Patient Experiences

Internationally, person-centred care has become a central tenet of many health and social care related policies and strategies. However, few studies exist that explicitly examine the linkage between patients' perceptions of a person-centred care climate and patients' experiences of care. This has been hampered by a dearth of instruments with acceptable psychometric properties. The aim of this study is to examine the relationship between patients' perceptions of person-centredness and their experiences of care. A cross sectional survey design was used to purposively sample (n = 345, 57.5%) patients from across 10 acute hospitals settings in Ireland. The data was collected Feb 2013-May 2013. Standardised instruments were used to measure patients' perceptions of person-centredness and their experiences of care. Questionnaire packs were distributed to a sample of patients based on predetermined inclusion criteria. Completed questionnaires were returned in a sealed envelope. The instruments were psychometrically tested prior to full analysis of the results. Ethical approval was granted by Research Ethics Committees in all participating hospitals. The psychometric properties of both instruments were determined as satisfactory. There was a moderate positive and significant relationship between patients' perceptions of a person-centred climate and patient experiences. Patients who perceived care as being more personcentred also reported a more positive patient experience. The emergence of new instruments designed to measure patients' perceptions of person-centredness and patient experiences have been shown to have acceptable psychometric properties. This study demonstrates clear linkage between patients' experiences of care and the key indicators of person-centred care.

This article examines the role of patients and caregivers as 'regulatory actors' in healthcare. It uses and extends 'regulatory space theory' to argue that failing to consider the role of patients and caregivers as 'regulatory actors' in healthcare regulatory spaces misses a key piece of the regulatory puzzle. We argue that in assisted dying and other healthcare contexts, evidence shows that some patients and caregivers do behave as regulatory actors, engaging in sustained and focused attempts to alter behaviour. We then suggest a framework which explicitly incorporates notions of why patients and caregivers act in regulatory ways is helpful in understanding what the appropriate response to such actions should be. While the contribution of patients and caregivers to regulation is valuable and should be supported where desired by the person, if patients and caregivers are acting out of necessity to address system issues or 'regulatory failure', other regulatory actors (e.g. governments) should proactively respond and address these issues to reduce the burden on patients and caregivers of having to take regulatory action.

Globally, the Coronavirus disease (COVID-19) pandemic in 2019 has accelerated the adoption of telehealth technologies. The implementation of the Saudi Telemedicine Network (STN) and other digital health initiatives, such as the telehealth clinic (THC) at King Abdullah bin Abdulaziz University Hospital (KAAUH), exemplifies this trend in Saudi Arabia. The aim of this study was to explore the patients' experience of THC in KAAUH during the COVID-19 pandemic and their' beliefs about their readiness to replace the traditional onsite clinical visits with THC from March to September 2020. A cross-sectional study targeted all 1398 patients who utilized THC at KAAUH. A self-administrated, validated survey collected the data. The survey used a Likert scale and included questions on satisfaction with THC services and the perceived effectiveness of telehealth as a substitute for in-person visits. The collected data was analyzed using frequency and percentage. A total of 252 patients responded to the THC postvisit survey. Overall, 217 patients (86%) were satisfied, 32 patients (13%) were dissatisfied, and only 3 patients (1%) were neutral about THC. Most patients (65.5%) agree that THC provided enough information about their health conditions, which can substitute for clinical visits. About 18.3% of patients were neutral, while 16.3% disagreed with the effectiveness of THC services and believed that they could not replace onsite visits. During the COVID-19 pandemic, most patients were satisfied at KAAUH-THC in Saudi Arabia and believed that it could replace the onsite visit to a physician's clinic. The 2 main causes of the patient's belief that THC could not replace an onsite clinical visit were: First, nonadherence to appointments led to missed calls and a complete medical service. Second, the patient's perception is that a physical examination and lab investigation cannot be completed through THC.

Introduction This report is the second from the Living with HIV program that specifically addresses the status of women with HIV/AIDS in Australia. The report comes, as did its predecessor Standing on shifting sand, from a national survey of Australian PLWHA. The HIV Futures II survey is a core component of a broader program of research concerned with the social and psychological experience of living with HIV.

Following surgery, NHS-patients are discharged from hospital with
a letter to their GP, with or without a follow-up outpatient appointment.
Post-operatively, they may be anxious about their recovery milestones
and complications. On one hand, these issues can lead to post-operative
patients seeking medical advice/care from less specialised professionals,
including their GP, urgent care centres and emergency departments. On
the other hand, patients may suffer complications and may delay seeking
medical care, making their management more difficult. In this paper, we
present a cost-effectiveness analysis to quantify the costs related to partial
or ineffective post-discharge pathways for surgical patients and estimate
the potential savings for NHS resources achieved by introducing an app
to connect patients with the surgical team post-discharge. Considering
costs from avoidable presentations to the Emergency Department, costs
borne by patients, environmental costs, and costs associated with antibiotic
tolerance and resistance as a result of late recognition of surgical site
infections, we estimate that a digitalised postoperative care pathway can
save over £60,000 per 100 patients even when accounting for the increased
number of outpatient clinic follow-ups.

Introduction: Evaluation of healthcare provision is essential in the ongoing assessment and consequent quality improvement of medical services. However, healthcare systems have sought to achieve a balance in services that are not only clinically effective but are also judged by patients as acceptable and beneficial. National Eye Hospital services all patients with eye diseases and eye injuries.

Objective: To determine the patient experience of quality of care at National Eye Hospital in Sri Lanka.
Methodology: A descriptive cross-sectional study was conducted from the 3rd of October 2022 to the 31st of October 2022 among 427 samples of in-ward patients with visual impairment who were admitted to the surgery at the National Eye Hospital. A systematic sampling technique was used to collect the sample. Quality of care was assessed through patient experience through an interview administered questionnaire.

Results: Out of the participants, 77% (N=287) were more than 65 years old. The majority were female (60%, N=246). Most patients were 70% (N=287) admitted for "cataract Surgery." The highest patient "agreement" was observed under the dimension of "competency of the staff," and the least "agreement" was in the dimension of "Sanitation of the unit." No statistically significant association (p>0.05) was observed with the relation of patient experience and category type of the illness of the patients, age and category type of the wards.

Conclusions: Patient experience was improved in terms of staff factors and least in terms of the facilities provided by the institute.
Recommendations: Improving the facilities of the National Eye Hospital is mandatory to improve the patient experience.

Patient-centred care is a key priority for governments, providers and stakeholders, yet little is known about the care preferences of patient groups. We completed a scoping review that yielded 193 articles for analysis. Five health states were used to account for the diversity of possible preferences based on health needs. Five broad themes were identified and expressed differently across the health states, including personalized care, navigation, choice, holistic care and care continuity. Patients' perspectives must be considered to meet the diverse needs of targeted patient groups, which can inform health system planning, quality improvement initiatives and targeting of investments. Résumé Les soins axés sur le patient sont une priorité clé pour les gouvernements, les fournisseurs et les intervenants, mais on en sait peu sur les préférences de soins des groupes de patients. Nous avons effectué un examen de la portée dans lequel 193 articles ont été analysés. Cinq états de santé ont été utilisés pour rendre compte de la diversité des préférences possibles en fonction des besoins en santé. Cinq grands thèmes ont été identifiés et exprimés différemment selon l'état de santé : les soins personnalisés, la navigation, le choix, les soins holistiques et la continuité des soins. Le point de vue du patient doit être pris en compte afin de répondre aux divers besoins des groupes ciblés, ce qui peut éclairer la planification du système de santé de même que les initiatives visant l' amélioration des soins ainsi que le ciblage des investissements.

Institut sociálního zdraví, Cyrilometodějská teologická fakulta, UP Olomouc Souhrn Východiska: Včasné vyhledání lékařské péče u podezření na závažné onemocnění, kterým karcinom prsu je, vede k brzké dia gnostice onemocnění a při jeho potvrzení k zahájení léčby. Tyto kroky zvyšují pravděpodobnost uzdravení. Přesto ně kte ré ženy nevyhledají lékařskou péči ihned při nalezení příznaků a návštěvu lékaře odkládají. Materiál a metody: V této studii se zaměřujeme na důvody, které vedou k odkládání vyhledání lékařské péče u českých žen. Tato studie je založena na kvalitativní metodologii DIPEx. Rozhovory se skládají z narativní části, na kterou navazuje polostrukturovaný rozhovor. Výzkumný soubor byl vybírán tak, aby naplnil podmínky maximální variace (různé oblasti ČR, různé věkové kategorie, vzdělání, stadium onemocnění, způsob léčby). Bylo sesbíráno 53 rozhovorů, které byly doslovně přepsány. Data, ze kterých byly vytvářeny kategorie, byla analyzována pomocí softwaru NVivo10 a byla kódována otevřeným kódováním. Ty se pak rozdělily do témat k tematické analýze. Výsledky: Analýza ukázala, že nejčastějším důvodem odložení návštěvy lékaře je nesprávná interpretace symptomů nebo nerozeznání symptomu jako závažného. V ně kte rých případech dochází ke spuštění obranných mechanizmů a příznak mohou ženy bagatelizovat. U ně kte rých žen dochází ke kognitivnímu zkreslení, protože se s příznakem setkaly v minulosti. Další ženy prioritizují jiné životní události před návštěvou lékaře. Ženy pozitivně hodnotily screeningová vyšetření. Závěr: Vzhledem k výsledkům doporučujeme edukační kampaně zaměřit nejen na rozpoznání příznaků a důležitost vyhledání lékaře, ale také na to, jak postupovat v případě potíží.

Most cases of prostate cancer are diagnosed at an early stage, and men live for many years after diagnosis. Thus, their well-being and quality of life are of great importance. This study investigated patient experiences and psychological well-being in a Finnish national sample of prostate cancer patients who received various types of treatment. Method: In a national sample (50%) of prostate cancer patients diagnosed in Finland in 2004, information was collected on the patients' experiences at diagnosis and choice of treatment (e.g. treatment selection, patient satisfaction with care and information, psychological reactions). In 2009, participants were asked about their experiences, and psychological well-being (psychological symptoms, satisfaction with life) was measured. In total, 1239 completed questionnaires (73%) were accepted for the study. Differences between treatments and predictors of psychological well-being were investigated using descriptive statistics and regression analysis. Results: Half of the respondents were satisfied with the care and information they received about the cancer and side effects of treatment. Experiences and psychological well-being were most positive among patients who received brachytherapy and poorest among patients who received hormonal therapy. Patients who underwent prostatectomy or brachytherapy were most likely to have been involved in treatment selection. Negative experiences, such as learning of the diagnosis in an impersonal way and dissatisfaction with the information and care received, were predictive of poorer well-being. Conclusions: Unmet supportive care and informational needs were common. Experiences and well-being varied between treatments. Patients tended to prefer prostatectomy and brachytherapy. Unmet needs, which would probably be reduced by improvements in care, appear to have a long-lasting impact on patients' psychological well-being.

Introduction: Assisted dying (AD) has been legalised in a small but growing number of jurisdictions globally, including Canada and Australia. Early research in both countries demonstrates that, in response to access barriers, patients and caregivers take action to influence their individual experience of AD, as well as AD systems more widely. This study analyses how patients and caregivers suggest other decision-makers in AD systems should address identified issues.
Methods: We conducted semistructured, qualitative interviews with patients and caregivers seeking AD in Victoria (Australia) and three Canadian provinces (British Columbia, Ontario and Nova Scotia). Data were analysed using reflexive thematic analysis and codebook template analysis.
Results: Sixty interviews were conducted with 67 participants (65 caregivers, 2 patients). In Victoria, this involved 28 interviews with 33 participants (32 caregivers, 1 patient) about 28 patient experiences. In Canada, this involved 32 interviews with 34 participants (33 caregivers, 1 patient) about 33 patient experiences. We generated six themes, corresponding to six overarching suggestions by patients and caregivers to address identified system issues: (1) improved content and dissemination of information about AD; (2) proactively develop policies and procedures about AD provision; (3) address institutional objection via top-down action; (4) proactively develop grief resources and peer support mechanisms; (5) amend laws to address legal barriers; and (6) engage with and act on patient and caregiver feedback about experiences.
Conclusion: AD systems should monitor and respond to suggestions from patients and caregivers with firsthand experience of AD systems, who are uniquely placed to identify issues and suggestions for improvement. To date, Canada has responded comparatively well to address identified issues, whereas the Victorian government has signalled there are no plans to amend laws to address identified access barriers. This may result in patients and caregivers continuing to take on the burdens of acting to address identified issues.
Patient or Public Contribution: Patients and caregivers are central to this research. We interviewed patients and caregivers about their experiences of AD, and the article focuses on their suggestions for addressing identified barriers within AD systems. Patient interest groups in Australia and Canada also supported our recruitment process.

This article offers interactive performance experiments drawn from the author's experience of a lifelong medical condition. Performance prompts encourage the reader to question the limitations of clinical language, grammar, and voice – going beyond linear narratives that frame health events as "news". An ensemble of recurring characters guide the reader through various un/common clinical scenarios, enacting the circularity and strangeness of the temporality of incurable disease. Positioned as an urgent search for meaning in the face of a recurring catastrophe, the exploration ends with an exuberant demand to re-enter the cycle, while remaining rooted in the present moment: Da Capo!

This article talks about Full-Stack Observability (FSO) and how important it is in the health care field. It talks about how important it is to solve issues like real-time tracking for better clinical services, data security and compliance, predictive and proactive healthcare management, and making sure that patients have a smooth experience across all channels. The number of healthcare organizations using FSO tools is projected to reach $9.3 billion by 2027. This shows how valuable they are to the field. The paper talks about real-life examples of healthcare providers that have successfully implemented FSO solutions. These examples show real-world benefits like higher clinician productivity, happier care teams, better data protection, better compliance with regulations, and better patient experiences. The paper also talks about how important FSO is for helping healthcare organizations handle the growing complexity of their IT environments, speed up their digitization efforts, and eventually make patient care better. FSO adoption is becoming a strategic must for organizations that want to drive innovation, ensure data protection, and provide exceptional patientcentered services as the healthcare industry continues to change and adopt new technologies.

Health care customers (patients) experience heightened emotions due to high stakes from risks to life, health, and well-being. Understanding and managing emotions during service experiences is an important area of inquiry because emotions influence customer perceptions, future intentions and behaviors. Yet despite its significance, research focusing on the impact of emotions on customer experiences remains fragmented, lacking a theoretically based conceptual framework. The authors attempt to fill this gap by addressing two important research questions contextualized in health care: (1) How can health care organizations better understand patient and family emotions during health care experiences? and (2) How should health care organizations use this understanding to design and better manage patient experiences to enhance patient well-being? The authors propose a new theoretically based framework on emotional responses following triggering events to enhance outcomes. Recommendations designed to enhance health care customer well-being are provided, as are directions to guide future work.

INCORPORATING MENTAL HEALTH ISSUES INTO PATIENT EXPERIENCE MANAGEMENT The prevalence of mental illness in the USA is significant (Reeves et al., 2011). Mechanic (2014) estimates that 'at any point in time, as many as 5-10% of the population has disorders that are serious and involve substantial impairment and a critical need for treatment and care' (Mechanic, 2014, p. 1418), more than ever before. In any given year, nearly 40 million people in the USA (18%) experience an anxiety disorder, and 9.1% of the US adult population experience symptoms consistent with major depression (Substance Abuse and Mental Health Services Administration, 2014). Mental health issues are increasingly being identified and treated. For instance, the World Health Organization (WHO) has predicted that depression will be the second most prevalent cause of disability by 2020 (Ferrari et al., 2013) and the costs of mental health and substance abuse treatment are daunting, having exceeded $135 billion (Mark, Levit, Vandivort-Warren, Buck, & Coffey, 2011). Mental health disorders can be a clinically important comorbid condition, and have interactions with other health issues.

Modern medicine has long been focused on the hard science that drives change through numbers-based analysis and datadriven metrics. This is as it should be, and has certainly allowed for vast amounts of progress to be made in healthcare, resulting in better outcomes, better patient safety, and better treatment options. Yet sometimes it seems that soft science principles, those ideas and data points based on human behavior, are given a more optional status for inclusion. A review of relevant studies shows many of the ways this has directly contributed to low satisfaction rates for both patients and providers. Soft skills can still be science and data based. This paper introduces the concept of Compassion Science, which uses data collected within the fields of trauma and cognitive science to provide answers that further optimize care and outcomes for oncology patients, increase trust and satisfaction levels for both patients and providers, and decrease the overall cost of care.

Background: When healthcare providers (HCPs) become patients, the experience affects their sense of identity, the care they receive, and their clinical practice. In child health, considerably less is known about the experiences of HCP-parents who access the pediatric healthcare system with their own children with disabilities and/or chronic medical conditions. Aims: This study aimed to examine the experiences of HCPs who have children with disabilities to identify their experiences with healthcare delivery. Methods and procedures: A qualitative descriptive study was conducted with HCP-parents, using focus groups and open-ended interviews. Data were analyzed using reflexive thematic analysis. Results: For HCP-parents, the experience of having a child with a disability affects how they see themselves, their patients, service organizations, and the healthcare system in general. Having medical knowledge and access to networks brings both benefits and unique challenges. HCPparents also have unique needs that are not currently being addressed. The lived experiences of HCP-parents can contribute to improving patient care. However, the value of this lived experience is unrecognized and underutilized. Conclusions: The lived experiences of HCP-parents can contribute important insights regarding service delivery, and in particular regarding the application of Family-Centered Service.

In the conceptualization of Person Centered Medicine (PCM) one can recognize core concepts as well as diversity at multiple levels. The core concepts convey vision and depth. Diversity displays plurality, richness and scope. And both are intertwined and articulated through the unfolding process and journey that the construction of PCM represents. This paper briefly elaborates on these complementary perspectives of PCM. And ends introducing a set of papers that illustrate its core and diversity.

Advanced and metastatic cancer has a complex diagnostic and management profile that places a heavy long-term burden on patients and healthcare systems. Little attention has been given to patients' experiences across their entire clinical journey. Using a qualitative, longitudinal methodology over a ten-month period, we examined the symptom-to-outcome trajectories of seven people attending a medical oncology clinic at a large, public tertiary referral center in Sydney, Australia. Rather than care being experienced as a largely linear progression through diagnosis, treatment and onto surveillance in which life may return to 'normal', participants are embedded in a cyclical clinical pathway. Recurrence or metastases are not a matter of 'if' but 'when'. This model of the patient journey points to a need for longitudinal, person-centered services to support the growing population of people with melanoma.

The aim of this systematic review is to analyze the data gathered from studies conducted to determine patient experiences in intensive care and levels of the recollection of the intensive care period that were published between December, 1998-April, 2013. The systematic review was carried out screening of the related publications. The findings of the systematic review were studied under the following two titles: "remembering the intensive care period" and "recalled experiences" of patients. Studying 15 papers which were found suitable to the inclusion criteria of the review indicated that majority of the patients had recollection of the intensive care process. The physical experiences of the patients were pain, sleep disturbances, discomfort, inactivity or over-activity, noise, thirst, headache, discomfort due to the endotracheal tube (ET), technological support, medical activities, and difficulties in aspiration and swallowing. On the other side, psychological experiences were hallucination, nightmares, fear, worry, anxiety, depression, loneliness, and thoughts about death, panic, nervousness, uncertainty, and despair. In addition, it was seen that patients experienced some communication difficulties. As a result of the systematic review, it was seen that patients could remember the intensive care period, and the number of negative experiences in intensive care were more than the positive ones.

Peripheral intravenous catheters (PIVCs) are important tools for the provision of treatment for unwell and premature neonates. This study aimed to explore current PIVC practices (i.e. insertion, product selection, complications and management priorities) within Australian and New Zealand neonatal units, to identify areas for innovation and practice change. The survey was distributed via Australian and New Zealand neonatal nursing associations, with 180 respondents (54% Australia; 46% New Zealand). Respondents reported an average of 2-3 insertion attempts were required per PIVC, with variability in cleansing agents, decontamination techniques, skin barrier films and PIVC dressing products used. The large majority of respondents reported seeing skin complications associated with PIVCs within their practice (94%). Infection prevention was the highest management priority, and skin complication prevention, the lowest priority. High quality research is necessary to inform neonatal PIVC insertion and management practices, to improve patient safety and treatment provision.

Background Family carers play a central role in supporting people at the end of life, but often suffer detrimental impacts on their own mental health as a result. This project conducted evidence synthesis of research into factors that may affect carers’ mental health to help identify ways of maintaining their mental health. It worked closely with a carer Review Advisory Panel to help ensure the findings made sense and were communicated meaningfully from the carers’ perspective. Aim To present: (1) principles and components that facilitated successful patient and public involvement in an evidence synthesis project to help inform patient and public involvement in similar projects; (2) recommendations for carer support that were instigated and produced by the Review Advisory Panel. Process and principles Nine Review Advisory Panel meetings including four to five carers, a lay Chair and three researchers were held. Solid ‘groundwork’ was invested in recruitment and relationship-building...

Aim.  The aim was to elucidate the lived experience of regular diabetes nurse specialist check‐ups among patients with type 2 diabetes.Background.  Diabetes care with diabetes nurse‐led clinics in primary care has been established in Sweden since the 1980s. Information about patients’ lived experience of these regular check‐ups is important in the further development of diabetes nursing in primary care.Methods.  Narrative interviews were conducted with 10 women and 10 men with type 2 diabetes regarding their lived experience in everyday life and the regular check‐ups by the diabetes nurse specialist. A phenomenological‐hermeneutic method inspired by Ricoeur was used in the analysis.Results.  Patients’– with type 2 diabetes – lived experience of regular check‐ups showed an overall positive influence on the patients’ way of living with the disease by underpinning and developing their understanding and management of daily life. This influence was interpreted as an interlinked chain com...

The study was conducted to assess the quality of life (QOL) of people living with HIV and AIDS (PLWHA) who are on antiretroviral therapy (ART) in Swaziland. A qualitative, exploratory, descriptive and contextual design was used. Twentyfour PLWHA on ART were purposefully selected to participate. Methods of data gathering consisted of: (1) in-depth individual semi-structured interviews; and (2) observations in the form of field notes. Data were analysed using Tesch's descriptive method of data analysis. The study revealed that PLWHA in Swaziland are faced with many challenges concerning ART that negatively influence their QOL. The

Assessments of treatments for 'subjective symptoms' are problematic and potentially contentious. These are symptoms without ascertainable pathophysiology, also referred to as 'medically unexplained.' Treatments of them may be assessed from different perspectives, and an assessment as seen from one perspective may be discrepant with an assessment as seen from another perspective. The observational study described in the paper represents one perspective. Patients in the study were treated with acupuncture for the subjective symptom of low back pain in a Traditional Chinese Medicine Clinic in China; acupuncture is a form of TCM, which is indigenous to China. Shortly after treatment began and six months afterward, patients reported 'clinically important improvements' on a variety of standard, cross-culturally validated outcome measures, including pain intensity, physical functioning, and emotional functioning; this assessment is consistent with numerous assessments of acupuncture in China and other Southeastern Asian countries. On the other hand, clinical trials represent another perspective from which to assess acupuncture. Although assessments based on trials are not uniform, several assessments based on them, including those published in journals such as Lancet and New England Journal of Medicine, conclude that acupuncture is not effective. These trials, however, were mainly situated in the U.S., western European countries, and other WEIRD (Western, Educated, Industrialized, Rich, Democratic) countries. This is notable, because the population of China, the indigenous context of acupuncture, is greater than populations of WEIRD countries combined. Patients' expectations of a treatment such as acupuncture

Objective: The study reports findings and patients’ characteristics that predict their experiences of primary health care (PHC) in Nigeria. Methods: A cross-sectional survey of 1680 patients attending 24 primary health centers in 6 states from the 6 geopolitical subdivisions in Nigeria. The patient evaluation scale was used for exit survey of patients’ experiences with PHC. Categorical findings and mean ratings on experiences of PHC were analyzed using both descriptive and inferential statistics. Results: The mean response rate was 98%, and most respondents were female (73%) and married (72%). A higher proportion of patients gave positive feedback on their relationships with staff (84%) than they did available space in the waiting area (60%). Higher self-rated health status and nonpayment for care at the point of receipt were consistent predictors of positive patient experiences from the multilevel analysis. Conclusion: Study reported findings and drivers of patient experiences with...

Factors influencing adherence to dietary guidelines: a qualitative study on the experiences of patients with type 2 diabetes attending a clinic in Cape Town Z Ebrahim Msc(Nutrition and Dietetics) , A De Villiers PhD(Dietetics)SU & T Ahmed Bsc (Med)(Hons)(Nutrition and Dietetics) To cite this article: Z Ebrahim Msc(Nutrition and Dietetics) , A De Villiers PhD(Dietetics)SU & T Ahmed Bsc (Med)(Hons)(Nutrition and Dietetics) (2014) Factors influencing adherence to dietary guidelines: a qualitative study on the experiences of patients with type 2 diabetes attending a clinic in

İzmir ilindeki sağlık çalışanlarının sağlık iletişiminde dil ve iletişim becerilerinin rolüne
yönelik algılarının nitel olarak değerlendirilmesi bu çalışmanın temel amacıdır. Amaç
doğrultusunda insanların belirli bir fenomenle ilgili anlayışlarını tanımlamak için kullanılan
nitel araştırma modellerinden biri olan fenomolojik yöntem esas alınmıştır. Çalışma grubu
olarak, İzmir ilinde faaliyet gösteren sağlık kurumlarında hizmet veren sağlık çalışanları
belirlenmiştir. Bu kapsamda sağlık sektöründe hizmet sağlayan farklı mesleklerden sağlık
çalışanlarından nitel veri toplama yöntemlerinden biri olan derinlemesine görüşme tekniği ile
veriler toplanmıştır. Verilerin toplanması sürecinde yarı-yapılandırılmış görüşme formu
kullanılmıştır. Formun hazırlanmasında sağlık iletişimine yönelik literatürdeki çalışmalardan
yararlanılmıştır. Araştırmanın örneklem grubunun belirlenmesinde, nitel örnekleme
yöntemlerinden biri olan amaçlı örnekleme yöntemi esas alınmış olup, 10 kamu ve 9 özel
sektör sağlık çalışanı olmak üzere toplam 19 katılımcı yer almıştır. Araştırma bulgularının
analizinde nitel analiz yöntemlerinden biri olan içerik analizi yöntemi kullanılmıştır. Yapılan
analiz sonucunda bulgular; sağlık çalışanlarının sağlık iletişiminde dil ve iletişim becerilerine
yönelik algıları, sağlık iletişiminde hedefledikleri taraflar, sağlık hizmetlerinde sağlık
iletişiminin rolü ve sağlık iletişiminin taraflar için ortaya çıkardığı fırsat ve riskler olmak
üzere dört ana tema üzerinden yorumlanmıştır. Bulgular katılımcıların sağlık iletişimini en
fazla etkili iletişim ve dil becerileri ile ilişkilendirildiğini göstermektedir. Buna ek olarak
katılımcıların sağlık iletişiminin taraflarını; sağlık çalışanları, hastalar ve hasta yakınları
arasındaki iletişim olmak üzere üç paydaş üzerinden tanımladığı, taraflara yönelik algılarda
çalışılan sektör ve meslek değişkenlerinin bir farklılık oluşturmadığı araştırma bulguları
kapsamında söylenebilmektedir. Katılımcıların sağlık iletişiminde dil ve iletişim becerilerinin
rolüne yönelik görüşlerinin ise sağlık iletişiminin tarafları özelinde farklı değerlendirmeleri
içerdiği belirlenmiştir.

Background: Patients satisfaction is an important component of the health care industry in this competitive modern era. The concept of patient satisfaction is also rapidly changing and the hospitals are using variety of techniques to improve patient care and organizational efficiency. Study Design: The study design was cross-sectional. Methodology: A total of 422 Patients, attending the Out Patient Department of GSMCH, Banur were randomly selected and a questionnaire was developed to evaluate patient satisfaction about the outpatient department services, logistic arrangement in the outpatient departments, perception about the performance of staff, behavior of staff, support service and any other suggestions of patients. Results: 80% patients expected the physicians to discuss their problems with them,100% patients expected to be physically examined.76% respondents expected their physician to be specialist, whereas 09% respondents said that they were unable to judge a physicians clinical competence. Technically competent doctor was rated as the most important attribute of the treating physician for patient satisfaction. Conclusions:In this study, it is found that majority of the patients are satisfied with the services provided. They were satisfied with the guidance, logistic arrangements, support services, nursing care, Doctors consultation etc. and satisfaction is the desired outcome of every hospital.

Aim: To explore the expectation of primary health care (PHC) patients to assist the development of a patient evaluation scale designed to promote patient-focused quality assessment and improvement in PHC Background: A significant proportion of patients seek health care from PHC facilities in Nigeria. Re-organising services to meet their expectations can lead to improved utilization and health benefits. This study is the preliminary phase of an iterative process for the development of a measure for patients’ evaluation of primary health care in Nigeria. Methods: Semi-structured qualitative interviews conducted with 47 patients drawn from 4 PHC centres in Rivers State and the Federal Capital Territory in Nigeria. The constant comparative method used to analyse verbatim transcripts led to the generation of a framework of codes, concepts, and categories that defined the expectations of patients for PHC in Nigeria. Findings: Analyses resulted in 44 coded themes for user’ description of t...

Background: Patients hospitalized in intensive care units may experience many psychological symptoms such as weakness, hopelessness, anxiety, anger, depression, sleep deprivation, sensory overload, sensory deprivation, agitation, delirium, and difficulty in adjustment. In order to prevent these psychological symptoms, it is possible to define these needs by supporting the patients and providing the necessary psychological care services by the nurses who are experts in their fields. Aim: This study was evaluate of the views of intensive care nurses on the psychological care needs of patients. Methods: A qualitative descriptive approach was taken in the study. Fifteen intensive care nurses were selected with reference to maximum variation sampling method from purposeful sampling method, and individual in-depth interviews were handed with a semi-structured interview form. The data obtained from the study were analyzed using the content analysis method. Results: The average age of the nurses participating in the research was 29.8; 40% of them were undergraduates and 53.3% of them worked in tertiary intensive care. Nurses have been working for an average of 7.43 years, and they have worked in intensive care for 4.36 years. As a result of analyses, it was determined that the views of intensive care nurses on patients' psychological care needs and practice were gathered under 4 main themes. These were psychological care in intensive care, communication, patient reactions, and approach to psychological problems. In addition, sub-themes such as empathy, reassurance, support, holistic care, communication style and difficulties in communication, psychological and physiological reactions, psychological problem solving, and the quality of psychological caregivers were also reached. Eight of the 15 nurses who participated in the interview believed that the psychological care needs of intensive care patients should be met by a specialist nurse (consultation liaison psychiatric nurse). Conclusion: Although nurses are aware of the first-and second-level psychological care needs of patients, their knowledge levels were insufficient in practice, and the intensive pace of work, long working hours, and a stressful work environment meant that they could not meet this need. In the light of this information, specialist psychiatric nurses (consultation liaison psychiatric nurses) should be employed in intensive care units, where the psychological care of patients can be met and intensive care nurses can receive support.

Background: Vascular access devices (VADs) play a vital role within the neonatal intensive care unit (NICU). However, VAD-use is not without signi cant risks, with complications such as infection, thrombosis, device occlusion and in ltration/extravasation frequently contributing to device-related failures and increase the risk of signi cant patient harm or injury. Methods: A retrospective, cross-sectional, single-center study in a large 112-bed NICU in Qatar that routinely collected intravenous device data from January 2016 to December 2018 was evaluated. The outcome of interest was to identify and evaluate the relationships between unmodi able and potentially modi able factors and Assess the situation and patients Better Before initiating vascular Access (ABBA), potentially reducing unwarranted complication rates leading to therapy failure within the neonatal setting. Results: During the study period, 23858 VADs were inserted. Of these, 89.3% were peripheral intravenous catheters (PIVCs). Infants who received a peripheral device were slightly older, with a median age of 8 (5) days, when compared to all infants receiving a central device, with a median age of 6 (4) days. Univariate logistic regression analyses identi ed 10 variables demonstrating signi cant relationships to devicerelated outcomes. Conclusions: Four subgroups of VAD were identi ed (peripheral intravenous catheters, extended dwellperipheral intravenous devices, peripherally inserted central catheters and umbilical venous catheters). Central vascular access (peripherally inserted central catheters and umbilical venous catheters) had the least reported complications. Future research toward improving patient and intravenous therapy-related outcomes plays an important role. It requires a focus on innovations and clinical advancements in the world of neonatology and vascular access devices. Article Summary Vascular access devices play a vital role within the NICU. Optimum assessment for appropriate device choices are important factors for clinicians and patients who require safe and reliable intravenous therapies. What is known about the subject?: Ill newborns, especially preterm infants, are often dependent on various central venous access devices for administration of required therapies. Complications occur frequently in this patient population and are generally well-de ned, however reliable, and accurate clinical data is often missing.

Background It is well established that the idle peripheral intravenous catheter (PIVC) provides no therapeutic value and is a clinical, economic and above all, patient concern. This study aimed to develop a decision aid to assist with clinical decision making to promote clinically indicated peripheral intravenous catheter (CIPIVC) insertion in the emergency department (ED) setting. Providing evidence for a uniform process could assist clinicians in a decision-making process for PIVC insertion. This could enable patients receive appropriate vascular access healthcare. Methods We performed a secondary analysis of data from a multicentre cohort of emergency department clinicians who performed PIVC insertion. We defined CIPIVC a priori as one used for a specific clinical treatment and or procedure such as prescribed intravenous (IV) fluids; prescribed IV medication; or IV contrast (for computerized tomography scans). We sought to refute or validate an assumption if the clinician performing or requesting the insertion decided the patient was >80% likely to need a PIVC. Using logistic regression, we derived a decision aid for CIPIVCs.

Objective:The aim of this study was to explore the experiences and preferences of terminally ill cancer patients regarding truth telling in the communication of poor prognoses.Method:We recorded and transcribed interviews with 45 patients who knew their cancer was terminal, and analyzed their responses hermeneutically.Results:Patients identified three different modes of truth: (1) the absolute objective truth that they are dying; (2) the partial truth about their condition including some facts but not all of the details; and (3) the desired truth, originating in the patient's own beliefs about a healthy or better life. Coping strategies were related to patients’ preferred mode of truth: (1) facing the truth in order to take action; (2) facing some parts of the truth in order to maintain hope; and (3) hovering between facing and avoiding the truth. In their struggle for existential survival, patients used different coping strategies, changing from one to another depending upon th...

Jack has just arrived in the hospital, he is checking his emails, complaining about the poor Internet connection, and making some 'phone calls before the doctor arrives to inform him about the procedure for the day. Jack does not see the need to be in bed; for him today's medical examination is just one item on his agenda. Yet, in an hour, he will have to lay down in bed and be wheeled downstairs to the operating theatre, wait a while in the pre-operative zone, and then be put to sleep. After a short stay in the recovery room he will return along the

To determine what resources, preparation, and support are needed for patients, providers, and leaders to meaningfully and appropriately engage in patient-centred health system redesign, researchers sought stakeholder groups. A qualitative descriptive design was selected using purposive participant samp 'what' and 'why' questions pertaining to stakeholder perceptions about patient engagemen patients, providers or leaders. Four project groups were selected; each group was responsible for a strategic initiative with Alberta Health Services and represented one of three different levels of the healthcare system (i governance). Semi-structured question guides were used to collect data. Thematic analysis of the transcribed participant responses revealed eleven major themes: and timing of engagement; recruitment and commitment; governance and structure; kno importance of communication around the reasons for patient engagement including building trust through collaboration clearly identifying goals, along with their roles and responsibilities. development of tools, resources and education materials required to support patient engagement activities tailored to the needs, understandings and perspectives of stakeholders.

Purpose: The EU COST Action 15111 collaboration on myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) aims to assess current research and identify knowledge gaps in Europe. Presently, our purpose is to map the effects of non-pharmacological therapies (NPTs) for ME/CFS, and what patients find important in the treatment process. Methods: A scoping mixed methods literature review of European studies identified 16 papers fulfiling our inclusion criteria. The quantitative and qualitative studies were synthesized separately in tables. Additionally, extracts from the qualitative studies were subjected to translational analysis. Results: Effect studies addressed cognitive behavioural therapy (CBT, n = 4), multimodal rehabilitation (n = 2) and activity-pacing (n = 2). CBT reduced fatigue scores more than usual care or waiting list controls. The effects of rehabilitation and activity-pacing were inconsistent. The contents, assessment methods and effects of rehabilitation and activity pacing studies varied. For patients, health professionals' recognition of ME/CFS and support were crucial, but they expressed ambiguous experiences of what the NPTs entail. Conclusions: Methodological differences make comparisons across NPTs impossible, and from a patient perspective the relevance of the specific contents of NPTs are unclear. Future well-designed studies should focus on developing NPTs tailored to patients' concerns and evaluation tools reflecting what is essential for patients.

Background: Peripheral intravenous catheter (PIVC) insertion is one of the most common clinical procedures worldwide, yet little data are available from Latin America. Our aim was to describe processes and practices regarding PIVC use in hospitalized patients related to hospital guidelines, characteristics of PIVC inserters, prevalence of PIVC complications, and idle PIVCs. Methods: In 2019 we conducted a multinational, cross-sectional study of adult and pediatric patients with a PIVC in hospitals from five Latin American countries: Argentina, Brazil, Chile, Colombia, and Mexico. We used two data collection tools to collect hospital guidelines and patient-specific data on the day of the study. The vessel health and preservation (VHP) model guided synthesis of the study aims/questions and suggested opportunities for improvement. Results: A total of 9,620 PIVCs in adult (86%) and pediatric inpatients in 132 hospitals were assessed. Routine replacement 8-72 hourly was recommended for adults in 22% of hospitals, rather than evidence-based Frontiers in Medicine 01 frontiersin.org Walker et al. 10.3389/fmed.2022.1039232 clinical assessment-based durations, and 69% of hospitals allowed the use of non-sterile tape rather than the international standard of a sterile dressing. The majority (52%) of PIVCs were inserted by registered nurses (RNs), followed by nursing assistants/technicians (41%). Eight percent of PIVCs had pain, hyperemia, or edema, 6% had blood in the extension tubing/connector, and 3% had dried blood around the device. Most PIVCs had been inserted for intravenous medications (81%) or fluids (59%) in the previous 24 h, but 9% were redundant. Conclusion: Given the variation in policies, processes and practices across countries and participating hospitals, clinical guidelines should be available in languages other than English to support clinician skills and knowledge to improve PIVC safety and quality. Existing and successful vascular access societies should be encouraged to expand their reach and encourage other countries to join in multinational communities of practice.

The aim of this systematic review is to analyze the data gathered from studies conducted to determine patient experiences in intensive care and levels of the recollection of the intensive care period that were published between December, 1998-April, 2013. The systematic review was carried out screening of the related publications. The findings of the systematic review were studied under the following two titles: "remembering the intensive care period" and "recalled experiences" of patients. Studying 15 papers which were found suitable to the inclusion criteria of the review indicated that majority of the patients had recollection of the intensive care process. The physical experiences of the patients were pain, sleep disturbances, discomfort, inactivity or over-activity, noise, thirst, headache, discomfort due to the endotracheal tube (ET), technological support, medical activities, and difficulties in aspiration and swallowing. On the other side, psychological experiences were hallucination, nightmares, fear, worry, anxiety, depression, loneliness, and thoughts about death, panic, nervousness, uncertainty, and despair. In addition, it was seen that patients experienced some communication difficulties. As a result of the systematic review, it was seen that patients could remember the intensive care period, and the number of negative experiences in intensive care were more than the positive ones.

Background: In Western healthcare policies, promotion of self-management of patients is an important topic. Currently, there is also a worldwide interest in the integration of complementary and alternative medicine (CAM) and conventional medicine into integrative medicine. This article explores the contribution of anthroposophic medicine (AM) to the promotion of self-management of patients. Material and Methods: The scientific literature on concepts of, evidence on and experiences of patients with AM was explored. Results: The AM approach contributes to: (1) a patient-centered, collaborative promotion of patient self-management by means of application of basic values (equivalence, servitude, and presence of mind) and specific methods; (2) a better coping with health-related issues by providing a spiritual worldview that serves as a coping strategy; by treating patients in such a way that they (further) develop self-regulating functioning, both on the physiological and the psychosoci...

Despite evidence suggesting that parent involvement was beneficial for infant and parent outcomes, the Family Integrated Care (FICare) programme was one of the first pragmatic approaches to enable parents to become primary caregivers in the neonatal intensive care unit (NICU). We aimed to analyse the effect of FICare on infant and parent outcomes, safety, and resource use. In this multicentre, cluster-randomised controlled trial, we stratified 26 tertiary NICUs from Canada, Australia, and New Zealand by country and size, and assigned them, using a computer-generated random allocation sequence, to provide FICare or standard NICU care. Eligible infants were born at 33 weeks' gestation or earlier, and had no or low-level respiratory support; parents gave written informed consent for enrolment. To be eligible, parents in the FICare group had to commit to be present for at least 6 h a day, attend educational sessions, and actively care for their infant. The primary outcome, analysed ...

Background: Person-centered care is widely recognized as a gold standard and is based on a supportive psychosocial climate for both residents and staff in nursing homes. Residents and staff may have different perspectives as to whether the climate in which they interact is person-centered, perhaps due to their different expectations of the nursing home environment and the provision of care services. The aim of this study was to explore and compare resident and staff perspectives of person-centered climate in aged care nursing homes. Methods: This is a descriptive cross-sectional study using a cluster random sampling method. The study collected data in 2016 from residents (n = 251) and nursing staff (n = 249) in 23 nursing homes using a Person-centered Climate Questionnaire-Patient version and Person-centered Climate-Staff version. T-tests for independent-samples were used to compare scores ranked by nursing staff and residents. Results: The mean scores of 'A climate of safety' subscale and 'A climate of everydayness' subscale rated by residents were significantly lower than those rated by nursing staff. The mean scores of 'A climate of hospitality' rated by residents were very low among the three subscales, an indicator of the need to improve a more home-like environment for residents. Residents in larger size nursing homes showed a higher score of person-centered climate compared with their counterparts in small size nursing homes. Conclusions: This study reveals that the perspectives and perceptions of person-centered climate differ between residents and nursing staff. Therefore, both resident and staff perspectives should be taken into account in attempting to improve person-centered climate for better care outcomes.

On 19 June 2019, voluntary assisted dying became operational in Victoria, Australia, via the Voluntary Assisted Dying Act 2017 (Vic). Some evidence has emerged of barriers to accessing voluntary assisted dying in Australia. Drawing on the findings from qualitative interviews we conducted with a patient and family caregivers in Victoria, we investigate how actions taken by patients and family caregivers to overcome barriers to access may be conceived of as ‘regulatory’. We adopt Black’s definition of regulation as sustained, focused, and intentional action directed at altering others’ behaviour. We found that participants performed various actions to overcome barriers to access, and primarily, these actions were motivated by a desire to support voluntary assisted dying access for individual patients. However, many participants were motivated to make the voluntary assisted dying system better for others. Participants perceived that actions to overcome barriers to access by patients and family caregivers improved their individual experience of the voluntary assisted dying process. Sometimes, their actions also altered the behaviour of key participants in Victoria’s voluntary assisted dying system or impacted the system as a whole. Patients and family caregivers are central to Victoria’s voluntary assisted dying system, so it is positive they can overcome barriers to involvement in regulation, such as information asymmetry and power imbalances. However, having to undertake ‘regulation’ to alter others’ behaviour and the system to address access issues is not an easy role. Patients and family caregivers should have opportunities to be involved in regulation if they wish, but for others who do not wish to be involved, consideration must be given to addressing barriers to accessing voluntary assisted dying to reduce the burden on patients and family caregivers of having to take action to overcome these access barriers.

No studies have explored the experiences of Canadian mechanical ventilator-assisted adolescents (VAAs) living at home as they transition from paediatric to adult health providers. A better understanding of the needs of this growing population is essential to provide transition services responsive to VAAs and caregiver-identified needs. Methods: We conducted semistructured telephone interviews with adolescents and family caregivers who had recently initiated or completed transition to adult care recruited from three Canadian university-affiliated paediatric home ventilation programs. We analyzed transcripts using a theoretical framework for understanding facilitators and barriers to transition. Results: We interviewed 18 individuals representing 14 episodes of paediatric to adult transition. Participants identified early planning, written informational materials and joint paediatric-adult provider-family transition meetings as facilitators of care transition to adult services and providers. Barriers included insufficient information, limited access to interprofessional (nursing and allied health) providers and reduced funding or health services. Barriers resulted in service disruption and a sense of 'medical homelessness'. While most families related a positive transition to a new 'medical home', families caring for VAAs with moderate-to-severe cognitive and/or physical dependence more commonly reported transition difficulties. Conclusions: Important opportunities exist to enable improvements in the transition experiences of VAAs and their family caregivers. To maximize service continuity during paediatric to adult transition, future research should focus on transition navigator roles, interprofessional health outreach and the needs of families caring for VAAs with cognitive and physical deficits.

Background: Structured education programmes are now established as an essential component to assist effective self-management of diabetes. In the case of Type 1 diabetes, the Dose Adjustment For Normal Eating (DAFNE) programme improves both glycaemic control and quality of life. Traditionally delivered over five consecutive days, this format has been cited as a barrier to participation by some patients, such as those who work full-time. Some centres in the UK have organised structured education programmes to be delivered one day a week over several consecutive weeks. This type of format may add benefit by allowing more time in which to practice skills between sessions, but may suffer as a result of weaker peer support being generated compared to that formed over five consecutive days.

The quality of the patient-physician relationship affects the patient's compliance with the treatment and satisfaction with the interview. Szasz and Hollender (1956) described three types of patient-physician relationships. In the relationship based on activity-passivity, the physician is equipped with broad powers, regardless of the patient's consent. Relationship based on guidance-cooperation defines the relationship between the patient who is ready to apply the commands of the physician and the physician who offers his professional experience. Relationship based on mutual participation is the patient-physician relationship when the physician provides professional support for the individual to contribute to his or her health. Patientphysician relationship was modeled by Emanuel EJ and Emanuel LL (1992) with a four-component classification. The physician who adopts authoritarian attitude in the paternalistic model can ignore his patient's preferences. In the informative model, all the information about the situation is presented to the patient, the patient makes his own choice and the physician applies the selected medical intervention. In the interpretive model, the physician sets out the patient's expectation, while doing so, takes the patient's values as reference and shapes the treatment on this basis. In the deliberative model that encourages shared decision-making between the physician and the patient, the physician and the patient discuss mutually about what options the patient can choose during the treatment process and the path to be followed. It should not be forgotten that the type of relationship to be adopted in the clinical interview may vary depending on the condition of the patient and the nature of the disease.

Background The care needs of women with gynecological cancer are complex and change over the course of their cancer journey. Specialist nurses are well positioned to play a role in meeting the needs of women with gynecological cancer although their role and scope of practice have not been well defined. As patients are a key stakeholder, understanding their experience of care is an important step in better defining the role and scope of practice of specialist nurses in gynecological oncology in Australia and New Zealand. Objectives This review sought to consider gynecological cancer patients' experiences of specialist nursing care. Exploring the patient's experience of care by a specialist nurse is one step in the process of better defining the role and scope of practice of specialist gynecological-oncology nurses in Australia and New Zealand. Inclusion criteria Types of participants This review included studies with a focus on women with gynecological cancer who had been cared for by a specialist nurse. Studies of women with gynecological cancer at any point on the continuum of care from prediagnosis to survivorship or end of life, including those with a recurrence of the disease, were included, with no limit to the duration of care received for inclusion in the review.