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A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Healthcare Quality and Patient Safety".

Deadline for manuscript submissions: closed (31 July 2023) | Viewed by 29624

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Dr. Mei-Yueh Lee

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Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
Interests: diabetes mellitus; diabetic kidney disease; diabetic complication; big data

Special Issue Information

Dear Colleagues,

Improving patient care has become a priority for all healthcare providers with the overall objective of achieving a high degree of patient satisfaction. Greater awareness among the public, increasing demand for better care, keener competition, more healthcare regulation, the rise in medical malpractice litigation, and concern about poor outcomes are factors that contribute to this change.

The quality of patient care is essentially determined by the quality of infrastructure, quality of training, competence of personnel, and efficiency of operational systems. The fundamental requirement is the adoption of a system that is “patient orientated”.

Existing problems in healthcare relate to both medical and non-medical factors, and a comprehensive system that improves both aspects must be implemented. Healthcare systems in developing countries face an even greater challenge since quality and cost recovery must be balanced with equal opportunities in patient care.

Dr. Mei-Yueh Lee
Guest Editor

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Keywords

adherence
assessment
patient care
quality of life
likert scale

Published Papers (13 papers)

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Research

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15 pages, 1804 KiB

Open AccessArticle

EASY-NET Program: Methods and Preliminary Results of an Audit and Feedback Intervention in the Emergency Care for Acute Myocardial Infarction in the Lazio Region, Italy

by Laura Angelici, Carmen Angioletti, Luigi Pinnarelli, Paola Colais, Egidio de Mattia, Nera Agabiti, Marina Davoli and Anna Acampora

Healthcare 2023, 11(11), 1651; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare11111651 - 05 Jun 2023

Cited by 1 | Viewed by 918

Abstract

Within the EASY-NET network program (NET-2016-02364191), Work Package 1 Lazio evaluates the effectiveness of a structured audit and feedback (A&F) intervention compared with the web-based regional periodic publication of indicators in improving the appropriateness and timeliness of emergency healthcare for acute myocardial infarction (AMI). This work describes the A&F methodology and presents the results of the first feedback delivered. The intervention involves sending periodic reports via e-mail to participating hospitals. The feedback reports include a set of volume and quality (process and outcome) indicators, calculated by facility through the health information system of the Lazio Region and compared with regional mean, target values and values calculated for hospitals with similar volumes of activity. Health managers and clinicians of each participating hospital represent the “feedback recipients”. They are invited to organize clinical and organizational audit meetings to identify possible critical issues in the care pathway and define, where necessary, improvement actions. A total of 16 facilities are involved. Twelve facilities present high volumes in all volume indicators, while three facilities present low volumes for each indicator. Concerning the quality indicators, four facilities do not present critical indicators or had average results, three facilities do not present critical indicators but show average results in at least one of the indicators and six facilities present a critical value for at least one of the indicators. The first report highlighted some critical issues in some facilities on several indicators. During the audit meetings, each facility analyzes these issues, defining appropriate improvement actions. The outcome of these actions will be monitored through subsequent reporting to support the continuous care quality improvement process. Full article

(This article belongs to the Special Issue Patient Care Assessment)

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11 pages, 642 KiB

Open AccessArticle

Development of the Self-Perceived Safety of Orthopedic Post-Surgery Inpatients (SPSOPSI) Scale

by Pei-Jung Yu, Lee-Ing Tsao and Chieh-Yu Liu

Healthcare 2022, 10(12), 2343; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare10122343 - 22 Nov 2022

Cited by 2 | Viewed by 1397

Abstract

In recent decades, patient safety in orthopedics has gained increasing importance and has been regarded as a core concept of medical care quality. However, according to currently published studies, measurement instruments used to evaluate post-surgery orthopedic patient’s perceptions are still very rare. This study aimed to develop a new measurement instrument, the self-perceived safety of orthopedic post-surgery inpatients (SPSOPSI) scale, which can provide healthcare workers with a better understanding of orthopedic patients’ self-perceived safety and give more precise clinical suggestions. Item analysis and exploratory factor analysis (EFA) were used, and the results showed that the six-factor model is good-fit: root mean square residual (RMR) 0.00, root mean square error of approximation (RMSEA) 0.06, goodness-of-fit index (GFI) 0.90, comparative fit index (CFI) 0.98, incremental fit index (IFI) 0.98. The results showed the SPSOPSI scale is a valid and reliable tool for health care providers can use to evaluate orthopedic post-surgery patients’ perceived safety. Full article

(This article belongs to the Special Issue Patient Care Assessment)

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10 pages, 1191 KiB

Open AccessArticle

Risk Analysis and Assessment of Lipid Abnormalities as the Earliest Complication in Newly Diagnosed Diabetic and Non-Diabetic Individuals of a Local Population

by Zunaira Ali Baig, Amir Rashid, Asifa Majeed, Zahra Masood, Asma Faryal, Zahra Arshad Khan and Aden Razaq

Healthcare 2022, 10(11), 2308; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare10112308 - 18 Nov 2022

Cited by 1 | Viewed by 1450

Abstract

Lipid variations have been frequently observed in global populations that can affect health status. Mainly studies have been conducted on the type 2 diabetic population, but limited data is available on newly diagnosed ones to unravel complications and risk predictors independent of disease progression. This study comprising 244 individuals was carried out to assess the lipid abnormalities in newly diagnosed diabetics and non-diabetics. The clinical and socio-demographic data were collected and analyzed using independent samples t-test and linear regression. Serum lipid variations were observed individually and in combination. The individuals in group I (diabetics with dyslipidemia) revealed elevated levels of low-density lipoprotein and serum triglycerides higher than in group II (non-diabetics with dyslipidemia). The frequency of deranged total cholesterol in group I was observed to be higher than in group II. Independent samples t-test showed a significant mean difference in variables between the two groups. Linear regression analysis showed a significant variable outcome for predictors between high-density lipoprotein (HDL) and physical activity (B= −0.043, 95% CI: −0.80, −0.006) and total cholesterol (TC) with family history (B= −0.062, 95% CI: −0.123, −0.001). The findings conclude that lipid levels deranged independently regardless of type 2 diabetes mellitus and present as an early onset in type 2 diabetes instead of later stage complication. These derangements of lipid levels are an independent risk factor for future cardiovascular pathology. Full article

(This article belongs to the Special Issue Patient Care Assessment)

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11 pages, 811 KiB

Open AccessArticle

Emphasising Organisational Routine: A Qualitative Study of Patient and Health Professional Experiences of Inpatient Oncology Care

by Jennifer Watermeyer, Harriet Etheredge, June Fabian and Sue Tager

Healthcare 2022, 10(11), 2145; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare10112145 - 28 Oct 2022

Viewed by 1167

Abstract

Background: Although the experience of hospitalisation for cancer management has been widely researched, such research from the African sub-continent is limited. Objective: This study explored experiences of patient care in a tertiary, inpatient oncology setting in urban South Africa, from the point of view of patients and health professionals. Methods: In-depth interviews and focus groups were conducted with participants. Participants included oncology inpatients, oncologists, nurses and nursing management (N = 46) at an oncology unit in Johannesburg, South Africa. Data were analysed by a multidisciplinary research group using reflexive thematic analysis principles. Results: Our results suggest that barriers to establishing effective organisational routines included communication breakdowns between patients and healthcare providers, a lack of predictability in interactions with doctors, deficient access to information and diminished confidence in nurses. Conclusions: Oncology inpatients may not feel in control of their circumstances, in part due to lacking routine in the hospital setting. Ironically, nurses, who are often at the frontline of patient management, appear to be underutilised or disabled by the healthcare system as conveyors of information. Implications for practice: Robust organisational routines for oncology inpatients may be a good mechanism for allaying uncertainty and conferring a sense of control. Nursing staff, as the individuals with the most direct patient contact, could be instrumental in nurturing organisational routines towards improving patient perceptions of care. Full article

(This article belongs to the Special Issue Patient Care Assessment)

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9 pages, 419 KiB

Open AccessArticle

Efficacy of Self-Management on Glucose Control in Type 2 Diabetes Mellitus Patients Treated with Insulin

by Hsiu-Chu Lin, Chin-Wei Tseng, Ping-Jung Hsieh, Hsiu-Ling Liang, Shu-Ping Sue, Chun-Yang Huang and Mei-Yueh Lee

Healthcare 2022, 10(10), 2080; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare10102080 - 19 Oct 2022

Cited by 2 | Viewed by 1335

Abstract

Diabetes mellitus (DM) is a chronic metabolic disease. If blood glucose is poorly controlled, it will cause a variety of chronic complications. Therefore, the issue of healthcare in diabetic patients is a problem that cannot be ignored. In this study, we aim to investigate the correlation between sociodemographic characteristics, self-management, and glycated hemoglobin (HbA1c) values in patients with type 2 diabetes treated with insulin. A total of 300 type 2 diabetic patients treated with insulin were enrolled. Type 2 diabetic patients treated with insulin had a significant negative correlation of HbA1c value to self-management total score. The lower the HbA1c value, the better the self-management of type 2 diabetic patients treated with insulin is. It is recommended that scale assessment tools be used to identify problems, improve the self-management ability of type 2 diabetic patients, and problem solve in patients in order to facilitate the effectiveness of blood glucose control of type 2 diabetic patients. Full article

(This article belongs to the Special Issue Patient Care Assessment)

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11 pages, 831 KiB

Open AccessArticle

Effects of an Asthma Education Camp Program on Quality of Life and Asthma Control among Thai Children with Asthma: A Quasi-Experimental Study

by Sirasuda Sommanus, Raweerat Sitcharungsi and Saranath Lawpoolsri

Healthcare 2022, 10(8), 1561; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare10081561 - 18 Aug 2022

Cited by 3 | Viewed by 1745

Abstract

Caregiver knowledge and management ability can improve asthma control and quality of life (QoL) among children with asthma. A quasi-experimental study was proposed to assess the effect of a 1 day educational camp program on the QoL of children with asthma and on their caregivers’ asthma knowledge and management. Children with asthma and their caregivers were invited to attend a camp. The Pediatric Asthma Quality of Life Questionnaire (PAQLQ), Childhood Asthma Control Test score, and forced expiratory volume in 1 s were assessed in children at the first, 3 month, 6 month, and 1 year visits. The caregiver’s knowledge, attitudes, and practice (KAP) survey was assessed at each visit. A total of 212 patients were enrolled (mean age: 8.56 ± 1.63 years) but only 72 patients attended the camp. There was no significant difference in baseline characteristics, asthma severity, or asthma risk factors between camp attendees and non-attendees. The KAP of caregivers who attended the camp was significantly higher than non-attendees at the 3 month and 6 month visits (16.86 ± 2.3 vs. 15.95 ± 2.78 (p = 0.009); 17.25 ± 2.22 vs. 16.7 ± 2.68 (p = 0.04)). QoL did not significantly differ between patient attendees vs. non-attendees. PAQLQ mean score correlated with asthma control, indicating that patients with well-controlled asthma had better QoL than those with unstable asthma control (p < 0.001). An asthma education camp can help increase self-management knowledge, even though its effect may be short-term. Integrating asthma education into routine care could enhance asthma management in children. Full article

(This article belongs to the Special Issue Patient Care Assessment)

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16 pages, 322 KiB

Open AccessArticle

Evaluation of the Satisfaction of Patients Seen in the Dermatology Department of a Spanish Tertiary Hospital

by Camino Prada-García and José Alberto Benítez-Andrades

Healthcare 2022, 10(8), 1560; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare10081560 - 18 Aug 2022

Cited by 1 | Viewed by 1699

Abstract

Patient satisfaction is of great importance and is a key factor in the quality of care. The most commonly used measure of this factor is satisfaction surveys. This study used the modified SERVQHOS healthcare quality survey model, which adapts the SERVQUAL survey. The main objective was to determine the degree of satisfaction of patients seen in the outpatient department of the Dermatology Service, as well as to describe and detect those aspects that could be improved to offer better quality care. A total of 250 patients responded to the survey. The mean Likert scale score for the 19 items on the perceived quality of care was 4.17 ± 0.796 points. Up to 92.8% were satisfied or very satisfied with the care received. All items were statistically correlated with overall satisfaction (p < 0.001). In the multivariate study, the variables with predictive capacity in relation to overall satisfaction (p < 0.05) were “the technology of the medical equipment”; “the directions to the consultation”; “the confidence that the staff transmits”; “the state of the consultation”; and “the interest of the staff in solving problems”. Satisfaction was significantly higher in men (p < 0.05), with a level of education up to primary school (p < 0.05) and no work activity (p < 0.001). The final mean score in the degree of perceived satisfaction was very high, indicating that the expectations of the patients were exceeded, and showing that satisfaction is closely linked to the qualities and skills of the staff in their relationship with the patient. Full article

(This article belongs to the Special Issue Patient Care Assessment)

11 pages, 551 KiB

Open AccessArticle

Evaluating the Hospital Standardized Home-Transition Ratios for Cerebral Infarction in Japan: A Retrospective Observational Study from 2016 through 2020

by Ryo Onishi, Yosuke Hatakeyama, Kanako Seto, Koki Hirata, Kunichika Matsumoto and Tomonori Hasegawa

Healthcare 2022, 10(8), 1530; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare10081530 - 13 Aug 2022

Cited by 1 | Viewed by 862

Abstract

Discharge to home is considered appropriate as a treatment goal for diseases that often leave disabilities such as cerebral infarction. Previous studies showed differences in risk-adjusted in-hospital mortality and readmission rates; however, studies assessing the rate of hospital-to-home transition are limited. We developed and calculated the hospital standardized home-transition ratio (HSHR) using Japanese administrative claims data from 2016–2020 to measure the quality of in-hospital care for cerebral infarction. Overall, 24,529 inpatients at 35 hospitals were included. All variables used in the analyses were associated with transition to another hospital or facility for inpatients, and evaluation of the HSHR model showed good predictive ability with c-statistics (area under curve, 0.73 standard deviation; 95% confidence interval, 0.72–0.73). All HSHRs of each consecutive year were significantly correlated. HSHRs for cerebral infarction can be calculated using Japanese administrative claims data. It was found that there is a need for support for low HSHR hospitals because hospitals with high/low HSHR were likely to produce the same results in the following year. HSHRs can be used as a new quality indicator of in-hospital care and may contribute to assessing and improving the quality of care. Full article

(This article belongs to the Special Issue Patient Care Assessment)

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10 pages, 881 KiB

Open AccessArticle

Genetic Testing on Patients with Developmental Delay: A Preliminary Study from the Perspective of Physicians

by Gwanwook Bang, Sook Joung Lee, Bomyee Lee, Minji Park and So-Youn Park

Healthcare 2022, 10(7), 1236; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare10071236 - 02 Jul 2022

Viewed by 1251

Abstract

This study aimed to discover and propose solutions to various decision-making problems, including obtaining consent, encountered by physicians when administering genetic testing to patients with disabilities. A preliminary survey and focus group interviews (FGIs) were conducted with 27 specialists who had 5–25 years of clinical experience in rehabilitation medicine, pediatrics, and obstetrics and gynecology, regarding their experience in providing genetic testing to people with developmental disabilities. This included the “role of medical staff in the patient’s decision-making process”, “difficulty of the consent process for genetic testing”, and so forth. Some limitations were identified in the genetic testing communication process for patients with disabilities. Although providing information corresponding to the level of understanding of each person and accurately evaluating the correct consenting ability is important, the usage rate of auxiliary tools, such as booklets and videos, was only 50.0%. Additionally, there were concerns regarding the marriage prospects of people with disabilities. For people with developmental disabilities to provide consent for genetic testing, legal consent forms and explanation aids that consider individual characteristics are necessary. Moreover, education on disability awareness throughout society, including cost support, is needed. Full article

(This article belongs to the Special Issue Patient Care Assessment)

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16 pages, 944 KiB

Open AccessArticle

Patients’ and Nurses’ Perceptions of Importance of Caring Nurse–Patient Interactions: Do They Differ?

by Jasenka Vujanić, Štefica Mikšić, Ivana Barać, Aleksandar Včev and Robert Lovrić

Healthcare 2022, 10(3), 554; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare10030554 - 16 Mar 2022

Cited by 7 | Viewed by 5084

Abstract

Nurse–patient interaction is a professional and therapeutic relationship created to enable nurses to assess, plan, and deliver health care aimed at meeting patients’ basic human needs. The main aim of this study was to identify distinctive characteristics and differences in perceptions between patients and nurses related to the importance of caring interactions and to examine the contribution of independent variables in explaining their perceptions. A total of 446 respondents were included in the research (291 patients and 155 registered nurses). Data were collected using the translated and standardized 70-item version of the Caring Nurse–Patient Interactions Scale (CNPI-70) version for patients and version for nurses. According to the overall CNPI-70 scale, there was a significant difference in patients’ and nurses’ perception (p < 0.001). Patients assessed caring nurse–patient interactions significantly higher (4.39) than nurses (4.16). Additionally, nurses assessed all subscales significantly lower than patients who assessed them high (p < 0.05), except for the subscales for “environment” (p = 0.123) and “spirituality” (p = 0.132). Independent variables did not contribute to an explanation of respondents’ perceptions. Providing quality physical assistance in meeting human needs through effective communication and teaching is crucial for promoting a holistic patient approach, improving psychosocial support and nurse–patient interaction, and attaining greater satisfaction with health care provided without additional financial investments. Full article

(This article belongs to the Special Issue Patient Care Assessment)

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11 pages, 1243 KiB

Open AccessArticle

Comparison of Mean Glandular Dose between Full-Field Digital Mammography and Digital Breast Tomosynthesis

by Kar Choon Teoh, Hanani Abdul Manan, Norhashimah Mohd Norsuddin and Iqbal Hussain Rizuana

Healthcare 2021, 9(12), 1758; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9121758 - 19 Dec 2021

Cited by 14 | Viewed by 2861

Abstract

Early detection of breast cancer is diagnosed using mammography, the gold standard in breast screening. However, its increased use also provokes radiation-induced breast malignancy. Thus, monitoring and regulating the mean glandular dose (MGD) is essential. The purpose of this study was to determine MGD for full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) in the radiology department of a single centre. We also analysed the exposure factors as a function of breast thickness. A total of 436 patients underwent both FFDM and DBT. MGD was auto calculated by the mammographic machine for each projection. Patients’ data included compressed breast thickness (CBT), peak kilovoltage (kVp), milliampere-seconds (mAs) and MGD (mGy). Result analysis showed that there is a significant difference in MGD between the two systems, namely FFDM and DBT. However, the MGD values in our centre were comparable to other centres, as well as the European guideline (<2.5 mGy) for a standard breast. Although DBT improves the clinical outcome and quality of diagnosis, the risk of radiation-induced carcinogenesis should not be neglected. Regular quality control testing on mammography equipment must be performed for dose monitoring in women following a screening mammography in the future. Full article

(This article belongs to the Special Issue Patient Care Assessment)

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Review

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8 pages, 417 KiB

Open AccessReview

Ethical Challenges Regarding Cosmetic Surgery in Patients with Body Dysmorphic Disorder

by Sorin Hostiuc, Oana-Maria Isailă, Mugurel Constantin Rusu and Ionut Negoi

Healthcare 2022, 10(7), 1345; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare10071345 - 20 Jul 2022

Cited by 3 | Viewed by 3498

Abstract

Body dysmorphic disorder (BDD) is an obsessive-compulsive disease, associated with increased addressability to plastic surgeons; however, as patients perceive body defects due to decreased insight, they are often unsatisfied with their appearance after cosmetic surgery. The purpose of this study is to evaluate the ethical reasoning that should be performed before accepting these patients as cosmetic surgery candidates. We will focus our analysis on three main areas of interest: autonomy, which in these patients is significantly decreased, beneficence as satisfaction, which in these particular patients does not justify performing the intervention, and loyalty, which should render cosmetic procedures immoral in patients with body dysmorphic disorder. Full article

(This article belongs to the Special Issue Patient Care Assessment)

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28 pages, 532 KiB

Open AccessReview

Adult Inpatients’ Perceptions of Their Fall Risk: A Scoping Review

by Elissa Dabkowski, Simon Cooper, Jhodie R. Duncan and Karen Missen

Healthcare 2022, 10(6), 995; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare10060995 - 27 May 2022

Cited by 8 | Viewed by 4945

Abstract

Patient falls in hospitals continue to be a global concern due to the poor health outcomes and costs that can occur. A large number of falls in hospitals are unwitnessed and mostly occur due to patient behaviours and not seeking assistance. Understanding these patient behaviours may help to direct fall prevention strategies, with evidence suggesting the need to integrate patients’ perspectives into fall management. The aim of this scoping review was to explore the extent of the literature about patients’ perceptions and experiences of their fall risk in hospital and/or of falling in hospital. This review was conducted using a five-stage methodological framework recommended by Arksey and O’Malley. A total of nine databases were searched using key search terms such as “fall*”, “perception” and “hospital.” International peer-reviewed and grey literature were searched between the years 2011 and 2021. A total of 41 articles, ranging in study design, met the inclusion criteria. After reporting on the article demographics and fall perception constructs and measures, the qualitative and quantitative findings were organised into five domains: Fall Risk Perception Measures, Patients’ Perceptions of Fall Risk, Patients’ Perceptions of Falling in Hospital, Patients’ Fear of Falling and Barriers to Fall Prevention in Hospital. Approximately two-thirds of study participants did not accurately identify their fall risk compared to that defined by a health professional. This demonstrates the importance of partnering with patients and obtaining their insights on their perceived fall risk, as this may help to inform fall management and care. This review identified further areas for research that may help to inform fall prevention in a hospital setting, including the need for further research into fall risk perception measures. Full article

(This article belongs to the Special Issue Patient Care Assessment)

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