Introduction: The increase in the number of patients presenting with osteoarthritis in the past decade has led to a 32% increase in knee replacement surgeries designed to reduce restrictions on patient movement and improve their quality of life. Patient satisfaction is becoming an increasingly important indicator of quality of care. This study was designed to identify predictors of various service components in the treatment process and hospital key performance indicators significantly associated with patient satisfaction. Materials and methods: A multicenter cross-sectional study was conducted with 856 patients having their primary total knee replacements at 41 hospitals. Patient satisfaction was queried via a validated, multidimensional questionnaire mainly using a six-point scale. In addition to bivariate calculations, patient satisfaction was the dependent variable in a binary logistic regression model. Results: The bivariate analysis showed a strong association between satisfaction and sex (male or female), the patients’ health before admission, and the length of stay. The number of cases treated at each hospital did not reveal any impact on satisfaction. The multivariate analysis identified three predictors associated with overall satisfaction. The strongest factor was the treatment outcome and the weakest was the quality of food. It became apparent that the statutory procedure minimums were not being met. Conclusions: The relevant factors influencing patient satisfaction were partially the same as previous study results and allowed more detailed conclusions. The results provide suggestions across hospitals that could help health care providers better meet needs of patients after knee arthroplasties.

Background: Since the 1980s, Saudi Arabia’s socio economic transformation has led to vast social development. As a result there has been increased adoption of behaviours such as smoking and sedentary life styles, which pose a risk to health. It is anticipated that cancer incidence will double over the next two decades and it is thus vital that high quality of care is provided to meet the growing health care demands. Moreover, it is important that patients are satisfied with their care provision. This thesis begins with a narrative synthesis of the existing literature about patient satisfaction in the Saudi context and beyond. An evaluation of the key concepts for understanding patient satisfaction illuminated the lack of evidence about the assessment of patient satisfaction including specific key domains of the structure and process of care. This evaluation also indicated the need to further investigate the Saudi patient perspectives in oncology hospital setting. The aim of my study was to examine the extent to which clinical effectiveness impacts upon patient satisfaction in oncology ward settings in the Kingdom of Saudi Arabia (KSA). Methods: A sequential explanatory mixed methods design was employed. The Donabedian quality framework (1980) and Patient experience model (Reimann and Strech 2010) were used to assess patient satisfaction with quality of care provided. A quantitative phase was followed by a qualitative phase. In the first phase, the European Organisation for Research and Treatment of Cancer (EORTC) IN-PATSAT32 validated questionnaire was used to collect data from 100 adult oncology inpatients at a Cancer Centre in Riyadh. The second qualitative phase involved semi-structured telephone and face to face interviews with 22 adult oncology inpatients who previously answered the questionnaire. Synthesis occurred at the intersection of quantitative Phase 1 and qualitative Phase 2 data. The qualitative Phase 2 thus further explored the satisfaction scores of quantitative Phase1 to deepen the understanding of patient satisfaction in oncology ward settings in KSA. Findings: The main findings were that patient satisfaction levels are influenced by the clinical effectiveness of doctors and nurses, accessibility to health care and socio-demographic factors. Specifically, the interpersonal aspects of care were deemed core to patient experiences in oncology ward settings in KSA. It emerged that doctor-patient relationships, nurse shortages and language barriers are particular areas where changes could be made to improve care, thereby enhancing patient satisfaction. These findings contribute important new insights into the interpersonal aspects of care in the light of the underlying social and cultural contextual factors that influence patient satisfaction in the KSA. Conclusion: This study has provided new evidence supporting the need for stronger interpersonal relations and a more patient-centred approach in the oncology health system in KSA. In particular, the influential role of cultural issues in influencing patient satisfaction in oncology ward settings was apparent. Evidence provided by this research will make a substantial contribution to policy makers and hospital management teams in the KSA wanting to improve patient satisfaction in oncology wards and in other health care settings.

Bakgrund: Som vårdgivare möter vi ofta patienter med psykosomatiska symtom och sjukdomar, patienter med fysiska symtom som saknar tydlig organisk förklaring. Inom primärvården har cirka 30% av patienterna medicinskt oförklarliga symtom. Tidigare forskning har visat att vårdgivare känner sig osäkra och otillräckliga när de handlägger patienter med psykosomatiska symtom. Det tycks vara svårt att veta hur man ska bemöta denna patientgrupp och hjälpa dem att uppnå god hälsa. Syfte: Syftet med litteraturstudien var att beskriva hur vuxna patienter med psykosomatiska symtom upplevde mötet med och bemötandet av sin vårdgivare samt beskriva de inkluderade artiklarnas datainsamlingsmetod. Metod: En beskrivande litteraturstudie baserades på tio vetenskapliga artiklar. Artiklarna söktes fram i databaserna PubMed och Cinahl. Ansatsen på de inkluderade artiklarna var både kvalitativ och kvantitativ. Artiklarna har noggrant granskats i syfte att finna skillnader och likheter. Resultat: Patienter som fick känslomässigt stöd, förklaringar, togs på allvar och var delaktiga i beslut var de som kände mest välbefinnande och tillfredsställelse med vårdgivaren och det bemötande de fick. De patienter som möttes av oengagerade vårdgivare, blev ifrågasatta och upplevde ett motstånd, kände att de var en börda för sjukvården. De inkluderade artiklarnas datainsamlingsmetoder var intervjuer och enkäter. Slutsats: Resultatet visade att många patienter med psykosomatiska symtom sökte bekräftelse. Kommunikation var viktigt för att dessa patienter skulle känna trygghet och förtroende. Genom vidare forskning och viss förändring i omhändertagandet av dessa patienter, skulle sjuksköterskan kunna bidra med denna trygghet i större utsträckning. / Background: As healthcare providers we often meet patients with psychosomatic symptoms and diseases, patients with physical symptoms who lack clear organic explanation. In primary care, approximately 30% of patients have medically unexplained symptoms. Previous research has shown that healthcare providers feel insecure and insufficient when handling patients with psychosomatic symptoms. It seems difficult to know how to respond to this patient group and help them achieve good health. Aim: The aim of the literature study was to describe how adult patients with psychosomatic symptoms experienced the encounter with and the treatment of their healthcare providers, and to describe the data collection methods of the included articles. Method: A descriptive literature study based on ten scientific articles. The articles were searched in the PubMed and Cinahl databases. The included articles were designed both qualitative and quantitative. The articles have been carefully reviewed in order to find differences and similarities. Result: Patients who received emotional support, explanations, were taken seriously and participated in decisions were those who felt most well-being and satisfaction with the care and the response they received. Patients who were met by uncommitted healthcare providers, and were questioned and experienced a resistance from their providers, were those who felt that they were a burden on healthcare. Data collection methods in the included articles were interviews and questionnaires. Conclusion: The result showed that many patients with psychosomatic symptoms sought confirmation. Communication was important for these patients to feel safe and confident. Through further research and some change in the treatment of these patients, the nurse could contribute to this safety to a greater extent.

The abbreviation of preoperative fasting with the provision of clear fluid two hours before the operation and the early introduction of a diet in the postoperative period, are indications that may bring benefits for the surgical patient. Objective: To assess the effects of reducing the time of preoperative fasting and early feeding in the postoperative period, in patients undergoing a laparoscopic cholecystectomy. Method: a randomized and controlled clinical trial conducted in a private hospital in Aracaju, Brazil, in which the variables investigated were: the presence of gastric residue, vomiting, bronchoaspiration and satisfaction in the post-operative period of 80 patients, who were randomly divided into two groups, the test group (40 patients) ingested 100 ml of coconut water two hours before induction of anesthesia and the control group (40 patients) followed the conventional fasting for six hours without ingest liquids and were submitted to laparoscopic cholecystectomy. A previous monitoring of patients still under consultation was done, those who met the inclusion criteria received guidance on the development of research and responded to a questionnaire with questions related to the occurrence of symptoms. The numerical scale was used for each patient, with the aim of evaluating the degree of satisfaction related to the reduction of the time of fasting in the preoperative period and early feeding in the postoperative period. The comparative analysis of groups was performed using the Mann-Whitney and Fischer´s Exact Test. The significance level of 5% was considered, while for the descriptive analysis percentages and tables were used. Results: There was no aspiration or regurgitation of gastric contents during the anesthetic induction. There were no deaths or post-operative complications. With regard to residual gastric volume, there was no significant difference between the test and control groups (p=0,704). In addition, there was no significant difference between the groups for the vomiting variable (p>0.05). After having their fasting reduced, the test group had a significant degree of satisfaction (p<0.001). Conclusion: The reduction of pre and post-operative fasting showed less discomfort with apparent satisfaction in patients undergoing laparoscopic cholecystectomy. / A abreviação do jejum pré-operatório com oferta de líquido claro duas horas antes da operação e a introdução precoce de dieta no pós-operatório, são indicações que poderão trazer benefícios para o paciente cirúrgico. Objetivo: Avaliar os efeitos da redução do tempo de jejum pré-operatório e alimentação precoce no pós-operatório, em pacientes submetidos à colecistectomia videolaparoscópica. Método: ensaio clínico randomizado e controlado realizado em um hospital particular de Aracaju, no qual as variáveis investigadas foram: a presença de resíduo gástrico, vômito, broncoaspiração e satisfação no pós-operatório de 80 pacientes, que foram aleatoriamente divididos em dois grupos, o grupo teste (40 pacientes) ingeriu 100 ml de água de coco duas horas antes da indução anestésica e o grupo controle (40 pacientes) seguiu o jejum convencional de seis horas sem ingerir líquidos e foram submetidos à colecistectomia videolaparoscópica. Foi feito um acompanhamento prévio dos pacientes ainda em consultório, aqueles que atenderam aos critérios de inclusão receberam orientações sobre o desenvolvimento da pesquisa e responderam a um questionário com perguntas relativas à ocorrência dos sintomas. A escala numérica foi empregada para cada paciente, com o intuito de avaliar o grau de satisfação relacionada à redução do tempo de jejum no pré-operatório e alimentação precoce no pós-operatório. A análise comparativa de grupos foi feita através do Teste de Mann- Whitney e Exato de Fischer. Considerou-se o grau de significância de 5% e para a análise descritiva foram utilizadas percentagens e tabelas. Resultados: Não houve aspiração ou regurgitação do conteúdo gástrico durante a indução anestésica. Não houve óbito nem complicações pós-operatória. No que se refere a volume residual gástrico, não houve diferença significativa entre os grupos teste e controle (p = 0,704). Também não houve diferença significativa entre os grupos para a variável vômito (p > 0,05). Após ter o seu jejum reduzido, o grupo teste teve um grau de satisfação significativo (p < 0,001). Conclusão: A redução do jejum pré e pós-operatório, sinalizaram menos desconforto com aparente satisfação em pacientes submetidos à colecistectomia videolaparoscópica

A demanda crescente de usuários de implante coclear (IC) e a distribuição irregular de profissionais especializados no país, tornam necessário o deslocamento de pacientes por longas distâncias para os atendimentos, com consequente aumento dos custos diretos e indiretos do tratamento. A teleconsulta pode ser vista como uma alternativa em potencial para o acesso desta população a estes serviços. O presente ensaio clínico, randomizado, controlado, avaliou a eficácia da teleconsulta síncrona na programação dos sistemas de IC em usuários acompanhados em um Programa de Implante Coclear credenciado pelo Sistema Único de Saúde. Participaram do estudo 79 indivíduos com idades entre nove e 68 anos (média de 21,6), 41 do sexo masculino e 38 do sexo feminino, usuários de IC por um período de 0,58 a 24,75 anos. Estes indivíduos foram divididos em dois grupos, de acordo com o modo de programação do IC: controle (n=40), que realizou o procedimento face a face e experimental (n=39) que realizou a teleconsulta síncrona. Treze fonoaudiólogos sem experiência na programação do dispositivo atuaram como facilitadores das teleconsultas. Os procedimentos de programação do IC englobaram a telemetria de impedância, definição dos níveis de estimulação elétrica, varredura e balanceamento dos eletrodos e ajuste fino da programação. Como medidas de avaliação de resultados foram utilizados o tempo dispendido na consulta, a audiometria em campo livre, o percentual de reconhecimento de sentenças no silêncio e no ruído, o limiar de reconhecimento de sentenças no silêncio e ruído (HINT-Brasil), a avaliação da satisfação com a consulta (escala MISS-21) e de aspectos pertinentes à teleconsulta. Os facilitadores responderam as questões abertas referentes à suas impressões dos atendimentos. Os dados foram analisados por meio de estatística inferencial (testes t de Student, Wilcoxon, Mann-Whitney e correlação de Spearman). Os resultados mostraram que após a programação do IC, em média, os participantes apresentaram limiares audiométricos abaixo de 30 dB NA. O reconhecimento da fala pós atendimento, respectivamente para os grupos experimental e controle, foram de 81,3% e 83,8% (silêncio) e 57,9% e 58,1% (ruído). No HINT-Brasil os resultados foram, respectivamente, para os grupos experimental e controle 61,4 dB NA e 61,8 dB NA (silêncio) e relação S/R de 9,5 dB NA e 10,4 dB NA (ruído). Os participantes estiveram satisfeitos com a consulta. Não houve diferença estatisticamente significativa entre os grupos em nenhuma das medidas de resultado. Todos os participantes relataram que teleconsulta pode ser vista como uma alternativa viável ao atendimento face a face e sua aplicação clínica facilitaria a rotina de pacientes usuários de IC. Os facilitadores destacaram a sua importância para o aprendizado e como ferramenta de formação continuada. A teleconsulta síncrona foi eficaz na programação dos sistemas de IC e amplamente aceita pelos usuários e profissionais. / The growing number of cochlear implant (CI) users and the uneven distribution of specialized professionals in the country makes necessary patients traveling over long distances to receive care, with consequent increase in direct and indirect costs of treatment. The telehealth can be viewed as an alternative for this population to access such services. This clinical randomized, controlled clinical trial evaluated the efficacy of synchronous teleconsultation in the programming of CI systems in a Cochlear Implant Program accredited by the National Health System in Brazil. Participate in this study 79 subjects aged between nine and 68 years (average 21.6), 41 males and 38 females, CI users for a period from 0.58 to 24.75 years. The participants were divided into two groups, according to the nature of consultation: control group (n = 40), who performed the CI programming face-to-face and experimental group (n = 39) who performed the CI programming through the synchronous teleconsultation. Thirteen audiologists without experience in CI programming acted as facilitators of teleconsultation. The CI programming procedures encompassed the impedance telemetry, setting of electrical stimulation levels, sweeping and balancing of the electrodes and programming evaluation in live speech mode. The outcome measures were the time spent in consultation, free field audiometry, the percentage of sentence recognition in quiet and in noise, the sentence recognition threshold in silence and noise (HINT-Brazil), satisfaction with the consultation (MISS-21 scale) and aspects related to teleconsultation. The facilitators responded open questions regarding their impressions of the teleconsultations. Data were analyzed using inferential statistics (Student t test, Wilcoxon, Mann-Whitney and Spearman correlation). The results showed that after CI programming, on average, the participants had audiometric thresholds below 30 dB HL. The speech perception for the experimental and control groups post CI programming were respectively, 81.3% and 83.8% (in silence) and 57.9% and 58.1% (in noise). In HINT-Brazil the results were, respectively, for the experimental and control groups 61.4 and 61.8 dB (silence) and S/N ratio of 9.5 dB and 10.4 dB (in noise). Participants were satisfied with the teleconsultation. There were no statistically significant difference between the groups in any of the outcome measures. All participants reported that teleconsultation could be a viable alternative to facilitate CI users follow up routine. Facilitators emphasized the importance of teleconsultation for learning and for continuing education. The teleconsultation was effective in programming the CI systems and accepted by users and professionals.

No description available.

Bakgrund: Sjuksköterskans roll i vården runt patienten är att vara omvårdnadsexpert. Vårdrelationen mellan patienten och sjuksköterskan är en viktig del av omvårdnaden. I sitt arbete har sjuksköterskan lagar och regler, riktlinjer och styrdokument att förhålla sig till. Omvårdnadsteorier föreslår olika system för hur en god omvårdnad ska bedrivas. Syfte: Att utforska vilka faktorer som påverkar patienters upplevelser av omvårdnad. Metod: Allmän litteraturöversikt. Uppsatsen är baserad på fyra kvalitativa och sex kvantitativa artiklar hämtade från Cinahl Complete, PsycINFO och PubMed. Artiklarna är kvalitetsgranskade och sammanställda efter resultatens likheter och olikheter. Resultat: Resultatet är presenterat i tre huvudkategorier, Demografiska faktorer, Kommunikation och Kompetens. En patient som får tydlig information, blir behandlad som en människa och som bemöts med vänlighet och respekt känner sig trygg och väl omhändertagen. En sjuksköterska som är kunnig och fingerfärdig och kan använda sig av sina personliga resurser för att få en god relation med patienten utstrålar professionalitet och självsäkerhet och har möjlighet att ge god omvårdnad till patienten Diskussion: Resultatet diskuteras utifrån patientupplevelsen, ramen för sjuksköterskeprofessionen och Joyce Travelbees teori om omvårdnadens mellanmänskliga aspekter / Background: The role of the nurse in caring for the patient is to be the nursing expert. The nurse-patient relation is an important part of nursing care. In her work the nurse has laws and regulations, guidelines and control documents to relate to. Nursing theories suggests different systems to carry out good nursing care. Aim: To explore which factors that affect the patient experience of nursing. Method: Literature review. The essay is based on four qualitative and six quantitative articles retrieved from Cinahl Complete, PsycINFO and PubMed. The articles were quality-reviewed and compiled based on their similarities and differences. Results: The result is presented in three main categories, Demographic factors, Communication and Competence. A patient who gets proper information, is treated like a human-being and with kindness and respect, feels safe and well taken care of. A nurse who is well educated and dexterous and who can use his or hers personal resources to get a good relation with the patient, emits professionality and self-confidence and has a possibility to give good nursing to the patient. Discussion: The result was discussed based on the patient experience, the scope of the profession of the nurse and Joyce Travelbee’s nursing theory

Orientador: Ana Carolina Pero Vizoto / Resumo: O período de adaptação funcional com as próteses totais novas envolve uma série de problemas transitórios, e este período está diretamente relacionado com o sucesso ou falha do tratamento. O objetivo deste estudo foi avaliar a influência da altura do rebordo mandibular no padrão de movimentos mandibulares, na máxima força de mordida oclusal, na função mastigatória, na ingestão de nutrientes e na satisfação dos pacientes em diferentes estágios após a instalação de próteses totais convencionais novas. Vinte e oito indivíduos desdentados totais (RN, n=14, rebordos mandibulares normais; RR, n=14, rebordos mandibulares reabsorvidos) receberam novas próteses totais convencionais. Um cinesiógrafo foi utilizado para registrar os movimentos mandibulares durante a abertura e fechamento e a mastigação de um alimento teste. A máxima força oclusal foi mensurada com o auxílio de um gnatodinamômetro digital, o desempenho mastigatório foi avaliado por meio do método dos tamises e a habilidade mastigatória pela aplicação de questionário específico baseado em uma escala visual analógica (EVA de 100,0 mm), a satisfação foi avaliada por meio de um questionário. A ingestão de nutrientes foi avaliada por meio de diário alimentar de três dias, e posteriormente foi traduzido em valores nutricionais por meio da utilização da Tabela Brasileira de Composição de Alimentos. Essas avaliações foram conduzidas em momentos distintos: 24 horas, 30 dias, três meses e seis meses após a instalação das próteses t... (Resumo completo, clicar acesso eletrônico abaixo) / Doutor

Patientenzufriedenheit spielt eine zunehmend wichtige Rolle im Qualitätsmanagement im Gesundheitswesen. Die ärztliche Empathie gilt dabei als ein wesentliches Element, um eine hohe Patientenzufriedenheit zu generieren. Vor dem Hintergrund abnehmender ärztlicher Empathie während der Aus- und Weiterbildung wird in der vorliegenden Arbeit untersucht, inwieweit Assistenzärzte im Vergleich zu Fachärzten die Patientenzufriedenheit in einer anästhesiologischen Prämedikationsambulanz beeinflussen. In einem prospektiv-beobachtendem Studiendesign wurden die Zufriedenheit der Patienten, deren demografische und medizinische Daten, deren vorhandene Vorinformationen sowie organisatorische und logistische Faktoren mithilfe eines selbst erstellten ZUF-8 adaptierten Fragebogens erhoben und anhand des Ausbildungsstandes des prämedizierenden Arztes der Assistenz- oder Facharztgruppe zugeteilt. Dabei zeigten sich Gesamtzufriedenheitswerte auf durchgehend hohem bis sehr hohem Niveau. Feine Unterschiede zugunsten der Assistenzärzte wurden in den Items Gesprächsqualität, Allgemeinzufriedenheit und Freundlichkeit gefunden. Im Bereich der organisatorischen und logistischen Faktoren ergaben sich u.a. länger empfundene Wartezeiten bei den Assistenzärzten. Abschließend macht diese Arbeit deutlich, dass Assistenzärzte im Vergleich zu Fachärzten trotz abnehmender ärztlicher Empathie eine gleichweg hohe Patientenzufriedenheit generieren können. Eine Verbesserung der organisatorischen Abläufe könnte eine weitere Optimierung der Patientenzufriedenheit versprechen.

Thesis (MPH.) -- University of Limpopo, 2021 / Background:Patient satisfaction is an important means of measuring the effectiveness of health care delivery and medical care. Patient satisfaction provides a picture of the extent to which the general health care needs of the patient provided by health care professionals are met to the satisfaction of the patient. Administration of patient satisfaction surveys provide an opportunity to identify and resolve potential problems before they become serious. Enhancing quality of service delivery in public health facilities is a prerequisite for the increased utilisation and sustainability of health care services to the population. The aim of the study was to investigate the level of patient satisfaction regarding service delivery provided by the doctors and nurses at a hospital in Botswana. Purpose:The study’s aim was to investigate the level of patient satisfaction regarding service delivery at a hospital in Botswana. Methods:Aquantitative approach using a self-administered structured questionnaire to collect data regarding patient satisfaction regarding service delivery at hospital was used.A consecutive sampling technique was used to select patients who fulfilled the study’s inclusion criteria. A sample size of 360 patients was required for the study, which was calculated based on the Taro Yamane formula. Data was analysed using SPSS version V.21.0. Results:The mean age of the outpatients was 38.5(SD ±15.6) years while,for the inpatients, the mean agewas 33.3(SD±12.4) years. The greater proportion of respondents in both groups was females. Nearly half (47%) of the outpatients were employed, whereas more than half (53%) of the inpatients were unemployed. The majority of the participants had a low level of education. The mean satisfaction level was 58.9 (SD±7.9)for outpatients, while for in patients, the mean satisfaction level was 70.3 (SD±12.5). A large proportion (65%) of the outpatients were satisfied compared to the inpatients (54%), however, the results were not statistically significant (p>0.05). There was no statistically significant relationship between the age, gender, employment status, level of education of the outpatients and their level of satisfaction. For inpatient variables, age, gender, and level of education were not associated with level of satisfaction (p>0.05). Conclusion: Inconclusion, regardless of the fact that certain aspects of care provided a t this hospital were unsatisfactory, the results of the present study revealed that, overall,more than half of the patients were satisfied with the inpatients and outpatient aspects of the xiv care they were provided.