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A 10-year population-based study of people with multiple sclerosis in Stockholm, Sweden: use of and satisfaction with care and the value of different factors in predicting use of care.

https://arctichealth.org/en/permalink/ahliterature275585
Source
BMC Health Serv Res. 2015;15:480
Publication Type
Article
Date
2015
Author
Charlotte Chruzander
Sverker Johansson
Kristina Gottberg
Ulrika Einarsson
Jan Hillert
Lotta Widén Holmqvist
Charlotte Ytterberg
Source
BMC Health Serv Res. 2015;15:480
Date
2015
Language
English
Publication Type
Article
Keywords
Ambulatory Care - utilization
Disabled Persons - psychology - statistics & numerical data
Epidemiologic Methods
Female
Hospitalization - statistics & numerical data
Humans
Male
Middle Aged
Multiple Sclerosis - epidemiology - psychology - therapy
Patient Acceptance of Health Care - psychology
Patient Satisfaction - statistics & numerical data
Primary Health Care - utilization
Sweden - epidemiology
Abstract
The national strategy for treatment of chronic diseases - including MS - and changes in the Swedish welfare system, call for analyses of the use of, and patient satisfaction with, care in a long-term perspective. The aim was therefore to explore the use of care and the predictive value of personal factors, disease-specific factors and functioning on the use of care and to explore patient satisfaction with care in a 10-year perspective.
Information regarding personal factors, disease-specific factors, functioning and satisfaction with care was collected by home-visits; use of care was collected from the Stockholm County Council computerised register.
Data from 121 people with MS (PwMS) was collected. Primary care accounted for the majority of all care. Neurology and Rehabilitation Departments together accounted for two-thirds of all hospital outpatient care. Rehabilitation Departments accounted for one-third of the total number of inpatient days. Lower coping capacity, impaired manual dexterity and activity of daily living dependency at baseline, together with progress in MS disability predicted a higher use of care. Overall, patient satisfaction with care was stable over time.
The extensive use of care offers challenges to care coordination. Implementation of person-centred care could be a strategy to increase efficacy/outcome of care.
Notes
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PubMed ID
26499940 View in PubMed
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Acquired brain injury self-management programme: a pilot study.

https://arctichealth.org/en/permalink/ahliterature123842
Source
Brain Inj. 2012;26(10):1243-9
Publication Type
Article
Date
2012
Author
Denise Kendrick
Noah D Silverberg
Susan Barlow
William C Miller
Jacqui Moffat
Author Affiliation
Vancouver General Hospital , Vancouver, BC , Canada.
Source
Brain Inj. 2012;26(10):1243-9
Date
2012
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adult
Brain Injuries - rehabilitation
Canada
Female
Humans
Male
Middle Aged
Patient compliance
Patient Satisfaction - statistics & numerical data
Pilot Projects
Program Evaluation
Quality of Life
Reproducibility of Results
Retrospective Studies
Self Care - methods
Abstract
Traditional rehabilitation is not well suited to individuals with chronic mild symptoms following an acquired brain injury. To address this, this study adapted a supported self-management programme (SMP) for this population. The aim of this study was to evaluate the potential effectiveness of this novel SMP.
Retrospective case series with repeated measures.
Fifty-three participants with chronic mild symptoms following an acquired brain injury (primarily mild traumatic brain injury) completed an SMP. The intervention involved eight coaching sessions with each an occupational therapist and psychologist, carried out in the community and based on SMP principles. The Canadian Occupational Performance Measure was administered at baseline, discharge and 3- and 9-month follow-up. This measure yielded scores for performance and satisfaction with daily functioning, covering the domains of self-care, productivity and leisure.
A complete case analysis of programme completers revealed that participants' ratings of their occupational performance and satisfaction improved markedly between baseline and discharge from the SMP. This set of outcome measures remained stable between discharge and the two follow-up points.
This pilot study suggests that SMPs may improve daily functioning in individuals with chronic mild ABI symptoms. More methodologically robust clinical trials are warranted.
PubMed ID
22658076 View in PubMed
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Acuity and anxiety from the patient's perspective in the emergency department.

https://arctichealth.org/en/permalink/ahliterature106257
Source
J Emerg Nurs. 2013 Nov;39(6):534-8
Publication Type
Article
Date
Nov-2013
Author
Anna Ekwall
Author Affiliation
Malmö, Sweden. Electronic address: anna.ekwall@skane.se.
Source
J Emerg Nurs. 2013 Nov;39(6):534-8
Date
Nov-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Anxiety - psychology
Attitude to Health
Cross-Sectional Studies
Emergency Nursing - methods
Emergency Service, Hospital
Female
Health Communication - methods
Humans
Male
Middle Aged
Nursing Staff, Hospital
Patient Acuity
Patient Satisfaction - statistics & numerical data
Prospective Studies
Questionnaires
Sweden
Triage
Young Adult
Abstract
Knowledge of a patient's perception of her medical needs and urgency may make it possible for emergency nurses to communicate the triage decision and make the patient understand the assessment and triage category. The aim of this study was to compare the patients' own assessments of their acuity to the triage nurse's assessment, as well as describe patient satisfaction and levels of anxiety.
A prospective, cross-sectional survey design was used. The sample consisted of 72 patients, 54% of whom were women. Median age was 55.9 years.
Agreement between the nurse and patient regarding acuity and triage category was rare. This may have consequences for patient safety, because patients may seek care at an inappropriate level, in both directions. Communication between the nurse and patient during the waiting time in the emergency department is very important, both for patient satisfaction and reduction of anxiety levels.
Helping the patient understand the severity of his medical condition and providing information about the triage category and its implications for care in the emergency department should be a focus in communication between the triage nurse and patient. It may well be that the patient's anxiety level is reduced and satisfaction increased if the triage code is known and understood by the patient.
Notes
Comment In: J Emerg Nurs. 2014 May;40(3):21024810503
PubMed ID
24209586 View in PubMed
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Adherence, preference, and satisfaction of postmenopausal women taking denosumab or alendronate.

https://arctichealth.org/en/permalink/ahliterature140933
Source
Osteoporos Int. 2011 Jun;22(6):1725-35
Publication Type
Article
Date
Jun-2011
Author
D L Kendler
M R McClung
N. Freemantle
M. Lillestol
A H Moffett
J. Borenstein
S. Satram-Hoang
Y-C Yang
P. Kaur
D. Macarios
S. Siddhanti
Author Affiliation
University of British Columbia, 600-1285 West Broadway, V6H 3X8 Vancouver, BC, Canada. kendler@ca.inter.net
Source
Osteoporos Int. 2011 Jun;22(6):1725-35
Date
Jun-2011
Language
English
Publication Type
Article
Keywords
Administration, Oral
Aged
Alendronate - administration & dosage - adverse effects - therapeutic use
Antibodies, Monoclonal - administration & dosage - adverse effects - therapeutic use
Antibodies, Monoclonal, Humanized
Bone Density - drug effects
Bone Density Conservation Agents - administration & dosage - adverse effects - therapeutic use
British Columbia
Epidemiologic Methods
Female
Humans
Injections, Subcutaneous
Medication Adherence - statistics & numerical data
Middle Aged
Osteoporosis, Postmenopausal - drug therapy - physiopathology - psychology
Patient Preference - statistics & numerical data
Patient Satisfaction - statistics & numerical data
Treatment Outcome
Abstract
In this study, 250 women with osteoporosis were randomized to 12 months with subcutaneous denosumab 60 mg every 6 months or oral alendronate 70 mg once weekly, then crossed over to the other treatment. The primary endpoint, treatment adherence at 12 months, was 76.6% for alendronate and 87.3% for denosumab.
The purpose of this study is to evaluate treatment adherence with subcutaneous denosumab 60 mg every 6 months or oral alendronate 70 mg once weekly.
In this multicenter, randomized, open-label, 2-year, crossover study, 250 postmenopausal women with low bone mineral density received denosumab or alendronate for 12 months, then the other treatment for 12 months. The alendronate bottle had a medication event monitoring system cap to monitor administration dates. Definitions were as follows: compliance, receiving both denosumab doses 6 (± 1) months apart or 80-100% of alendronate doses; persistence, receiving both denosumab doses and completing the month 12 visit within the visit window or = 2 alendronate doses in the final month; adherence, achieving both compliance and persistence. This report includes data from the first 12 months.
The primary study endpoint, adherence in the first 12 months, was 76.6% (95/124) for alendronate and 87.3% (110/126) for denosumab. Risk ratios for denosumab compared with alendronate at 12 months were 0.58 (p = 0.043) for non-adherence, 0.48 (p = 0.014) for non-compliance, and 0.54 (p = 0.049) for non-persistence. Subject ratings for treatment necessity, preference, and satisfaction were significantly greater for denosumab and ratings for treatment bother were significantly greater for alendronate. Adverse events were reported by 64.1% of alendronate-treated subjects and 72.0% of denosumab-treated subjects (p = 0.403). The most common adverse events were arthralgia, back pain, pain in extremity, cough, and headache (each in
PubMed ID
20827547 View in PubMed
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Advance information improves user satisfaction with the levonorgestrel intrauterine system.

https://arctichealth.org/en/permalink/ahliterature189988
Source
Obstet Gynecol. 2002 Apr;99(4):608-13
Publication Type
Article
Date
Apr-2002
Author
Tiina Backman
Sakke Huhtala
Riitta Luoto
Juhani Tuominen
Ilkka Rauramo
Markku Koskenvuo
Author Affiliation
Department of Obstetrics and Gynaecology, University Hospital, University of Turku, Finland. backman@nly.fimnet.fi
Source
Obstet Gynecol. 2002 Apr;99(4):608-13
Date
Apr-2002
Language
English
Publication Type
Article
Keywords
Adult
Female
Finland - epidemiology
Humans
Intrauterine Devices, Medicated - utilization
Levonorgestrel - administration & dosage
Odds Ratio
Patient Education as Topic - methods
Patient Satisfaction - statistics & numerical data
Women's health
Abstract
To evaluate parameters associated with and the impact of advance information given in a regular outpatient setting on user satisfaction with the levonorgestrel-releasing intrauterine system.
A questionnaire was sent to 23,885 women in Finland who had had a levonorgestrel intrauterine system inserted between 1990 and 1993. The number of returned questionnaires was 17,914 (response rate 75%). Cumulative logistic regression analysis was based on the five-grade scale of satisfaction as a dependent variable.
Most users of the levonorgestrel-releasing intrauterine system (74%) were very or fairly satisfied with it, although over 70% of them had chosen it because of dissatisfaction with their previous method of contraception. User satisfaction increased with age and was associated with the amount of information about different symptoms (menstrual, greasiness of hair/skin, pregnancy, pelvic inflammatory disease, and missed periods) regardless of whether the symptom in question was actually experienced. The women who received information about the possibility of absence of menstruation were more satisfied than the less informed women (odds ratio 5.0, 95% confidence interval 4.1, 5.9).
Information received at the insertion visit is strongly associated with increased user satisfaction among the users of the levonorgestrel intrauterine system. The association between high user satisfaction and advance information was strongest regarding the possibility of missing periods.
PubMed ID
12039121 View in PubMed
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Agreement between patients and general practitioners on quality deviations during the cancer diagnostic pathway and associations with time to diagnosis.

https://arctichealth.org/en/permalink/ahliterature270236
Source
Fam Pract. 2015 Jun;32(3):329-35
Publication Type
Article
Date
Jun-2015
Author
Henry Jensen
Cecilie Sperling
Mette Sandager
Peter Vedsted
Source
Fam Pract. 2015 Jun;32(3):329-35
Date
Jun-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Cross-Sectional Studies
Delayed Diagnosis - adverse effects - statistics & numerical data
Denmark
Early Detection of Cancer - statistics & numerical data
Female
General Practitioners - statistics & numerical data
Humans
Male
Middle Aged
Neoplasms - diagnosis
Patient Satisfaction - statistics & numerical data
Prognosis
Quality Assurance, Health Care - methods - statistics & numerical data
Quality of Life
Registries
Surveys and Questionnaires
Young Adult
Abstract
High quality and minimal delay are crucial and anticipated elements in the diagnostic cancer pathway as delay in the diagnosis may worsen the prognosis and cause lower patient satisfaction.
The aim of this study was to describe agreement in reported quality deviations (QDs) between general practitioners (GPs) and cancer patients during the diagnostic pathway in primary care and to estimate the association between length of diagnostic interval and level of agreement on reported QDs.
The study was carried out as a Danish cross-sectional study of incident cancer patients identified in the Danish National Patient Registry. Data were collected by independent questionnaires from patients (response rate: 53.0%) and their GPs (response rate: 73.8%), and 2177 pairs of questionnaires were subsequently combined. Agreement between GP- and patient-reported QDs was estimated using Cohen's Kappa, whereas the association between level of agreement and time to diagnosis was estimated using quantile regression.
Patients reported QDs in 29.0% and GPs in 28.5% of the cases, but agreed only slightly on QD presence (Kappas between -0.08 and 0.26). Agreement on 'QD presence' was associated with a 54-day (95%CI: 44-64) longer time to diagnosis than agreement on 'no QD presence'. The association with a longer diagnostic interval was stronger when only GP reported a QD the association than when only patient reported a QD.
Included GPs and patients agreed only slightly on QD presence although they reported the same amount of QDs; this suggests that GPs and patients see QDs as two different concepts. QD presence had a stronger impact on time to diagnosis when reported by the GP (alone or in agreement with the patient) than when reported by the patient alone. The GP may thus be the most important source of information on QD and diagnostic interval, while the patient information tends to underpin this assessment.
PubMed ID
25888583 View in PubMed
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The Alberta population-based prospective evaluation of the quality of life outcomes and economic impact of bariatric surgery (APPLES) study: background, design and rationale.

https://arctichealth.org/en/permalink/ahliterature140191
Source
BMC Health Serv Res. 2010;10:284
Publication Type
Article
Date
2010
Author
Raj S Padwal
Sumit R Majumdar
Scott Klarenbach
Dan W Birch
Shahzeer Karmali
Linda McCargar
Konrad Fassbender
Arya M Sharma
Author Affiliation
Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. rpadwal@ualberta.ca
Source
BMC Health Serv Res. 2010;10:284
Date
2010
Language
English
Publication Type
Article
Keywords
Adaptation, Physiological
Adaptation, Psychological
Adult
Alberta
Bariatric Surgery - economics - methods - psychology
Body mass index
Cohort Studies
Cost of Illness
Cost-Benefit Analysis
Female
Follow-Up Studies
Health Care Costs
Humans
Male
Middle Aged
Obesity, Morbid - diagnosis - surgery
Patient Satisfaction - statistics & numerical data
Patient Selection
Postoperative Care - methods
Postoperative Complications - physiopathology
Preoperative Care - methods
Prospective Studies
Quality of Life
Risk assessment
Time Factors
Treatment Outcome
Waiting Lists
Weight Loss
Abstract
Extreme obesity affects nearly 8% of Canadians, and is debilitating, costly and ultimately lethal. Bariatric surgery is currently the most effective treatment available; is associated with reductions in morbidity/mortality, improvements in quality of life; and appears cost-effective. However, current demand for surgery in Canada outstrips capacity by at least 1000-fold, causing exponential increases in already protracted, multi-year wait-times. The objectives and hypotheses of this study were as follows: 1. To serially assess the clinical, economic and humanistic outcomes in patients wait-listed for bariatric care over a 2-year period. We hypothesize deterioration in these outcomes over time; 2. To determine the clinical effectiveness and changes in quality of life associated with modern bariatric procedures compared with medically treated and wait-listed controls over 2 years. We hypothesize that surgery will markedly reduce weight, decrease the need for unplanned medical care, and increase quality of life; 3. To conduct a 3-year (1 year retrospective and 2 year prospective) economic assessment of bariatric surgery compared to medical and wait-listed controls from the societal, public payor, and health-care payor perspectives. We hypothesize that lower indirect, out of pocket and productivity costs will offset increased direct health-care costs resulting in lower total costs for bariatric surgery.
Population-based prospective cohort study of 500 consecutive, consenting adults, including 150 surgically treated patients, 200 medically treated patients and 150 wait-listed patients. Subjects will be enrolled from the Edmonton Weight Wise Regional Obesity Program (Edmonton, Alberta, Canada), with prospective bi-annual follow-up for 2 years. Mixed methods data collection, linking primary data to provincial administrative databases will be employed. Major outcomes include generic, obesity-specific and preference-based quality of life assessment, patient satisfaction, patient utilities, anthropometric indices, cardiovascular risk factors, health care utilization and direct and indirect costs.
The results will identify the spectrum of potential risks associated with protracted wait times for bariatric care and will quantify the economic, humanistic and clinical impact of surgery from the Canadian perspective. Such information is urgently needed by health-service providers and policy makers to better allocate use of finite resources. Furthermore, our findings should be widely-applicable to other publically-funded jurisdictions providing similar care to the extremely obese.
Clinicaltrials.gov NCT00850356.
Notes
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PubMed ID
20932316 View in PubMed
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Alexithymia and life satisfaction in primary healthcare patients.

https://arctichealth.org/en/permalink/ahliterature159882
Source
Psychosomatics. 2007 Nov-Dec;48(6):523-9
Publication Type
Article
Author
Aino K Mattila
Outi Poutanen
Anna-Maija Koivisto
Raimo K R Salokangas
Matti Joukamaa
Author Affiliation
Tampere School of Public Health, FIN-33014, Tampere, Finland. aino.mattila@uta.fi
Source
Psychosomatics. 2007 Nov-Dec;48(6):523-9
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Affective Symptoms - epidemiology - psychology
Comorbidity
Depressive Disorder - epidemiology - psychology
Female
Finland - epidemiology
Follow-Up Studies
Humans
Interview, Psychological
Male
Middle Aged
Odds Ratio
Patient Satisfaction - statistics & numerical data
Personal Satisfaction
Primary Health Care - utilization
Psychiatric Status Rating Scales
Risk factors
Self-Assessment
Sickness Impact Profile
Abstract
The relationship between life satisfaction and alexithymia was studied in a sample of 229 patients as a part of a naturalistic follow-up study of depression in Finnish primary health care. The measures were the abbreviated Life Satisfaction Scale and the 20-item Toronto Alexithymia Scale. Depression was assessed by telephone with the short form of the Composite International Diagnostic Interview. Of all subjects, 19.2% were alexithymic, and 9.2% were depressed. Alexithymia was negatively associated with life satisfaction even when depression and other confounding factors were controlled for. Alexithymia is a risk factor for life dissatisfaction in primary-care patients.
PubMed ID
18071100 View in PubMed
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All payer, single payer, managed care, no payer: patients' perspectives in three nations.

https://arctichealth.org/en/permalink/ahliterature213503
Source
Health Aff (Millwood). 1996;15(2):254-65
Publication Type
Article
Date
1996
Author
K. Donelan
R J Blendon
J. Benson
R. Leitman
H. Taylor
Author Affiliation
Department of Health Policy and Management, Harvard School of Public Health, Boston, USA.
Source
Health Aff (Millwood). 1996;15(2):254-65
Date
1996
Language
English
Publication Type
Article
Keywords
Adult
Canada
Cross-Sectional Studies
Data Collection
Delivery of Health Care - organization & administration
Fee-for-Service Plans
Female
Germany, West
Humans
Internationality
Male
Managed Care Programs
Middle Aged
National health programs - organization & administration
Patient Satisfaction - statistics & numerical data
Random Allocation
Single-Payer System
United States
Abstract
We present data on patients' experiences with access to and cost and quality of health services in the United States, Canada, and Germany. In general, patients report favorably about their care. U.S. respondents report more problems with access to care, even controlling for the severe problems of the uninsured. Differences in managed care versus fee-for-service plans in the United States mirror some of the problems observed in international comparisons--access to specialists and tests and waiting times for and quality of some services. Different cost containment strategies have measurable effects on patients' perspectives, particularly among patients who are sicker.
PubMed ID
8690382 View in PubMed
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An emergency department-based nurse discharge coordinator for elder patients: does it make a difference?

https://arctichealth.org/en/permalink/ahliterature177113
Source
Acad Emerg Med. 2004 Dec;11(12):1318-27
Publication Type
Article
Date
Dec-2004
Author
Alex Guttman
Marc Afilalo
Rivka Guttman
Antoinette Colacone
Chantal Robitaille
Eddy Lang
Stephen Rosenthal
Author Affiliation
Emergency Department, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, Quebec, Canada. alex.guttman@mcgill.ca
Source
Acad Emerg Med. 2004 Dec;11(12):1318-27
Date
Dec-2004
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Emergency Nursing - methods
Emergency Service, Hospital - organization & administration - statistics & numerical data
Follow-Up Studies
Health Services for the Aged - organization & administration
Hospitalization - statistics & numerical data
Humans
Outcome and Process Assessment (Health Care)
Patient Compliance - statistics & numerical data
Patient Discharge
Patient Satisfaction - statistics & numerical data
Prospective Studies
Quebec
Risk
Abstract
To evaluate the impact of an emergency department (ED)-based nurse discharge plan coordinator (NDPC) on unscheduled return visits within 14 days of discharge, satisfaction with discharge recommendations, adherence with discharge instructions, and perception of well-being of elder patients discharged from the ED.
Patients aged 75 years and older discharged from the ED of the Sir Mortimer B. Davis-Jewish General Hospital were recruited in a pre/post study. During the pre (control) phase, study patients (n = 905) received standard discharge care. Patients in the post (intervention) phase (n = 819) received the intervention of an ED-based NDPC. The intervention included patient education, coordination of appointments, patient education, telephone follow-up, and access to the NDPC for up to seven days following discharge.
Patients in the two groups were similar with respect to gender and age. However, the patients managed by the ED NDPC appeared to be, at baseline, less autonomous, frailer, and sicker. The unadjusted relative risk for unscheduled return visits within 14 days of discharge was 0.79 (95% confidence interval [95% CI] = 0.62 to 1.02). A relative risk reduction of 27% (95% CI = 0% to 44%) for unscheduled return visits was observed for up to eight days postdischarge, and a relative risk reduction of 19% (95% CI = -2% to 36%) for unscheduled return visits was observed for up to 14 days postdischarge. Significant increases in satisfaction with the clarity of discharge information and perceived well-being were also noted.
An ED-based NDPC, dedicated specifically to the discharge planning care of elder patients, reduces the proportion of unscheduled ED return visits and facilitates the transition from ED back home and into the community health care network.
Notes
Erratum In: Acad Emerg Med.2005 Jan;12(1):12
PubMed ID
15576523 View in PubMed
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