satisfaction with care
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2021 ◽  
Author(s):  
Sabina Gall ◽  
Uta Kiltz ◽  
Tanja Kobylinski ◽  
Ioana Andreica ◽  
Kristina Vaupel ◽  
...  

Abstract The aim of this project was to understand patients’ knowledge and opinion about biosimilars and to evaluate patient satisfaction with care after education on multiswitching of biosimilars (bsDMARDs) by rheumatologists in comparison to nurse specialists. Adult patients with rheumatoid arthritis, axial spondyloarthritis or psoriatic arthritis who underwent a non-medical switch to the adalimumab biosimilar MSB 11022 were randomized into a group in which information about multiswitching of bsDMARDs was provided by a nurse specialist or a rheumatologist. Validated outcome tools and standardized parameters for assessment of disease activity and function were used at baseline and 12 weeks after switching. Patients’ satisfaction with care was assessed by the Leeds Satisfaction Questionnaire. A structured questionnaire was used to assess patient’s knowledge. A total of 102 patients was randomized, 40 were seen by the rheumatologist (39.2%) and 62 by the nurse (60.8%). Fifty patients (49%) had already undergone one and 52 multiple switches (51%). Less than one third of patients was able to correctly answer questions on manufacturing, effectiveness, clinical trial evidence and cost of bsDMARDs. Patients were generally satisfied with care irrespective of whether the information had been given by the nurse or the rheumatologist. No difference in outcomes was seen.Patient satisfaction and outcomes after education about bsDMARDs and switching by nurses and rheumatologists were similarly good. The number of switches did not have a negative impact on patient satisfaction.


2021 ◽  
Author(s):  
Kie Kanda ◽  
Stacy Blythe ◽  
Rebekah Grace ◽  
Lynn Kemp

Abstract Aim To synthesise and analyse the existing literature regarding parent satisfaction with sustained home visiting care for mothers and children Background Sustained home visiting programs have been found to support improved health, wellbeing, and developmental outcomes for children and families. However, there is limited knowledge with regards to the level of parent satisfaction with care provided at home, and the factors and elements of care parents perceive to be critical to their satisfaction. It is important for healthcare practitioners to understand what practices and process parents consider to be a priority in securing their ongoing engagement. Design: Integrative review Data sources: PubMed/Medline, CINAHL, Embase, and PsycINFO Methods A multi-step approach was used to search and retrieve peer-reviewed studies from the databases. Study selection, data extraction, data synthesis and critical appraisal were undertaken by two independent researchers. Results A total of 13 studies met the inclusion criteria, including nine quantitative and four qualitative studies. The review found that parents provided with home visiting interventions had higher levels of satisfaction with care than those who received routine or facility-based care. Service dose was a factor associated with parent satisfaction. Other elements of care parents perceived as important to service satisfaction included the strength of the nurse-client relationship, being treated with respect, empowerment, and emotional support. Conclusion While it is critically important that home visiting practitioners provide evidence-based care and interventions, it is equally important that services are delivered in the context of positive and empowering relationships. Further research is recommended to understand the care process and mechanisms that enhance parent satisfaction and positive experiences, providing optimal quality of care.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Nancy Somi ◽  
Nicole Dear ◽  
Domonique Reed ◽  
Ajay Parikh ◽  
Anange Lwilla ◽  
...  

Abstract Background Increased availability of HIV care over the past decade has dramatically reduced morbidity and mortality among people living with HIV (PLWH) in sub-Saharan Africa. However, perceived and experienced barriers to care, including dissatisfaction with services, may impact adherence and viral suppression. We examined the associations between satisfaction with HIV care and antiretroviral therapy (ART) adherence and viral load suppression. Methods The African Cohort Study (AFRICOS) is a prospective observational study conducted at PEPFAR-supported clinics in four African countries. At enrollment and twice-yearly study visits, participants received a clinical assessment and a socio-behavioral questionnaire was administered. Participants were classified as dissatisfied with care if they reported dissatisfaction with any of the following: waiting time, health care worker skills, health care worker attitudes, quality of clinic building, or overall quality of care received. Robust Poisson regression was used to estimate prevalence ratios and 95% confidence intervals (CIs) for associations between satisfaction with care and ART adherence and between satisfaction with care and viral suppression (viral load < 1000 copies/mL). Results As of 1 March 2020, 2928 PLWH were enrolled and 2311 had a year of follow-up visits. At the first annual follow-up visit, 2309 participants responded to questions regarding satisfaction with quality of care, and 2069 (89.6%) reported satisfaction with care. Dissatisfaction with waiting time was reported by 177 (7.6%), building quality by 59 (2.6%), overall quality of care by 18 (0.8%), health care worker attitudes by 16 (0.7%), and health care worker skills by 15 (0.7%). After adjusting for age and site, there was no significant difference in viral suppression between those who were satisfied with care and those who were dissatisfied (aPR: 1.03, 95% CI 0.97–1.09). Satisfaction with HIV care was moderately associated with ART adherence among AFRICOS participants (aPR: 1.09; 95% CI 1.00–1.16). Conclusions While patient satisfaction in AFRICOS was high and the association between perceived quality of care and adherence to ART was marginal, we did identify potential target areas for HIV care improvement, including reducing clinic waiting times.


2021 ◽  
Vol 84 (4) ◽  
pp. 593-600
Author(s):  
P Van Ouytsel ◽  
A Szalai ◽  
A Van Gossum ◽  
M Arvanitakis ◽  
H Louis

Background and aims: Efficiency of a low FODMAPs diet (LFD) to relieve symptoms in patients with irritable bowel syndrome (IBS) has been proved in several studies. Our study aimed to evaluate the management of IBS-patients when explanations about LFD are given by the physician without dietician intervention. Patients and methods: Patients with IBS were evaluated prospectively after explanations about the LFD were given with the help of a leaflet. A first questionnaire evaluating trigger foods and diet acceptability was submitted to the patient after the consultation. Six weeks later, a second questionnaire evaluated patient’s understanding and adherence to the diet, the evolution of symptoms, and the need for a specific dietetic support. Results: Thirty-five patients were included (69% female; mean age 45±15). Seventy-four percent of the patients thought that their symptoms were related to food ingestion, and 97% were ready to go on a diet to improve their symptoms. During the second visit, 91% of the patients reported understanding correctly the explanations, 52% followed LFD regularly, 28% sometimes and 20% did not follow LFD at all or barely. Multiple non-adherence factors were reported. All symptoms, except constipation, decreased significantly six weeks after starting LFD. Finally, 77% of the patients reported satisfaction with care and 69% were willing to be supported by a dietician. Conclusions: Most IBS patients understood explanations given by GI physicians, but low compliance to the diet and a wish for dietician support was highlighted, suggesting that a dietician intervention should be scheduled when LFD is implemented.


2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 180-180
Author(s):  
Carolyn L. Qian ◽  
Charu Vyas ◽  
Eva Gaufberg ◽  
Emilia Kaslow-Zieve ◽  
Chinenye C. Azoba ◽  
...  

180 Background: Hospitalized patients with cancer often experience a high symptom burden, which may impact care satisfaction and healthcare utilization. However, research describing these patients’ care satisfaction, symptom burden, and health care use is lacking. We sought to investigate relationships among care satisfaction, physical and psychological symptom burden, and hospital length of stay (LOS) in hospitalized patients with cancer. Methods: We prospectively enrolled patients with cancer and unplanned hospitalizations from 9/2014 to 4/2017. Upon admission, we assessed patients’ care satisfaction (FAMCARE items: satisfaction with care coordination and the speed with which symptoms are treated) as well as their physical (Edmonton Symptom Assessment System [ESAS]) and psychological (Patient Health Questionnaire-4 [PHQ-4]) symptoms. We used regression models to identify factors associated with care satisfaction, and we also examined associations of care satisfaction with patients’ symptom burden and hospital length of stay (LOS). Results: Among 1,576 participants (median age = 65.0 years [range:19-96], 46.3% female, 70.9% with incurable cancer, 58.4% admitted to a dedicated oncology service), most reported being “satisfied” or “very satisfied” with care coordination (90.1%) and the speed with which symptoms are treated (89.0%). Older age (care coordination: B < 0.01, P = 0.022, speed with which symptoms are treated: B = 0.01, P = 0.001) and admission to a dedicated oncology service (B = 0.20, P < 0.001 for each) were associated with higher care satisfaction. Higher satisfaction with care coordination was associated with lower ESAS-physical (B = -1.28, P = 0.007), ESAS-total (B = -2.73, P < 0.001), PHQ4-depression (B = -0.14, P = 0.022), and PHQ4-anxiety (B = -0.16, P = 0.008) symptoms. Higher satisfaction with the speed with which symptoms are treated was associated with lower ESAS-physical (B = -1.32, P = 0.003), ESAS-total (B = -2.46, P < 0.001), PHQ4-depression (B = -0.14, P = 0.014), and PHQ4-anxiety (B = -0.17, P = 0.004) symptoms. Greater satisfaction with care coordination (B = -0.48, P = 0.040) and the speed with which symptoms are treated (B = -0.44, P = 0.041) were both associated with shorter LOS. Conclusions: Hospitalized patients with cancer report high care satisfaction, which correlates with older age and admission to a dedicated oncology service. Significant associations among higher care satisfaction, lower symptom burden, and shorter hospital LOS highlight the importance of improving symptom management and care coordination in this population.


BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e048821
Author(s):  
Lars Vedel Kessing ◽  
Natacha Blauenfeldt Kyster ◽  
Pernille Bondo-Kozuch ◽  
Ellen Margrethe Christensen ◽  
Birgitte Vejstrup ◽  
...  

IntroductionDespite current available treatment patients with bipolar disorder often experience relapses and decreased overall functioning. Furthermore, patients with bipolar disorder are often not treated medically or psychologically according to guidelines and recommendations. A Clinical Academic Group is a new treatment initiative bringing together clinical services, research, education and training to offer care and treatment that is based on reliable evidence backed up by research. The present Clinical Academic Group for bipolar disorder (the CAG Bipolar) randomised controlled trial (RCT) aims for the first time to investigate whether specialised outpatient treatment in CAG Bipolar versus generalised community-based treatment improves patient outcomes and clinician’s satisfaction with care in patients with bipolar disorder.Methods and analysisThe CAG Bipolar trial is a pragmatic randomised controlled parallel-group trial undertaken in the Capital Region of Denmark covering a catchment area of 1.85 million people. Patients with bipolar disorder are invited to participate as part of their outpatient treatment in the Mental Health Services. The included patients will be randomised to (1) specialised outpatient treatment in the CAG Bipolar (intervention group) or (2) generalised community-based outpatient treatment (control group). The trial started 13 January 2020 and has currently included more than 600 patients. The outcomes are (1) psychiatric hospitalisations and cumulated number and duration of psychiatric hospitalisations (primary), and (2) self-rated depressive symptoms, self-rated manic symptoms, quality of life, perceived stress, satisfaction with care, use of medication and the clinicians’ satisfaction with their care (secondary). A total of 1000 patients with bipolar disorder will be included.Ethics and disseminationThe CAG Bipolar RCT is funded by the Capital Region of Denmark and ethical approval has been obtained from the Regional Ethical Committee in The Capital Region of Denmark (H-19067248). Results will be published in peer-reviewed academic journals, presented at scientific meetings and disseminated to patient organisations and media outlets.Trial registration numberNCT04229875.


2021 ◽  
Vol 34 (4) ◽  
pp. 398-404
Author(s):  
Tonya J. Roberts ◽  
Thor Ringler ◽  
Seth Jovaag

The Veterans Affairs (VA) Storybook Program was developed to enhance nurse-patient relationships and satisfaction with care. Personal stories about nurses were distributed to patients on a medical/surgical unit. Quantitative and qualitative evaluation data were collected from patients and nurses to capture patients’ descriptions of nurses and perceptions of program value. Results show patients describe nurses differently after reading the storybook. Patients were highly satisfied with the program, and interviews suggest the stories fostered connection and developed an atmosphere of trust. Story programs may be an effective, structured approach to enhancing nurse-patient relationships.


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