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PURPOSE The process and outcomes of delivering medical care for chronic low back pain might affect patient satisfaction. We aimed to determine the associations of process and outcomes with patient satisfaction. METHODS We conducted a cross-sectional study of patient satisfaction among adult participants with chronic low back pain in a national pain research registry using self-reported measures of physician communication, physician empathy, current physician opioid prescribing for low back pain, and outcomes pertaining to pain intensity, physical function, and health-related quality of life. We used simple and multiple linear regression models to measure factors associated with patient satisfaction, including a subgroup of participants having both chronic low back pain and the same treating physician for >5 years. RESULTS Among 1,352 participants, only physician empathy (standardized [beta], 0.638; 95% CI, 0.588-0.688; t = 25.14; P < .001) and physician communication (standardized [beta], 0.182; 95% CI, 0.133-0.232; t = 7.22; P < .001) were associated with patient satisfaction in the multivariable analysis that controlled for potential confounders. Similarly, in the subgroup of 355 participants, physician empathy (standardized [beta], 0.633; 95% CI, 0.529-0.737; t= 11.95; P < .001) and physician communication (standardized [beta], 0.208; 95% CI, 0.105-0.311; t = 3.96; P < .001) remained associated with patient satisfaction in the multivariable analysis. CONCLUSIONS Process measures, notably physician empathy and physician communication, were strongly associated with patient satisfaction with medical care for chronic low back pain. Our findings support the view that patients with chronic pain highly value physicians who are empathic and who make efforts to more clearly communicate treatment plans and expectations. Key words: patient satisfaction; chronic low back pain; physician communication; physician empathy; opioid prescribing https://doi.org/10.1370/afm.2949, INTRODUCTION Donabedian proposed the triad model of quality-of-care assessment on the basis of structure, process, and outcomes more than 3 decades ago. (1) The model remains relevant today, with the [...]

PURPOSE Most patients are escorted to exam rooms (escorted rooming) although patients directing themselves to their exam room (self-rooming) saves patient and staff time while increasing patient satisfaction. This study assesses patient and staff perceptions after pragmatic implementation of self-rooming. METHODS In October-December 2020, we surveyed patients and staff in 25 primary care clinics after our institution expanded self-rooming from 4 specially built clinics during the COVID-19 pandemic. Semi-structured surveys asked about rooming process used, rooming process preferred, and perceptions of self-rooming compared with escorted rooming. RESULTS Most patients (n = 1,561) preferred self-rooming (86%), especially among patients aged Over one-half of staff (n = 241; 180 clinical, 61 nonclinical) preferred self- rooming (59%) and thought most patients liked self-rooming (65.8%), especially among clinical staff and in early adopter clinics ([less than or equal to] 2016). Few staff reported worse waiting times for patients (12.4%), medical assistants (MAs) (15.9%), and clinicians (16.4%) or worse crowding in waiting areas (1.7%) and hallways (10.1%). Unlike patient-reported confusion (7.6%), most staff thought self-rooming led to more patient confusion (63.8%), except in early-adopter clinics (44.4%). CONCLUSIONS Self-rooming is a patient-centered innovation that is also acceptable to staff. We demonstrated that pragmatic implementation is feasible across primary care without expensive technology or specially designed buildings. Key words: primary care; self-rooming; organizational innovation; patientcentered care, INTRODUCTION Self-rooming is a relatively new process where patients direct themselves to an assigned exam room immediately after checking in, bypassing the traditional experience in which a staff member would [...]

Background and Objectives Concern about mistreatment and abuse during childbirth care is growing, and evidence suggests that many women worldwide experience mistreatment during childbirth. The study aimed to assess the prevalence of abused women during labor, types of abuse, rate of satisfaction with birth care among abused women, and associated sociodemographic and obstetric factors with mistreatment and abuse in the delivery room. Methods A cross-sectional study was conducted with data from 1196 women who experienced a vaginal delivery at least once within the past year in a public health setting in Erbil city, Kurdistan Region, Iraq. The author developed a questionnaire after a comprehensive review of the literature. Data were collected through direct interviews with the sample. Frequency, percentage, and chi-square tests were used for data analysis. Results About half of the study sample (49.9%) mentioned that they experienced mistreatment and/or abuse during labor and delivery. The most experienced type of mistreatment and abuse were as follows: lack of privacy (84.6%), patient-blaming (58.5), purposeful neglect (51.6%), abandonment of care, and detention in facilities (43.9%), Non-consented care (42.9%). The rate of physical and verbal abuse was 24.3% and 29.8%, respectively. There was a highly significant association between parity and general satisfaction with birth care with experiencing abuse (P = 0.006, P [less than or equal to] 0.001). Conclusions Mistreatment and abuse of women during childbirth are present among Kurdish women, leading to generally non-satisfaction with birth care, and exploring the reasons behind why health care providers mistreatment and abuse women during childbirth is critical., Author(s): Hamdia Mirkhan Ahmed [sup.1] Author Affiliations: (1) grid.412012.4, 0000 0004 0417 5553, College of Health Sciences & Center for Research and Education in Women's Health, Hawler Medical University, , [...]

Author(s): Sri Harsha Chalasani (corresponding author) [1]; C.L Gurudatt [2]; Madhan Ramesh [1] INTRODUCTION Patient satisfaction encompasses a multidimensional approach to determining how well the patient's expectations about the service [...]

The diagnostic experiences of autistic adults in New Zealand have not been investigated and little is known globally about autistic adults' satisfaction with the autism diagnostic process. This study describes the diagnostic experiences of 70 autistic adults living in New Zealand and explores how these experiences are related to satisfaction during three stages of the diagnostic process. The results show that autistic adults were reasonably satisfied with the early query and diagnostic assessment stages, but were dissatisfied with the post-diagnostic support stage, with significant unmet needs. Dissatisfaction during the post-diagnostic support stage was also related to satisfaction during previous stages and poor coordination of supports. Suggestions are made on how to improve the autism diagnostic pathway for autistic adults in New Zealand., Author(s): Kiah Evans [sup.1] [sup.2] [sup.3] , Larah van der Meer [sup.3] [sup.4] [sup.5] , Matthew J. F. Eggleston [sup.6] , Lauren J. Taylor [sup.7] , Hiran Thabrew [sup.8] , [...]

Objective The objective of this study was to identify factors related to satisfaction with virtual visits during pregnancy in an effort to prioritize intervention targets for pregnant women during the COVID-19 pandemic. Methods The study relied on data obtained from pregnant women (N = 416) who participated in the Perinatal Experiences and COVID-19 Effects (PEACE) Study from May 21 to November 22, 2020. Using a cross-sectional design, this study examined factors including COVID-19 related experiences and prenatal care changes in association with patient satisfaction of virtual prenatal care. Results Overall, women reported being very or extremely satisfied (27.9%) or moderately satisfied (43.5%) with their virtual prenatal experiences, however, 89.9% indicated a preference for in-person care under non-pandemic conditions. Those who completed the survey further into the pandemic were less satisfied with virtual prenatal care ([beta] = - 0.127, p < 0.01). After accounting for this and other sociodemographic characteristics, COVID-19 pregnancy worries ([beta] = - 0.226, p < 0.001) and the number of prenatal care changes due to the pandemic ([beta] = - 0.137, p < 0.01) were associated with lower satisfaction. Conclusion Our findings demonstrate general satisfaction with virtual visits among pregnant women in this study although in general women would prefer in-person care if it weren't for a pandemic. Women worried about the impact of pandemic on their pregnancy, as well as those experiencing transitions in their prenatal care may need more information and reassurance. Additional studies are needed to understand the unmet needs through virtual care compared to in-person care., Author(s): Cindy H. Liu [sup.1] [sup.2] [sup.3] , Deepika Goyal [sup.4] , Leena Mittal [sup.2] [sup.3] , Carmina Erdei [sup.1] [sup.3] Author Affiliations: (1) grid.62560.37, 0000 0004 0378 8294, Department [...]

Introduction: Brief Cognitive Behavioral Therapy for Chronic Pain (Brief CBT-CP) is a biopsychosocial treatment designed to improve access to nonpharmacological pain care in primary care. Results from a clinical demonstration project in Veterans Health Administration (VHA) clinics showed rapid improvement in pain outcomes following Brief CBT-CP treatment in Primary Care Behavioral Health (PCBH). As part of this larger project, the current work aimed to understand patients' perspectives of Brief CBT-CP via a self-report survey completed posttreatment. Method: Thirty-four primary care patients received Brief CBT-CP as part of their usual VHA care and subsequently completed an anonymous survey that included questions regarding treatment modality, intervention content, utility, and satisfaction, as well as global assessment of change in pain-related functioning. Results: Participants reported that Brief CBT-CP content was useful (91%) and that they were satisfied with the intervention overall (89%), including appointment length, frequency of encounters, and comprehensibility of content. On average (M = 4.50, SD = 1.71), participants reported 'somewhat better' to 'moderately better' pain-related functioning following treatment. Exploratory descriptive analysis indicated that self-reported change in function following treatment may vary by patient characteristics, including gender and opioid use history. Discussion: Patients were receptive to Brief CBT-CP, were satisfied with their experience during treatment, and reported benefit in pain-related functioning after treatment. Further development and evaluation of Brief CBT-CP as a feasible biopsychosocial treatment option for pain in primary care clinics using the PCBH model of integration is warranted. Public Significance Statement This study showed that patients who completed Brief Cognitive Behavioral Therapy for Chronic Pain found treatment to be highly acceptable in terms of the length and frequency of appointments, understandability and utility of treatment content, and impact on pain-related functioning. This protocol is well suited for delivery in integrated primary care settings and may serve to extend the reach of safe, behavioral treatments for chronic pain. Keywords: chronic pain, primary health care, mental health services, primary care behavioral health, cognitive behavioral therapy, Recommendations for chronic pain management increasingly emphasize nonpharmacological interventions due to safety concerns over opioids (Dowell et al., 2016). Psychological therapies are effective treatments for chronic pain (Williams et al., [...]

Objective To examine the impact of the COVID-19 pandemic on birth satisfaction and perceived health care discrimination during childbirth, and in turn, the influence of these birth experiences on postpartum health. Study Design We conducted a cross-sectional, bilingual web survey of 237 women who gave birth at two hospitals in New York City and assessed patient-reported experience and outcomes following the first wave of SARS-CoV-2 infections in the New York region. We ascertained SARS-CoV-2 status at delivery from the electronic medical record using participant-reported name and date of birth. We compared birth experience during the COVID-19 pandemic (March 15, 2020-May 11, 2020) to a pre-pandemic response period (January 1, 2020-March 14, 2020). We estimated risk ratios for associations between birth experience and anxiety, depressive symptoms, stress, birth-related PTSD, emergency department visits, timely postpartum visit, and exclusive breastfeeding. Multivariable models adjusted for age, race-ethnicity, insurance, education, parity, BMI, previous experience of maltreatment/abuse and cesarean delivery. Results Women who gave birth during the peak of the pandemic response, and those that were SARS-CoV-2 positive, Black, and Latina, had lower birth satisfaction and higher perceived health care discrimination. Women with lower birth satisfaction were more likely to report higher postpartum anxiety, stress, depressive symptoms, and lower exclusive breastfeeding. Experiencing one or more incident of health care discrimination was associated with higher levels of postpartum stress and birth-related PTSD. Conclusion Hospitals and policy-makers should institute measures to safeguard against a negative birth experience during the ongoing COVID-19 pandemic, particularly among birthing people of color., Author(s): Teresa Janevic [sup.1] [sup.2] [sup.3] , Sheela Maru [sup.1] [sup.4] [sup.5] , Sarah Nowlin [sup.2] [sup.6] , Katharine McCarthy [sup.2] [sup.3] , Veerle Bergink [sup.1] [sup.3] [sup.7] , Joanne [...]

Objective High maternal and neonatal mortality rates in developing regions like Pakistan are linked to low rates of institutional deliveries. One way to improve rates of institutional deliveries is through improving institutional delivery service satisfaction in women. The aim of this research is to identify which factors influence delivery service satisfaction during the period of COVID-19 and which socio-demographic characteristics of women are associated with greater fear of catching COVID-19 during institutional deliveries. Methods A total of 190 women who had given birth between May to June, 2020, were sampled from two private and two public sector hospitals in Lahore, Pakistan. A standardized tool was modified for use and a combination of descriptive statistics and multivariate regression was applied. Results The results reveal that a majority of women, at 74.7%, are afraid of contracting COVID-19; specifically, women delivering at public hospitals, those who are illiterate or semi-literate, with more than four children, with low household income, and who are unemployed. Regression models are used to identify factors related to higher satisfaction, including the following: (i) pre-delivery care (explanatory power of R.sup.2 = 0.651); (ii) during delivery care (R.sup.2 = 0.716); (iii) after delivery care for women (R.sup.2 = 0.525); and (iv) after delivery care for newborn (R.sup.2 = 0.780). The main areas which influence satisfaction include the following: service quality of staff and administration; maintenance of hygiene and sanitation; involvement in decision-making; provision of necessary information; and advice for breastfeeding, immunization and family planning. Conclusions for Practice Based on our findings, we recommend improved regulation of delivery services in both public and private hospitals and increased protection for disadvantaged women groups to maintain service quality during the pandemic., Author(s): Sara Rizvi Jafree [sup.1] , Ainul Momina [sup.2] , Amina Muazzam [sup.3] , Rabia Wajid [sup.4] , Gloria Calib [sup.5] Author Affiliations: (1) grid.444905.8, 0000 0004 0608 7004, Department [...]

Context: At onset of the COVID-19 pandemic, primary care quickly transitioned to the use of virtual care. Although much is known about the challenges and opportunities of virtual care for providers and practices, little remains known about the patient experience with virtual care in primary care. The involvement of patients and other key stakeholders as partners in the research process is crucial to generate relevant findings to guide policy and decision-makers in a way that enhances quality of care and patient outcomes. Objective: Describe a multi-pronged approach to inform a population based, mixed-methods research study investigating patients' experiences with virtual care in Ontario, Canada. Study Design: Mixed-methods--a province-wide survey and descriptive qualitative interviews running in parallel. Our multi-pronged approach engaged Patients, Researchers, Policy makers and other data users throughout the study. I) Patients: We recruited a Patient Advisory Committee through patient advocacy groups and health-oriented organizations, and selected individuals to maximize geographical, gender, and sociocultural variation. II) Professional Organizations: We integrated the Association of Family Health Teams of Ontario, Alliance for Healthier Communities, and Ontario College of Family Physicians as key members of the research team. III) Primary Care Practices: We partnered with primary care practices who were data users. Practices disseminated the survey to their patients. IV) Policy and Decision-Makers: We conducted ongoing consultations with stakeholders from Ontario Health and Ontario Ministry of Health for a reciprocal dynamic that informed the research process and enabled rapid uptake of research findings by key stakeholders. Our multi-pronged process used a mixture of involvement and collaboration models of engagement. Results: 55 interviews were conducted with patients and 534 survey respondents met eligibility criteria. The multi-pronged approach provided success with rapid dissemination of results to inform immediate system and practice-level decisions on the use of virtual care. We produced a comprehensive report for provincial policy and decision-makers, conducted 3 presentations to provincial policy and decisionmakers, provided each participating practice with detailed practice-specific reports, and participated in an invited panel. Conclusions: Patient and stakeholder engagement is a key component to primary care research., Presenters Rachelle Ashcroft, PhD, Simone Dahrouge, PhD, Kiran Saluja, PhD, Simon Lam, BA, [...]