to call button” and “help with toileting”. This study confirms that inpatient unit design plays a direct role in improvement for patient experience and should be considered as an important area of focus for future development.

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Correlation of Knee Instability With Alignment And Repetitive Physical Activity In Patients With Knee Osteoarthritis: A Cross-Sectional Study

10.21203/rs.3.rs-686545/v1 ◽

2021 ◽

Author(s):

Makoto Wada ◽

Tsuyoshi Miyazaki ◽

Yusuke Yamamoto ◽

Takumi Sakamoto ◽

Takahiro Adachi

Keyword(s):

Physical Activity ◽

Knee Osteoarthritis ◽

Medical Center ◽

Pearson Correlation ◽

Multiple Logistic Regression Analysis ◽

Cross Sectional Study ◽

Knee Instability ◽

Knee Alignment ◽

Cross Sectional ◽

Before And After

Abstract Objectives. Malalignment, dynamic knee instability, and repetitive physical activity are considered biomechanical risk factors for knee osteoarthritis (KOA), though the correlations among these factors are poorly understood. The purpose of this study was to elucidate the relationship between knee instability and alignment, and to determine the effects of repetitive physical activity on knee instability in patients with KOA.Methods. The study subjects were 68 patients with radiographic tibiofemoral KOA and 68 control subjects. Each participant underwent clinical evaluation, muscle strength test, radiography, and knee instability test. Instability was evaluated before and after repetitive stepping exercise using triaxial accelerometer. Results. Mediolateral acceleration correlated (p<0.01) with two coronal alignments (mechanical axis; HKA and joint line convergent angle; JLCA). Pearson correlation coefficient was small (r=0.23-0.24) before but increased after stepping (r=0.28-0.33). Increased mediolateral acceleration after stepping correlated with JLCA (r=0.37, p<0.001) . There were significant differences in coronal alignments, gait speed, mediolateral acceleration, and accelerations in all directions between the control and KOA groups. Anteroposterior acceleration did not correlate with sagittal knee alignment. Multiple logistic regression analysis identified HKA/JLCA, and increased mediolateral acceleration after stepping as significant diagnostic predictors of KOA.Conclusion. We found a direct relationship between knee instability and knee alignment or repetitive physical activity. Repetitive stepping activity significantly increased mediolateral acceleration in KOA patients, compared to the control. Stepping increased the correlation between mediolateral acceleration and coronal alignment. In knees with large JLCA, repetitive stepping provided much larger mediolateral instability. Our results suggest that, in addition to JLCA, the increase in mediolateral acceleration after repetitive physical activity, possibly contributes to the development of KOA.Trial registrationTan-nan Regional Medical Center TRMC No. 2018-1

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Evaluating the Experiences of New and Existing Teledermatology Patients post-Covid19 Implementation (Preprint)

10.2196/preprints.25999 ◽

2020 ◽

Author(s):

Judy Hamad ◽

Amy Fox ◽

Maria Suzanne Kammire ◽

Alison Nancy Hollis ◽

Saif Khairat

Keyword(s):

Patient Satisfaction ◽

Patient Experience ◽

Medical Center ◽

Cross Sectional Study ◽

Rapid Expansion ◽

Secondary Outcome ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Significant Difference ◽

Willingness To Use

BACKGROUND With the rapid shift to remodel office-based dermatology into virtual clinics during the coronavirus disease-19 (Covid-19) pandemic teledermatology received an upsurge of utilization. OBJECTIVE To assess the patient experience with teledermatology among new versus existing clinic patients in the context of the rapid practice shift to teledermatology during the Covid-19 pandemic. METHODS We report a cross-sectional study of 184 teledermatology patients seen during Covid-19 at a major Southeastern medical center from May 13th to June 5th 2020. The primary outcome was patient satisfaction levels among new and existing patients. The secondary outcome was future willingness to use teledermatology. RESULTS Of 288 teledermatology patients seen during the study period, 184 (64%) completed the survey. Patients reported high overall satisfaction with teledermatology (Figure 1), with 159 (86%) participants reporting positive overall satisfaction and experience with teledermatology. New patients had significantly higher overall satisfaction with teledermatology than follow-up patients (mean Likert 4.70 for new, 4.43 for existing; p=0.03). Overall, satisfaction with teledermatology did not significantly differ by age, race/ethnicity, education level, residence, or insurance status (p>0.05). There was no significant difference in overall satisfaction by prior telehealth experience (p=0.53), video versus telephone visit type (p=0.17), or platform type (0.22). Prior telehealth experience was associated with a higher odds of willingness to use telehealth in the future (OR 2.39, 95% CI 1.31-4.35, p=0.004). CONCLUSIONS This cross-sectional survey-based study reports that the rapid expansion of teledermatology was met with high levels of patient satisfaction during the Covid-19 pandemic. Further studies are needed to identify ideal disease-specific scheduling algorithms to ensure the visit modality suits the dermatologic condition being addressed. As teledermatology experiences wider adoption with the Covid-19 pandemic, it is essential to examine patient experience and satisfaction with teledermatology.

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“Your Child Has Cerebral Palsy”: Parental Understanding and Misconceptions

Journal of Child Neurology ◽

10.1177/0883073821991300 ◽

2021 ◽

pp. 088307382199130

Author(s):

Mugdha Mohanty ◽

Forrest Beaulieu ◽

Spoorthi Sampath ◽

Dimira Tambunan ◽

Shivangi Kataria ◽

...

Keyword(s):

Cerebral Palsy ◽

Electronic Medical Records ◽

Medical Records ◽

Medical Center ◽

Pearson Correlation ◽

Primary Caregivers ◽

Cross Sectional Study ◽

Cross Sectional ◽

Telephone Surveys ◽

Children With Cerebral Palsy

Importance: Caregivers of children with cerebral palsy can best help their child if they understand the disorder and the correct terminology. Objective: To assess caregiver understanding of cerebral palsy. Design: This was a cross-sectional study from a large tertiary medical center in Boston, to assess understanding of the term cerebral palsy by primary caregivers of children and adolescents with cerebral palsy. All cases were obtained from hospital electronic medical records. Telephone surveys were conducted. Caregiver understanding of cerebral palsy was assessed by open-ended responses (50%) and success in answering true/false questions about cerebral palsy (50%). Participants: Primary caregivers of children 18 years and younger with cerebral palsy. Results: Thirty-three percent of caregivers denied ever being told that their child had cerebral palsy. Most caregivers identified cerebral palsy as a brain problem (79%), lifelong condition (73%), often caused by a perinatal (60%) or gestational (40%) insult. Fifty-two percent knew that cerebral palsy was nonprogressive. Sixty-two percent of caregivers believed they had a good, very good, or excellent understanding of cerebral palsy, whereas the investigators found 69% of caregivers had a good, very good, or excellent understanding of cerebral palsy (P = .006). Most caregivers rated very good or excellent the setting where cerebral palsy was discussed (58%), the explanations provided (55%), and the amount of time spent (45%), yet using a Pearson correlation coefficient, most important was the time spent ( r = 0.53). Conclusions: Following discussion with their child’s physician, most primary caregivers of children with cerebral palsy have a good, very good, or excellent understanding of cerebral palsy. Most critical to a good understanding of cerebral palsy was the time spent in explaining the diagnosis.

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Cut off value of plasma 25-hydroxyvitamin D concentration for predicting metabolic syndrome

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2019.6_7.10 ◽

2019 ◽

pp. 68-73

Author(s):

Trong Nghia Nguyen ◽

Thi Nhan Nguyen ◽

Thi Dua Dao

Keyword(s):

Metabolic Syndrome ◽

Medical Center ◽

Cross Sectional Study ◽

Control Group ◽

Cross Sectional ◽

Hydroxyvitamin D ◽

The Metabolic Syndrome ◽

25 Hydroxyvitamin D ◽

Key Words Metabolic Syndrome ◽

And Control

Background: The metabolic syndrome is a constellation of cardiometabolic risk factors that tend to cluster together in affected individuals more often than predicted by chance. The presence of the metabolic syndrome substantially increases the risk of developing type 2 diabetes and cardiovascular disease, and is associated with a range of adverse clinical outcomes, many of which are closely associated with aging. Current estimates suggest that approximately 20 - 25% of the world’s population is affected by the metabolic syndrome. The prevalence of the metabolic syndrome rises with age and more than 45% of people aged over 60 years have the metabolic syndrome. Recent studies show that low vitamin D status is very common in the world and this is a risk factor of metabolic syndrome. Objective: (1) Plasma 25-hydroxyvitamin D concentration in subjects with metabolic syndrome. (2) Cut off value of plasma 25-hydroxyvitamin D concentration for predicting metabolic syndrome. Material and method: A cross-sectional study with control group on 318 adult subjects for health examinations at International Medical Center at Hue Central Hospital, including 139 subjects with metabolic syndrome and control group of 179 healthy subjects. Metabolic syndrome was defined according to the IDF, NHLBI, AHA, WHF, IAS, IASO (2009). Plasma hydroxyvitamin D concentration was measured using chemiluminescent microparticle immunoassay. Reciever operating characteristic (ROC) curve were generated to assess sensitivity and specificity for different cut off value of 25-hydroxyvitamin D concentration for predicting metabolic syndrome. Results: Plasma 25-hydroxyvitamin D concentration in subjects with metabolic syndrome was 26.4 ng/ml, incidence of plasma 25-hydroxyvitamin D deficiency (59.7%) was significantly higher than in control group (23.5%) (p < 0.001). The optimal cut off point for 25-OH-D concentration for predictor of metabolic syndrome as 26.4 ng/ml (AUC=0.657, sensitivity=53.4%, specificity=71.6%). Conclusion: In 139 subjects with metabolic syndrome, the plasma 25-hydroxyvitamin D concentration was 26.4 ng/ml and the incidence of 25-hydroxyvitamin D deficiency in the metabolic syndrome group was 59.7%. The optimal cut off point for plasma 25-hydroxyvitamin D concentration for predictor of metabolic syndrome as 26.4 ng/ml. Key words: Metabolic syndrome, 25-hydroxyvitamin D

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Characteristics and risk factors associated with stroke subtypes among adult patients admitted to stroke unit of JUMC

Current Hypertension Reviews ◽

10.2174/1573402115666191121120228 ◽

2019 ◽

Vol 15 ◽

Author(s):

Bekalu Getachew Gebreegziabher ◽

Tesema Etefa Birhanu ◽

Diriba Dereje Olana ◽

Behailu Terefe Tesfaye

Keyword(s):

Risk Factors ◽

Stroke Unit ◽

Medical Center ◽

Data Entry ◽

Public Health Problem ◽

Cross Sectional Study ◽

Chi Square ◽

Cross Sectional ◽

Factors Associated ◽

Stroke Subtypes

Background: Stroke is a great public health problem in Ethiopia. According to reports, in-hospital stroke mortality was estimated to be 14.7% in Ethiopia. Despite this, in this country researches done on factors associated with stroke sub-types were inadequate. Objective: To assess the Characteristics and risk factors associated with stroke sub-types among patients admitted to JUMC. Methods and materials: A retrospective cross sectional study was conducted from May 2017 to May 2018 in stroke unit of Jimma University Medical Center. A total of 106 medical charts of patients diagnosed with stroke were reviewed. Checklist comprising of relevant variables was used to collect data. SPSS version 21 was employed for data entry and analysis. Chi-square test was used to point-out association and difference among stroke sub-types. The data was presented using text, tables and figures. Result: From a total of 106 patients, 67(63.2%) were men. The mean ± SD of age was 52.67±12.46 years, and no significant association was found. Of all the patients, 59(55.6%) had ischemic strokes and 47(44.4%) had hemorrhagic strokes. The most common risk factor in the patients was alcohol use with a prevalence of 69.9%. Of all the risk factors, only sex, cigarettes smoking and dyslipidemia were significantly associated to sub-types of stroke. Conclusion: Ischemic stroke was the most common subtype of stroke. Sex of patient, cigarette smoking and dyslipidemia are significantly associated with the two stroke subtypes.

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Risk factors for cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage

Open Medicine ◽

10.1515/med-2020-0169 ◽

2020 ◽

Vol 15 (1) ◽

pp. 598-604

Author(s):

Valentina Opancina ◽

Snezana Lukic ◽

Slobodan Jankovic ◽

Radisa Vojinovic ◽

Milan Mijailovic

Keyword(s):

Risk Factors ◽

Subarachnoid Hemorrhage ◽

Cerebral Vasospasm ◽

Aneurysmal Subarachnoid Hemorrhage ◽

Medical Center ◽

White Blood Cells ◽

Cerebral Aneurysms ◽

International Normalized Ratio ◽

Cross Sectional Study ◽

Cross Sectional

AbstractIntroductionAneurysmal subarachnoid hemorrhage is a type of spontaneous hemorrhagic stroke, which is caused by a ruptured cerebral aneurysm. Cerebral vasospasm (CVS) is the most grievous complication of subarachnoid hemorrhage (SAH). The aim of this study was to examine the risk factors that influence the onset of CVS that develops after endovascular coil embolization of a ruptured aneurysm.Materials and methodsThe study was designed as a cross-sectional study. The patients included in the study were 18 or more years of age, admitted within a period of 24 h of symptom onset, diagnosed and treated at a university medical center in Serbia during a 5-year period.ResultsOur study showed that the maximum recorded international normalized ratio (INR) values in patients who were not receiving anticoagulant therapy and the maximum recorded white blood cells (WBCs) were strongly associated with cerebrovascular spasm, increasing its chances 4.4 and 8.4 times with an increase of each integer of the INR value and 1,000 WBCs, respectively.ConclusionsSAH after the rupture of cerebral aneurysms creates an endocranial inflammatory state whose intensity is probably directly related to the occurrence of vasospasm and its adverse consequences.

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Panic and Trust during COVID-19: A Cross-Sectional Study on Immigrants in South Korea

Healthcare ◽

10.3390/healthcare9020199 ◽

2021 ◽

Vol 9 (2) ◽

pp. 199

Author(s):

Myeong Sook Yoon ◽

Israel Fisseha Feyissa ◽

So-Won Suk

Keyword(s):

Public Health ◽

South Korea ◽

Pearson Correlation ◽

Cross Sectional Study ◽

Native Community ◽

Cross Sectional ◽

The Public ◽

Marginalized Groups ◽

Local Media ◽

Effective Public Health

In the COVID-19 pandemic, marginalized groups like migrants are disproportionately affected. As panic, fear of neglect, and mistrusting institutions in these groups are presumed to be apparent, their detachment to health services still needs to be investigated. This study comparatively analyzed the level of panic and trust between South Koreans and immigrants who are living within highly affected areas of South Korea. Mann–Whitney-U-Test and Pearson correlation showed panic is more pronounced in the Korean group while having a similar panic display pattern with the immigrants. The immigrant group appears to highly trust the Korean health system, health institutions, local media, and the local native community. Beyond conventional expectations, participant’s average panic score showed a statistically significant positive correlation with items of the trust scale, indicating a level of individual reliance amid the pandemic panic. Thus, ascertaining institutional trust and matured citizenry are identified as factors for effective public health outcomes. During such a pandemic, this study also reminded the public health needs of immigrants as secondary citizens, and presumptions of immigrants’ mistrust in such settings might not always be true.

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Evaluation of Patient Experience During Virtual and In-Person Urgent Care Visits: Time and Cost Analysis

Journal of Patient Experience ◽

10.1177/2374373520981487 ◽

2021 ◽

Vol 8 ◽

pp. 237437352098148

Author(s):

Saif Khairat ◽

Xi Lin ◽

Songzi Liu ◽

Zhaohui Man ◽

Tanzila Zaman ◽

...

Keyword(s):

Patient Experience ◽

Care Delivery ◽

Turnaround Time ◽

Cross Sectional Study ◽

Emergency Department Visits ◽

Urgent Care ◽

Cross Sectional ◽

Significant Difference ◽

Virtual Visits ◽

One Year

Urgent care (UC) is one of the fastest growing venues of health care delivery for nonemergent conditions. This study compared the patient experience during virtual and in-person urgent care visits. We conducted a cross-sectional study of patients with the same diagnosis during Virtual Urgent Care (VUC) and in-person UC visits with the same diagnosis with regard to time and cost over a period of one year. We recorded and analyzed 16 685 urgent care visits: In-person UC (n = 14 734), VUC (n = 1262). Significant differences were found in the average total time for a visit in an in-person UC (70.89 minutes), and VUC (9.38 minutes). The average total cost of VUC ($49) and in-person UC ($142.657) differed significantly. Significant difference was found between UC turnaround time and VC turnaround time (Dependent variable (DV): 53.77, P < .01). We found significant differences in cost and time between in favor of virtual visits. Our findings suggest additional policy reform to expand the use of virtual care among target populations to improve access, reduce costs, meet the needs of patients, and reduce emergency department visits.

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Relationship between perceived social support and self stigma in caregivers of patients with schizophrenia

International Journal of Social Psychiatry ◽

10.1177/00207640211001886 ◽

2021 ◽

pp. 002076402110018

Author(s):

Yeliz Karaçar ◽

Kerime Bademli

Keyword(s):

Social Support ◽

High School Graduates ◽

Perceived Social Support ◽

Mental Health Center ◽

Pearson Correlation ◽

Skill Training ◽

Cross Sectional Study ◽

Cross Sectional ◽

Social Support Scale ◽

Schizophrenic Patients

Background: The study was conducted to determine the relationship between self-stigmatization and perceived social support in caregivers of schizophrenia with patient. Methods: A cross-sectional study design was used. The study sample consisted of 84 participants who cared for schizophrenic patients registered in a community mental health center. In the data collection, the ‘Self-stigmatizing Scale for Families’ and ‘Multidimensional Perceived Social Support Scale’ were used. The data were analyzed via frequency, mean, standard deviation, Cronbach’s alpha analysis, linear regression, Pearson correlation analysis, independent samples t-test, and ANOVA test. Results: Self-stigmatization (32.48 ± 15.15) and perceived social support (44.36 ± 22.88) were found to be moderate in caregivers. Self-stigmatization was found to be higher in caregivers who do not work; have a spouse, mother, or father; have a disease; do not receive support from their family and have not received any education about schizophrenia ( p < .05). It was determined that, with increasing age, perceived social support decreases, and the perception of social support increases in caregivers who are high school graduates, working, having children, have no illness, and are educated about schizophrenia ( p < .05). It was determined that, as the level of perceived social support increases in caregivers, self-stigmatization decreases ( p < .05). Conclusion: It was determined that, as the perceived social support increases in caregivers, self-stigmatization decreases. We recommend providing informative support about schizophrenia, to increase hope and social-skill training, and to implement interventions that include caregivers in the fight against stigma.

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695. Infective endocarditis in people who inject drugs (PWID) at UK Medical Center

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.887 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S399-S400

Author(s):

Evelyn Villacorta Cari ◽

John T Henderson ◽

Donna R Burgess ◽

J Zachary Porterfield ◽

Nicole Leedy ◽

...

Keyword(s):

Infective Endocarditis ◽

Tricuspid Valve ◽

Bacterial Infections ◽

Medical Center ◽

Cross Sectional Study ◽

Addiction Medicine ◽

University Of Kentucky ◽

Cross Sectional ◽

Health Crisis ◽

Gram Negative

Abstract Background The Intravenous Drug Use (IVDU) epidemic has been developing into a public health crisis in the last twenty years. As a result, the incidence of severe bacterial infections such as infective endocarditis (IE) has been rising dramatically. Methods Cross-sectional study, we reviewed records of all admissions to University of Kentucky hospitals with IVDU associated ICD9/10 codes who received an Infectious Diseases consult during 2018 and focused on the cases with a diagnosis of IE. We describe associated epidemiologic, clinical, and microbiological features Results We include 391 patients in this cohort, among those 157 patients were for IE. Patients had a median age of 34 years old (range: 20 - 62); 81 (51.5%) were female, and five (6.1%) were pregnant and 153 (97.4%) identified as white. A previous episode of infective endocarditis was reported in 55 (35%) cases. The most common illicit substances used were heroin 68 (43.3%) and methamphetamine 65 (41.45%). Tobacco abuse was reported in 134 (86.4%) cases. Fever reported in 93 (59.8%) cases, shortness of air in 43 (28.0%) cases, and chest pain in 44 (28.6%) cases were the most common symptoms. Hepatitis C antibody was positive in 115/149 (73.2%) and 3/143 (1.9%) were HIV positive. Right-sided IE was more frequent, the tricuspid valve was involved in 94 (59.8%) patients. Gram-positive pathogens were isolated in 139 (88.5%) patients, Staphylococcus aureus was isolated in 102 (64.9%) patients, of which 67 (65.7%) were methicillin resistant. Gram-negative pathogens were isolated in 18 (11.2%) patients. Eighty-eight (56.4%) patients had an addiction medicine consult during their admission, (22.9%) patients left against medical advice and 20 (12.7%) patients needed to be readmitted within 30 days after discharge. Overall mortality was 12.7% and was significantly associated with infection by gram-negative pathogens (RR: 2.5; CI 95% 1.05 – 6.25, p=0.037). Conclusion Infectious endocarditis is a frequent complication in PWID which carries a high risk of mortality and often involves the tricuspid valve. The most common pathogen isolated was S. aureus, isolation of gram-negative pathogens was associated with increased mortality. Disclosures All Authors: No reported disclosures

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