SATISFACTION OF PATIENTS WITH FIRST MEDICAL CARE: CROSS-SECTION STUDY (ON THE EXAMPLE OF CITY KYIV)

After reorganization of ambulatory-polyclinic net of medical institutions in city Kyiv in 2013 and creation of centers of first medical care (FMC), the necessity in monitoring of patients’ satisfaction with received first medical care appeared. Aim. To estimate satisfaction of patients of FMC Centers of city Kyiv with received first medical care, to compare it with patients’ satisfaction in rural area of Ukraine and in European Union countries. Materials and methods. The cross-section study was realized in FMC centers of city Kyiv during 6 months of 2017 year. In total 397 persons, 18 years old and more, who addressed to doctors of the first link during no less than one year, were selected for the study. The used EUROPEP instrument, the questionnaire, consists of 23 questions with their possible assessment by Likert five-point scale and includes the following aspects: doctor-patient-relationship, assessment of direct medical care, information and support of a patient by a doctor, organization aspects of care, its accessibility. The internal succession of the questionnaire Cronbach's alpha was estimated, and its reliability was checked. Main indices of research results were mean EUROPEP indices (minimum 1, maximum 5). Results. The study has established, that satisfaction of Ukrainian patients with FMC (index - 75,5 %) is statistically reliably lower than indices of European Union countries. In average, only 37,16 % of respondents estimated the level of received FMC as “perfect” and correspondingly 38,35 % of patients as “good”. There were revealed problems with an access to medical care, namely: “Time of waiting for a consultation near a cabinet” received the least mark (3,29 and 45,59 % respectively), “Possibility of registration for consultation by phone” is also low (3,47 and 59,95 % respectively). Problems in communications, the low level of trust and doctor’s authority were revealed in the decreased index “Doctor’s help in fighting against negative emotions, connected with your health status” (3,72 and 56,17 % respectively). There was studied, that in Ukraine satisfaction of patients, who live in rural area, is statistically reliably lower than Kyiv indices. Conclusion. The study of satisfaction of patients with received FMC revealed imperfection of the existing system of first medical care. The research results may be used at elaborating new functional-organizational model of activity of first medical care, including patients’ satisfaction as an important component in the integrative dimension of the medical help quality.&nbsp

Most Patients with Colorectal Tumors at Young Age Do Not Visit a Cancer Genetics Clinic

Contains fulltext : 70595.pdf (publisher's version ) (Open Access)PURPOSE: This study examined the referral process for genetic counseling at a cancer genetics clinic in patients with colorectal cancer and to search for determinants of variation in this referral process. METHODS: Patients who were recently diagnosed with colorectal cancer at a young age or multiple cancers associated with Lynch syndrome, hereditary nonpolyposis colorectal cancer, (N = 119) were selected from PALGA, the nationwide network and registry of histopathology and cytopathology in the Netherlands. In a retrospective analysis, we examined whether these patients visited a cancer genetics clinic and identified determinants for referral to such a clinic. Factors of patients, professional practice, and hospital setting were explored with logistic regression modeling. RESULTS: Thirty-six (30 percent) patients visited a cancer genetics clinic. Seventy percent of patients whom the surgeon referred to a cancer genetics clinic decided to visit such a clinic. Analysis of determinants showed that patients with whom the surgeon discussed referral and that were treated in a teaching hospital were more likely to visit a cancer genetics clinic. CONCLUSION: The referral process is not optimally carried out. To deliver optimal care for patients suspected of hereditary colorectal cancer, this process must be improved with interventions focusing on patient referral by surgeons and raising awareness in nonteaching hospitals

High workload and job stress are associated with lower practice performance in general practice: an observational study in 239 general practices in the Netherlands

Contains fulltext : 80493.pdf (publisher's version ) (Open Access)BACKGROUND: The impact of high physician workload and job stress on quality and outcomes of healthcare delivery is not clear. Our study explored whether high workload and job stress were associated with lower performance in general practices in the Netherlands. METHODS: Secondary analysis of data from 239 general practices, collected in practice visits between 2003 to 2006 in the Netherlands using a comprehensive set of measures of practice management. Data were collected by a practice visitor, a trained non-physician observer using patients questionnaires, doctors and staff. For this study we selected five measures of practice performance as outcomes and six measures of GP workload and job stress as predictors. A total of 79 indicators were used out of the 303 available indicators. Random coefficient regression models were applied to examine associations. RESULTS AND DISCUSSION: Workload and job stress are associated with practice performance.Workload: Working more hours as a GP was associated with more positive patient experiences of accessibility and availability (b = 0.16). After list size adjustment, practices with more GP-time per patient scored higher on GP care (b = 0.45). When GPs provided more than 20 hours per week per 1000 patients, patients scored over 80% on the Europep questionnaire for quality of GP care.Job stress: High GP job stress was associated with lower accessibility and availability (b = 0.21) and insufficient practice management (b = 0.25). Higher GP commitment and more satisfaction with the job was associated with more prevention and disease management (b = 0.35). CONCLUSION: Providing more time in the practice, and more time per patient and experiencing less job stress are all associated with perceptions by patients of better care and better practice performance. Workload and job stress should be assessed by using list size adjusted data in order to realise better quality of care. Organisational development using this kind of data feedback could benefit both patients and GP

Mitochondrial disease: Needs and problems of children, their parents and family. A systematic review and pilot study into the need for information of parents during the diagnostic phase

Contains fulltext : 51979.pdf (publisher's version ) (Closed access)OBJECTIVE: Firstly, this paper aims to systematically review the mitochondrial disease literature to identify studies assessing the needs and problems in the daily life of children with a mitochondrial disease and of their parents and family. The second aim is to provide more insight into the need for information by the parents of these children during the diagnostic process while in hospital. DESIGN: A systematic review and a pilot study, using a qualitative (focus group interviews; n = 7) and a quantitative (questionnaire; n = 37) design. RESULTS: Mothers reported great socioeconomic and psychoaffective strain and showed psychopathological symptoms in the two studies published with respect to this topic. The pilot study showed that parents considered an honest and interested attitude of the person who is giving the information as most important. Furthermore they wanted oral and written information and a central point where they could go with their questions at any time they felt the need. The need for information increased during the four phases of the diagnostic process and was highest in the fourth phase. CONCLUSIONS: The few studies found in the review, combined with expectations that having a mitochondrial disease must have a great impact on these children and their parents and family, call for more research in their needs and problems. Furthermore, there are gaps in the current information provision to parents of these children. A better understanding of the needs and problems of these children and their family is essential for effective care planning and might result in an improved quality of life

Respiratory and Bronchitic Symptoms Predict Intention to Quit Smoking among Current Smokers with, and at Risk for, Chronic Obstructive Pulmonary Disease

Rationale: Smoking cessation is the most important intervention for patients with chronic obstructive pulmonary disease (COPD). What leads smokers with COPD to quit smoking remains unknown

Hospital Variation in Utilization of Life‐Sustaining Treatments among Patients with Do Not Resuscitate Orders

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/144225/1/hesr12651_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/144225/2/hesr12651.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/144225/3/hesr12651-sup-0001-AuthorMatrix.pd

Zadovoljstvo pacijenata radom medicinske sestre / medicinskog tehničara u primarnoj zdravstvenoj zaštiti

Introduction. Patient satisfaction with provided health care is an important indicator of health care quality. Research on patient satisfaction has been very frequent in recent years. Aim. A prospective, cross-sectional study was conducted at the Health Centre of the Ministry of the Interior of the Republic of Croatia between April and June 2019. The aim of this study was to examine the satisfaction of patients with the work of nurses in primary health care. Methods. A standardized Nursing Practitioner Satisfaction Survey questionnaire, for which we received the author’s approval, was used. The study involved 200 patients from the Health Centre of the Ministry of the Interior of the Republic of Croatia. Patients who came to the Health Centre’s outpatient clinics requiring only the services of nurses were included in the study. Out of 200 patients surveyed, 185 questionnaires were filled out correctly, while 15 were filled out incorrectly. Results. Patients from the Health Centre of the Ministry of the Interior of the Republic of Croatia are satisfied with the work of nurses in primary health care. There is no statistically significant difference in the satisfaction with the work of nurses in primary health care according to gender, education, marital or working status. There is a statistically significant difference in patient satisfaction with the work of nurses according to the respondents’ age, where respondents in the age group between 26 and 40 years are less satisfied (Kruskal-Wallis test, Me=3.8). There is a statistically significant difference in the satisfaction of patients with the work of nurses in primary health care according to the respondents’ annual income, where satisfaction is more pronounced among respondents with an annual income between 26.000 to 35.000 HRK and in the range between 36.000 to 45.000 HRK (Kruskal-Wallis test, p<0.01). Conclusion. The patients who took part in the study are satisfied with the work of nurses in primary health care. There are significant differences in terms of age and annual income.Uvod. Zadovoljstvo pacijenata pruženom zdravstvenom njegom jedan je od važnih indikatora kvalitete zdravstvene skrbi i zadnjih se godina učestalo provode istraživanja na temu zadovoljstva pacijenata. Cilj. Provedeno je prospektivno presječno istraživanje u Domu zdravlja Ministarstva unutarnjih poslova Republike Hrvatske u periodu od travnja do lipnja 2019. godine. Cilj istraživanja bio je ispitati zadovoljstvo pacijenata radom medicinskih sestara/tehničara u primarnoj zdravstvenoj zašiti. Metode. Primijenjen je standardizirani upitnik Nursing Practitioner Satisfaction Survey, za koji smo dobili odobrenje autorice. U istraživanju je sudjelovalo 200 pacijenata Doma zdravlja Ministarstva unutarnjih poslova Republike Hrvatske. U istraživanje su bili uključeni pacijenti koji su došli u ambulante Doma zdravlja i trebali usluge samo medicinskih sestara/tehničara. Od 200 anketiranih pacijenata 185 anketa ispravno je ispunjenih, dok je 15 anketa bilo neispravno ispunjeno. Rezultati. Pacijenti Doma zdravlja Ministarstva unutarnjih poslova Republike Hrvatske zadovoljni su radom medicinskih sestara/tehničara u primarnoj zdravstvenoj zaštiti. Ne postoji statistički značajna razlika u zadovoljstvu radom medicinskih sestara/tehničara u primarnoj zdravstvenoj zaštiti prema spolu, stručnoj spremi, bračnom te radnom statusu. Statistički je značajna razlika u zadovoljstvu pacijenata radom medicinskih sestara/tehničara prema dobi ispitanika, nezadovoljniji su ispitanici u dobnoj skupini od 26 do 40 godina (Kruskal-Wallisov test, Me = 3,8). Postoji statistički značajna razlika u zadovoljstvu pacijenata radom medicinskih sestara/tehničara u primarnoj zdravstvenoj zaštiti prema visini godišnjih prihoda ispitanika, gdje je zadovoljstvo u većoj mjeri prisutno kod ispitanika s godišnjim prihodima u rasponu od 26.000,00 kn do 35.000,00 kn i rasponu od 36.000,00 kn do 45.000,00 kn (Kruskal-Wallisov test, p < 0,01). Zaključak. Pacijenti u ovom istraživanju zadovoljni su radom medicinskih sestara/tehničara u primarnoj zdravstvenoj zaštiti. Postoje značajne razlike s obzirom na dob i visinu godišnjih prihoda

The EUROPEP questionnaire for patient’s evaluation of general practice care: Bulgarian experience

Aim To validate the Bulgarian EUROPEP-questionnaire and its implementation to measure patient evaluation of general practice care in Bulgarian population. Methods A multicenter cross-sectional study was conducted at twenty five primary care practices from South-Central Region of Bulgaria. A total of 1000 adult patients aged over 18 years and visiting the practice for more than a year were approached consecutively to take part in the study. The internal consistency and test-retest reliability of the EUROPEP questionnaire were evaluated. To confirm the construct validity of the questionniare, еxplanatory factor analysis was performed. Results Cronbach’alpha for “clinical behaviour” is 0.95 and for “organisation of care” 0.81. Factor analysis identifed two factors, which accounted for 77.0% of the total variation in these items. On average, 58.7% of respondents rated the level of care received as excellent. The waiting time in the waiting room was the item most poorly rated (33.8%). The item “keeping patients’ records and data confidential” was the most highly rated (88.8%). Patients were less satisfied with “providing quick services for urgent health problems” (78.5% excellent or good) and “getting an appropriate for them appointment” (76.2% excellent or good). Conclusion Two scales with satisfactory psychometric properties were established in the Bulgarian version of the EUROPEP-questionnaire. The study identified areas requiring improvement in general practice, such as reduction in waiting times and obtaining patient’s convenience appointment