Satisfaction with and use of inhalation devices in patients with bronchial asthma v1

Introduction:Greater patient satisfaction with his or her inhalation device is associated with better adherence to pharmacological therapy and better clinical outcomes, such as improved quality of life, greater asthma control and fewer exacerbations. Objective: To determine the satisfaction level of a group of patients diagnosed with bronchial asthma with respect to their devices for inhalation of bronchodilators and glucocorticoids. Methods: This was a cross-sectional study of patients treated in the Colombian health system. Satisfaction with inhalation devices was evaluated with the FSI-10 instrument (Evaluation of Satisfaction with the Inhaler). A score of ≥ 44 points indicated high satisfaction. Results: In total, 362 patients from 59 cities were identified, their median age was 55 years, and 74.6% were women. The average score was 44.6; 68.5% of patients showed high satisfaction, especially with metered-dose inhalers, and 63.4% did not use them with an inhalocamera. Users of metered-dose inhalers (OR: 1.80; 95% CI: 1.05–3.10) and those who received training by medical specialists (OR: 2.29; 95% CI: 1.33–3.97) had high satisfaction, while patients who were older (40–64 vs. <40 years: OR: 0.38; 95% CI: 0.19–0.78 and ≥ 65 vs. <40 years: OR: 0.35; 95% CI: 0.15–0.81), resided in the Caribbean region (OR: 0.48; 95% CI: 0.29–0.81) and had a university education (OR: 0.54; 95% CI: 0, 32–0.90) had lower satisfaction. Conclusions: The majority of patients with asthma used metered-dose inhalers without an inhalocamera, and their overall satisfaction was higher than that of patients using other inhalation devices. Patients who received special training from medical specialists showed better satisfaction.

Present status of portfolio based training and assessment in postgraduate residency program in Bangabandhu Sheikh Mujib Medical University (BSMMU): A quantitative approach

Since 2009, the portfolio has been a prerequisite for the evaluation of postgraduate residency programs at BSMMU. This descriptive cross-sectional study was conducted with the aim of investigating the current status of portfolio-based training and assessment in BSMMU`s postgraduate training program. Total 264 residents and 30 faculty members selected conveniently and completed the Likert scale-based questionnaire. A checklist was used for reviewing portfolios (n=33) those were preserved by residents. Study revealed that most of the respondents were male (68.6% of residents and 93.3% of faculty members). About 60% of residents have given positive views on presence of instruction and purpose about maintaining the portfolio. Several participants expressed concerns because the portfolio content is self-reported; it may include bias or inaccuracy. Regarding opinions of respondents on characteristics of portfolio, both of the respondents perceived high satisfaction on portfolio based learning, reasonable contents, and practicable and feasible use of portfolio (p<0.05) except regular updating (p<0.05) and comprehensiveness of portfolio. In line with ownership and motivation, faculty members (4.03) highly assumed that the portfolio completed by residents as requirement of the university than residents (3.22) and p<0.05). Residents did not agree that they worked on the portfolio during university deadline (2.89) whereas faculty members ((3.73) showed vary positive views in this regard. Concerning commitments to use the portfolio, both respondents have conveyed high expression (mean >3.5) on the relationship between residents and supervisors so the role of an available supervisor in direct observations of the residents and dedicated educational meetings, giving feedback and support, cannot be exaggerated. Relating to assessment of portfolio, overall views of the respondents have expressed poor to moderate views and faculty members (2.37 to 4.23) have less satisfaction than residents (2.88 to 3.73). Though there are so many constraints such as the lack of clear purposes and instructions, poor understanding regarding ownership, assessment issues, and confusion about educational impact in future, but the portfolio as a feasible and acceptable tool to train and assess clinical competence and clinical specialization. Study recommended for generic format of portfolio based training and assessment to be considered in Bangladesh context. All Stakeholders should be well oriented at the beginning for utilizing the portfolio (supervision, monitoring and assessment system). Bangladesh Journal of Medical Education Vol.13(1) January 2022: 69-78

COVID-19 Vaccine Education (CoVE) for Health and Care Workers to Facilitate Global Promotion of the COVID-19 Vaccines

The COVID-19 vaccine is being rolled out globally. High and ongoing public uptake of the vaccine relies on health and social care professionals having the knowledge and confidence to actively and effectively advocate it. An internationally relevant, interactive multimedia training resource called COVID-19 Vaccine Education (CoVE) was developed using ASPIRE methodology. This rigorous six-step process included: (1) establishing the aims, (2) storyboarding and co-design, (3) populating and producing, (4) implementation, (5) release, and (6) mixed-methods evaluation aligned with the New World Kirkpatrick Model. Two synchronous consultations with members of the target audience identified the support need and established the key aim (Step 1: 2 groups: n = 48). Asynchronous storyboarding was used to co-construct the content, ordering, presentation, and interactive elements (Step 2: n = 14). Iterative two-stage peer review was undertaken of content and technical presentation (Step 3: n = 23). The final resource was released in June 2021 (Step 4: >3653 views). Evaluation with health and social care professionals from 26 countries (survey, n = 162; qualitative interviews, n = 15) established that CoVE has high satisfaction, usability, and relevance to the target audience. Engagement with CoVE increased participants’ knowledge and confidence relating to vaccine promotion and facilitated vaccine-promoting behaviours and vaccine uptake. The CoVE digital training package is open access and provides a valuable mechanism for supporting health and care professionals in promoting COVID-19 vaccination uptake.

Satisfaction and Experience of Palliative Patients with 24/7 Hotline Service During the COVID-19 Pandemic in Saudi Arabia

Background: The COVID-19 pandemic prompted a number of shifts on healthcare. Conventional face-to-face visits were shifted during lockdown to virtual ones. Palliative care (PC) virtual visits have had high satisfaction rates, especially with patients in remote areas. Due to a number of factors, further studies are needed to develop tools that can be helpful and cost effective in improving patient’s quality of life. Objective: Our aim is to learn the main reasons palliative patients in Saudi Arabia sought help via calling the free 24/7 hotline and to discuss the hotline’s satisfaction and effectiveness in solving the palliative patient’s concerns during COVID-19. Methods: A cross-sectional sample analysis was obtained from 214 patients from different regions in Saudi Arabia. A total number of 843 calls were made to the 24/7 PC hotlines from the period of 17 April 2020 to 28 February 2021, shortly after COVID-19 pandemic began. The purpose of the call, the caller's relationship to the patient, the status of the complaint, and the satisfaction rate were collected at the end of the call through a voluntary phone survey. Results: The primary reasons that palliative patients called the hotline were: 30% for medication refills, (n=247), 24.7% for medical complaints, (n=205), 15.8% were for booking a new appointment (n=131). Patients themselves accounted for 27.8% of the callers and patient’s sons/daughters accounted for 51.3%. 85% of patients said that their issue had been resolved by the end of the call and 89% of our sample were happy with the service provided through the hotline. Conclusion: The 24/7 hotline service for PC patients in Saudi Arabia was successful in its application and resulted in a high level of satisfaction among a wide sample of participants. The main reasons palliative patients reached out were to request medication refills, seek assistance with a medical complaint, and to book a new appointment. Our hotline service effectively solved 85% of patients' issues.

Changing perceptions of telemedicine in a surgical outpatients clinic

Background/Aims Before the COVID-19 pandemic, telemedicine was not widely used in surgical departments. Despite its increased use during the pandemic, there is a lack of data on the patient perspective. This study investigated patients' views of telemedicine in a surgical outpatients clinic setting. Method A single-centre cross-sectional study was performed, involving patients who were due to attend the surgical outpatients clinic of one surgical team. Independent investigators contacted the patients by telephone after their virtual telephone consultation to administer the questionnaire. Patient satisfaction rates were recorded using the PSQ-18 questionnaire. Patient consultation preferences were recorded and analysed. Results A total of 223 patients participated in this study. The majority of patients' perceptions shifted in favour of virtual consultations after the onset of the pandemic (P<0.05). Sub-group analysis showed no significant differences between the preferences of older and younger patients before or after the onset of the pandemic. Overall, patients reported high satisfaction rates with their virtual consultations. Conclusions Patient perceptions are changing in favour of virtual telemedicine consultations. Training healthcare providers in this method of service delivery is essential to maintain a good quality of care.

Reporting Inpatients’ Experiences and Satisfaction in a National Psychiatric Facility: A Study Based on the Random Forest Algorithm

Understanding psychiatric inpatients’ experiences is important to establish a culture of patient-centric care and promote trust in healthcare. This study aimed to evaluate nine dimensions of patients’ experiences and investigate their association with patient satisfaction, revisit intention, and positive word-of-mouth (WoM) recommendation. Cross-sectional questionnaire data from five years of surveying (2016–2020) in the main psychiatric hospital in Bahrain were statistically analyzed, involving 763 psychiatric inpatients with an overall 65.6 ± 17.2 length of stay (days). The findings show that across the five years 2016–2020, the overall reported satisfaction was “very high” (4.75 ± 0.44) with no significant differences between these five years (F [4, 758] = 0.66, p = 0.620). The experience of confidentiality received the highest rating (4.72 ± 0.45). The experiences of ease of access, hospitality quality, and quality of responsiveness to one's needs significantly correlated with revisit intention ( p ˂ 0.05). Patients with high satisfaction had greater potential for revisit intention (r [761] = 0.08, p = 0.027), which was associated with WoM recommendation (r [761] = 0.08, p = 0.033). Overall, men were less likely than women to experience convenient access to psychiatric wards. The findings of the Random Forest algorithm indicate the tendency of female patients with short-term stays to demonstrate lower satisfaction rates, and thus innovative approaches are needed when managing these groups’ psychiatric problems.

The Impact of the Implementation of Rural Internet Centers on Rural Residents in Beranang and Tanjung Sepat

The development of information and communication technology (ICT) has been proven to be able to help facilitate daily activities that were previously carried out manually in a more productive direction. There is no doubt technology is also changing the lifestyle of our society. The government has implemented various efforts to ensure that the people in Malaysia, whether in urban or rural areas, can master ICT, including through the Beranang Rural Internet Center (PID) and Tanjung Sepat PID. This study has two objectives, namely to find out the impact of PID implementation on the rural population, as well as to study the proposed improvement of PID implementation on the rural population. This study uses a qualitative approach that is in-depth interviews with policy makers at KKMM and policy implementers of which are supervisors working at PID and also a focus group involving 28 PID users, to collect data. The results of this study found that the implementation of PID is indeed effective in developing the rural population. Consumers get such high satisfaction especially in the economic aspect. However, the limited aspect of facilities interferes with user satisfaction to use this PID. This is because the area allocated for PID is found to be small and only a limited number of computers are provided. Dissemination activities on various PID programs also need to be increased because there are still many rural residents who think that PID is just a place to access the internet. Keywords: Information technology, policy, rural Internet center, rural, digital.

Experiences with alternative online lectures in medical education in obstetrics and gynecology during the COVID-19 pandemic—possible efficient and student-orientated models for the future?

Purpose The onset of the COVID-19 pandemic posed an eminent challenge for medical teachers worldwide. Face-to-face lectures and seminars were no longer possible, and alternatives had to be found. E-learning concepts quickly emerged as the only practicable solutions and also offered the opportunity to evaluate whether traditional face-to-face lectures could be translated into an online format, independent of the COVID-19 pandemic. Methods We offered an e-learning program consisting of lecture notes, screencasts with audio narration, and online webinars that covered topics normally taught in traditional lectures and seminars. To evaluate the learning behavior and quality of our e-learning program, we drafted a questionnaire that students completed at the end of the 2020 summer semester that had been designed to enable a comparative analysis of the different e-learning modules. Results Voluntary participation in the online courses was high. Survey analysis revealed high satisfaction with and a distinctive preference for the format, even under regular, COVID-19-independent conditions. In general, a positive appraisal of e-learning—especially as a substitute for regular lectures—was found. Students also reported higher studying efficiency. Exam results were equal to those of previous semesters. Conclusion Both acceptance of and satisfaction with our e-learning modules were high, and students displayed increased demand for this kind of e-learning format. We, therefore, conclude that e-learning offerings could serve as reasonable, efficient, student-orientated substitutes for certain medical courses, especially lectures. These curricular adaptations would correlate with the high digitalization seen in students’ everyday lives. This correlation may also hold true independent of the ongoing COVID-19 pandemic.

Pediatric neurology and telehealth before and during SARS-CoV-2 pandemic

Telehealth has been known in medicine for over 70 years. Until the year 2020 it has been utilized in a limited setting to provide long-distance care for individuals residing in areas lacking health facilities. SARS-CoV-2 pandemic shifted the priorities of healthcare system towards COVID-19 infections, which resulted in the transition of non-emergency consultations to telemedicine in many countries. Since pediatric neurology requires frequent follow-up and multidisciplinary care, the purpose of our work is to determine the spectrum of use of telehealth in pediatric neurology before and during the pandemic. Secondly, we would like to discuss the differences of focus in tele-neurology for children patients between the pre-pandemic and during pandemic timeframes.Within 171 articles of PubMED database, 36 substantial articles on the introduction of telehealth to pediatric neurology were included in the review. 30.5% of the articles have included the implementation of telemedicine before the pandemic, 69.5% of the articles discussed improvements made after the pandemic started. The spectrum of disorders and interventions considered for telehealth included epilepsy, cerebral palsy, rare diseases, teleneuropsychology and teleneurorehabilitation. Among major differences between pre-pandemic and pandemic research, increase in international cooperation and discussion of not only medical, but also scientific and academic impact of the pandemic could be noted.Telehealth offers sustainable alternatives to many interventions which cannot be performed in-person during public health emergency such as SARS-CoV-2 pandemic. Despite high satisfaction of caregivers and healthcare professionals from the virtual visits, solutions are still far from perfection and need improvements to provide more support for the patients with various disorders, cover the concerns of privacy and confidentiality, as well as support patients from low-income and lack of electronic techology backgrounds.

Complications of first tarsometatarsal joint arthrodesis

Objective: First tarsometatarsal joint (TMTJ) arthrodesis, also known as Lapidus, is a surgical procedure used to treat severe hallux valgus, associated hypermobility of the first ray, and/or osteoarthritis of the first TMTJ. Despite the high satisfaction rate and high corrective power, this technique is not without complications. This study aimed to report the complications of first TMTJ arthrodesis. Methods: This is a case series of 16 patients treated with first TMTJ arthrodesis. Patients were evaluated based on foot radiographs, clinical alignment of the hallux, and signs and symptoms. Results: Eight patients had either major or minor complications. Three patients had recurrent deformity (1 with associated nonunion), 2 had delayed union, 2 had hardware loosening (1 with associated nonunion), and 1 had wound dehiscence. Conclusion: First TMTJ arthrodesis requires greater care in choosing the surgical technique for the treatment of hallux valgus. In addition, some points should be considered to minimize complications as much as possible. We believe that data are still scarce to provide a concrete basis. Level of Evidence IV; Therapeutic Studies; Case Series.