ObjectiveTo systematically review the research on pediatric treatment satisfaction of medication (TS-M). MethodsThe PubMed, Embase, Cochrane Library, CBM, WanFang Data, VIP, CNKI databases and medical scale websites were electronically searched to collect studies on pediatric TS-M from inception to November 2022. Two reviewers independently screened literature, and extracted data. Using descriptive analysis, we comprehensively reviewed the TS-M assessment tool selected for the studies of children. We evaluated the methodological quality and measurement properties of existing TS-M scales for children using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) assessment criteria. ResultsA total of 157 studies were included, including 150 pediatric studies using TS-M evaluation tools and 7 studies on the development and validation of TS-M scales for children, covering 7 specific TS-M scales for children. Our review revealed that 67.3% of the pediatric studies used unvalidated self-administered TS-M questionnaires or interviews, 24.7% used adult TS-M scales, and only 6.0% used two pediatric-specific TS-M scales. The results of the quality assessment indicated that the development quality of existing TS-M pediatric scales was considered "doubtful" or "inadequate", and the internal consistency was "sufficient" but the structural validity was probably "uncertain". High-quality research on the content validity, test-retest reliability and construct validity of the pediatric TS-M scale was still lacking. ConclusionCurrently, the use of TS-M evaluation tools in pediatric studies has irrationalities: over 90% of pediatric studies use self-made questionnaires or adult scales to evaluate children's TS-M; and the existing pediatric TS-M scales globally have narrow applications, questionable development quality, and lack some measurement performance studies. Pediatric TS-M scales with a wide range of applications are lacking.
Objective To improve the satisfaction of standardized remote consultation of epilepsy center in patients with refractory epilepsy, and initially establish a standardized remote consultation model of three-level comprehensive epilepsy center. Methods Based on the characteristics of our epilepsy center, we designed a set of standardized remote consultation process of epilepsy center in tertiary hospitals, including sorting out patient data before consultation, improving examination, application of multi-modal technology during consultation, notification of results after consultation, and decision of operation time and method. A total of 209 patients who received remote consultation in our epilepsy center from January 2022 to June 2023 were selected as the observation group, and 150 patients who received offline consultation in our epilepsy center during the same period were randomly selected as the control group. The satisfaction of patients in the two groups on the service of doctors and nurses in consultation and the consultation results were compared. Results Through the application of the new multi-modal remote consultation mode, the number of consultations gradually increased, Compared with the offline consultation mode, there was no significant difference in patients' satisfaction with the service of doctors and nurses in remote consultation mode (P<0.05). Conclusion The establishment of standardized remote consultation mode in epilepsy center has effectively reduced the economic burden of patients, simplified the medical treatment process and improved the service quality, but the consultation quality has not been affected.
Patient satisfaction is regarded as a key component of measuring and reporting quality of medical services. It is also an important indicator in performance appraisal for public hospitals in China. Based on the literature review on the theories and practices of patient satisfaction assessment in China and other countries and areas, this paper performed an in-depth analysis on the theoretical frameworks and instruments for patient satisfaction assessment, as well as their applications in management practices. Further research and improvements are needed.
Objective To verify the reliability and validity of a self-developed satisfaction evaluation questionnaire for outpatient department employees in public hospitals, and to provide suitable tools for conducting such surveys. Methods Two anonymous surveys were conducted on all employees of the Outpatient Department of West China Hospital of Sichuan University in July 2019 and November 2021, respectively. Questionnaire items were screened using methods such as item distribution, coefficient of variation, and decision value, and the reliability and validity of the questionnaire were evaluated using Spearman-Brown coefficient and Cronbach’s α coefficient, exploratory factor analysis, and confirmatory factor analysis. Results The final questionnaire retained 14 items, which could be divided into two dimensions: work conditions and interpersonal environment, and the overall fit index of structural equation model were as follows: χ2/ν=6.957, the standardized root mean square residual was 0.061, the root mean square error of approximation was 0.147, the goodness-of-fit index was 0.796, the adjusted goodness-of-fit index was 0.719, the normed fit index was 0.849, the relative fit index was 0.819, the incremental fit index was 0.868, the Tucker-Lewis Index was 0.841, and the comparative fit index was 0.867. The combined reliability of the two factors in the questionnaire was 0.94 and 0.91, respectively. The average variance extraction was 0.67 and 0.76, respectively, and the square root of the average variance extraction was 0.82 and 0.87, respectively, both of which were greater than the correlation coefficient of 0.71 between the two factors. The Spearman-Brown coefficient of the final questionnaire was 0.913, and the Cronbach’s α coefficients for the overall and two dimensions were 0.953, 0.937, and 0.910, respectively. Conclusion The reliability and validity of the satisfaction evaluation questionnaire for outpatient department employees in public hospitals are good and the questionnaire can be applied to practical surveys.
ObjectiveTo understand the current research status of conservative mastectomy with breast reconstruction for breast cancer, so as to provide a reference for surgeons and patients with breast cancer to choose surgical method. MethodThe recently domestic and foreign literature on the research of conservative mastectomy with breast reconstruction for breast cancer was reviewed and summarized. ResultsAt present, conservative mastectomy mainly included nipple sparing mastectomy, skin sparing mastectomy, and skin reduction mastectomy. All three surgical methods were safe and effective in the treatment of breast cancer, and the complications could be controlled. When combined with breast reconstruction, the better cosmetic effect could be obtained, and the postoperative satisfaction and quality of life of patients were markedly improved. ConclusionsAfter comprehensively preoperative evaluation for patients with breast cancer, conservative mastectomy provides a treatment choice for them. After conservative mastectomy, individualized reconstruction scheme is formulated according to size and sagging degree of breast, as well as individual expectations of patients, which can obtain a higher quality of life while treating diseases for patients with breast cancer.
Objective
To explore the application effects of nursing quality control mode based on nurse satisfaction.
Methods
A total of 226 nurses in 12 nursing units were selected from December 2013 to June in 2014 as the study subjects. Then, we compared the nurse satisfaction, patient satisfaction, and the effect of nursing quality control before and after the implementation of quality control mode in which nurses participated actively.
Results
After a half-year practice of nursing quality mode, all the investigation items of the project were significantly different from those before the mode application (P>0.05), except Q1, Q2, Q8, and Q10 in the nurse satisfaction questionnaire, q1, q2, q3, q4, and q14 in the patient satisfaction questionnaire, and quality of emergency management in the nursing quality control section.
Conclusion
Application of nursing quality control mode can fully mobilize the enthusiasm of nurses, improve nurse satisfaction and the effect of nursing quality management, which has a high value of application in clinical nursing management.
Objective
To explore the postoperative satisfaction of patients with lumbar disc herniation after enhanced recovery after surgery and its related factors.
Methods
A total of 102 patients with lumbar disc herniation were selected and analyzed by convenient sampling method from September 2016 to June 2017. The patients’ general information, functional status [using the Oswestry Disability Index (ODI) to investigate the preoperative, postoperative and post-discharge ODI] and patients’ satisfaction (1 month after the discharge) were collected.
Results
A total of 102 patients, including 62 males and 40 females, aged from 14 to 82 years with an average of (43.8±14.4) years were included in the study.The mean length of hospital stay was (6.61±2.49) days. The total score of patients’ satisfaction was 62.43±6.37, and the satisfaction degree was at the middle and high level. Postoperative and post-discharge ODIs were associated with patients’ satisfaction (rs=0.328, 0.452; P<0.05).
Conclusions
The postoperative satisfaction of patients with lumbar disc herniation after enhanced recovery after surgery should be further improved. The medical staff should pay attention to the recovery of postoperative function in order to improve the patients’ satisfaction.
Objective To study the effect of multi-disciplinary treatment (MDT) on the surgical efficacy and satisfaction of patients undergoing total knee arthroplasty (TKA) for the first time. Methods The clinical data of patients who underwent unilateral TKA for single-compartment osteoarthritis of the knee in the General Hospital of Ningxia Medical University between January and September 2022 were retrospectively collected and analyzed. According to whether MDT was performed on patients during the perioperative period, they were divided into MDT group and traditional group. Perioperative nutrition-related indicators, perioperative complications, total hospitalization time, Visual Analogue Scale (VAS), and Hospital for Special Surgery Knee Score (HSS) before and after surgery were detected and recorded. Results A total of 95 patients were included. Among them, there were 42 cases in the MDT group and 53 cases in the traditional group. The postoperative complications and total hospital stay of patients in the MDT group were lower than those in the traditional group, and their satisfaction scores were higher than those in the traditional group (P<0.05). The perioperative serum total protein (TP), hemoglobin (Hb), serum albumin (ALB) levels, VAS score, and HSS score of both groups of patients changed over time. The intra group comparison results showed that compared with preoperative, the levels of TP, Hb, and ALB in both groups decreased on the 1st and 3rd postoperative days (P<0.05). On the 3rd day after surgery, the levels of TP, Hb, ALB in the MDT group and Hb, ALB in the traditional group were lower than on the 1st day after surgery (P<0.05). There was no statistically significant difference in TP levels between the traditional group on the 3rd day after surgery and the 1st day after surgery (P>0.05). The results of intra group comparison at different time points showed that there were statistically significant differences in VAS score and HSS score between the two groups (P<0.05). Conclusion The application of MDT in elderly patients undergoing unilateral TKA for the first time can shorten the total hospitalization time, reduce the incidence of perioperative complications, and improve the surgical efficacy and patient satisfaction.
Objective
To optimize the environment of outpatient clinics in large hospitals, facilitate the patients’ visits and improve the comprehensive management level.
Methods
From September to November 2015, 2 hospitals in each part of a provincial city (middle, east, west, north and south), a total of 10 hospitals were chosed by convenient sampling method. The forms, types and distribution of outpatient navigation service system were investigated and analyzed by using a self-designed questionnaire.
Results
There were a total of 14 forms of counseling-guide services in the 10 hospitals. Just 1 hospital provided all the 14 forms of counseling-guide services, and 2 hospitals provided 13 forms of counseling-guide services, which were relatively complete. While the other 7 large hospitals provided only 4 to 6 forms of counseling-guide services, which were relatively simple.
Conclusion
Qualified outpatient navigation service system can help patients to receive more effective treatment, optimize the environment, highlighting the modern hospital humanistic service and the concept of intelligent service and scientific management.
Objective
To manage the preoperative, intraoperative and postoperative pain of percutaneous kyphoplasty (PKP) under the concept of enhanced recovery after surgery (ERAS) and explore the role of pain management under the ERAS concept in enhancing postoperative rehabilitation of PKP.
Methods
From January to December 2016, 136 patients with osteoporotic compression fractures treated with PKP of local anesthesia were selected, among which 71 patients in the ERAS group were treated between July and December 2016, who were treated with celecoxib capsule for analgesia before the operation and such local anesthetics as lidocaine and ropivacaine combined with intravenous injection of dexmedetomidine hydrochloride for multi-mode analgesia during the operation; after the operation, celecoxib capsules and tizanidine hydrochloride tablets were orally administered by the routine for analgesia; if the pain was increased, 40 mg parecoxib would be added for analgesia by intramuscular injection. While 65 patients in the conventional group were treated between January and June 2016, who were given intraoperative local anesthesia with lidocaine; if the patients suffered from severe pain after the operation, they would be given 40 mg parecoxib by intramuscular injection. The Visual Analogue Scale (VAS), mean arterial pressure (MAP), the complications after surgery, postoperative infections, bed rest time, length of hospital stay and patient satisfaction were compared between the two groups.
Results
There was no statistical difference in age, gender or fracture vertebral number between the two groups (P>0.05). The preoperative, intraoperative and postoperative VAS scores (4.0±1.5, 4.8±1.8, 1.6±1.1), MAP change [(22.0±4.7) mm Hg (1 mm Hg=0.133 kPa)], bed rest time [(1.5±0.7) days], and length of hospital stay [(3.8±0.8) days] in the ERAS group were significantly less than those in the conventional group [4.7±1.7, 5.7±1.5, 2.4±1.1, (31.3±6.1) mm Hg, (2.1±0.8) days, and (5.0±1.6) days, respectively] (P<0.05). The incidence of intraoperative complication of bone cement leakage (4.2%, 3/71) in the ERAS group was lower than that in the conventional group (13.8%, 9/65) (P<0.05); there was no statistical difference in postoperative pulmonary infection between the two groups (P>0.05). Patients’ satisfaction was significantly improved from 86.2% (the conventional group) to 95.8% (the ERAS group) (P<0.05). There was no incision infection, urinary tract infection or venous thrombosis in the two groups.
Conclusion
With the concept of ERAS, taking a management of pain can effectively alleviate the dis-comfortable pain feeling, improve the patients’ satisfaction, and enhance the recovery for the patients after PKP surgery.
