Mathewsvogel8271

03; 95% CI -0.05 to -0.00; P = .047). The top 2 scores of the GSS were independently associated with women (compared to men odds ratio [OR] 2.12, 99% CI 1.01-4.45, P = .046) and lower level of education (masters' degree compared to high school; OR 0.16, 95% CI 004-0.61, P = .007). The GSS had no floor effect, a ceiling effect of 38%, a skewness of -0.08, and a kurtosis of 1.3. The 38% ceiling effect of the iterative (Guttman-style) satisfaction measure is lower than ordinal satisfaction scales, but still undesirably high. Alternative approaches for reducing the ceiling effect of patient experience measures are needed.As access is the lowest rated dimension in surveys of outpatient experience, we sought to identify patient, practice, and provider factors associated with positive ratings of timeliness of primary care appointments. A cross-sectional study with multivariable, multilevel logistic regression was performed using survey responses from 236 695 individuals receiving care in the Veterans Health Administration (VA). Top box ratings (response of "always") for whether the patient reported receiving an appointment as soon as they needed in primary care for routine care and for care needed right away were the main outcomes. Independent variables capturing patient, practice, and provider factors were obtained from survey responses and VA databases. Degree of continuity with primary care provider and duration of relationship were strongly associated with higher ratings. Shorter primary care appointment wait times for both new and returning patients were associated with higher ratings. Independent wait times for mental health and specialty appointments had no effect. Older age, better self-reported physical and mental health, lower disease complexity, and rural residence were patient factors associated with higher ratings while gender, race, ethnicity, and education had little effect. Measures of continuity with primary care provider as well as appointment wait times have strong association with positive patient ratings of appointment timeliness. Patients treated in Veterans Affairs clinics may value continuity with their primary care provider over longer times. Initiatives to improve access could focus on improving continuity and ensuring efforts to improve access do not impact continuity.

Effective doctor-patient communication is of great importance in order to optimize medical consultation outcomes. However, it can be difficult to address all patients' concerns and expectations in clinic.

To identify how much patients know about their medical condition, their fears and concerns, and their expectations, as well as evaluate the benefits of using a preconsultation questionnaire routinely.

This study included consecutive patients attending dermatology outpatients from Dundee (Scotland) and Granada (Spain) who completed a simple preconsultation 3-part questionnaire. Answers to this questionnaire were discussed during clinic visits.

Two hundred patients participated in the study. Of all, 111 (55.5%) patients already knew their diagnosis or were able to describe their symptoms and/or feelings quite accurately at their visit to Dermatology. Most patients (85%) had fears regarding their dermatological problem. A majority of patients (97%) came to clinic with specific expectations, and many (41.5%) had multiple expectations. A high proportion of patients (74%) found the questionnaire useful.

Patients attend clinic with different levels of knowledge, fears, and expectations. We recommend using a brief and easy to use preconsultation questionnaire as a cost-effective way of enhancing doctor-patient communication.

Patients attend clinic with different levels of knowledge, fears, and expectations. We recommend using a brief and easy to use preconsultation questionnaire as a cost-effective way of enhancing doctor-patient communication.Empowerment is integral to patient-centered practice, particularly as this relates to people with chronic conditions, though operationally it is poorly understood in this context. Empowerment, therefore, as experienced by patients with a chronic condition needs exploration. This article reports the experience of empowerment by patients in one specialist epilepsy service in Ireland as an exemplar of broader issues affecting empowerment of patients with chronic conditions. A Frameworks Approach was used to analyze in-depth interviews with patients (n = 10) in one Irish epilepsy service. Analysis was further informed by nonparticipatory observation of service delivery. Results indicate that patients' negative experiences of empowerment appear to be derived from traditional social norms relating to clinician patient power dimensions and social stigma internalized by clinicians at an unconscious level. With this in mind, educational approaches based upon critical social theory may provide a framework and guide to enable services to engage with these issues and embrace empowerment of patients with chronic conditions within therapeutic engagement.Many children and adolescents with type 1 diabetes (T1D) have difficulties reaching the national treatment goal for HbA1c (long-term blood sugar) which is associated with increased risk for complications. This makes it important to explore what patients and their caregivers describe important in coping with everyday life. The study has been conducted within a pediatric diabetes team in the south of Sweden. The aim was to explore how Experienced-Based Co-Design (EBCD) can be used to identify, test, and evaluate improvement efforts in order to support the family with a child with T1D. A modified variant of EBCD based on focus groups, workshops, and interviews with stakeholders was used. The improvement proposal parental coaching was tested and was appreciated by the participants. The qualitative content analysis of the interviews showed that the coaching program contributed to better confidence and self-efficacy. Both coaches and coachees described that the coaching contributed to better competence and a feeling of hope after attending the coach program. Experienced-Based Co-Design gave an opportunity to explore what´s important to improve, based on experiences and needs of several stakeholders.A developing body of evidence indicates that chaplain care is associated with higher levels of patient/family satisfaction with their hospital care. We examined the association between chaplain care and patient experience among patients at Rush University Medical Center in Chicago who responded to Hospital Consumer Assessment of Healthcare Providers and Systems and Press Ganey survey items between 2011 and 2017. Information about chaplain care was taken from the inpatients' electronic medical record. Our analyses included 11 741 patients, 26.5% of whom had received any chaplain care. Patients with lower self-rated health were more likely to have received chaplain care (P less then .001). In bivariate analyses, chaplain care was associated with lower likelihood of reporting the highest score for 4 patient experience items (P less then .001). In multi-variable models that adjusted for patient self-rated health and other factors, the association between chaplain care and the 4 patient experience items was nonsignificant. There was no effect modification for patient religious affiliation, self-rated health, or other demographic factors. The chaplain care-patient experience association may be more complex than has initially appeared, and further research is needed to help us better understand it.Telehealth has been used for decades to improve access to care for rural and underserved patients. The adoption of telehealth in orthopedic oncology is novel and expected to positively impact patient access and compliance. this website However, no previous evaluation has been published of this expected impact. The objective of this pilot project was to evaluate patients' perceptions regarding orthopedic oncology telehealth services. A 13-question satisfaction survey was distributed to patients who used tele-orthopedic oncology. Fifteen respondents (a response rate of 42%) reported satisfaction with services at 9.7 of 10. Median travel distance to the nearest in-person orthopedic oncologist was greater than 150 miles (241 km). These results are consistent with the previous findings of high satisfaction with telehealth in other specialties. Health care organizations are likely to benefit from offering telehealth to orthopedic oncology patients with limited access.The "No One Dies Alone" (NODA) program was initiated to provide compassionate companions to the bedside of dying patients. This study was designed to test the following hypotheses (1) Empathy scores would be higher among medical students who volunteered to participate in the NODA program than nonvolunteers; (2) Spending time with dying patients would enhance empathy in medical students. Study sample included 525 first- and second-year medical students, 54 of whom volunteered to participate in the NODA program. Of these volunteers, 26 had the opportunity to visit a dying patient (experimental group), and 28 did not, due to scheduling conflicts (volunteer control group). The rest of the sample (n = 471) comprised the "nonvolunteer control group." Comparisons of the aforementioned groups on scores of the Jefferson Scale of Empathy confirmed the first research hypothesis (P less then .05, Cohen d = 0.37); the second hypothesis was not confirmed. This study has implications for the assessment of empathy in physicians-in-training, and timely for recruiting compassionate companion volunteers (armed with personal protective equipment) at the bedside of lonely dying patients infected by COVID-19.

The purpose of this qualitative pilot study was to evaluate drawing, narration, color use, and meaning through discussion to increase insight surrounding youth's lived experience with type 1 diabetes.

This qualitative study reflects a convenience sample of 20 (female = 12, male = 8) youth aged 8 to 15 years with an established diagnosis of type 1 diabetes. During a nonclinic session, 3 drawings-self-portrait, face of diabetes, and future self-portrait-were created. Interviews were completed with an art therapist or clinic nurse practitioner using a standardized script.

All "face" of diabetes drawings depicted images separate from self. The most frequent color noted was gray, due to pencil use. No significant difference in disclosures or dialogue were observed between interviews conducted by the art therapist or nurse practitioner. Emerging themes noted diabetes is unpredictable and stigmatizing, causes fears, and impacts daily life, yet discussions evidenced overall coping and resilience.

Drawing during clinic visits enhances communication and understanding of youth's lived experience. Findings offer clinical benefit when managing care and support for chronic health conditions.

Drawing during clinic visits enhances communication and understanding of youth's lived experience. Findings offer clinical benefit when managing care and support for chronic health conditions.The empathy and quality of communication between the physician and patient is believed to correlate with patient satisfaction and knowledge of the diagnoses and treatment plan. Examining patients' understanding of their plan can allow providers to better aid patients upon their discharge from the hospital in the hopes of improving home care compliance. We sought to evaluate factors that we hypothesized to have an impact on a patient's ability to understand their medical management plan in the inpatient setting. Over a 14-month period, patients were given a 10-question survey during their stay on the inpatient medical units at a safety-net tertiary care community hospital. The survey was given to patients to self-complete after our research team introduced it. A total of 366 patients were surveyed. Of the patients surveyed, more than two-thirds of participants had a clear idea of the management plan for their condition (68.5%), while 3.1% had no knowledge of their management plan. Significant associations between knowledge of the management plan and participants knowing their attending physician's name (P less then .