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• Patients have high expectations prior to spine surgery. • Only 27% of patients met their expected Oswestry Disability Index (ODI). • Standard success criteria may not reflect patient expectations. • Patient expectations exceed their actual surgical outcome. Defining success in spine surgery lacks a standardized approach, and all existing concepts are based on registrations after surgery. To examine patients' expectations before spine surgery assessed by a modified Oswestry Disability Index (ODI) and Numeric Rating Scale (NRS). The authors asked: how do the expectations align with actual outcomes and can a patient's individual expectations be used as a success criterion in itself? Prospective single-center study. Patients scheduled for spine surgery at Akershus University Hospital (AHUS) were included in the study. They underwent 1 of 3 procedures: decompression for spinal stenosis, disc removal for lumbar disc herniation, or spinal fusion for degenerative disc disease. Modified and standard version of ODI and NRS (back and leg pain). Preoperatively, the patients were given a modified ODI and NRS questionnaire in which they were asked to register the minimum acceptable functional impairment and pain they anticipated to have postsurgery. The patients' expectations were compared with 3-and 12-month follow-up data from the Norwegian Registry for Spine Surgery (NORspine) with ODI, NRS and Global Perceived Effect (GPE) scale. We used simple descriptive statistics. A total of 93 patients completed the preop questionnaire. Of these, 65 responded to the 3-month follow-up and 53 at 12-month follow-up. The mean (95%CI) ODI before surgery was 38.3 (34.2–42.3), the mean (95% CI) preoperative NRS back pain was 6.34 (5.81–6.88), and leg pain was 6.67 (6.08–7.26). The patients expected a mean (95% CI) ODI of 10.5 (7.5–13.5), mean (95%CI) NRS back pain of 2.5 (2.1–3.0), and NRS leg pain of 1.8 (1.5–2.2). The actual clinical outcome after 12 months were a mean (95% CI) ODI of 21.7 (17.0–26.5), NRS back pain of 3.4 (2.8–4.1), and leg pain of 2.8 (2.0–3.5). Only 12 (30.8%) patients achieved their expected ODI, while 26 (65.0%) classified themselves as significantly better according to GPE. Patients seem to have high expectations before spine surgery, and the expectations may exceed the clinical outcome. Only 30.8% had their ODI expectations met, but perceived benefit was higher. High expectations may be due to inadequate preoperative information and/or the unsuitability of ODI for capturing expectations. [ABSTRACT FROM AUTHOR]

Objective: To examine help-seeker satisfaction with the first communication of a tinnitus diagnosis by a healthcare provider, whether help-seekers undertook treatment and how they rated this treatment. Design: A survey design assessed tinnitus characteristics and distress, health status, help-seeking, diagnosis communication, treatment and patient satisfaction. Study sample: A self-selected cohort and a population-based cohort. Results: Satisfaction scores were examined against demographic, clinical factors, and type of healthcare provider. A total of 281 adults participated (median age 61.6, IQR = 10.8 years), 52.3% sought help for tinnitus and 22.4% received treatment. The most frequently seen healthcare providers were general practitioners (34.0%), audiologists (29.3%) and ear, nose and throat specialists (25.9%). About two-thirds (64.1%) of help-seekers were unsatisfied with the first communication of a tinnitus diagnosis they received, and 56.5% rated their first tinnitus treatment as poor. Help-seekers were significantly more satisfied with audiologists than other providers regarding the communication of the first tinnitus diagnosis. Higher tinnitus distress scores were significantly associated with lower patient satisfaction with communication of first tinnitus diagnosis. No other factors were associated with patient satisfaction. Conclusion: There are significant communication barriers along the tinnitus clinical pathway. Identifying and addressing these barriers could improve patient satisfaction. [ABSTRACT FROM AUTHOR]

The need for a comprehensive patient experience model across healthcare sectors is crucial. This study introduces IEXP's five-dimension model: physical, emotional, social, cultural, and healthcare. Unlike hospital-centric frameworks, this model acknowledges holistic experiences, vital for chronic conditions. Applied to chronic obstructive pulmonary disease (COPD) and spinal cord injury (SCI), it showcases its adaptability. This model benefits healthcare, patient groups, pharmaceuticals, and medical tech, optimizing care, policy support, adherence, and patient-focused tech. Despite limitations and a chronic condition focus, the model adds value in shaping patient experience cross-sector. [ABSTRACT FROM AUTHOR]

A central component of a patient's abortion experience is pain perception and optimization of pain management choices. Yet, data on patients' experience of pain and their preferences regarding pain strategies are limited and tend to utilize solely quantitative data. This study utilized a qualitative thematic analysis to identify patient priorities, preferences, and expectations for pain management during first-trimester surgical abortion with nitrous oxide or oral sedation. Thirty-one patients seeking a first-trimester surgical abortion, self-selecting inhaled nitrous oxide (NO) (16 patients), or oral sedation (PO) with oxycodone and Ativan (15 patients) enrolled in this prospective cohort study. Participants provided demographic data, rated procedure pain on a 10 cm visual analog scale (VAS), and participated in semi-structured interviews. We analyzed qualitative data using a content analysis approach. Pre-procedure participants wanted a positive experience. Participants endorsed an ideal analgesic as having a quick onset of action, minimal side effects, no addiction potential, and being effective at reducing pain. After the procedure, there we start differences between priorities in NO and PO participants. NO participants valued the resumption of everyday activities, while PO participants desired ongoing anxiolysis. Anticipatory counseling often mitigated higher procedure pain and more medication side effects than anticipated. Participants emphasized that positive interactions with providers/staff significantly improved their abortion experience. Preemptive comprehensive counseling about procedure and analgesic effectiveness, along with providing options for analgesia, will facilitate an affirmative and patient-centered abortion experience. [ABSTRACT FROM AUTHOR]

Our objective was to understand how empathy and self-awareness content, alongside traditional deescalation training, might impact ambulatory clinic staff responses to patient and family escalation events. Verbal and physical workplace violence is escalating across healthcare organizations, including ambulatory clinics. Deescalation content is often developed with acute care, psychiatric, or emergency care in mind. There is a need for relevant and empathic deescalation training for ambulatory clinic staff to address their specific needs. We developed empathic and self-reflective deescalation training which was interactive and relevant to ambulatory clinic staff. Staff were trained using both in-person and virtual modalities. Participant self-reflection pre- and postintervention questionnaires indicated increases in understanding and application of deescalation methodologies. Multiple ambulatory clinics where staff participated saw a decrease in patient complaints and grievances. Participating ambulatory clinics also saw an improvement in the likelihood to recommend practice. However, participating ambulatory clinics did not see a reduction in reported patient-involved workplace violence events. Ensuring both empathy and self-awareness content in deescalation training, along with relevant ambulatory clinic scenarios, support ambulatory staff to respond effectively and appropriately to escalation events, helps reduce patient complaints, and improves patient satisfaction. [ABSTRACT FROM AUTHOR]

Patient expectations of receiving antibiotics for common symptoms can trigger unnecessary use. We conducted a survey (n = 564) between January 2020 to June 2021 in public and private primary care clinics in Texas to study the prevalence and predictors of patients’ antibiotic expectations for common symptoms/illnesses. We surveyed Black patients (33%) and Hispanic/Latine patients (47%), and over 93% expected to receive an antibiotic for at least 1 of the 5 pre-defined symptoms/illnesses. Public clinic patients were nearly twice as likely to expect antibiotics for sore throat, diarrhea, and cold/flu than private clinic patients. Lack of knowledge of potential risks of antibiotic use was associated with increased antibiotic expectations for diarrhea (odds ratio [OR] = 1.6; 95% CI, 1.1-2.4) and cold/flu symptoms (OR = 2.9; 95% CI, 2.0-4.4). Lower education and inadequate health literacy were predictors of antibiotic expectations for diarrhea. Future antibiotic stewardship interventions should tailor patient education materials to include information on antibiotic risks and guidance on appropriate antibiotic indications. [ABSTRACT FROM AUTHOR]

Achieving a minimal clinically important difference (MCID) in patient-reported outcomes following total knee arthroplasty (TKA) is common, yet up to 20% patient dissatisfaction persists. Unmet expectations may explain post-TKA dissatisfaction. No prior studies have quantified patient expectations using the same patient-reported outcome metric as used for MCID to allow direct comparison. This was a prospective study of patients undergoing TKA with 5 fellowship-trained arthroplasty surgeons at one academic center. Baseline Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) and Pain Interference (PI) domains were assessed. Expected PROMIS scores were determined by asking patients to indicate the outcomes they were expecting at 12 months postoperatively. Predicted scores were generated from a predictive model validated in the Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement (FORCE-TJR) dataset. T -tests were used to compare baseline, expected, and predicted PROMIS scores. Expected scores were compared to PROMIS MCID values obtained from the literature. Regression models were used to identify patient characteristics associated with high expectations. There were 93 patients included. Mean age was 67 years (range, 30 to 85) and 55% were women. Mean baseline PROMIS PF and PI was 34.4 ± 6.7 and 62.2 ± 6.4, respectively. Patients expected significant improvement for PF of 1.9 times the MCID (MCID = 11.3; mean expected improvement = 21.6, 95% confidence interval [CI] 19.6 to 23.5, P <.001) and for PI of 2.3 times the MCID (MCID = 8.9; mean expected improvement = 20.6, 95% CI 19.1-22.2, P <.001). Predicted scores were significantly lower than expected scores (mean difference = 9.5, 95% CI 7.7 to 11.3, P <.001). No unique patient characteristics were associated with high expectations (P >.05). To our knowledge, this study is the first to quantify preoperative patient expectations using the same metric as MCID to allow for direct comparison. Patient expectations for improvement following TKA are ∼2× greater than MCID and are significantly greater than predicted outcome scores. This discrepancy challenges currently accepted standards of success after TKA and indicates a need for improved expectation setting prior to surgery. [ABSTRACT FROM AUTHOR]

Abstract Trans people have diverse life experiences which may include gender-affirming care (GAC). GAC positively impacts the quality of life of trans adults. However, they are often met with barriers to care and are particularly vulnerable within the healthcare system. The needs and expectations surrounding GAC may vary between individual patients. This article aims to analyze trans adults’ perceptions, expectations, and recommendations on GAC. Twenty-seven semi-structured interviews were conducted by a team of academic and peer researchers; transcribed interviews were then analyzed using a codebook and thematic analysis. Three main themes were identified; the liberating experience of GAC; the uneven distribution of knowledge and power between patients and providers; and the recommended practices in GAC. Additional training and research are necessary to facilitate high-quality care for trans adults accessing GAC.

Abstract Background Educating patients regarding surgery is an important aspect of the preoperative process. It helps individuals answer their queries, reduce anxiety, and improve overall satisfaction with the surgical experience. Objective To compare patients’ expectations with their real-perioperative surgical experiences. Also, to evaluate the effectiveness of preoperative education and, thus, improve the doctor-patient relationship. Methodology Through consecutive sampling, 65 adult patients were selected from the ENT department of Khyber Teaching Hospital. Preoperative education was provided to all the subjects using a 25-point pro-forma, and their queries were addressed. Postoperatively, all participants were interviewed regarding their expectations and real perioperative surgical experiences. The gaps were noted, and participants were asked about their preferences for addressing such gaps in future interactions. Postoperatively, patients were asked to give comments on how a certain part of preoperative education could have been better delivered. Results Among the 65 patients, 28 (43.1%) were male, and 37 (56.9%) were female. The majority (38.5%) had a primary/secondary school education. Eight (12.3%) patients had ear surgery, 19 (29.2%) had nose surgery, and 38 (58.5%) had throat surgery. Almost 39 (60%) patients had preoperative fear/anxiety. After preoperative education, 17 (26.2%) patients experienced perioperative fear/anxiety, which was a significant reduction (p = 0.001). Preoperative anxiety was greater in females (M: F = 8:13, p = 0.00), while perioperative anxiety was comparable among both genders after patient education (M: F = 5:12, p = 0.18). The greatest dissatisfaction was noted regarding the surgical schedule (33.8%), range of motion (16.9%), deep breathing exercises (13.8%), and preoperative fasting (12.3%). Most importantly, patients’ comments were noted, when they were asked to suggest a better way to educate preoperatively in their respective area of dissatisfaction. Patients appreciated detailed explanations with practical demonstrations for range of motion exercises. One patient complained about no clear instructions on postoperative resumption of snuff. Conclusion Preoperative patient education should be a two-way process involving active participation and continuous feedback. By educating patients properly through a multidisciplinary approach, healthcare providers can further enhance patient satisfaction, alleviate anxiety, and improve the overall quality of care.

Background: Educating patients regarding surgery is an important aspect of the preoperative process. It helps individuals answer their queries, reduce anxiety, and improve overall satisfaction with the surgical experience. Objective: To compare patients' expectations with their real-perioperative surgical experiences. Also, to evaluate the effectiveness of preoperative education and, thus, improve the doctor-patient relationship. Methodology: Through consecutive sampling, 65 adult patients were selected from the ENT department of Khyber Teaching Hospital. Preoperative education was provided to all the subjects using a 25-point pro-forma, and their queries were addressed. Postoperatively, all participants were interviewed regarding their expectations and real perioperative surgical experiences. The gaps were noted, and participants were asked about their preferences for addressing such gaps in future interactions. Postoperatively, patients were asked to give comments on how a certain part of preoperative education could have been better delivered. Results: Among the 65 patients, 28 (43.1%) were male, and 37 (56.9%) were female. The majority (38.5%) had a primary/secondary school education. Eight (12.3%) patients had ear surgery, 19 (29.2%) had nose surgery, and 38 (58.5%) had throat surgery. Almost 39 (60%) patients had preoperative fear/anxiety. After preoperative education, 17 (26.2%) patients experienced perioperative fear/anxiety, which was a significant reduction (p = 0.001). Preoperative anxiety was greater in females (M: F = 8:13, p = 0.00), while perioperative anxiety was comparable among both genders after patient education (M: F = 5:12, p = 0.18). The greatest dissatisfaction was noted regarding the surgical schedule (33.8%), range of motion (16.9%), deep breathing exercises (13.8%), and preoperative fasting (12.3%). Most importantly, patients' comments were noted, when they were asked to suggest a better way to educate preoperatively in their respective area of dissatisfaction. Patients appreciated detailed explanations with practical demonstrations for range of motion exercises. One patient complained about no clear instructions on postoperative resumption of snuff. Conclusion: Preoperative patient education should be a two-way process involving active participation and continuous feedback. By educating patients properly through a multidisciplinary approach, healthcare providers can further enhance patient satisfaction, alleviate anxiety, and improve the overall quality of care. [ABSTRACT FROM AUTHOR]

Trans people have diverse life experiences which may include gender-affirming care (GAC). GAC positively impacts the quality of life of trans adults. However, they are often met with barriers to care and are particularly vulnerable within the healthcare system. The needs and expectations surrounding GAC may vary between individual patients. This article aims to analyze trans adults' perceptions, expectations, and recommendations on GAC. Twenty-seven semi-structured interviews were conducted by a team of academic and peer researchers; transcribed interviews were then analyzed using a codebook and thematic analysis. Three main themes were identified; the liberating experience of GAC; the uneven distribution of knowledge and power between patients and providers; and the recommended practices in GAC. Additional training and research are necessary to facilitate high-quality care for trans adults accessing GAC. [ABSTRACT FROM AUTHOR]

Purpose: The healthcare sector, especially in Kerala, is experiencing significant transformations driven by escalating patient expectations. Patient satisfaction has become a cornerstone of healthcare quality assessment, influencing clinical effectiveness profoundly. Modern private hospitals in Kerala have embraced technological advancements to elevate service standards and compete fiercely. Design/Methodology/Approach: A study in Thrissur examines patient satisfaction in private medical colleges, revealing preferences among male patients aged 41-60 with higher incomes and education levels. They prioritize timely service, cleanliness, and accurate diagnosis. Variables like length of stay, career, marital status, and education shape patient perceptions. Empirical methods, including statistical analysis, elucidate these findings, highlighting the evolving dynamics of patient expectations and healthcare delivery in Kerala. Findings: Research underscores patient satisfaction, disease severity, treatment protocols, and outcomes as critical quality indicators. Practical Implications: Despite Kerala's robust healthcare infrastructure, retaining skilled professionals poses challenges due to migration trends. Thrissur emerges as a pivotal healthcare hub, fostering infrastructure growth. Originality/Value: Patients now demand superior services alongside medical care, leading to dilemmas in choosing between public and private healthcare facilities. [ABSTRACT FROM AUTHOR]

The purpose of this study was to analyze the satisfaction of universal health coverage (UHC) program patients with health services at the Ketapang health center in Sampang district. Puskesmas Ketapang is one of the puskesmas in sampang district which includes the largest number of people registered in the universal health coverage program. This research method is descriptive with a qualitative approach where data collection techniques are carried out through direct interviews with medical personnel and also patients who come to visit the Puskesmas, documentation, observation, and data analysis. The results showed that patients (UHC) were very satisfied with the services provided from the puskesmas seen from reliability, responsiveness, assurance, empathy, but there were still patients who were less satisfied with the physical evidence or facilities provided at the Puskesmas. The results of the study seen from the dimension 5 gap there are no triggers for the gap, this shows that the quality of service that has been provided from the health center is good and in accordance with patient expectations. [ABSTRACT FROM AUTHOR]

Background: Limited information is available on the experiences of patients during rehabilitation after anterior cruciate ligament reconstruction (ACLR). Aim: The current study aimed to identify factors that differentiated positive and negative patient experiences during rehabilitation after ACLR. Method and design: A survey-based study with an online platform was used to identify factors that differentiated positive and negative patient experiences during rehabilitation after ACLR. Seventy-two patients (age 27.8 [8.8] y) after ACLR participated. Data were analyzed and themes were identified by comparing categories and subcategories on similarity. Main findings: Positive patient experiences were room for own input, supervision, attention, knowledge, honesty, and professionalism of the physiotherapist. Additionally, a varied and structured rehabilitation program, adequate facilities, and contact with other patients were identified as positive patient experiences. Negative experiences were a lack of attention, lack of professionalism of the physiotherapists, a lack of sport-specific field training, a lack of goal setting, a lack of adequate facilities, and health insurance costs. Conclusions: The current study identified factors that differentiated positive and negative patient experiences during rehabilitation after ACLR. These findings can help physiotherapists in understanding the patient experiences during rehabilitation after ACLR. [ABSTRACT FROM AUTHOR]

Abstract Background Patients’ ideas, concerns, and expectations are three important concepts in consultation techniques. Limited studies on these concepts include responses from both health care providers and care recipients of the same consultation. Highlighting both perspectives provides an increased understanding of the consultation. This study aims to explore the perspectives of patients and health care professionals about patients’ expectations of primary health care during consultations with primary care physicians and compare the two sets of perspectives. Methods A cross-sectional study. Patients (n = 113) and physicians (n = 67) from five primary health care centers completed a questionnaire after planned consultations. Their responses to open-ended questions about patients’ expectations, from patients’ and physicians’ perspectives were analyzed with qualitative content analyses. Results The patients expected a personal journey, through the primary health care system where they were the subject of interest. A journey, with ready access to a health care provider followed by a consultation with the physician, medical measures administered, their outcomes discussed, and a plan developed for continued health care. The physicians observed patients’ expectations to concern the responsibilities placed on primary health care where patients were the object of interest. Patients’ short-term expectations were described in a similar way by both patients and physicians. Patients expressed their long-term expectations as more personal and interpersonal whereas physicians observed them from a more professional and organizational standpoint. Conclusions Patients and physicians have different views of what patients expect of primary health care. While patients’ short-term expectations were perceived by physicians, their long-term expectations were not. Patients expected more of a personal journey through the primary health care system while physicians observed patients’ expectations to concern the responsibilities placed on primary health care. Identifying and meeting patients’ expectations is an important part of patient-centered care, and a better understanding of patients’ expectations is needed to improve health professionals’ consultation skills.

Isotretinoin is a form of Vitamin A used in treatment of severe, refractory acne vulgaris with treatment duration ranging anywhere from 3 to 12 months. The side effects of isotretinoin require monthly dermatologist visits and utilize a risk-management program called iPLEDGE REMS run by the Federal Drug Administration (FDA), which verifies that patients are not pregnant while starting or while taking isotretinoin. The physical and mental side effects experienced on isotretinoin are unique to each patient and can be severely debilitating. My own experience taking isotretinoin for 8 months was filled with multiple unexpected side effects that affected both my physical and mental health. As a result, I strongly believe dermatologists should help patients in analyzing the risk versus benefit profile of isotretinoin, present all other options, and ultimately emphasize patient-provider shared-decision making. Furthermore, at monthly visits dermatologists should be required to implement open dialogue regarding side effects to avoid patient feelings of fear and shame. Additionally, the iPLEDGE REMS system should consider creating a systematic documentation of symptoms to help normalize experiences and guide treatment plans. [ABSTRACT FROM AUTHOR]

Introduction Lateral ankle sprain is the most common ankle injury and up to 40% of those who sustain a lateral ankle sprain will develop chronic ankle instability (CAI). The aim of this study was to explore the thoughts and expectations of CAI-patients concerning their condition and expectations of care in an orthopedic setting. Study Design Qualitative study Methods Nine semi-structured one-to-one interviews were conducted with CAI-patients who were referred to an orthopedic setting. Interviews were recorded, transcribed, and analyzed using systematic text condensation with an inductive goal free approach. Results Seven themes emerged. The themes were Injury history and symptoms (Lateral ankle sprain during sport, pain and instability), Information from health professional (conflicting information about management and prognosis), Management (mental and physical challenges), Expectation and hope (explanation of symptoms, prognosis and imaging to provide clarification of condition), Activity and participation (restriction in sport and daily life and feelings of uncertainty), Support (support from family/friends) and Identity (low ability to participate in sport and social life result in loss of identity). Conclusion The impact of CAI exceeds an experience of pain and instability. Patients experienced loss of identity, having to manage uncertainty regarding their diagnosis and prognosis and had hopes of being able to explain their condition. Level of Evidence Not applicable [ABSTRACT FROM AUTHOR]

Background Patients’ ideas, concerns, and expectations are three important concepts in consultation techniques. Limited studies on these concepts include responses from both health care providers and care recipients of the same consultation. Highlighting both perspectives provides an increased understanding of the consultation. This study aims to explore the perspectives of patients and health care professionals about patients’ expectations of primary health care during consultations with primary care physicians and compare the two sets of perspectives. Methods A cross-sectional study. Patients (n=113) and physicians (n=67) from five primary health care centers completed a questionnaire after planned consultations. Their responses to open-ended questions about patients’ expectations, from patients’ and physicians’ perspectives were analyzed with qualitative content analyses. Results The patients expected a personal journey, through the primary health care system where they were the subject of interest. A journey, with ready access to a health care provider followed by a consultation with the physician, medical measures administered, their outcomes discussed, and a plan developed for continued health care. The physicians observed patients’ expectations to concern the responsibilities placed on primary health care where patients were the object of interest. Patients’ short-term expectations were described in a similar way by both patients and physicians. Patients expressed their long-term expectations as more personal and interpersonal whereas physicians observed them from a more professional and organizational standpoint. Conclusions Patients and physicians have different views of what patients expect of primary health care. While patients’ short-term expectations were perceived by physicians, their long-term expectations were not. Patients expected more of a personal journey through the primary health care system while physicians observed patients’ expectations to concern the responsibilities placed on primary health care. Identifying and meeting patients’ expectations is an important part of patient-centered care, and a better understanding of patients’ expectations is needed to improve health professionals’ consultation skills. [ABSTRACT FROM AUTHOR]

Patient satisfaction is an important aspect of medical care. This study aimed to assess if patient satisfaction improved when patients shared their expectations with the provider in writing before a visit, and providers purposefully addressed those expectations during the visit. We gave 2 types of questionnaires to 343 patients: Version 1 asked for written expectations before the visit and assessed the visit quality after addressing those expectations, while Version 2 only evaluated the visit without soliciting expectations. Patient satisfaction and meeting expectations were measured on a 1–10 Likert-type scale. The grouped that shared written expectations before the visit (n = 169) showed a significantly higher patient satisfaction score (9.88) compared to the group without shared expectations (n = 136, score 9.43, P <.0001). Conveying written expectations to healthcare providers before the visit improved patient satisfaction, potentially enhancing compliance and overall medical outcomes. [ABSTRACT FROM AUTHOR]

Background/purpose: Improved communication can optimize treatment outcomes and patient satisfaction. Findings emphasize the need for tailored communication strategies based on patient characteristics. Implementing communication courses can enhance patient-centered care and reduce conflicts. Therefore, this study examined the feasibility of integrating doctor-patient communication education in Taiwan's dental education system. Materials and methods: Using interviews and questionnaires, we conducted descriptive statistics and generalized linear mixed-effects model analysis on the importance of doctor-patient communication from the dentist and patient perspectives. Results: More than 600 patient surveys and four interviewed dentists with 20+ years of experience stressed doctor-patient communication in dentistry. Patients' age and income were positively related to the emphasis on physician-patient communication but negatively associated with dental assistants' communication. Dentists valued communication education but differed in its execution and importance. Conclusion: It is recommended to initiate dentist-patient communication education during university studies and continue its practice to adapt to the changing societal dynamics. Individuals with higher socioeconomic status and older age show a greater appreciation for dentist-patient communication, potentially driven by self-promotion, thereby highlighting the diverse nature of doctor-patient relationships. Based on our findings, we suggest to implement the doctor-patient communication courses in Taiwan.

Abstract Background Many chiropractors use spinal manipulative techniques (SMT) to treat spinal pain. A recent Delphi study posited 18 items across five domains as predictors of patients experiencing non-specific low back pain most likely to experience a strong and immediate positive response to SMT. We sought to create a ‘pen and paper’ questionnaire that would measure these items and then pilot its use in a clinical setting to determine its ‘usability’ for a larger study. Knowing this information would inform a more efficacious use of SMT. Method Of the 18 items identified in the Delphi study, 13 were deemed historical in nature and readily provided by the chiropractor and patient. A literature search revealed reliable and valid measures for two more items. The remaining three items were generated by creating descriptive questions matched to an appropriate Likert scale. A panel of six chiropractors who had used SMT for at least 7 years when treating non-specific low back pain was formed to evaluate the items for clarity and relevance. Ten Western Australian chiropractors were then recruited to pilot the questionnaire on ten consecutive patients with non-specific low back pain where SMT was used from March to June 2020. Ethics approval was obtained from Murdoch University. Results COVID-19 restrictions impacted on practitioner recruitment and delayed the data collection. Of the intended 100 participants, only 63 could be recruited over a 3-month period from seven chiropractors. Time constraints forced the closure of the data collection. The measures of all predictor items demonstrated ceiling effects. Feedback from open-ended practitioner questions was minimal, suggesting an ease of use. Conclusion The length of time and level of participation required to collect the calculated sample size was inadequate and suggested that incentivization may be required for a larger investigation. Significant ceiling effects were found and suggested that participants did so because of a positive bias toward chiropractic care and the use of SMT. The questionnaires in this pilot study require alternative measures and further validation before use in a larger study.

Introduction: Violence is not an inherent byproduct of human relationships, but conflicts are. The factors and circumstances that lead to tension and conflicts between health seekers and Nepali medical establishments and staff members who work there are examined in this article. Development: Embedded with relevant literature review, through the analysis of qualitative information, this part of the article is developed into four different sections. The first part deals with the context of the medical consultations that result in the development of a problematic relationship. This is followed by the examination of different types of violence, confrontations, and protests that emerge through such relationships. The implications of swelling medical promises and consequent heightened expectations are analyzed in the third part whereas the fourth part highlights how the typical medical practices that exist in Nepali hospitals itself is increasing the possibility of confrontations and violence. Conclusions: The frequent occurrence of tussles and medical violence in both public and private hospitals in Nepal suggests that they can happen in any hospital, irrespective of ownership. There is always a communication gap between the service providers and the patient party because of the esoteric nature of medicine. Conflict and violence towards service providers can also thrive in the context of a differential explanatory model of the two sides. The mounting animosity also signals a decline in trust between healthcare providers and seekers in Nepal.

Prior studies suggest that patient expectations impact postoperative patient-reported outcomes (PROMs). However, no consensus exists on an appropriate expectations tool. To examine the impact of patient expectations using a modified version of the Oswestry Disability Index (ODI) on clinical outcomes and patient satisfaction 1 year after lumbar fusion for degenerative pathologies. Prospective longitudinal cohort. Adults undergoing 1 to 2 level lumbar fusion were identified from four tertiaty spine centers. ODI, EuroQol-5D, Numeric rating scales for back and leg pain. Preoperatively, patients completed the ODI, as well as a modified ODI reflecting their expected improvement across the 10 ODI items. For example, item 1 in the ODI asks about Pain Intensity at the moment whereas the Expectations ODI asks "One year after surgery, I expect to have..." The difference between this modified ODI score and the baseline ODI score (Baseine ODI minus Expectations ODI) was defined as the Patient Expectation Score. Patients were stratified into tertiles based on their Expectations score into High (HE), Moderate (ME), and Low (LE) Expectations and compared. There were 30 patients in the HE, 35 in the ME, and 26 in the LE Group, with similar demographics and surgical parameters. Patients in the HE group had worse ODI scores preoperatively (54.96 vs 41.42, p<.001) and were expecting a greater improvement in ODI (43.8 vs 13.5, p<.001). There were fewer patients in the HE group (13, 43%) who reported that they were satisfied with the results compared to either the ME (20, 71%) or LE group (22, 85%, p=.041) despite having similar ODI scores and change in ODI scores 1 year postoperatively. An expectations tool, linked to a disease-specific measure may provide the clinician with a practical method of assessing a patient's expectation of results after treatment and aid in the shared decision-making during the preoperative surgical process. [ABSTRACT FROM AUTHOR]

Background: Recently, recommendations were given for a new scoring of the Oral Health Impact Profile (OHIP). The original seven domain structure should be replaced by a four‐dimensional scale. Objectives: To investigate the effect of dental prosthetic treatment on the seven domains and the four‐dimensional scale of the OHIP‐G49/53 questionnaire. Methods: Seventy four patients were grouped according their pre‐ and post‐treatment situation and the type of treatment they received. Patients completed the OHIP‐G49/53 questionnaire before prosthetic treatment (T0), and at 1 week (T1), 3 months (T2) and 6 months (T3) after treatment. Treatment effects on the seven domains and the four dimensions of the OHIP scale were analysed, and the oral health‐related quality of life (OHRQoL) was measured. Patients' expectations of their prosthetic treatment were also evaluated. Data were analysed using two‐way Mixed ANOVA, regression analysis, and Cronbach's alpha test with a level of significance of α ≤.017. Results: OHRQoL significantly improved following prosthetic treatment compared with baseline. The largest improvement was found between T0 and T1 evaluations (all p ≤.001). Unlike the seven‐domain scale, the four OHIP dimensions demonstrated further significant improvements across the T1/T2/T3 evaluations (all p ≤.017). Different pre‐treatment findings had different treatment effects on the four OHIP dimensions and seven OHIP domains. Patients' expectations were mainly fulfilled. Conclusion: Compared with the seven‐domain scale, the four dimensions showed significant follow‐up changes, suggesting the four dimensions are suitable for evaluating treatment effects up to 6 months. Clinically meaningful effects of dental prosthetic treatment can be sensitively measured using the four‐dimensional OHIP scale. [ABSTRACT FROM AUTHOR]

Rationale: Preoperative patient education through 'joint class' has potential to improve quality of care for total joint replacement (TJR). However, no formal guidance exists regarding curriculum content, potentially resulting in inter‐institutional variation. Objective: We aimed to (a) synthesize curriculum components of 'joint classes' across high‐volume institutions and (b) develop a preliminary theory of change model for development and evaluation guided by the existing curricula and related literature. Methods: We reviewed 'joint class' curricula from the websites of the 10 highest‐volume TJR centres (by average annual 2017–2019 volume) that publicly disclosed this information. Two reviewers qualitatively compared available content and noted common categories, which were synthesized into key domains across institutions. We then reviewed the PubMed database for literature on pre‐TJR patient education and education needs in the past 10 years. Drawing on our curriculum synthesis and related literature, we proposed a theory of change model: hypothesized mechanisms through which 'joint class' confers benefits to patients and health systems. Results: We identified 30 categories in our review of existing class content, which we synthesized into seven key domains: (I) Practical Elements, (II) Logistics, (III) Medical Information, (IV) Modifiable Risk Factors, (V) Expected Outcomes, (VI) Patient Role in Recovery and (VII) Enhanced Education. Variation across institutions was noted. Our preliminary model based on the curriculum synthesis and related literature on the impact of 'joint class' includes three levels: (1) Practical Elements ('joint class' accessibility and information quality), (2) Class Goals (increased health literacy, increased adherence, risk mitigation, realistic expectations, and reduced anxiety) and (3) Target Outcomes (improved clinical outcomes, positive patient experience and increased patient satisfaction). Conclusion: Our synthesis identified core common topics included in pre‐TJR education but also highlighted variation across institutions, supporting opportunities for standardization. Clinicians and researchers can use our preliminary model to systematically develop and evaluate 'joint classes,' with the goal of establishing a standard of care for TJR preoperative education. [ABSTRACT FROM AUTHOR]

The purpose of this study is to provide an overview of patients' experiences using a precision medicine (PM) clinic that conducts pharmacogenomics-based (PGx) testing for adverse drug reactions. The study aimed to identify the features of the clinic valued most by patients and areas for improvement. A paper survey was used to collect data. Survey questions focused on patients' perceptions of the PM testing and the overall clinic experience. Sixty-seven patients completed the survey. Quantitative data were analyzed using SPSS and frequencies were reported. Open-ended responses were coded and organized thematically. Patients reported that the clinic services increased confidence in their medication usage. Feeling respected by staff, receiving education, and quick appointments were highly valued by patients. Suggested areas for improvement included better communication from the clinic to patients, expansion of clinic services, and education for other healthcare providers. The findings demonstrate that patient experience goes beyond the clinical care provided. Current and potential future providers of PM should invest the time and energy to configure their care delivery system to enhance the patient experience. [ABSTRACT FROM AUTHOR]

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This paper retrospectively collected doctor ⁃ patient dispute files in a hospital from 2019—2021 doctor⁃patient and established a Service Quality（SERVQUAL）scale to analyze the gaps and problems between patients’expectations of healthcare treatment and their actual perceptions using two ⁃ dimensional quadrant analysis. The results found that in the measured comparison between patients’ expectations and actual perceptions, four indicators demonstrated significant sorting differences, which are patients’medical process （-0.35）, medical registration time（-0.43）, hospital humanistic atmosphere（-0.37）, and medical and nursing professional attitudes（- 0.28）. In the two ⁃ dimensional quadrant analysis of service quality evaluation, three indicators, namely, hospital’s humanistic atmosphere, the doctor ⁃ patient communication system, and the medical treatment effectiveness, were in the“improvement area”. The study found that the overall humanistic atmosphere of the hospital could be improved by strengthening the service consciousness of the healthcare staff. This hospital should focus on enhancing the management and supervision of departments with a higher proportion of complaints. This study also recommends that the hospital strengthen public health education to enhance patients’perceptions about medical treatment and develop doctor ⁃ patient communication training according to dental characteristics to enhance the effectiveness of medical education and effectively alleviate medical disputes in this stomatological hospital. [ABSTRACT FROM AUTHOR]

Patient dissatisfaction has been reported in 15 to 20% of traditional total knee arthroplasty (TKA) procedures. While contemporary improvements may have positive effects on patient satisfaction, these may be offset by increasing obesity prevalence among patients who have knee osteoarthritis. We performed this study to determine whether obesity severity impacts patient-reported TKA satisfaction. We compared patient demographic characteristics, preoperative expectations, preoperative and minimum 1-year postoperative patient-reported outcome measures as well as postoperative satisfaction level among 229 patients (243 TKAs) who had World Health Organization (WHO) Class II or III obesity (group A), and 287 patients (328 TKAs) who had WHO classifications of normal weight, overweight, or Class I obesity (group B). Group A patients were younger and had more severe preoperative back and contralateral knee pain, more frequent preoperative opioid medication use, and lower preoperative and postoperative patient-reported outcome measures (P <.01). A similar proportion of patients in both groups expected at least 75% improvement (68.5 versus 73.2%, P =.27). While satisfaction was higher than traditional reporting for both groups (89.4 versus 92.6%, P =.19), group A patients were less likely to be highly satisfied (68.1 versus 78.5%, P =.04) and were more likely to be highly dissatisfied (5.1 versus 0.9%, P <.01). Patients who have Class II and III obesity report greater TKA dissatisfaction. Additional studies should help determine whether specific implant designs or surgical techniques may improve patient satisfaction or whether preoperative counseling should incorporate lower satisfaction expectations for patients who have WHO Class II or III obesity. [ABSTRACT FROM AUTHOR]

Abstract Background Healthcare systems are shifting toward “patient-centered” care often without assessing the values important to patients. Analogously, the interests of the patient may be disparate with physician interests, as pay-for-performance models become common. The purpose of the study was to determine which medical preferences are essential for patients during their surgical care. Methods This prospective, observational study surveyed 102 patients who had undergone a primary knee replacement and/or hip replacement surgery about hypothetical scenarios regarding their surgical experience. Data analysis included categorical variables presented as a number and percent, while continuous variables presented as mean and standard deviation. Statistical analysis for anticoagulation data included the Pearson chi-square test and one-way ANOVA test. Results A large majority, 73 patients (72%), would not pay to have a four-centimeter or smaller incision. The remaining 29 patients (28%) would prefer to have a four-centimeter or smaller incision and would pay a mean of $1,328 ± 1,629 for that day. A significant number of patients preferred not to use anticoagulation (p = 0.019); however, the value attributed to avoiding a specific method of anticoagulation was found not to be significant (p = 0.507). Conclusions The study determined the metrics prioritized by hospitals and surgeons are not important to the majority of patients when they evaluate their own care. These disconnects in the entitlements patients expect and receive can be solved by including patients in discussions with physicians and hospital systems.

The SARS-CoV-2 (COVID-19) pandemic introduced many challenges and nuances that have transformed medical practice and research. The uncertainty caused by COVID-19 led to inevitable challenges to patient–provider relationships. The ever-changing landscape of COVID-19 research and policy proved to be challenging for the medical community and patients. These challenges also exacerbated long-standing issues regarding patient–provider communication and trust. On the other hand, these challenges gave voice to a burgeoning patient advocacy community. Through social media, advocacy and patient organizing, patients harnessed their power and organized over challenges relating to COVID-19 fears and concerns, ramifications of "Long COVID," and much more. During this unprecedented pandemic, there was a realization that the science and research surrounding COVID-19 is evolving and that there may be a benefit to embracing the dynamic nature of research and the scientific process. We propose that providers and the medical community should consider epistemological humility, which acknowledges insufficiencies related to the state of medical knowledge with a sense of understanding and respect for not having all of the answers. We argue that there is untapped potential in saying, "We don't know" and explaining why. There is an implicit culture that providers should be responsible for knowing everything and solving every problem. Epistemological humility challenges this culture, and inherently gives credence and voice to patient perspectives. We assert that epistemological humility is necessity when addressing contemporary health challenges such as COVID-19. [ABSTRACT FROM AUTHOR]

The quality of healthcare service delivery is generally determined by how patients' expectations were met successfully. This narrative study explores how women perceive and experience healthcare during childbirth in the context of Bangladesh. This study is inspired by Clandinin and Connelly's three-dimensional paradigm of narrativity that combines temporality, social interaction, and place. To unearth patient-driven narratives, the researcher purposely picked 12 women who gave birth in different private and public health facilities in Bangladesh. Four themes standout from the women's narratives. Excerpts of women's stories have been included in discussing the themes as well as author's conviction on this phenomenon. Most of the participants experienced a shared level of difficulty in choosing the health facilities (private vs public), motivated primarily by delivery costs and social background. Women with a higher level of education and financial means often opted to give birth in private facilities due to their negative perception and experience of the public facility. There was evident discontent when doctors decided for cesarean deliveries. Women were dissatisfied by providers' general lack of empathy and vicarious emotion. However, those women who gave birth in public hospitals expressed some degree of satisfaction which might be attributed to their low expectations and moderate social standing. Women's stories also delved into how societal norms, taboos, and elderly relatives put them in uncomfortable situations. To improve patient–provider interactions, healthcare practitioners should prioritize patient-centered care and collaborative decision-making. Reducing healthcare disparity and resolving superannuated pregnancy norms are also critical challenges. [ABSTRACT FROM AUTHOR]

Globally, systems have invested in a variety of dementia care programs in response to the aging population and those who have been diagnosed with dementia. This study is a qualitative secondary analysis of interview data from a larger study investigating stakeholder perceptions of programs that support caregivers and people living with an Alzheimer's Disease or Alzheimer's Disease-related dementia (AD/ADRD) in five North American jurisdictions. This study analyzed interviews with individuals living with an AD/ADRD and caregivers of individuals living with an AD/ADRD (n = 11). Thematic analysis was conducted to understand how the perception of dementia may have shaped their engagement and experience with healthcare systems. Our analysis resulted in three main themes of care users' experience: (i) undesirable experience owing to the overarching negative shared understanding and stereotyping of dementia; (ii) dismissal throughout disease progression when seeking health and social care support; and (iii) dehumanization during care interactions. The findings carry critical social and clinical implications, for example, in informing person-centered approaches to care, and communication tools clinicians can use to enhance provider, patient, and caregiver well-being. [ABSTRACT FROM AUTHOR]

Improved communication can optimize treatment outcomes and patient satisfaction. Findings emphasize the need for tailored communication strategies based on patient characteristics. Implementing communication courses can enhance patient-centered care and reduce conflicts. Therefore, this study examined the feasibility of integrating doctor-patient communication education in Taiwan's dental education system. Using interviews and questionnaires, we conducted descriptive statistics and generalized linear mixed-effects model analysis on the importance of doctor-patient communication from the dentist and patient perspectives. More than 600 patient surveys and four interviewed dentists with 20+ years of experience stressed doctor-patient communication in dentistry. Patients' age and income were positively related to the emphasis on physician-patient communication but negatively associated with dental assistants' communication. Dentists valued communication education but differed in its execution and importance. It is recommended to initiate dentist-patient communication education during university studies and continue its practice to adapt to the changing societal dynamics. Individuals with higher socioeconomic status and older age show a greater appreciation for dentist-patient communication, potentially driven by self-promotion, thereby highlighting the diverse nature of doctor-patient relationships. Based on our findings, we suggest to implement the doctor-patient communication courses in Taiwan. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to assess the anticipations of orthodontic treatment held by both patients and parents. This would enable the provision of optimal services for expectations that are rational, while also facilitating discussions or guidance for expectations that are impractical. One of the key goals of healthcare systems today is to meet patient expectations. The declaration of a patient's desires is significant because healthcare providers frequently undervalue their need for treatment. When a clinician is aware of patient demands, they are better equipped to meet the patient's realistic expectations while explaining the least possibility to fulfil arbitrary expectations, thus results in more rewarding therapeutic interventions. METHODOLOGY: The data collection process involved the utilization of a non-randomized sampling technique, specifically selecting 300 participants as determined through Epi info using a structured form. The study focused on recruiting new patients who exhibited internal motivation, along with anatomical or morphological issues related to their teeth or jaws. A prior history of orthodontic treatment was an exclusion criterion. Participants with craniofacial syndromes or malformations, as well as those dealing with mental or psychological health conditions, were excluded from the research. RESULTS: In total, 300 individuals were examined, with 170 females and 130 males. Improvement in facial appearance was the most popular reason for seeking orthodontic treatment (180 patients out of 300), although other functions like mastication, better oral health and communication were mentioned by 120 patients. 70% (210) had a thought, since they would receive treatment, they would be more accepted by society and thus improve their social standing, while the remaining 30% (90) thought that it would have no difference. CONCLUSION: Essentially, expectations from orthodontic interventions among patients are quite uniform, although males generally display more practical perceptions regarding treatment duration and the initial appointment. However, when it comes to dietary and beverage restrictions during orthodontic treatment, patient expectations differ from those held by their parents. [ABSTRACT FROM AUTHOR]

Background: Many chiropractors use spinal manipulative techniques (SMT) to treat spinal pain. A recent Delphi study posited 18 items across five domains as predictors of patients experiencing non-specific low back pain most likely to experience a strong and immediate positive response to SMT. We sought to create a 'pen and paper' questionnaire that would measure these items and then pilot its use in a clinical setting to determine its 'usability' for a larger study. Knowing this information would inform a more efficacious use of SMT. Method: Of the 18 items identified in the Delphi study, 13 were deemed historical in nature and readily provided by the chiropractor and patient. A literature search revealed reliable and valid measures for two more items. The remaining three items were generated by creating descriptive questions matched to an appropriate Likert scale. A panel of six chiropractors who had used SMT for at least 7 years when treating non-specific low back pain was formed to evaluate the items for clarity and relevance. Ten Western Australian chiropractors were then recruited to pilot the questionnaire on ten consecutive patients with non-specific low back pain where SMT was used from March to June 2020. Ethics approval was obtained from Murdoch University. Results: COVID-19 restrictions impacted on practitioner recruitment and delayed the data collection. Of the intended 100 participants, only 63 could be recruited over a 3-month period from seven chiropractors. Time constraints forced the closure of the data collection. The measures of all predictor items demonstrated ceiling effects. Feedback from open-ended practitioner questions was minimal, suggesting an ease of use. Conclusion: The length of time and level of participation required to collect the calculated sample size was inadequate and suggested that incentivization may be required for a larger investigation. Significant ceiling effects were found and suggested that participants did so because of a positive bias toward chiropractic care and the use of SMT. The questionnaires in this pilot study require alternative measures and further validation before use in a larger study. [ABSTRACT FROM AUTHOR]

Women's satisfaction has been found to be a good indicator of quality of care and is associated with the utilization of healthcare services. Women's needs and satisfaction could be improved through the provision of high-quality antenatal care services. This study assessed women's expectations of and satisfaction with antenatal care and their associated factors in a semiurban setting in Tanzania. A cross-sectional survey using the Expectations and Satisfaction with the Prenatal Care Questionnaire (PESPC) was used to measure pregnant women's expectations of and satisfaction with antenatal care in the two districts of Kibaha and Bagamoyo, involving 338 pregnant women. The data were analyzed using SPSS version 26. In the expectation subscale, women had high expectations for personalized care (78.4%), other services (from a social worker and nutritionist) (68.8%), and complete care (being taken care of on time, receiving excellent care, and receiving information without prompting) (60.9%), while expectations for continuity of care were the lowest (38.9%). In the satisfaction subscale, women were highly satisfied with providers' care (being cared for with respect, healthcare provision, the way they were made to feel, and the ability to ask questions) (88.9%), while the least satisfying aspect was system characteristics (e.g., waiting times, scheduling, parking, tests and examinations, and facilities) (63.4%). Distance from a health facility was a significant predictor of both women's expectations of and satisfaction with antenatal care services, while age and number of pregnancies were also significant predictors of antenatal care expectations. To meet expectations for quality antenatal care services and improve satisfaction with antenatal care, policymakers should improve system characteristics, including the availability of human resources and medical supplies, increased consultation time, flexible schedules, and reduced waiting time. Additionally, ensuring the accessibility of evidence-based health information is important for increasing health literacy among pregnant women. [ABSTRACT FROM AUTHOR]

This study investigated how patients expected and experienced to be put first and cared for in diagnostic imaging settings and how putting the patient first was operationalized in practice. A qualitative field study was conducted in two Danish hospitals to investigate patients' expectations and experiences of care and involvement during CT examinations. Data collection methods included semi-structured interviews and participant observations of five examination cases. Three Computed Tomography (CT) guided lung biopsy intervention studies and two conventional CT studies of the chest of patients being investigated for lung cancer in Fast Track Cancer Referral Programs (FTCRP) were included. Patients reported low expectations of receiving care and being involved during examinations. Perceptions of receiving care predominantly consisted of being received in a kind, personalized manner. Expectations of involvement in the procedure were reported in terms of readiness to do as they were told , complying with requests put to each patient. Concepts of care and involvement were challenged in their formal meanings and found to be entangled in complex interactions within sociotechnical boundaries. Patient's expectations of receiving care and being involved in the diagnostic imaging procedures, were expressed in noncommittal terms, and were overshadowed by patients' focus on getting through the examination, in order to get an answer to their tentative diagnose. The concepts of care and patient involvement were negotiated and reconceptualized within the sociotechnical framework of the diagnostic imaging situation of the individual patient. The concept of "tinkering" is suggested as a means of understanding how patientcare is performed during diagnostic imaging procedures. Issues were identified that may help professionals to put "the patient first", thus, improving patient centered care. [ABSTRACT FROM AUTHOR]

The patent expiry of Humira in 2018 opened up the current European market to eight adalimumab biosimilars – (in alphabetical order) Amgevita, Amsparity, Hulio, Hukyndra, Hyrimoz, Idacio, Imraldi and Yuflyma – for the treatment of various immune and inflammatory conditions. Amjevita, Hadlima, Hyrimoz and Yuflyma have recently become available in the USA, with others expected to reach this market in 2023 as the US patent protection for Humira ends. Although adalimumab biosimilars demonstrate efficacy, safety and immunogenicity similar to the originator, they may differ in product excipient(s) and preservatives, along with their device type(s). Physicians may find it both difficult and time consuming to navigate their way among the array of available adalimumab biosimilars when they need to make a treatment decision. This article explores the characteristics of various adalimumab biosimilars to help clinicians navigate the various options available across Europe and the USA. In addition to drug selection, effective patient–physician communication is needed to nurture realistic patient expectations and minimize potential nocebo effects when prescribing biosimilars.

Background: Healthcare systems are shifting toward "patient-centered" care often without assessing the values important to patients. Analogously, the interests of the patient may be disparate with physician interests, as pay-for-performance models become common. The purpose of the study was to determine which medical preferences are essential for patients during their surgical care. Methods: This prospective, observational study surveyed 102 patients who had undergone a primary knee replacement and/or hip replacement surgery about hypothetical scenarios regarding their surgical experience. Data analysis included categorical variables presented as a number and percent, while continuous variables presented as mean and standard deviation. Statistical analysis for anticoagulation data included the Pearson chi-square test and one-way ANOVA test. Results: A large majority, 73 patients (72%), would not pay to have a four-centimeter or smaller incision. The remaining 29 patients (28%) would prefer to have a four-centimeter or smaller incision and would pay a mean of $1,328 ± 1,629 for that day. A significant number of patients preferred not to use anticoagulation (p = 0.019); however, the value attributed to avoiding a specific method of anticoagulation was found not to be significant (p = 0.507). Conclusions: The study determined the metrics prioritized by hospitals and surgeons are not important to the majority of patients when they evaluate their own care. These disconnects in the entitlements patients expect and receive can be solved by including patients in discussions with physicians and hospital systems. [ABSTRACT FROM AUTHOR]

Patient-partners are invaluable in health professions' education. Sharing their lived experiences with prospective and current healthcare providers can provide an opportunity for these participants to hone their patient-centric skills. However, sharing stories publicly is a vulnerable role and may feel emotionally risky for patient-partners. Using reflective dialogue, this manuscript outlines recommendations through the Sender-Receiver Model of Communication for Patient-Partners encounters when working with patient-partners in health professions' education. These recommendations include recognizing that: Patient-partners need to consider if they are ready to share their story. Some stories are wounds requiring further healing; other stories are scars fully processed by patient-partners and ready to be shared publicly. The audience should differentiate between questions that can promote critical thinking versus feel like a "personal attack." Audiences should recognize vulnerability patient-partners may experience in sharing their stories and engage accordingly. Pre-session and post-session debriefs are important. Shared stories may elicit intense emotions from patient-partners and audiences. Both groups should be given an opportunity to process and work through emotions. [ABSTRACT FROM AUTHOR]

The objective of this scoping review was to describe the extent and type of evidence related to seeking help for tinnitus and satisfaction with healthcare providers including diagnosis, services and treatments along the clinical pathway. The selection criteria were adults aged 18 and over with tinnitus who sought help and where patient satisfaction with healthcare providers was reported. Online databases MEDLINE (OvidSP), Embase (OvidSP), PsycINFO (OvidSP) and CINAHL plus (EBSCO) were searched for original studies in English. The search had no date limit. Twenty-one records were eligible for data extraction. Studies reported that the most common healthcare providers seen were general practitioners, ear, nose and throat specialists and audiologists. Depression and tinnitus severity were related to an increase in the number of times help was sought and the type of healthcare provider seen may also impact patient satisfaction. The majority of participants were unlikely to receive a referral to a specialist at the initial GP consultation. Although there is limited research in this area, help-seekers for tinnitus were generally dissatisfied and reported negative interactions with healthcare providers. However, once in a specialised tinnitus clinical setting, studies reported that most help-seekers were satisfied and had positive interactions with healthcare providers. [ABSTRACT FROM AUTHOR]

Rationale: Total knee arthroplasty is a common surgical procedure but not appropriate for all patients with knee osteoarthritis. Patient decision aids (PtDAs) can promote shared decision making and enhance understanding and expectations of procedures among patients, resulting in better discussions between patients and healthcare providers about whether total knee arthroplasty is the most appropriate option. Aims and Objectives: Evaluate impact of an individualised PtDA for osteoarthritis patients considering total knee arthroplasty 1 year after baseline assessment. Methods: Prospective, randomised controlled trial comparing an intervention arm (IA) and routine care arm (RCA). The IA included an online individualised patient reported outcome measures (PROMs) based PtDA and one‐page summary report for the surgeon. We report secondary outcomes from the final assessment: patient expectations, decisional regret, patient satisfaction with outcomes of knee replacement, health‐related quality‐of‐life (HRQOL) and depression. We report changes in HRQOL between baseline and final assessments, study arms, and surgical versus non‐surgical patients. Descriptive statistics were used to describe participant characteristics and continuous variables. Dichotomous outcomes (expectations, decisional regret, satisfaction) were analyzed using logistic regression and continuous outcomes (HRQOL, depression) were modelled using linear regression. Results: Overall, 140 participants completed all study assessments (IA: n = 69, RCA: n = 71); n = 108 underwent surgery (IA: n = 49, RCA: n = 59). Regardless of study arm, most participants reported expectations were met, minimal decisional regret, satisfaction with outcomes of knee replacement, and had improvements in HRQOL. While no significant differences in study outcomes were found between study arms, IA results were in the direction hypothesised in favour of the PtDA. Conclusions: Although we were not able to detect statistically significant benefits associated with implementing this PROMs‐based PtDA, there was no apparent negative effect on these outcomes 1 year after baseline. We anticipate there may be benefit to implementing this PtDA earlier in the osteoarthritis care pathway where patients have more opportunities to manage their disease non‐surgically. [ABSTRACT FROM AUTHOR]