Physician Attire Influences Patient and Family Perceptions of Care in the Palliative Care Unit in Japan

Background: Physician attire influences perceptions of care. This study was conducted to evaluate the impact of physician attire on perceptions of care by patients and families in a Japanese palliative care unit. Methods: From November 2018 to February 2020, patients and family members admitted to the Palliative Care Unit at Jichi Medical University Hospital were recruited and completed a survey consisting of 4 demographic questions and 15 questions regarding perceptions of care. A 7-point Likert scale (1 = strongly agree, 4 = neutral, 7 = strongly disagree) was used to judge attire (name tag, long sleeve white coat, short sleeve white coat, scrubs, scrub color, jeans, sneakers) addressing patient and overall impact on perception of care. Results: Of 203 patients admitted, 79 were enrolled. Surveys were received from 23 patients and 52 family members. Patients and families want physicians to wear name tags (median, interquartile range) (2, 1-2) and white coats (3, 2-4). Patients want to be addressed by surnames (2, 1.5-4). Patients and family members have neutral opinions about short sleeve white coats (4, 4-4) and scrubs (4, 4-4). Jeans were not liked (4, 4-6) while sneakers are acceptable (3, 2-4). The impact of attire on perceptions of care is significantly (p = .04) greater for patients (3, 2-4) than family members (4, 3-4). Conclusion: Patients and family members prefer their physicians to wear name tags and white coats and address patients by surnames. Physician attire has a significantly greater impact on perceptions of care for patients than family members in a palliative care unit.

Exploring the Relationship between Window View Quantity, Quality, and Ratings of Care in the Hospital

Hospital ratings reflect patient satisfaction, consumer perception of care, and create the context for quality improvement in healthcare settings. Despite an abundance of studies on the health benefits of the presence and content of window views, there is a gap in research examining how these features may impact patient satisfaction and consumer perceptions of the quality of care received. A quantitative exploratory study collected data from 652 participants regarding their previous stay in the hospital, their perception of windows in their room, and their perception of their room, the hospital, and the quality of care received. On a scale of 0–10, participants with access to windows gave a 1-unit higher rating for the hospital. Access to window views from their bed provided a 1-unit increase, and having a view to green spaces resulted in a 2-unit increase in hospital ratings. Statistically significant results were also found for room ratings and care ratings. Windows in the patient rooms impact the key patient satisfaction measures and patient experience during the hospital stay. Patient room design, bed set up, and quantity and quality of window views may play an important role in shaping the patient’s experience.

SP2.2.2Analgesia prescribing in acute surgical admissions - dual-centre cross-sectional study

Aim Pain is a common presenting complaint of acute surgical inpatients and has a great impact on their subjective wellbeing and the perception of care they receive if not addressed promptly and efficiently. It is also a common cause of patients’ complaints if not properly addressed. We set out to evaluate if analgesia is prescribed locally in accordance with WHO analgesia ladder and NICE CKS analgesia guidelines for mild-to-moderate pain. Method We performed cross-sectional studies of adults aged 16 and over, admitted under general or vascular surgery in two DGHs (2018-2020) with complaints of pain on admission. 30 patients were included in both studies with an average age 53/56 years. We undertook notes review, checked observation charts and drug charts for pain grading and analgesia prescribing following initial clinical assessment. Results In the first study, average pain score of 6 was obtained. Only 19/30 patients (63%) had regular analgesia prescribed. Only 2/30 (6%) were started on regular weak opioids, with further 8/30 (26%) on as required/PRN weak opioids. 17/30 (56%) patients had PRN Oramorph prescribed. Only 2/30 (6%) were started on PRN NSAIDs despite only 46% having cautions/contraindications. 5/30 patients with pain scores of 9-10 not had any regular analgesia prescribed. Comparable results were achieved in the second hospital we audited. Conclusions This study shows significant under-prescribing of analgesia, especially regular analgesia for surgical patients with moderate-severe pain, and skipping of weaker opioids/NSAIDs in favour of Oramorph. There is significant scope for improvement following educational session implementation.

Comparison of Patient Perception and Satisfaction of Face-to-Face Versus Telemedicine Encounters in Hand Surgery

Background: The coronavirus disease 2019 (COVID-19) surge has enabled the widespread usage of telemedicine (TM) and presents a unique opportunity to determine the hand surgery patients’ perception of care using validated patient satisfaction scores. Methods: Electronic surveys were distributed to patients aged 18 years and older who underwent a video TM encounter with a single surgeon at an academic medical center during the initial COVID-19 surge (March 23 to October 22, 2020). The study-specific questions were derived from the Press Ganey (PG) Medical Practice TM Survey and compared with institutional PG Outpatient Medical Practice Survey data. Three cohorts were defined: pre-COVID face-to-face, post-COVID TM, and post-COVID face-to-face. Results: Thirty of 65 TM patients (46.2%) responded. No differences in sex, age, or visit type were identified between cohorts. The TM cohort was more likely to live greater than 300 miles from the institution. Median response for all cohorts for the PG care provider and overall experience responses were “very good,” and no differences were identified between cohorts. Patient satisfaction with their TM experience was high with median satisfaction scores for arranging and connecting to a TM visit, talking with the provider over a video connection, and having the provider understand the clinical problem were “very good.” Patients in the TM cohort reported no difference in preference for face-to-face or TM visits. Conclusions: Patients are satisfied with TM as a substitute for face-to-face visits suggesting that TM can possibly be used to deliver comparable patient experience for hand surgery encounters.

1148 Analgesia Prescribing in Acute Surgical Admissions - Dual-Centre Cross-Sectional Study

Aim Pain is a common presenting complaint of acute surgical inpatients and has a great impact on their subjective wellbeing and the perception of care they receive if not addressed promptly and efficiently. It is also a common cause of patients’ complaints if not properly addressed. We set out to evaluate if analgesia is prescribed locally in accordance with WHO analgesia ladder and NICE CKS analgesia guidelines for mild-to-moderate pain. Method We performed cross-sectional studies of adults aged 16 and over, admitted under general or vascular surgery in two DGHs (2018-2020) with complaints of pain on admission. 30 patients were included in both studies with an average age 53/56 years. We undertook notes review, checked observation charts and drug charts for pain grading and analgesia prescribing following initial clinical assessment. Results In the first study, average pain score of 6 was obtained. Only 19/30 patients (63%) had regular analgesia prescribed. Only 2/30 (6%) were started on regular weak opioids, with further 8/30 (26%) on as required/PRN weak opioids. 17/30 (56%) patients had PRN Oramorph prescribed. Only 2/30 (6%) were started on PRN NSAIDs despite only 46% having cautions/contraindications. 5/30 patients with pain scores of 9-10 not had any regular analgesia prescribed. Comparable results were achieved in the second hospital we audited. Conclusions This study shows significant under-prescribing of analgesia, especially regular analgesia for surgical patients with moderate-severe pain and skipping of weaker opioids/NSAIDs in favour of Oramorph. There is significant scope for improvement following educational session implementation to junior doctors.

Perception of Caring Behavior of Nurses and Patients

ABSTRACT Introduction: Nurses have several tasks but one of the most crucial for them is to provide quality patient care. However, patients’ perception of care might differ with what nurses think. Patients perceive caring as a developed interpersonal relationship between themselves and their nurses. Contrarily, nurses perceive caring as providing quality care through being knowledgeable and compliant in the prescribed orders through the course of treatment. Aims: This study aims to develop a distinct comparison between the perception of care of patients and nurses. Methodology: A descriptive-comparative design was utilized. Survey data were collected from 200 nurses and 160 patients in the general nursing units of a private, tertiary-level general hospital in the Philippines. The Caring Behaviors Inventory-24 (CBI-24) was used to obtain perceptions of care between nurses and patients. Data was analyzed using t-test to compare care perceptions between nurses and patients. Statistical significance was based on p < .05. Results: The results showed no statistical difference between nurses’ and patients’ CBI-24 scores. Among CBI-24 items, only seven had significant statistical difference. Specifically, staff nurses reported higher scores for ‘spending time with the patient’ and ‘demonstrating professional knowledge and skill’ while patients reported higher scores for ‘giving instructions or teaching the patient,’ ‘supporting the patient,’ ‘being patient or tireless with the patient,’ ‘including the patient in planning his or her care,’ and ‘giving the patient’s treatments and medications on time.’ Conclusions: In general, the perceptions of care between nurses and patients is at the same level. However, there are specific caring behaviors where nurses over- or underestimate themselves. Overall, the results can be used to develop strategies to further improve the quality of care provided to patients. Keywords: Nurses, Patients, Philippines, Nursing Care Management, Caring

Parturients Perception of Care Providers Attitude Towards Women During Labour And Delivery In Southwest Cameroon

Background: The period of labour and childbirth for women is a delicate moment and predisposes them to disrespectful care which has been reported in many countries. In Cameroon, data which could help in formulating policies to modify these attitudes is rare.Objectives: To assess parturients’ perception on the respect and disrespect of women by care providers as well as determining the prevalence, types and predisposing factors of physical and verbal abuse during labour and delivery, in the Buea and Limbe Regional hospitals, Cameroon. Methods: It was a hospital based cross-sectional study carried out in Buea and Limbe Regional hospitals from February 15th to April 20th 2021. It involved parturients aged between 15 and 45 in their first eight weeks post-delivery. Data was collected using a structured questionnaire, and the collected data was entered into and analyzed with SPSS version 25. Dependent variables were dichotomized and a bivariate logistic regression model was fitted to obtain the determinants of mistreatments during labour and delivery, while Chi-squared test was used to establish association between socio-demographic characteristics and care categories. A P-value <0.05 was considered statistically significant. Results: We sampled 274 parturients aged between 15 and 42 (mean=26.69yrs and SD= + 5.34). Sixty-nine (25.18%) of the respondents reported at least a physical and/or verbal mistreatment. The most common physical and verbal mistreatments were abdominal fundal pressure to facilitate expulsion and scolding. Muslims were more likely to report insult. Parturients perceived both respectful and disrespectful forms of care.Conclusion: Disrespectful care during labour and delivery may not be uncommon in our country as suggested by the findings in this study. There is need for development of interventions to address the drivers of disrespect and abuse which will encourage clients’ future facility utilization. More studies are needed in other areas of the country to support this evidence.