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Healthcare professionals continually face pressure for increased transparency in their supply chains (SCs). This research examines how healthcare SC information disclosures and physician operations influence patient perceptions (i.e., satisfaction with physicians and attitude toward healthcare service providers). Evidence from prior research might not be applicable in the healthcare context because of intense regulations and safety concerns. Moreover, previous studies have mostly adopted an internal, operational perspective. By contrast, we provide healthcare professionals with guidance on how to maximize patient perceptions. Anchoring on signaling theory and construal level theory of psychological distance, we examine whether and how the disclosed information in a healthcare context influences patients' perceptions with two vignette‐based studies. In contrast with literature on SC transparency, we do not find a main effect of SC disclosures in healthcare. Instead, the effects depend on the content disclosed. We find that spatial and temporal distances of the healthcare SC significantly influence patients' perceptions. Furthermore, a three‐way interaction shows that by strategically disclosing manufacturing and distribution information, especially when these occur close to the patient's home country, and incorporating service recovery actions, such as closer follow‐ups, professionals can maximize patient perception outcomes. [ABSTRACT FROM AUTHOR]

Purpose: The utilization of remote patient monitoring (RPM) with home blood pressure monitoring has shown improvement in blood pressure control and adherence with follow-up visits. Patient perceptions regarding its use in the obstetric population have not been widely studied. The aim of this study was to assess patients' knowledge about hypertensive disorders of pregnancy and perceptions and satisfaction of the RPM program. Methods: Descriptive analysis of survey responses of patients with PPHTN enrolled into the RPM program for 6 weeks after delivery between October 2021 and April 2022. Surveys were automatically administered at 1-, 3-, and 6-week postpartum. Responses were further compared between Black and non-Black patient-reported race. Results: 545 patients received the RPM program. Of these, 306 patients consented to data collection. At 1 week, 88% of patients that responded reported appropriately that a blood pressure greater than 160/110 is abnormal. At 3 weeks, 87.4% of patients responded reported they were "very" or "somewhat" likely to attend their postpartum follow-up visits because of RPM. At 6 weeks, 85.5% of the patients that responded were "very" or "somewhat" satisfied with the RPM program. Responses were not statistically different between races. Conclusions: Majority of postpartum patients enrolled in the RPM program had correct knowledge about hypertension. In addition, patients were highly satisfied with the RPM program and likely to attend postpartum follow-up based on responses. Further research is warranted to validate these findings and to address any barriers for patients who did not utilize the program. [ABSTRACT FROM AUTHOR]

Background: Little is known about patient and the public perspectives on decentralized and hybrid clinical trials in Canada. Methods: We conducted an online survey (English and French) promoted on social media to understand perspectives of people in Canada about decentralized and hybrid clinical trials. The survey had two sections. We co-produced this project entirely with patient, caregiver, and family partners. Results: The survey had 284 (14 French) individuals who started or completed Section 1, and 180 (16 French) individuals who started or completed Section 2. People prefer to have options to participate in clinical trials where aspects are decentralized or hybridized. 79% of respondents preferred to have options related to study visits. There were concerns about handling adverse events or potential complications in decentralized trials, however, communication options such as a dedicated contact person for participants was deemed helpful. Most respondents were amenable to informed consent being done at a satellite site closer to home or via technology and were split on privacy concerns about this. Most preferred travel to a site within an hour, depending on what the trial was for or its impact on quality of life. Due to the response rate, we were unable to explore associations with gender, age, health status, geography, ethnicity, and prior clinical trial participation. Conclusion: Our findings indicate an openness in Canada to participating in trials that decentralize or hybridize some aspects. These trials are perceived to provide benefits to participants and ways to increase equity and accessibility for participants. [ABSTRACT FROM AUTHOR]

To identify the preferences and perceptions of migraine patients for acute and preventive treatment options and to investigate which treatment outcomes are the most important. The authors performed a choice-format survey in a cohort of migraine patients from Greece and Cyprus. A self-administered questionnaire developed in collaboration with the Greek Society of Migraine Patients was used. Questionnaires were collected from 617 migraine patients. Efficacy was preferred over safety as the single most important parameter, both in acute and preventive treatment. When analyzing single outcomes, patients prioritized a complete pain remission at 1-hour post-dose for acute therapies. Regarding migraine prevention, a 75% reduction in frequency, intensity of pain, accompanying symptoms and acute medication intake were considered as most important. Conversely, outcomes routinely used in clinical trials, namely complete or partial pain remission at 2-hours post-dose for acute treatment and 50% or 30% reduction in migraine frequency for prevention, were not deemed particularly relevant. Tablet formulation was mostly preferred, both in acute and preventive treatment. Conclusion: Listening to patients' needs may add a piece of the puzzle that is generally missing in clinical practice and often explains the lack of adherence in both acute and preventative anti-migraine therapies. [ABSTRACT FROM AUTHOR]

This Open Forum is relevant for investigators who conduct research with historically understudied and marginalized populations. The authors introduce a U.S. Department of Veterans Affairs clinical trial that experienced challenges with recruitment of African American or Black veterans and was terminated for not achieving its recruitment goals. The role of power dynamics in clinical research is discussed, specifically how unequal distributions of power may create recruitment challenges. The authors summarize three lessons learned and offer recommendations for sharing power equitably between investigators and potential participants. By recounting these experiences, the authors seek to promote culturally sensitive, veteran-centered approaches to recruitment in future clinical trials. [ABSTRACT FROM AUTHOR]

The priorities of individuals with chronic stroke are not always reflected in clinical practice. This study provides insight into meaningful factors related to long-term motor recovery in stroke survivors. Thirty individuals with chronic stroke participated in semi-structured interviews about movement, recovery, and barriers to and facilitators of mobility and paretic arm use. The interviews were analyzed using inductive thematic analysis. Three categories, the individual, environment, and task, defined five emergent themes. Individual: (1) mindset is a strong and consistent influencer of daily physical activity and overall recovery; (2) severe physical impairment limits physical activity and recovery, regardless of other factors; and (3) a negative perception of disability impacts mindset and willingness to move in public. Environment: (4) social and physical environments influence physical activity and recovery. Task: (5) participation in meaningful activities increases physical activity and promotes long-term recovery. Strategies to incorporate paretic arm use, exercise, and encouragement from others facilitate physical activity. Insufficient paretic limb function, environmental obstacles, and fear are barriers to physical activity. Neurorehabilitation must address the factors that are meaningful to stroke survivors. Building motor capacity is essential and must be integrated with factors such as a positive mindset and proper environment. Individual differences reinforce the need for personalized care. [ABSTRACT FROM AUTHOR]

Introduction Objective Materials and Methods Results Discussion The public health response (PHR) to the COVID‐19 pandemic significantly disrupted healthcare services worldwide. Our hospital, a major tertiary centre, is a unique two‐state service across Queensland and New South Wales (NSW).The primary objective is to describe changes in service demand and delivery in our hospital resulting from the COVID‐19 PHR. The secondary objective is to investigate patient perceptions of this impact.We performed a retrospective interrupted time series analysis and a population‐based survey to examine patient perceptions of the impact of the COVID‐19 PHR. The study periods were demarcated by the initiation of the COVID‐19 PHR on 1 March 2020 with the ‘pre’ and ‘during’ COVID‐19 periods defined as the 12 months before and after this date respectively.More patients were seen during the COVID‐19 PHR period. The number or stage of cancer diagnoses was not different (P > 0.05). There was evidence (P = 0.03) of an increase in overall occasions of service and fewer failed attendances (P = 0.005). Fewer surgeries were performed on NSW patients (P = 0.005). The survey response rate was 19.3% (n = 185) with 48% stating that COVID‐19 had negatively affected their emotional wellbeing. More participants from NSW than Queensland identified border closures as the most significant impact of the COVID‐19 PHR.The COVID‐19 PHR resulted in an unexpected increase in unit service demand and delivery. The necessary implementation of telephone appointments, while less preferred by patients, sustained service requirements. Cross‐border tertiary healthcare services should consider the significant impact of border restrictions on patient wellbeing. [ABSTRACT FROM AUTHOR]

On most online platforms, just about anyone can disseminate plastic surgery (PS) content regardless of their educational or professional background. This study examines the general public's perceptions of the accuracy of online PS content and the factors that contribute to the discernment of credible information. The Amazon Mechanical Turk crowdsourcing platform was used to survey adults in the United States. The survey assessed respondent demographics, health literacy (HL), and perceptions of online PS content accuracy. T -tests, Chi-square tests, and post hoc analyses with Bonferroni corrections assessed differences between HL groups. Multivariate linear regressions assessed associations between sociodemographic variables and perceptions of online content. In total, 428 (92.0%) of 465 complete responses were analyzed. The median age of respondents was 32 y (interquartile range: 29-40). Online sources were predominantly perceived to have a high degree of accuracy, with mean scores of various platforms ranging from 3.8 to 4.5 (1 = not accurate at all; 5 = extremely accurate). The low HL group perceived social media sites and review sites to be more accurate than the high HL respondents, particularly for Reddit (P = 0.004), Pinterest (P = 0.040), and Snapchat (P = 0.002). There is a concerning relationship between low HL and the perceptions of the accuracy of online PS sources. This study underscores the need for education campaigns, the development of trustworthy online resources, and initiatives to improve HL. By fostering a more informed public, individuals seeking PS can make better informed decisions. • The general public considers social media platforms to have high degrees of accuracy. • Respondents with low health literacy perceived social media and review sites to be more accurate compared to the high health literacy group. • The findings underscore the need for public education campaigns to promote the dissemination of accurate information and initiatives to improve health literacy. [ABSTRACT FROM AUTHOR]

Design. Retrospective review. Objective. Characterize negative reviews of spine surgeons in the United States. Summary. Physician rating websites significantly influence the selection of doctors by other patients. Negative experiences are impacted by various factors, both clinical and nonclinical, geography, and practice structure. The purpose of this study was to evaluate and categorize negative reviews of spine surgeons in the United States, with a focus on surgical versus nonsurgical reviewers. Methods. Spine surgeons were selected from available online professional society membership directories. A search for reviews was performed on Healthgrades.com, Vitals.com, and RateMDs. com for the past 10 years. Free response reviews were coded by complaint, and qualitative analysis was performed. χ2 and Fisher exact tests were used to compare categorical variables, and multiple comparisons were adjusted with Benjamini-Hochberg correction. A binary logistic regression model was performed for the top three most mentioned nonclinical and clinical complaint labels. A P-value <0.05 was considered statistically significant. Results. A total of 16,695 online reviews were evaluated, including 1690 one-star reviews (10.1%). Among one-star reviews, 64.7% were written by nonsurgical patients and 35.3% by surgical patients. Nonclinical and clinical comments constituted 54.9% and 45.1% of reviews, respectively. Surgeons in the South had more "bedside manner" comments (43.3%, P <0.0001), while Northeast surgeons had more "poor surgical outcome" remarks compared with all other geographic regions (14.4%, P< 0.001). Practicing in the South and Northeast were independent predictors of having complaints about "bedside manner" and "poor surgical outcome," respectively. Conclusion. Most one-star reviews of spine surgeons were attributed to nonsurgical patients, who tended to be unsatisfied with nonclinical factors, especially "bedside manner." However, there was substantial geographic variation. These results suggest that spine surgeons could benefit from focusing on nonclinical factors (bedside manner), especially among nonoperative patients, and that regional nuances should be considered in delivering spine care. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsDiscussion\nIMPLICATIONS FOR REHABILITATIONTo explore patient and clinician perceptions of blunt chest trauma management and recovery, when discharged directly home from the Emergency Department (ED).This was a qualitative study, completed in a trauma unit in Wales. Blunt chest trauma was defined as an isolated blunt injury to the chest wall, resulting in bruising or rib fractures. Data collection involved semi-structured telephone interviews and focus groups with patients and clinicians respectively. Data analysis was completed using reflexive thematic coding.Twelve patient interviews and three focus groups (23 clinicians) were conducted. In the interviews, seven males and five females participated, with a mean age of 54 years (range 28–74). Clinicians included nurses, doctors, and therapists. Two main themes emerged; 1) the ED experience and 2) recovery once home; each with a number of sub-themes. Results highlighted the significant impact of pain on recovery, and that there is a disjuncture between organisational perspectives of clinicians, and the individual personal perspective of patients.Recovery from blunt chest trauma for patients discharged directly home from the ED is a challenging and complex process. Protocol-driven care does not always lead to good patient experience, as it focuses primarily on hospital services and resources.Recovery from blunt chest trauma is a complex process, leading to poor outcomes including pain and disability.Protocol-driven care of blunt chest trauma does not always lead to a good patient experience.Patients with blunt chest trauma benefit from reassurance that their severity of pain is normal, prior to discharge home from the Emergency Department (ED).Education regarding pacing activity, rest, and reliance on others for a period of time following injury can lead to an improved recovery experience. [ABSTRACT FROM AUTHOR]

The purpose of this research was to explore patients' shared perceptions of what makes them feel valued and devalued during in-patient and out-patient medical visits and patients' recommendations for increasing feelings of value. A criterion-based snowball sampling method was used to recruit participants who are adults living in Anchorage, Alaska, and have had an in-patient or out-patient medical visit within at least the past year. Semi-structured qualitative interviews were conducted using eight open-ended questions via Zoom web conferencing. Data were stored and managed electronically. A thematic analysis approach guided data analysis. A phenomenological approach was applied to capture participants' shared experiences. This study's key findings highlight a shared patient perception that communication is paramount in conveying value: conversations with healthcare providers instill value, feeling valued is essential to well-being, feeling devalued is driven by depersonalization, and devaluation perpetuates discontinuity in healthcare. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to assess the use of glucometers by patients and the analytical performance of glucometers provided by the primary care services. Methods: The analytical performance of 48 glucometers Accu-Chek® Active, was assessed through quintuplicate analyses of one Roche and one PNCQ (National Quality Control Program) control sample at different concentrations; 31 were also evaluated by a single proficiency testing sample. The evaluation metrics included imprecision, bias, and total error and were measured according to quality specifications based on biological variation (QSBV). Glucometer users answered a questionnaire regarding their experience. Results: Among the 48 glucometers evaluated with internal control samples, 17 met precision criteria at both control levels according to QSBV, while 24 met the criteria at only one control level. Of the 31 glucometers further evaluated through proficiency test, 11 met accuracy criteria according to QSBV, and only one device showed an unacceptable result. Out of these 31, only 15 demonstrated a total error within the acceptable maximum limits based on QSBV. Conclusions: Overall, our findings showed that patients had a good understanding of glucometer usage and suggested that some glucometers should be replaced, as they sometimes failed to meet even the manufacturer’s acceptable variation limits, and/or did not meet QSBV.

(1) Background: This observational cohort study describes the frequency, content, and satisfaction with advance care planning (ACP) conversations with healthcare providers (HCPs), as reported by patients with advanced colorectal cancer. (2) Methods: The patients were recruited from two tertiary cancer centers in Alberta, Canada. Using the My Conversations survey with previously validated questions, the patients were asked about specific ACP elements discussed, with which HCPs these elements were discussed, their satisfaction with these conversations, and whether they had a goals of care designation (GCD) order. We surveyed and analyzed data from the following four time points: enrollment, months 1, 2, and 3. (3) Results: In total, 131 patients were recruited. At enrollment, 24% of patients reported discussing at least one ACP topic. From enrollment to month 3, patients reported a high frequency of discussions (80.2% discussed fears, 71.0% discussed prognosis, 54.2% discussed treatment preferences at least once); however, only 44.3% of patients reported discussing what is important to them in considering health care preferences. Patients reported having ACP conversations most often with their oncologists (84.7%) and cancer clinic nurses (61.8%). Patients reported a high level of satisfaction with their ACP conversations, with over 80% of patients reported feeling heard and understood. From enrollment to month 3, there was an increase in the number of patients with a GCD order from 53% to 74%. (4) Conclusions: Patients reported more frequent conversations compared to the literature and clinical documentation. While the satisfaction with these conversations is high, there is room for quality improvement, particularly in eliciting patients’ personal goals for their treatment.

Data on the problems physicians face when providing care for atopic dermatitis (AD) is limited. To understand the current status of AD management in Japan and identify the difficulties physicians are having and their support requirements, a cross-sectional online survey was conducted using the AD task force of the Japanese Society for Cutaneous Immunology and Allergy. Society members were sent an online questionnaire on demographic information, daily clinical practice, and perceptions of AD management. Using responses to 17 items listed as barriers to the treatment of atopic dermatitis (Question 12) and questions about the treatment difficulty of those items, 284 respondents were divided into three groups using unstratified cluster analysis. These three groups were classified as highdifficulty, medium-difficulty, and low-difficulty groups, and the relationship between physicians' cognition and daily practice was examined for each group. There were no significant differences in affiliations or specializations among the three clusters. The low-difficulty group had a significantly higher proportion of participants believing that it was possible to achieve long-term remission, satisfaction, and motivation in AD management while carrying out precise assessments of skin lesions as part of their daily practice. Some physicians experience problems in their practice. This results indicate that AD management can be improved if satisfaction and motivation can be increased by providing appropriate support. [ABSTRACT FROM AUTHOR]

(1) Background: This observational cohort study describes the frequency, content, and satisfaction with advance care planning (ACP) conversations with healthcare providers (HCPs), as reported by patients with advanced colorectal cancer. (2) Methods: The patients were recruited from two tertiary cancer centers in Alberta, Canada. Using the My Conversations survey with previously validated questions, the patients were asked about specific ACP elements discussed, with which HCPs these elements were discussed, their satisfaction with these conversations, and whether they had a goals of care designation (GCD) order. We surveyed and analyzed data from the following four time points: enrollment, months 1, 2, and 3. (3) Results: In total, 131 patients were recruited. At enrollment, 24% of patients reported discussing at least one ACP topic. From enrollment to month 3, patients reported a high frequency of discussions (80.2% discussed fears, 71.0% discussed prognosis, 54.2% discussed treatment preferences at least once); however, only 44.3% of patients reported discussing what is important to them in considering health care preferences. Patients reported having ACP conversations most often with their oncologists (84.7%) and cancer clinic nurses (61.8%). Patients reported a high level of satisfaction with their ACP conversations, with over 80% of patients reported feeling heard and understood. From enrollment to month 3, there was an increase in the number of patients with a GCD order from 53% to 74%. (4) Conclusions: Patients reported more frequent conversations compared to the literature and clinical documentation. While the satisfaction with these conversations is high, there is room for quality improvement, particularly in eliciting patients' personal goals for their treatment. [ABSTRACT FROM AUTHOR]

Background and Purpose: Individuals with multiple sclerosis (MS) frequently report low physical activity and psychosocial support due to concerns with transportation, time, finances, access to services, and lack of caregiver support. These barriers can be addressed by online group interventions; however, utility of such programs in individuals with MS has not been examined yet. The purpose of this retrospective study was, therefore, to (a) investigate the feasibility, safety, and outcomes of a virtual group exercise program in individuals with MS, and (b) explore the participant perceptions after the program. Methods: Retrospective data from the medical records of 17 individuals with MS (mean [SD] age = 53.5 [12.3] years, body mass index = 28.2 [7.2]) who completed the virtual 13-week group exercise program, pre- and post-training functional status questionnaires, and the end-of-program feedback were extracted. The exercise program included aerobic, resistance, balance, and flexibility training components recommended for people with MS. Feasibility, safety, outcomes, and participant perceptions were determined by adherence to the prescribed daily exercise dosage, number of adverse events, within-group differences in self-reported functional status, and thematic analysis of the participant feedback, respectively. Results: Participants were adherent (79%), reported minimal adverse effects, and demonstrated significant changes (P < 0.05) in functional status post-training. Several themes on the perceived barriers, facilitators, and suggestions for improvement were identified. Discussion and Conclusions: A virtual 13-week group exercise program can be feasible, safe, effective, and well received by individuals with MS. Future research should investigate the dose-response effectiveness of telehealth and compare various telehealth models of exercise training using large randomized controlled trials. [ABSTRACT FROM AUTHOR]

Background: Healthcare institutions are increasingly receiving patients from diverse cultural backgrounds because of migration, rapid urbanisation, and easier access to healthcare. Because the satisfaction of these patients is linked to their perceptions of appropriate cultural care, understanding patient perspectives about cultural competence is imperative. Additionally, patient perceptions about nurses’ cultural competence are largely unexplored in South Africa. Aim: This study explored how the concept of cultural competence is perceived by patients. Setting: Three public sector hospitals in Gauteng, one from each of the three different levels of public sector hospitals – district (level one), regional (level two), and academic (tertiary, level three). Methods: This study derives from the qualitative phase of a larger sequential exploratory mixed methods study. The study population was patients in public sector hospitals. A total of 21 interviews were conducted after purposive stratified sampling was done. Data analysis followed Tesch’s eight steps of data analysis. Results: Patients in public sector hospitals in Gauteng believe consideration of culture is important in nursing. They identified the cultural needs they would like nurses to acknowledge, such as being asked about their food preferences and mentioned the need to evaluate nurses’ level of cultural competence. Conclusion: Patient perceptions about cultural competence and their cultural needs can assist nurses in gauging how culturally competent they are and improving care to patients. Contribution: Patients’ perceptions revealed that nurses must be competent to acknowledge their specific cultural needs such as food, language preferences, and religious practices.

BackgroundThe pursuit of quality services can lead to both service enhancement and increased motivation to visit dental centers for oral health treatment.AimsThe purpose of this study is to investigate the effect of dental center service quality factors on revisit intention among adult patients by applying an extended service quality model (SERVQUAL).MethodsThis cross-sectional study was conducted between September and November 2023 in the outpatient waiting areas and clinical settings of Umm Al-Qura University Dental Teaching Hospital (UQU-DTH). A sample of 355 patients was invited by the convenience sampling method. The data was collected through a validated Arabic version of the extended SERVQUAL questionnaire. A hierarchical regression analysis was used to assess the incremental effects of the extended SERVQUAL factors on the intention of patients to revisit the UQU-DTH while controlling for demographic variables. Cronbach alpha was used to examine the internal consistency of each model factor.ResultsA total of 330 completed responses were received, with a 93% response rate. The findings indicated that demographic variables such as age and level of education contribute to some extent but become negligible when the extended SERVQUAL factors are included in the model. Moreover, the extended SERVQUAL model factors substantially improved the model. Three factors were found to positively and significantly affect the revisit intention, namely, “staff-related factors,” “cost-effectiveness,” and “responsiveness.” Overall, the model explained 65.6% of the variance in the revisit intention (R2 = 0.656, p

Abstract Introduction Community Client-Led ART Delivery (CCLAD) is a community HIV care model. In this model, a group of persons living with HIV (PLHIV) in a specific location, take turns going to the HIV clinic to pick up Antiretroviral Treatment refills for members. The uptake of this model, however, remains low despite its improvements in patient retention. In this study, we explored PLHIV’s perceptions of this model and identified the factors associated with its low uptake. Methods This was a mixed methods study based on a retrospective review of records of PLHIV and in-depth interviews. We reviewed the medical records of people receiving ART to determine their current model of ART delivery and conducted in-depth interviews with 30 participants who were eligible to be enrolled in the CCLAD model at the Mulago ISS clinic. We performed logistic regression to identify factors associated with the uptake of the CCLAD model and inductive thematic analysis to explore PLHIV’s perceptions of the CCLAD model. Results A total of 776 PLHIV were sampled for the study, 545 (70.2%) of whom were female. The mean age (standard deviation) was 42 (± 9.3) years. Overall, 55 (7.1%) received ART using the CCLAD model. Compared to other ART-delivery models, CCLAD was associated with being on ART for at least eight years (AOR 3.72; 95% CI: 1.35–10.25) and having no prior missed clinic appointments (AOR 10.68; 95% CI: 3.31–34.55). Mixed perceptions were expressed about the CCLAD model. Participants interviewed appreciated CCLAD for its convenience and the opportunities it offered members to talk and support each other. Others however, expressed concerns about the process of group formation, and feeling detached from the health facility with consequences of lack of confidentiality. Conclusion The current uptake of the CCLAD model is lower than the national recommended percentage of 15%. Its uptake was associated with those who had been in care for a longer period and who did not miss appointments. Despite CCLAD being perceived as convenient and as promoting support among members, several challenges were expressed. These included complexities of group formation, fear of stigma and feelings of detachment from health facilities among others. So, while CCLAD presents a promising alternative ART delivery model, more attention needs to be paid to the processes of group formation and improved patient monitoring to address the feelings of detachment from the facility and facility staff.

Investigations of institutional failure in healthcare typically use staff narratives to identify the cultural factors contributing to the incident. But, to what extent can staff, who are embedded in the culture and who were part of the failing, reflect on and report on the culture? We investigate this by comparing 40 witness statements from staff and 53 witness statements from patients and relatives collected by a public inquiry into a major UK healthcare failure (Clostridium difficile outbreak). Through quantitative text analysis, we found that, while staff and external stakeholders both recognised problems in care, they diverged on the factors considered paramount. Staff emphasised underlying factors such as under‐resourcing and training (causal culture), while patients and relatives emphasised corrective behaviours such as communication for identifying and taking precautions against the spread of C. difficile (corrective culture). The results indicate that patients and relatives may be able to report on cultural factors that staff do not report or are unaware of, thus allowing a more complete analysis. Even in light of an institutional failure, staff may have incomplete accounts of the contributing cultural factors, with implications for learning and postincident improvement. [ABSTRACT FROM AUTHOR]

Background: Injectable medicines are increasingly used to manage abnormal levels of lipids, which is a major risk factor for cardiovascular events. Enhancing our understanding of patients' perceptions of these injectables, can inform practice with the aim of increasing uptake and medication adherence. Aim: To explore patient's experiences of using injectables and to identify potential facilitators and barriers to using injectable therapies in dyslipidaemia. Design: A qualitative descriptive study using semi‐structured interviews was conducted with patients who were using injectables to manage their cardiovascular conditions. Methods: A total of 56 patients, 30 from the United Kingdom and 26 from Italy, were interviewed online from November 2020 to June 2021. Interviews were transcribed and schematic content analysis performed. Results: Four distinct themes emerged from interviews with patients and caregivers: (i) Their behaviours and personal beliefs; (ii) Knowledge and education about injectable medication; (iii) Clinical skills and previous experiences and (iv) Organizational and governance. Participants expressed initial fears such as needle phobia, and their concerns about commencing therapy were compounded by a lack of accessible information. However, patients' pre‐existing knowledge of lipid lowering medication, previous experience with statins and history of adverse side effects informed their decision‐making regarding using injectables. Organization and governance‐related issues were primarily around the distribution and management of medication supply within primary care, and the lack of a standardized clinical support monitoring system. Conclusion: Changes are needed in clinical practice to better educate and support patients to improve the uptake of injectables and optimize their use of these medications in the management of dyslipidaemia. Impact: This study suggests that injectable therapies were acceptable to people with cardiovascular disease. However, healthcare professionals need to play a key role in improving education and providing support to aid patients' decision‐making regarding commencing and adhering to injectable therapies. Reporting Method: The study adhered to the Consolidated Criteria for Reporting Qualitative Research. Patient or Public Contribution: There was no patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: Patients with chronic kidney disease (CKD) are routinely prescribed complex medication regimes. Medication reconciliation, medicine reviews, patient counselling and disease state and medication education are all key pharmacist-led interventions, which can improve medication adherence in patients with CKD. Aim: To characterize peer reviewed literature on the role of pharmacists in supporting medication adherence of patients with chronic kidney disease and highlight the impact they might have in the health outcomes for patients. Method: This review was performed in accordance with the Scoping Review Framework outlined in the Joanna Briggs Institute Reviewer's Guide. Four electronic databases were searched (Medline (Ovid), Emcare, Scopus and Web of Science) for all relevant literature published up until November 2022. A total of 32 studies were reviewed against an exclusion and inclusion criteria, with findings from each study categorized into barriers, interventions, perceptions, financial implications and outcomes. Results: Eight eligible studies were identified, where pharmacists' interventions including medication reconciliation, medicine reviews, patient counselling and disease state and medication education, were all reported to have a positive effect on medication adherence. Although pharmacy services in chronic kidney disease were acceptable to patients and pharmacists, these services were under-utilized and limited by logistical constraints, including staffing shortages and time limitations. Patient education supplemented with education tools describing disease states and medications was reported to increase patient adherence to medication regimes. Conclusions: Pharmacist-led interventions play an integral role in improving medication adherence in patients with chronic kidney disease, with their inclusion in renal care settings having the potential to improve outcomes for patients. [ABSTRACT FROM AUTHOR]

Introduction: Community Client-Led ART Delivery (CCLAD) is a community HIV care model. In this model, a group of persons living with HIV (PLHIV) in a specific location, take turns going to the HIV clinic to pick up Antiretroviral Treatment refills for members. The uptake of this model, however, remains low despite its improvements in patient retention. In this study, we explored PLHIV's perceptions of this model and identified the factors associated with its low uptake. Methods: This was a mixed methods study based on a retrospective review of records of PLHIV and in-depth interviews. We reviewed the medical records of people receiving ART to determine their current model of ART delivery and conducted in-depth interviews with 30 participants who were eligible to be enrolled in the CCLAD model at the Mulago ISS clinic. We performed logistic regression to identify factors associated with the uptake of the CCLAD model and inductive thematic analysis to explore PLHIV's perceptions of the CCLAD model. Results: A total of 776 PLHIV were sampled for the study, 545 (70.2%) of whom were female. The mean age (standard deviation) was 42 (± 9.3) years. Overall, 55 (7.1%) received ART using the CCLAD model. Compared to other ART-delivery models, CCLAD was associated with being on ART for at least eight years (AOR 3.72; 95% CI: 1.35–10.25) and having no prior missed clinic appointments (AOR 10.68; 95% CI: 3.31–34.55). Mixed perceptions were expressed about the CCLAD model. Participants interviewed appreciated CCLAD for its convenience and the opportunities it offered members to talk and support each other. Others however, expressed concerns about the process of group formation, and feeling detached from the health facility with consequences of lack of confidentiality. Conclusion: The current uptake of the CCLAD model is lower than the national recommended percentage of 15%. Its uptake was associated with those who had been in care for a longer period and who did not miss appointments. Despite CCLAD being perceived as convenient and as promoting support among members, several challenges were expressed. These included complexities of group formation, fear of stigma and feelings of detachment from health facilities among others. So, while CCLAD presents a promising alternative ART delivery model, more attention needs to be paid to the processes of group formation and improved patient monitoring to address the feelings of detachment from the facility and facility staff. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: During the COVID-19 pandemic, many surgical societies released guidelines that included cancellation of elective cases. The aim of this study was to better understand our patients' perceptions of the severity of their pelvic floor disorders (PFDs) and to determine what factors influenced this perception. We also aimed to better understand who might be amenable to telemedicine visits and what factors influenced this decision. Methods: This is a cross-sectional quality improvement study that included women at least 18 years of age diagnosed with a pelvic floor disorder being evaluated within a university Female Pelvic Medicine and Reconstructive Surgery clinic during the COVID-19 pandemic. Patients whose appointments and procedures were being cancelled were queried on whether they would be willing to answer a telephone questionnaire developed by the clinical and research teams. We gathered descriptive data from 97 female patients with PFDs using a primary phone questionnaire. The data were analyzed using proportions and descriptive statistics. Results: Of the 97 patients, the majority (79%) viewed their conditions as non-urgent. Factors that influenced patients' perception of urgency included race (p=0.037), health status (p≤0.001), a history of diabetes (p=0.011), and willingness to attend an in-person appointment (p=0.010). Further, 52% of respondents were willing to attend a tele-health appointment. Statistically significant factors influencing this decision were ethnicity (p=0.019), marital status (p=0.019), and willingness to attend an in-person appointment (p=0.011). Conclusion: The majority of women did not view their conditions as urgent during the COVID-19 pandemic and were amenable to a telehealth appointment. [ABSTRACT FROM AUTHOR]

Background: Little evidence is available regarding patient perceptions of the treatment of shoulder instability. The aim of this study is to investigate patient perceptions regarding the operative and nonoperative treatment of anterior shoulder instability. Methods: Patients who presented to the emergency department or outpatient clinic between 2016 and 2020 were retrospectively selected using diagnosis and procedure codes. Online focus groups and semistructured interviews were conducted, systematically recorded and subsequently transcribed to MaxQDA 2007 for qualitative analysis. Coded transcripts of all focus groups were subjected to a grounded theory–based analysis. Results: Six focus groups and two semistructured interviews were hosted with 35 included patients. The mean age of included patients was 34.1 years (±11.5). Eight patients were female (23%), and 27 patients were male (77%). Fear of (recurrent) dislocation, preoperative counseling, communication between surgeon and physiotherapists and need for a consistent postoperative rehab protocol turned out to be important patient perceptions. The most crucial factor for discontent was a lack of communication from the surgeon. Discussion: This patient-centered focus group study revealed that fear of (recurrent) dislocation, preoperative counseling, communication between surgeons and physiotherapists and the need for a consistent postoperative rehabilitation protocol was the most frequently discussed themes. [ABSTRACT FROM AUTHOR]

BackgroundThe onset of the COVID-19 pandemic led to the postponement of low-acuity surgical procedures in an effort to conserve resources and ensure patient safety. This study aimed to characterize patient-reported concerns about undergoing surgical procedures during the pandemic.MethodsWe administered a cross-sectional survey to patients who had their general and plastic surgical procedures postponed at the onset of the pandemic, asking about barriers to accessing surgical care. Questions addressed dependent care, transportation, employment and insurance status, as well as perceptions of and concerns about COVID-19. Mixed methods and inductive thematic analyses were conducted.ResultsOne hundred thirty-five patients were interviewed. We identified the following patient concerns: contracting COVID-19 in the hospital (46%), being alone during hospitalization (40%), facing financial stressors (29%), organizing transportation (28%), experiencing changes to health insurance coverage (25%), and arranging care for dependents (18%). Nonwhite participants were 5 and 2.5 times more likely to have concerns about childcare and transportation, respectively. Perceptions of decreased hospital safety and the consequences of possible COVID-19 infection led to delay in rescheduling. Education about safety measures and communication about scheduling partially mitigated concerns about COVID-19. However, uncertainty about timeline for rescheduling and resolution of the pandemic contributed to ongoing concerns.ConclusionsProviding effective surgical care during this unprecedented time requires both awareness of societal shifts impacting surgical patients and system-level change to address new barriers to care. Eliciting patients' perspectives, adapting processes to address potential barriers, and effectively educating patients about institutional measures to minimize in-hospital transmission of COVID-19 should be integrated into surgical care.

Abstract Introduction Professionalism is a crucial component of medical practice. It is a culturally sensitive notion that generally consists of behaviors, values, communication, and relationships. This study is a qualitative study exploring physician professionalism from the patients’ perspective. Methods Focus group discussions with patients attending a family medicine center attached to a tertiary care hospital were carried out using the four gates model of Arabian medical professionalism that is appropriate to Arab culture. Discussions with patients were recorded and transcribed. Data were thematically analyzed using NVivo software. Results Three main themes emerged from the data. (1) In dealing with patients, participants expected respect but understood delays in seeing physicians due to their busy schedules. In communication, participants expected to be informed about their health conditions and to have their questions answered. (2) In dealing with tasks, participants expected proper examination and transparency of diagnosis, but some expected the physician to know everything and did not appreciate them seeking outside opinions. They expected to see the same physician at every visit. (3) In physician characteristics preferences, participants preferred friendly smiling physicians. Some cared about the outer appearance of the physician whereas others did not. Discussion/conclusions The findings of the study explained only two themes of the four gates model namely dealing with patients and dealing with tasks. Cultural competence and how to benefit from patients’ perceptions to be an ideal physician should be incorporated into the process of physicians’ training.

Abstract Aims To examine patients' perceptions of care quality following a same‐day procedure in the cardiac catheterization laboratory and understand the extent to which they were prepared for discharge. Design Single‐centre, mixed‐methods study. Methods Postdischarge, online survey of patients who underwent a same‐day procedure in the cardiac catheterization laboratory (n = 150) and one‐on‐one interviews with 13 of these patients. Results Survey responses were positive with mean scores between 4.39–4.83 out of five and 63.3% of respondents (n = 95) extremely likely to recommend the service to others. Interview data analysis identified three themes: the care experience, information and education for safe discharge, and follow‐up needs. Participants spoke highly of their interactions with clinicians and were satisfied with their care experience. Mode and content of information delivered varied, with some participants lacking guidance about postdischarge health management and clarity about follow‐up plans. Patient or public contribution Participants were patients.

ObjectiveTo identify the factors that impact COVID-19 vaccine decision-making in vaccine-hesitant vasculitis patients, and compare their perceptions with other rheumatology patients, given existence of data suggesting rheumatology patients may have disease-specific factors that influence their COVID-19 vaccine decision-making.MethodsThis cross-sectional study surveyed adult rheumatology patients from the Kaye Edmonton Clinic Rheumatology Clinic, in Canada, between June and August 2021, using an anonymous online questionnaire. Survey responses were analyzed for statistical differences using chi-square analysis.ResultsThe COVID-19 Vaccine Perceptions Survey had a response rate of 70.9%. Of the total 231 respondents, 103 patients were diagnosed with vasculitis. At the time of the survey, 10.6% of vasculitis patients refused to receive a COVID-19 vaccine compared to 6.3% for other rheumatology patients. Compared to other rheumatology patients, vaccine-hesitant vasculitis patients were significantly more concerned about almost every aspect of available COVID-19 vaccines [e.g., safety (p < 0.001), components (p < 0.001)], and feared that they could contract SARS-CoV-2 from a vaccine (p < 0.001). These vaccine-hesitant patients were also significantly less pleased with the government's pandemic response, less confident in healthcare team-provided information (p < 0.001), and more likely to report that healthcare providers had no role in their COVID-19 vaccine decision-making (p < 0.001).ConclusionVaccine-hesitant vasculitis patients may have multiple considerations influencing COVID-19 vaccine hesitancy, including vaccine and disease-specific concerns, along with unfavorable perceptions of the healthcare system (government and healthcare providers). Healthcare providers can address some of these concerns by initiating patient-centered discussions around immunizations to help support educated decision-making.

Objective: Long-term type 2 diabetes management requires open communication between a patient and their provider for self-care adherence. This study explored facilitators and barriers to diabetes-specific communication in West Virginia, a medically underserved state with the highest prevalence of diabetes (16.2%) in the U.S. Methods: A secondary qualitative analysis was conducted using data from semi-structured interviews (n = 34) and 4 focus groups (n = 23) with participants of a diabetes education program. Transcripts were analyzed using thematic analysis. Results: Three facilitators to patient-provider communication emerged: “Patient-Provider Partnership”, “Provider Accessibility”, and “Empowerment Through Education”. Partnership with providers, especially those who were accessible outside of scheduled appointments, and empowerment obtained through diabetes education facilitated diabetes-specific patient-provider communication. However, barriers included “Providers' Focus on ‘Numbers' Rather than Patient Concerns”, “Patient Lack of Preparation for Appointments”, and “Providers ‘Talking Down to’ Patients”. Conclusion: The findings highlight patient- and provider-related factors that impact diabetes-specific communication. Innovation: Previous interventions have trained providers in communication skills. Despite some success, challenges in implementation remain considering providers' limited time and overwhelming demands. This study suggests that diabetes education programs incorporating communication and self-advocacy skills could be a promising alternative as they can empower patients to communicate their diabetes-specific needs/preferences with providers.

Why you should read this article: • To recognise the importance of seeking the views of children about their experiences of healthcare • To enhance your understanding of children's experiences of staying in hospital from the perspective of children and children's nurses • To consider the improvements in nursing practice that could be made to enhance the care of children in hospital Children should have a voice in relation to all aspects of healthcare as respected and credible service users, a belief endorsed by the United Nations Convention on the Rights of the Child. The children's nurse is the healthcare professional who delivers care most frequently to children in hospital and their families, so is in an optimal position to offer valuable insight into children's experiences of being in hospital. Therefore, it is important to listen to the voices of children and children's nurses in relation to this area. This article is informed by a narrative literature review and study, undertaken by the author as part of her doctoral thesis, which explored children's experiences of staying overnight in hospital from the perspective of children and children's nurses. In this article, the author summarises the main findings from the study and considers the implications for children's nursing practice based on her reflection on these findings. [ABSTRACT FROM AUTHOR]

This study identifies different factors influencing the patient's decision to receive dental treatments during the ongoing pandemic and identifies their expectations at the dental office during Covid-19. A cross-sectional study was conducted among 306 people in a dental institute. A questionnaire was used to collect primary demographic data. It consisted of questions concerning patient attitude regarding the utilization of dental services and expectations from the dental setup during the pandemic. The chi-square test was used to analyze the association between variables with a significance level set at p=0.05. The mean age of the study population was 37±5.3 years, with the majority being males (52%). Many female patients (60.76%) and those from the lower middle class (38.59%) were apprehensive about getting the disease during their visit. Covid19 was not considered a threat among adolescents/middle-aged (47.27%) and upper lower-class patients (41.81%). Spending extra during this period was acceptable by 65.7% of patients, though a few (16.3%) responded or felt that the hospital should be considerate and bear the expenses. They (38.9%) had no specific complaints about the cleanliness issue of the hospital premises. All the above results were significant statistically (p≤0.05). Though apprehension of contracting the disease was observed among many patients, their dental problems were considered a priority, influencing their visit to the dental hospital. [ABSTRACT FROM AUTHOR]

Background: Robotic surgery (RS) is increasingly employed in colorectal surgical practice, widening the range of surgical techniques offered to patients. We investigated the perceptions of patients with colorectal cancer in relation to RS, open surgery (OS) and conventional laparoscopic surgery (CLS), to identify ideas or assumptions which, in the context of shared surgeon–patient decision-making, may affect the resultant choice of surgical technique. We also investigated salient factors affecting patients' perioperative experience, including those of RS patients, to guide improvements in care and preoperative patient preparation. Methods: This study was conducted on patients who underwent resection of left-sided colorectal cancer at a large UK teaching hospital from November 2020 to July 2021. Purposive sampling was used to ensure a roughly equal proportion of patients who underwent RS, CLS and OS. The patients included in the study participated in semi-structured interviews six weeks postoperatively. The interview schedule allowed discussion around patients' experience of their surgery and postoperative recovery, and their perceptions of surgical techniques. Interview transcripts were coded manually using inductive thematic analysis, and analyst triangulation was employed to refine coding schemes and ensure reliability of emerging themes. Results: Twenty-seven patients were recruited to the study; RS n = 9 (median age 69 [range 60–80] years); CLS n = 10 (median age 72 [range 32–82] years; OS n = 8 (median age 71 [range 60–75] years). Patients understood the technological benefits of RS but were concerned by a risk of technological failure causing patient harm. OS was understood to be associated with more pain and longer recovery than RS or CLS. Patients perceived CLS to be more technically challenging compared with OS. Less pain and smaller wounds than expected were significant positive factors in the experience of RS and CLS patients specifically. Complications and emotional impact were significant factors in the experience of all groups, for which many patients felt underprepared. Conclusions: Patients generally have a positive view of RS and technical innovation in surgery. Concerns mostly centred around failure of technology. Many patients felt unprepared for significant factors in their perioperative experience. Surgeons and healthcare providers should be prepared to address patients' perceptions and expectations of colorectal surgery preoperatively. [ABSTRACT FROM AUTHOR]

Remote monitoring rehabilitation programs are new technologies growing in popularity for patients undergoing lower extremity total joint arthroplasty. The purpose of this study was to assess the patients' perceptions of these technologies. Patients who underwent total hip arthroplasty (THA), total knee arthroplasty arthroplasty (TKA), and unicompartmental knee arthroplasty (UKA) from September 2020 to February 2022, and participated in a clinical study utilizing remote monitoring and an app-based rehabilitation program were given a questionnaire 3 months postoperatively to assess their perceptions of these technologies. There were 166 patients who completed the survey (42 THA; 106 TKA; 18 UKA). There were 92% of patients who found the technology easy to use. A majority of patients felt the technologies motivated them. The TKA/UKA patients felt more strongly that these technologies allowed the surgeon to monitor their recovery closely (81.9% versus 65.9%; P =.009). There were 85% of THA patients and 94.5% of TKA/UKA patients recommended these technologies. The THA patients felt more strongly that digital rehabilitation could completely replace in-person physical therapy compared to TKA/UKA patients (85.4% versus 41.3%; P <.001). A majority (83%) of patients recommended a combination of inpatient and technology-assisted rehabilitation (THA 90.2%; 84.4% TKA/UKA). The THA and TKA/UKA patients found remote monitoring rehabilitation easy to use, increased motivation, and recommend it to other patients undergoing lower extremity arthroplasty. They recommend a combination of technology and in-person rehabilitation postoperatively. The THA patients felt these technologies could replace in-person rehabilitation programs. IV. [ABSTRACT FROM AUTHOR]

Purpose: To assess the literature on men’s preferences and perceptions regarding prostate cancer radiation therapy. Methods: A scoping review was undertaken as per JBI guidelines. Searches were conducted in PubMed, CINAHL, Scopus and Science Direct with search terms including “prostate cancer,” “radiotherapy,” “radiation therapy,” “radiation oncology,” “patient preferences,” “patient perceptions” and “patient experience.” The resultant studies were mapped and grouped according to the emergent themes and pathway stages. Results: A total of 779 titles and abstracts were screened by two independent reviewers. Fifty-two full-text studies were reviewed, with 27 eligible for inclusion. There were 4 pre-treatment, 13 during treatment and 10 post-treatment studies covering broad themes of information needs (n = 3), preferences and decisions (n = 6), general experiences (n = 8), side effects (n = 6), and support (n = 4). There were a mix of methodologies, including 11 qualitative, 14 quantitative (including four preference studies), one mixed methods and one narrative review. Conclusion: There were only four preference studies, with the remaining 23 reporting on perceptions. Overall, there is a paucity of literature regarding patient preferences and perceptions of prostate cancer radiation therapy, particularly when considering how many clinical and technical studies are published in the area. This highlights opportunities for future research.

Background: The complexity of prostate cancer care can impact on patient understanding and participation in shared decision-making. This study used a survey-based approach to investigate patients’ recall of their prostate cancer treatment, and more broadly, to understand the perceptions of patients and the general population of prostate cancer treatment. Method: The survey was completed by 236 patients with prostate cancer (PCa cohort) and 240 participants from the general population of Australia (GenPop cohort). Free-text comments from both cohorts were analysed using content analysis. The PCa cohort reported which treatments and image-guidance related procedures they had received. These patient-reports were compared to medical records and analysed using proportion agreement, kappa statistics and regression analysis. Results: 135 (57%) PCa and 99 (41%) GenPop respondents provided at least one comment. Five major themes were identified by both cohorts: sharing experiences of treatment; preferences insights and reflections; mindsets; general commentary on the survey; and factors missing from the survey. There was overall good treatment recall amongst the PCa cohort, with proportions of correct recall ranging from 97.3% for chemotherapy to 66.8% for hormone therapy. There was a tendency for younger patients (

Background: In March 2020, the World Health Organization (WHO) declared Severe Acute Respiratory Syndrome Coronavirus 2 (SARS2-CoV-2) as global pandemic. This health crisis has overwhelmed the healthcare system, leading to unprecedented morbidity and mortality rates. During this pandemic, pharmacies tried to maintain their services either through remote services or face-to-face dispensing and consultation. Objectives: This study aimed to share the strategies and plans adopted by the pharmaceutical services department to maintain the healthcare services during the SARS2-CoV-2 crisis and evaluate the patient's perspective. Methods: A cross-sectional analytical survey was conducted among patients/patient relatives who attended King Hamad University Hospital (KHUH) outpatient pharmacies in the Kingdom of Bahrain between February 2021 and May 2021. Patients have two options: either to submit the survey online through barcode scanning or to fill it as a physical paper and submit it to the pharmacy staff (Online-based and paper-based). A total of 641 responses were received. Hospital applied safety logistics to ensure staff and patient safety. Results: Post-hoc analysis revealed that patients aged between 20 and 39 years had less agreement than patients ≤ 19 years old in terms of preferring to continue the same services after the pandemic (p = 0.009). More level of understanding of pharmacy services was seen among patients with higher educational levels compared to elementary and secondary levels in cases of services related to adverse events (p = 0.038) and wrong/missed medication rectification (p = 0.018). Unemployed patients were more in agreement than employed ones regarding continuing the same procedure after the pandemic, services related to wrong/missed medication rectification, and safety while staying in the pharmacy waiting area. Conclusion: Most patients were satisfied with the face-to-face counseling, pharmacy-adapted strategies, and services during the SARS2-CoV-2 pandemic. Face-to-face service during the pandemic was equally comfortable across all age groups and gender.

Introduction: Professionalism is a crucial component of medical practice. It is a culturally sensitive notion that generally consists of behaviors, values, communication, and relationships. This study is a qualitative study exploring physician professionalism from the patients' perspective. Methods: Focus group discussions with patients attending a family medicine center attached to a tertiary care hospital were carried out using the four gates model of Arabian medical professionalism that is appropriate to Arab culture. Discussions with patients were recorded and transcribed. Data were thematically analyzed using NVivo software. Results: Three main themes emerged from the data. (1) In dealing with patients, participants expected respect but understood delays in seeing physicians due to their busy schedules. In communication, participants expected to be informed about their health conditions and to have their questions answered. (2) In dealing with tasks, participants expected proper examination and transparency of diagnosis, but some expected the physician to know everything and did not appreciate them seeking outside opinions. They expected to see the same physician at every visit. (3) In physician characteristics preferences, participants preferred friendly smiling physicians. Some cared about the outer appearance of the physician whereas others did not. Discussion/conclusions: The findings of the study explained only two themes of the four gates model namely dealing with patients and dealing with tasks. Cultural competence and how to benefit from patients' perceptions to be an ideal physician should be incorporated into the process of physicians' training. [ABSTRACT FROM AUTHOR]

Objective: Enhancing cancer patients' sense of control can positively impact psychological well-being. We developed and assessed the psychometric properties of Valued Outcomes in the Cancer Experience (VOICE)TM, a measure of patients' perceived control over key personal priorities within their cancer experience. Methods: VOICE construction and testing were completed in three phases with separate participant samples: (1) item generation and initial item pool testing (N = 459), (2) scale refinement (N = 623), and (3) confirmatory validation (N = 515). Results: A 21-item measure was developed that captures cancer patients' sense of control in seven key domains: (1) Purpose and Meaning, (2) Functional Capacity, (3) Longevity, (4) Quality Care, (5) Illness Knowledge, (6) Social Support, and (7) Financial Capability. VOICE demonstrated adequate internal consistency (full-scale α = 0.93; factor α = 0.67–0.89) and adequate to strong convergent and discriminatory validity. Significance of results: VOICE measures cancer patients' perceived control across a diverse range of personal priorities, creating a platform for elevating patient perspectives and identifying pathways to enhance patient well-being. VOICE is positioned to guide understanding of the patient experience and aid the development and evaluation of supportive care interventions to enhance well-being. [ABSTRACT FROM AUTHOR]

Many studies show that most people, even at-risk individuals, do not undergo routine clinical skin cancer screening, and many questions remain unanswered regarding the participation (or lack thereof) in annual skin cancer screening. Perhaps the largest unanswered question is the most essential: why do people fail to undergo annual skin cancer screening? We provide an avenue to answer this question by creating the Perceptions of Annual Skin Cancer Screening Scale (PASCSS). In Study 1, we conduct a qualitative investigation to identify potential scale dimensions and items (n=233). In Study 2, we test the validity and psychometric properties of our initial item list via exploratory factor analysis (n=406). In Study 3, we further test the psychometric properties of our item list via confirmatory factor analysis (n=587). These three studies provide strong support for the validity and psychometric properties of our item list, resulting in the PASCSS. The PASCSS includes 48 items and 12 dimensions that each represent unique perceptions regarding annual skin cancer screening. We encourage future authors to utilize the PASCSS to identify those most at risk for failing to participate in annual skin cancer screening as well as develop adaptive interventions that can target these participants. [ABSTRACT FROM AUTHOR]

Aims: To examine patients' perceptions of care quality following a same‐day procedure in the cardiac catheterization laboratory and understand the extent to which they were prepared for discharge. Design: Single‐centre, mixed‐methods study. Methods: Postdischarge, online survey of patients who underwent a same‐day procedure in the cardiac catheterization laboratory (n = 150) and one‐on‐one interviews with 13 of these patients. Results: Survey responses were positive with mean scores between 4.39–4.83 out of five and 63.3% of respondents (n = 95) extremely likely to recommend the service to others. Interview data analysis identified three themes: the care experience, information and education for safe discharge, and follow‐up needs. Participants spoke highly of their interactions with clinicians and were satisfied with their care experience. Mode and content of information delivered varied, with some participants lacking guidance about postdischarge health management and clarity about follow‐up plans. Patient or public contribution: Participants were patients. [ABSTRACT FROM AUTHOR]

Background: Evidence exists of pharmacists providing free or partially subsidised clinical services in order to meet patient healthcare needs. Little is known about how patients perceive the quality and importance of such unfunded services to their healthcare. Objectives: To explore pharmacy user perspectives about unfunded services such as their valuation, why they chose to access these services from the pharmacy as well as their willingness to pay should pharmacies need to start charging for the provision of such services owing to budgetary constraints. Methods: This study was nested in a larger nationwide study where 51 pharmacies were recruited across fourteen locations across New Zealand . Semi-structured interviews were conducted with patients who had accessed unfunded services in community pharmacies. Patients were followed up to identify their percieved health outcomes resulting from accessing the unfunded service. Results: A total of 253 patient interviews were conducted on-site across 51 pharmacies in New Zealand. Two main themes were identified pertaining to (1) patient-provider relationship and (2) Willingness to pay. A total of fifteen different considerations were found to influence pharmacy users' decisions to access health services from the pharmacy. It was found that 62.8% of patients were willing to pay for unfunded services and the majority paying NZD$10. Conclusion: Patients positively rate these services and largely deem them important for their healthcare. Willingness to pay for services were also variable between patients and were dependant on the type of service accessed.

Introduction: Oral health-related quality of life is a significant subjective factor that is strongly influenced by how people perceive their own physical, mental, social, and spiritual well-being, as well as by their own values, convictions, and beliefs, as well as by the history and cultural context of their own societies. The present study will evaluate the relationship between facial aesthetics and selfesteem and oral health related quality of life. Aim: To examine if or not there is a correlation between the dental aesthetic component and patients perceptions of whether or not their malocclusion has any effect on self-esteem and the psychosocial impact it has. Materials and Methods: This cross-sectional study examined 357 subjects (250 girls and 107 boys between 13 and 27 years old, mean age 19.23+-3.45) at Guru Nanak Institute of Dental Sciences and Research in Kolkata, West Bengal, India, from January 2020 to July 2022. The patients were given multiple questionnaires to assess how oral health affects quality of life and self-esteem. Dental aesthetics measured using Dental Aesthetic Index (DAI). Self-esteem measured using Rosenberg Self-Esteem Scale (RSES). Results: DAI scores is negatively correlated with (RSES) Rosenberg self-esteem score (r=-0.429, p>0.00). Conclusion: All of the participants in the study experienced a significant psychosocial impact from their malocclusion. In comparison to a group of persons with little or minimal malocclusion, they reported considerably more 'psychological impact' and lower 'dental self-confidence' and resulting in a worse QoL. This study provides evidence to support the theory that individuals' perceptions of their own psychosocial influence are related to their satisfaction with their smile's appearance. [ABSTRACT FROM AUTHOR]

In late 2019 and early 2020, a novel coronavirus, COVID-19 (coronavirus disease 2019), spread across the world, creating a global pandemic. In the state of Pennsylvania, non-emergent, elective operations were temporarily delayed from proceeding with the normal standard of care. The primary purpose of this study was to determine the proportion of patients who required prescription pain medication during the surgical delay. Secondarily, we sought to determine the proportion of patients who perceived their surgical procedure as non-elective and to evaluate how symptoms were managed during the delay. A single institutional database was used to retrospectively identify all shoulder and elbow surgical procedures scheduled between March 13 and May 6, 2020. Charts were manually reviewed. Patients who underwent non–shoulder and elbow–related procedures and patients treated by surgeons outside of Pennsylvania were excluded. Patients whose surgical procedures were postponed or canceled were administered a survey evaluating how symptoms were managed and perceptions regarding the delay. Preoperative functional scores were collected. Statistical analysis was performed to determine associations between procedure status, preoperative functional scores, perception of surgery, and requirement for prescription pain medication. A total of 338 patients were scheduled to undergo shoulder and elbow surgery in our practice in Pennsylvania. Surgery was performed as initially scheduled in 89 of these patients (26.3%), whereas surgery was postponed in 179 (71.9%) and canceled in 70 (28.1%). The average delay in surgery was 86.7 days (range, 13-299 days). Responses to the survey were received from 176 patients (70.7%) in whom surgery was postponed or canceled. During the delay, 39 patients (22.2%) required prescription pain medication. The surgical procedure was considered elective in nature by 73 patients (41%). One hundred thirty-seven patients (78%) would have moved forward with surgery if performed safely under appropriate medical guidelines. Lower preoperative American Shoulder and Elbow Surgeons scores (r = −0.36, P <.001) and Single Assessment Numeric Evaluation scores (r = −0.26, P =.016) and higher preoperative visual analog scale scores (r = 0.28, P =.009) were correlated with requiring prescription pain medication. Higher preoperative American Shoulder and Elbow Surgeons scores were positively correlated with perception of surgery as elective (r = 0.4, P <.001). Patients undergoing elective shoulder and elbow surgical procedures during the COVID-19 (coronavirus disease 2019) pandemic experienced a delay of nearly 3 months on average. Fewer than half of patients perceived their surgical procedures as elective procedures. Nearly one-quarter of patients surveyed required extra prescription pain medicine during the delay. This study elucidates the fact that although orthopedic shoulder and elbow surgery is generally considered "elective," it is more important to a majority of patients. These findings may also be applicable to future potential mandated surgical care delays by other third-party organizations. [ABSTRACT FROM AUTHOR]

Introduction: Telehealth's potential to improve access to specialty health care, increase favorable patient outcomes, and save money demands attention. Unfortunately, patients often fail to embrace telehealth. The COVID‐19 pandemic fueled greater telehealth usage globally. Little is known about patient perceptions of telehealth in the context of a pandemic. Therefore, we sought to understand patient perceptions of telehealth during the COVID‐19 pandemic and explore relevant policy implications. Design: Researchers used a cross‐sectional, non‐experimental design to survey 366 patients across two telehealth programs at a Mississippi academic health sciences center between November 1, 2021 and November 15, 2021. Methods: As part of a larger, psychometric study on patient acceptance of telehealth, participants rated the item, "The COVID‐19 pandemic has made me more open to using telehealth" on a 5‐point Likert scale (1 = strongly disagree; 5 = strongly agree). Means of the different groups were analyzed using independent t‐test and one‐way ANOVA with Bonferroni post‐hoc multiple comparisons. Results: Of the total participants, 73% (n = 366) either agreed or strongly agreed that the COVID‐19 pandemic had made them more open to using telehealth. Significant differences existed by age (p = 0.016), race/ethnicity (p = 0.015), and sex (p < 0.001), however, groups did not differ by age during post‐hoc analysis. A significant difference in the mean responses was observed between black participants (M = 4.29) and white participants (M = 3.91; p = 0.011). In addition, female participants (M = 4.11) rated the item higher than male participants (M = 3.65). Conclusion: As access to telehealth increased due to the COVID‐19 pandemic, patients' perceptions to telehealth seem to have shifted in the positive direction as well. Findings may be used to support expansion of telehealth and advocacy for patients in a variety of settings. Clinical Relevance: Study findings indicate that participants of telehealth are more open to using telehealth due to the COVID‐19 pandemic. Implementing telehealth should be a priority to increase access to care for those who have limited access to specialty care, and policymakers should advocate to decrease barriers to telehealth within their institutions. [ABSTRACT FROM AUTHOR]