Scarf and Akin Osteotomies for Correction of Hallux Abducto Valgus. A Ten-year Retrospective Patient Evaluation From Five Podiatric Surgery Centres Using PASCOM PSQ-10.

BackgroundCorrective surgery for hallux abducto valgus is one of the most commonly performed elective procedures in foot and ankle practice, with over a hundred different surgical solutions having been proposed throughout the literature. The purpose of the study was to identify the clinical and patient reported outcomes following Scarf-Akin osteotomies from five podiatric surgery centres over a ten-year period.MethodThis is a retrospective review from five podiatric surgical units which looked at patients who underwent Scarf osteotomies (in isolation or in combination with Akin procedures) over a ten-year period. Data was collected from the patient satisfaction questionnaires of the PASCOM-10 audit tool, which were completed by the patient six months post operatively, and further analysed using Microsoft Excel spreadsheet software.ResultsA total of 1351 patients were recorded undergoing Scarf (with or without an Akin) osteotomy for hallux abducto valgus, with 1227 females (90.83%) and 124 males (9.17%) identified but with only 1189 who had completed the patient satisfaction questionnaire. 96.8% of patients felt that their foot was either ‘better’ or ‘much better’ following surgery and that their original expectations of surgery had been met. Over 75% of patients had no post-operative sequalae identified, with metatarsal fracture noted to be the highest sequalae at 4.8%.ConclusionFrom the five podiatric surgery units reviewed, Scarf osteotomies (with or without an Akin osteotomy) for hallux abducto valgus correction, have a high level of patient satisfaction with low post-operative sequalae.Level of clinical evidenceIV (retrospective review).

TP8.1.8 Blue flag clinics. A way to achieve a 2 week wait service in the age of plentiful referrals, radiological pressures and pension threat

Introduction In early 2019 increased referrals to the Breast 2WW Service, limited radiologist capacity and the pension crisis combined to cause the 2 week wait target to fail. A multidisciplinary solution was sought. Using the Nottingham Breast Institute triage criteria and decoupling clinical and radiological assessments, patients were referred along 2 pathways; red and blue flag. Methods Patients were clinically assessed by a trained breast surgeon within 2 weeks. Red flag patients underwent standard triple assessment. The aim for blue flag patients was to undergo any necessary imaging within 10 days. In both cohorts selected patients were given a patient satisfaction questionnaire. Data from red flag clinics were obtained from cancer services. Notes were reviewed for blue flag patients. Results Data on 858 blue flag patients seen were analysed. There was no difference between satisfaction scores. Conclusions The 2WW target was regained within a month of implementing change. As long as the standard operating procedure is maintained, the triage criteria adopted were successful and reduced pressure on radiology services. Patient safety and satisfaction were maintained.

EP.WE.499Patient satisfaction with head and neck cancer telephone triage service during the COVID-19 Pandemic in a District General Hospital

Aims A head and neck cancer telephone triage pathway was implemented in March 2020 using the Head and Neck Cancer Risk Calculator as part of the 2 week wait cancer referral pathway. This was in response to the COVID-19 pandemic to stream cancer referrals to minimize unnecessary interactions and appointments with health services. The aim of this study is to assess patient satisfaction with the telephone triage system via a customised patient satisfaction questionnaire in the setting of a district general hospital. Methods A custom designed patient satisfaction questionnaire covering different facets of the patient experience will be used to measure patient satisfaction. These 16 questions (including open ended questions) are adapted from internally validated questionnaires. All continuous new head and neck cancer referrals to Torbay Hospital over two 6 week periods will be analysed, the first at the inception of the telephone triage service and the second several months later. The focus is on patient satisfaction towards the method of delivery of the telephone triage service rather than the content of delivery. Results and Conclusions Data collection is ongoing at the moment and preliminary results suggest that patient satisfaction is mixed, with a proportion of patients being unsatisfied that they did not get an examination, and a larger proportion of patients satisfied with the easier accessibility and safety of the service in the midst of the pandemic.

166 An audit of Patient Satisfaction after Breast Reconstruction and Presentation of a Novel Decision-Making Aid for Oncological Breast Surgery Patients

Background Breast reconstruction presents women with life-changing decisions at a time of immense pressure due to a concurrent cancer diagnosis. Objectives To assess whether patient satisfaction with breast care teams, patient autonomy in pre-operative consultation and information provision at Ysbyty Glan Clwyd (YGC) met the standards published in the National Mastectomy and Breast Reconstruction Audit (NMBRA), 2011. To use data collected to generate a novel decision-making aid. Method A patient satisfaction questionnaire, ‘Betsi-Q’, was created and sent to 100 mastectomy patients from YGC. Statistical significance was tested using Chi-squared test, T-test (Yates correction) and Z- score. Results Completed questionnaires were returned by 44 respondents (44%). Although shy of the 90% NMBRA recommendation, patient satisfaction with the team was reported high in 35/41 respondents (85%). The audit identified 36 respondents (86%) felt they made an informed decision regarding breast reconstruction, exceeding the 80% NMBRA recommendation. Information regarding the emotional and sexual benefits of breast reconstruction over mastectomy alone, were discussed with 10 respondents (26%), despite recommendations to discuss with all patients. Exploration of more than one option for breast reconstruction was only reported in 29/42 respondents (70%), below the 90% NMBRA recommendation. Conclusions Patient satisfaction with the team at YGC is high but efforts to ensure all patients are making an informed decision should be made. The decision-making tool designed alongside this audit aims to address these recommendations. Early identification and correction of misinformation, along increasing the variety of resources for patient education will be beneficial to manage expectations and enhance patient experience.

The Effect of WeChat on Parental Care Burden, Anxiety, and Depression in Children after CHD Surgery during COVID-19 Pandemic

Objectives This study aimed to explore the effect of applying WeChat in the follow-up and health education of children after congenital heart disease (CHD) surgery during the coronavirus disease 2019 (COVID-19) epidemic. Methods Data from 135 children were retrospectively analyzed. The care burden, anxiety, depression, and satisfaction of the parents of patients at home were analyzed and compared. Results One month after discharge, the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Zarit Burden Interview (ZBI), and Patient Satisfaction Questionnaire-18 scores of the WeChat follow-up group were significantly better than those of the outpatient follow-up group (p < 0.05). Compared with the discharge time, the SAS, SDS, and ZBI scores were significantly improved in the WeChat follow-up group but not in the outpatient follow-up group (p < 0.05). Conclusion During the COVID-19 epidemic, the application of WeChat to the follow-up management of children after CHD surgery can effectively reduce care burden and relieve anxiety and depression in parents at home. It can also improve the satisfaction of parents with medical treatment.

Patient Satisfaction and Recommendations for Delivering a Group-Based Intensive Outpatient Program via Telemental Health during the COVID-19 Pandemic (Preprint)

BACKGROUND Although group-based intensive outpatient programs (IOPs) are a level of care commonly utilized by adults with serious mental illness (SMI), few studies have examined the acceptability of group-based IOPs that required rapid transition to a telemental health (TMH) format during the COVID-19 pandemic. OBJECTIVE The aim of this study is to evaluate patient satisfaction and future recommendations for a group-based IOP that was transitioned to a TMH format during the COVID-19 pandemic. METHODS A 17-item patient satisfaction questionnaire was completed by patients at discharge and covered three areas: IOP TMH satisfaction, future recommendations, and video technology challenges. Descriptive and content analyses were conducted for the quantitative and open-ended questions respectively. RESULTS A total of 76 patients completed the program in 2020. A subset of patients (N = 40) responded to the survey at program discharge. Results indicated that patients were satisfied overall with the TMH program format. 50% of the patients preferred the program continue offering the TMH format and the rest preferred returning back to in person after the pandemic. Patients indicated the elements of the program that they found most valuable and provided recommendations for future program improvement. CONCLUSIONS Overall, adults with SMI reported high satisfaction with the group-based IOP delivered via TMH. Healthcare systems may want to consider offering both TMH and in-person formats regardless of the state of the pandemic. Patients’ feedback on future improvements should be considered to help ensure long-term success.

Measurement Properties of Physical Therapy Patient Satisfaction Questionnaire (PTPSQ) in an Iranian Musculoskeletal Population

Purpose: A valid and reliable tool that could measure patient satisfaction with physical therapy care for Persian-speaking patients will improve communication and enhance the involvement of people in research on health care quality and disparities. We aimed to evaluate the psychometric properties of the Persian version Physical Therapy Patient Satisfaction Questionnaire (PTPSQ). Methods: In this cross-sectional study, a prospective validation study design was adopted. In this methodological study, 297 patients from several physiotherapy centers in Kerman City, Iran, were evaluated using the PTPSQ. After the seventh session, a demographic questionnaire, visual analog scale, and the global rating of change were also answered by the participants (time point 1). The psychometric evaluation included factor analysis, divergent validity, convergent validity, and analysis of floor and ceiling effects. Reproducibility and internal consistency were investigated in this regard. To assess the test-retest reliability, 40 participants (randomly selected) completed the PTPSQ, again 24 to 48 hours later (time point 2). This research project was reviewed and approved by the Ethics Committee of the University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. SPSS v. 24 was used for statistical analysis. Results: The interclass correlation coefficient was in the range of 0.80-0.94 with the Cronbach alpha coefficient of 0.92. The standard error of measurement, minimal detectable change, and coefficient of variation for the questionnaire were 5.14, 14.39, and 0.21, respectively. Factor analysis revealed the 3-factor model. The relationship between the PTPSQ scores and the patient satisfaction index was relatively good (>0.40). Conclusion: Our results showed strong psychometric properties of the PTPSQ. Thus, we recommended its use in the Persian-speaking population.