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Objective To examine how a general inpatient satisfaction survey functions as a hospital performance measure. Methods We conducted a mixed-methods pilot study of the Hospital Consumer Assessment of Health Providers and Systems survey in Odisha, India. We divided the study into three steps: cognitive testing of the survey, item testing with exploratory factor analysis and content validity indexing. Cognitive testing involved 50 participants discussing their interpretation of survey items. The survey was then administered to 507 inpatients across five public hospitals in Odisha, followed by exploratory factor analysis. Finally, we interviewed 15 individuals to evaluate the content validity of the survey items. Findings Cognitive testing revealed that six out of 18 survey questions were not consistently understood within the Odisha inpatient setting, highlighting issues around responsibilities for care. Exploratory factor analysis identified a six-factor structure explaining 66.7% of the variance. Regression models showed that interpersonal care from doctors and nurses had the strongest association with overall satisfaction. An assessment of differential item functioning revealed that patients with a socially marginalized caste reported higher disrespectful care, though this did not translate into differences in reported satisfaction. Content validity indexing suggested that discordance between experiences of disrespectful care and satisfaction ratings might be due to low patient expectations. Conclusion Using satisfaction ratings without nuanced approaches in value-based purchasing programmes may mask poor- quality interpersonal services, particularly for historically marginalized patients. Surveys should be designed to accurately capture true levels of dissatisfaction, ensuring that patient concerns are not hidden. [phrase omitted] [phrase omitted] Objectif Examiner le fonctionnement d'une enquete generale de satisfaction des patients hospitalises en tant que mesure de la performance des hopitaux. Methodes Nous avons mene une etude pilote mixte de l'enquete Hospital Consumer Assessment of Health care Providers and Systems a Odisha, en Inde. Nous avons subdivise l'etude en trois etapes: tests cognitifs de Lenquete, test par items avec analyse factorielle exploratoire et indexation de la validite du contenu. Les tests cognitifs concernaient 50 personnes, qui ont discute de leur interpretation des questions de l'enquete. Lenquete a ensuite ete soumise a 507 patients hospitalises dans cinq hopitaux publics d'Odisha, puis a fait l'objet d'une analyse factorielle exploratoire. Enfin, nous avons interroge 15 personnes pour evaluer la validite du contenu des questions de Lenquete. Resultats Les tests cognitifs ont revele que six des 18 questions de Lenquete n'etaient pas toujours comprises par les patients hospitalises a Odisha, ce qui met en evidence les problemes lies aux responsabilites en matiere de soins. Une analyse factorielle exploratoire a permis d'identifier une structure a six facteurs expliquant 66,7% de la variance. Des modeles de regression ont mis en evidence que les soins interpersonnels prodigues par des medecins et des infirmieres avaient le plus grand impact sur la satisfaction globale. Une evaluation du fonctionnement differentiel des items a revele que les patients appartenant a une caste socialement marginalisee signalaient davantage d'irrespect dans les soins, bien que cela ne se traduise pas par des differences au niveau de la satisfaction declaree. L'indexation de la validite du contenu a suggere que la discordance entre les experiences d'irrespect dans les soins et les evaluations de satisfaction pourrait etre due a la faiblesse des attentes des patients. Conclusion L'utilisation devaluations de la satisfaction sans approches nuancees dans les programmes d'achat bases sur la valeur est susceptible de masquer des services interpersonnels de mauvaise qualite, en particulier pour les patients historiquement marginalises. Les enquetes doivent etre concues de maniere a saisir avec precision les veritables niveaux d'insatisfaction, en evitant de masquer les preoccupations des patients. [phrase omitted] Objetivo Examinar el funcionamiento de una encuesta general de satisfaccion de los pacientes hospitalizados como medida de rendimiento de los hospitales. Metodos Se realizo un estudio piloto de metodos mixtos de la encuesta de Evaluacion del consumidor hospitalario sobre proveedores y sistemas de atencion sanitaria en Odisha (I ndia). Se dividio el estudio en tres pasos: prueba cognitiva de la encuesta, prueba de elementos con analisis factorial exploratorio e indexacion de la validez del contenido. La prueba cognitiva consistio en que 50 participantes discutieran su interpretacion de los elementos de la encuesta. A continuacion, se administro la encuesta a 507 pacientes ingresados en cinco hospitales publicos de Odisha, tras lo cual se realizo un analisis factorial exploratorio. Por ultimo, se entrevisto a 15 personas para evaluar la validez de contenido de los elementos de la encuesta. Resultados Las pruebas cognitivas revelaron que seis de las 18 preguntas de la encuesta no se comprendian de forma coherente en el entorno hospitalario de Odisha, lo que evidenciaba problemas relacionados con las responsabilidades de la atencion. El analisis factorial exploratorio identifico una estructura de seis factores que explicaban el 66,7% de la varianza. Los modelos de regresion mostraron que la atencion interpersonal por parte de medicos y personal de enfermeria presentaba la mayor asociacion con la satisfaccion general. Una evaluacion del funcionamiento diferencial de los elementos revelo que los pacientes de una casta socialmente marginada informaron de una atencion mas irrespetuosa, aunque esto no se reflejo en diferencias en la satisfaccion declarada. La indexacion de la validez de contenido sugirio que la discordancia entre las experiencias de atencion irrespetuosa y los indices de satisfaccion podria deberse a las bajas expectativas de los pacientes. Conclusion El uso de indices de satisfaccion sin enfoques matizados en los programas de compras basadas en el valor puede enmascarar servicios interpersonales de mala calidad, en particular para pacientes historicamente marginados. Las encuestas deben disenarse para captar con precision los verdaderos niveles de insatisfaccion, de forma que no se oculten las preocupaciones de los pacientes., Introduction In 2018, the Indian government launched the world's largest health insurance scheme, Pradhan Mantri Jan Arogya Yojana. (1) The scheme aims to cover secondary and tertiary care for 500 [...]

Purpose The prevalence of burnout in intensive care unit (ICU) professionals is difficult to establish due to the variety of survey instruments used, the heterogeneity of the targeted population, the design of the studies, and the differences among countries regarding ICU organization. Methods We performed a systematic review and meta-analysis examining the prevalence of high-level burnout in physicians and nurses working in adult ICUs, including only studies that use the Maslach Burnout Inventory (MBI) as a tool to evaluate burnout and involving at least 3 different ICUs. Results Twenty-five studies with a combined population of 20,723 healthcare workers from adult ICUs satisfied the inclusion criteria. Combining 18 studies including 8187 ICU physicians, 3660 of them reported a high level of burnout (prevalence 0.41, range 0.15-0.71, 95% CI [0.33; 0.5], I.sup.2 97.6%, 95% CI [96.9%; 98.1%]). The heterogeneity can be at least in part explained by the definition of burnout used and the response rate as confirmed by the multivariable metaregression done. In contrast, there was no significant difference regarding other factors such as the study period (before or during the coronavirus disease 2019 (COVID-19) pandemic), the income of the countries, or the Healthcare Access and Quality (HAQ) index. Combining 20 studies including 12,536 ICU nurses, 6232 of nurses were reporting burnout (prevalence 0.44, range 0.14-0.74, [95% CI 0.34; 0.55], I.sup.2 98.6% 95% CI [98.4%; 98.9%]). The prevalence of high-level burnout in ICU nurses for studies performed during the COVID-19 pandemic was higher than that reported for studies performed before the COVID-19 pandemic (0.61 [95% CI, 0.46; 0.75] and 0.37 [95% CI, 0.26; 0.49] respectively, p = 0.003). As for physicians, the heterogeneity is at least in part explained by the definition used for burnout using the MBI but not by the number of participants. When compared, the prevalence of high-level burnout was not different between ICU physicians and ICU nurses. However, the proportion of ICU nurses with a high level of emotional exhaustion was higher than for ICU physicians (0.42 [95% CI, 0.37; 0.48] and 0.28 [0.2; 0.39], respectively, p = 0.022). Conclusion According to this meta-analysis, the prevalence of high-level burnout is higher than 40% in all ICU professionals. However, there is a great heterogeneity in the results. To evaluate and to compare preventive and therapeutic strategies, there is the need to use a consensual definition of burnout when using the MBI instrument., Author(s): Laurent Papazian [sup.1] [sup.2] [sup.3], Sami Hraiech [sup.2] [sup.4], Anderson Loundou [sup.5], Margaret S. Herridge [sup.6], Laurent Boyer [sup.5] Author Affiliations: (1) Centre Hospitalier de Bastia, , 20600, Bastia, [...]

Background. The purpose of this study was to determine pediatric nurses' knowledge of autism spectrum disorders (ASD). Methods. We conducted a population-based online survey of 273 pediatric nurses in eastern Saudi Arabia using convenience sampling method. Perceived knowledge was assessed using the knowledge of childhood autism among Health Professionals Questionnaire (KCAHW) that was translated into Arabic. We used multivariate regression analysis to determine the influence of demographic factors on the perceived knowledge. Using Pearson's correlation analysis, we assessed the correlation between the outcome variables and the predictor variables. Results. ASD knowledge is generally higher among pediatric nurses with higher academic qualifications (r=0.29, p, Author(s): Majed Alruwaili (corresponding author) [1]; Osama Mohamed Elsayed Ramadan [1]; Mostafa shaban [1]; Abeer Alruwaili [1]; Nourah Alsadaan [1]; Sayed Ali [2]; Abdulellah Al Thobaity [3]; Dauda Salihu [1] [...]

Problem The coronavirus disease 2019 (COVID-19) pandemic could affect health service provision of less urgent interventions, such as peritoneal dialysis for chronic kidney disease patients. Approach To assess how peritoneal dialysis centres in Thailand adapted their provision of care, we invited medical directors and peritoneal dialysis managers to respond to an online survey on 1 July 2021. We asked whether they had modified or deferred their training, catheter insertion or removal, intravenous supplements, follow-up and home visits, and workload. Local setting Patients needing dialysis receive peritoneal dialysis free of charge in Thailand. As of 31 December 2020, 240 peritoneal dialysis centres in Thailand have provided care to 32 284 patients. Relevant changes At 24.6% (29/118) of centres, educational sessions for patients were modified. Catheter insertion continued at 71.9% (82/114) of centres. Few facilities (19.7%; 23/117) continued to perform peritoneal equilibration tests as usual. On-site intravenous injections were mostly transferred to health centres close to the patients' homes. Most centres reduced their outpatient follow-up visits (51.7%; 61/118) and stopped visiting patients at home (66.9%; 79/118). Peritoneal dialysis nurses reported an increased workload at 62.7% (74/118) of centres, and in many instances (66.1%; 78/118) were providing nursing care to COVID-19 patients and administering COVID-19 vaccines. Lessons learnt Health-care providers altered clinical care activities to protect their patients from COVID-19. However, further evidence is needed on the consequences of such alteration in care. To prepare for future pandemics, actors need to explore nonconventional peritoneal dialysis care as well as financial and nonfinancial incentive mechanisms for such care. Probleme La pandemie de maladie a coronavirus 2019 (COVID-19) est susceptible d'affecter la realisation, par les services de sante, d'interventions moins urgentes, telles que les dialyses peritoneales pour les patients atteints de maladies renales chroniques. Approche Afin d'evaluer comment les centres medicaux procedant a des dialyses peritoneales en Thailande ont adapte leur prestation de soins, nous avons invite des directeurs medicaux et des personnes effectuant des dialyses peritoneales a repondre a une enquete en ligne le 1er juillet 2021. Nous leur avons demande s'ils avaient modifie ou reporte leur formation, l'insertion ou le retrait de catheters, des supplements intraveineux, des visites de suivi ou a domicile et leur charge de travail. Environnement local En Thailande, les patients necessitant une dialyse beneficient gratuitement d'une dialyse peritoneale. Au 31 decembre 2020, 240 centres thailandais realisant des dialyses peritoneales ont fourni des prestations a 32 284 patients. Changements significatifs Dans 24,6% (29/118) des centres, les seances educatives destinees aux patients ont ete modifiees. L'insertion de catheters s'est poursuivie dans 71,9% (82/114) des centres. Peu de centres (19,7%; 23/117) ont continue a effectuer le test d'equilibrage peritoneal comme a leur accoutumee. Les injections intraveineuses sur place ont ete transferees pour la plupart dans des centres de sante proches du domicile des patients. La plupart des centres ont reduit leurs visites de suivi ambulatoire (51,7%; 61/118) et ont cesse de rendre visite aux patients a leur domicile (66,9%; 79/118). Le personnel infirmier charge de realiser des dialyses peritoneales a signale une augmentation de sa charge de travail dans 62,7% (74/118) des centres et, dans de nombreux cas (66,1%; 78/118), il fournissait des soins infirmiers aux patients atteints de la COVID-19 et vaccinait contre la COVID-19. Lecons tirees Les prestataires de soins de sante ont modifie leurs activites cliniques pour proteger leurs patients contre la COVID-19. Cependant, des preuves supplementaires sont necessaires sur les consequences d'une telle modification du schema de soins. Pour se preparer aux futures pandemies, les acteurs de la sante doivent envisager des interventions de dialyse peritoneale non conventionnelles ainsi que des mecanismes d'incitation financiere et non financiere pour ces soins. Situacion La pandemia de la coronavirosis de 2019 (COVID-19) podria afectar a la prestacion de los servicios sanitarios de intervenciones menos urgentes, como la dialisis peritoneal para pacientes con enfermedades renales cronicas. Enfoque Para evaluar como los centros de dialisis peritoneal de Tailandia adaptaron su prestacion de cuidados, se invito a los directores medicos y a los gestores de dialisis peritoneal a responder a una encuesta en linea el 1. de julio de 2021. Se les pregunto si habian modificado o aplazado su formacion, la insercion o retirada de cateteres, los suplementos por via intravenosa, las visitas de revision y a domicilio y la carga de trabajo. Marco regional Los pacientes que necesitan dialisis reciben dialisis peritoneal de forma gratuita en Tailandia. A 31 de diciembre de 2020, 240 centros de dialisis peritoneal en Tailandia atendieron a 32 284 pacientes. Cambios importantes Se modificaron las sesiones educativas para los pacientes en el 24,6 % (29/118) de los centros. La insercion de cateteres continuo en el 71,9 % (82/114) de los centros. En pocos centros (19,7 %; 23/117) se siguio realizando la prueba de equilibrio peritoneal de forma habitual. Las inyecciones por via intravenosa in situ se transfirieron en su mayoria a los centros sanitarios cercanos a los domicilios de los pacientes. La mayoria de los centros disminuyeron sus visitas de revision ambulatoria (51,7 %; 61/118) y dejaron de visitar a los pacientes en sus domicilios (66,9 %; 79/118). Las enfermeras dedicadas a la dialisis peritoneal informaron de un incremento de la carga de trabajo en el 62,7 % (74/118) de los centros, y en muchos casos (66,1 %; 78/118) estaban proporcionando cuidados de enfermeria a los pacientes de la COVID-19 y administrando las vacunas contra la COVID-19. Lecciones aprendidas Los proveedores de servicios sanitarios modificaron las actividades de atencion clinica para proteger a sus pacientes de la COVID-19. No obstante, se necesitan mas evidencias sobre las consecuencias de esta modificacion de la atencion. Para prepararse para futuras pandemias, los agentes sanitarios deben explorar los cuidados de dialisis peritoneal no convencionales, asi como los mecanismos de incentivos financieros y no financieros para estos cuidados., Introduction The coronavirus disease (COVID-19) pandemic has challenged health systems worldwide. In Thailand, the pandemic has gradually affected the health-care provision for other diseases than COVID-19, including peritoneal dialysis for [...]