Background: In the current period, competition among the healthcare sector has increased and healthcare providers try to get loyalty and satisfy the patients by establishing different strategies. Purpose: : This current study aims to discover ophthalmology practice-related factors and patient loyalty and to analyze the mediating role of patient satisfaction in private ophthalmology services in various private centers in the Kingdom of Saudi Arabia. Methods: : The nature of the study is quantitative, and data is collected with a questionnaire. We used a pre-tested questionnaire that was divided into different sections assessing ophthalmology practice-related factors, patient satisfaction, and patient loyalty. These were measured using a 5-point Likert scale, focusing on financial aspects, access to facilities, staff services, and ophthalmologist services. Further, the smartPLS technique was used to extract the results by using SmartPLS. Results: : The analysis sample size consisted of 323 participants from Saudi Arabia. The results found that ophthalmologist service has a positive relationship with patient satisfaction (β= 0.369, p = 0.000) as well as patient loyalty (β= 0.234, p = 0.004), but there are some ophthalmology practice-related factors such as financial aspects, access and facilities, and staff service, which showed no relationship with patient loyalty but a positive relationship with patient satisfaction. Further analysis found that patient satisfaction as a mediator has a positive relationship between ophthalmology practice-related factors, namely, ophthalmologist service (β= 0.228, P= 0.000), financial aspects (β= 0.102, p = 0.019), access and facilities (β= 0.109, p =0.000), and staff service (β= 0.188, p = 0.000) with patient loyalty. Conclusion: : The present study findings reveal the importance of focused patient satisfaction improvements in enhancing patient loyalty within ophthalmological clinic settings in Saudi Arabia. Furthermore, we recommend future exploratory prospective research to find the satisfaction and loyalty factors that change over a period of time.
{"title":"Ophthalmology Practice-Related Factors and Patient Loyalty: Mediating Role of Patient Satisfaction","authors":"Abdulmohsen Almulhim, Abdullah Fahad AlMulhim","doi":"10.2147/ppa.s461314","DOIUrl":"https://doi.org/10.2147/ppa.s461314","url":null,"abstract":"<strong>Background:</strong> In the current period, competition among the healthcare sector has increased and healthcare providers try to get loyalty and satisfy the patients by establishing different strategies.<br/><strong>Purpose:</strong> : This current study aims to discover ophthalmology practice-related factors and patient loyalty and to analyze the mediating role of patient satisfaction in private ophthalmology services in various private centers in the Kingdom of Saudi Arabia.<br/><strong>Methods:</strong> : The nature of the study is quantitative, and data is collected with a questionnaire. We used a pre-tested questionnaire that was divided into different sections assessing ophthalmology practice-related factors, patient satisfaction, and patient loyalty. These were measured using a 5-point Likert scale, focusing on financial aspects, access to facilities, staff services, and ophthalmologist services. Further, the smartPLS technique was used to extract the results by using SmartPLS.<br/><strong>Results:</strong> : The analysis sample size consisted of 323 participants from Saudi Arabia. The results found that ophthalmologist service has a positive relationship with patient satisfaction (<em>β</em>= 0.369, p = 0.000) as well as patient loyalty (<em>β</em>= 0.234, p = 0.004), but there are some ophthalmology practice-related factors such as financial aspects, access and facilities, and staff service, which showed no relationship with patient loyalty but a positive relationship with patient satisfaction. Further analysis found that patient satisfaction as a mediator has a positive relationship between ophthalmology practice-related factors, namely, ophthalmologist service (<em>β</em>= 0.228, P= 0.000), financial aspects (<em>β</em>= 0.102, p = 0.019), access and facilities (<em>β</em>= 0.109, p =0.000), and staff service (<em>β</em>= 0.188, p = 0.000) with patient loyalty.<br/><strong>Conclusion:</strong> : The present study findings reveal the importance of focused patient satisfaction improvements in enhancing patient loyalty within ophthalmological clinic settings in Saudi Arabia. Furthermore, we recommend future exploratory prospective research to find the satisfaction and loyalty factors that change over a period of time.<br/><br/>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"44 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141936145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-06eCollection Date: 2024-01-01DOI: 10.2147/PPA.S476738
Mustafa S Saeed, Gamal K Adam, Samah M Hussein, Nadiah AlHabardi, Ishag Adam
Purpose: The present study was conducted to determine the prevalence and factors associated with adherence to iron-folic acid supplementation (IFAS) among pregnant women in eastern Sudan.
Methods: A cross-sectional survey was conducted among pregnant women who obtained antenatal care (ANC) at Gadarif Maternal Hospital in eastern Sudan between May 1 and August 31, 2023. Face-to-face interview questionnaires were used to gather sociodemographic, obstetric, and clinical data (age, parity, education, residence, and previous medical diseases). Knowledge of anemia and IFAS was assessed. Multivariate analysis was performed to adjust for confounders.
Results: A total of 568 pregnant women were enrolled in the present study. Among them, 449 (79.0%) adhered to the IFAS. The multivariate analysis showed that the adjusted odds ratio (AOR) of IFAS adherence increased with ANC visits > 4 (AOR = 1.68, 95.0% CI = 1.01-2.77) and knowledge of anemia (AOR = 2.06, 95.0% CI = 1.437-3.276). In the univariate analysis, maternal occupation and knowledge of IFAS adherence were the only factors associated with IFAS adherence. Maternal age, parity, gestational age, education, residence, occupation, medical insurance, medical disease, and husband's occupation were not associated with IFAS. Forgetfulness (71.0%), frustration from taking many drugs (54.6%), and unpleasant tests of the supplement (50.7%) were the main reasons for not taking the IFAS.
Conclusion: About four out of five pregnant women adhered to the IFAS, indicating a good level of adherence, especially among women who attended more than four ANC visits and those with good knowledge of anemia. More attention is needed to encourage ANC to increase adherence to IFAS.
{"title":"Prevalence and Factors Associated with Adherence to Iron-Folic Acid Supplementation Among Pregnant Women in Eastern Sudan: A Cross-Sectional Study.","authors":"Mustafa S Saeed, Gamal K Adam, Samah M Hussein, Nadiah AlHabardi, Ishag Adam","doi":"10.2147/PPA.S476738","DOIUrl":"10.2147/PPA.S476738","url":null,"abstract":"<p><strong>Purpose: </strong>The present study was conducted to determine the prevalence and factors associated with adherence to iron-folic acid supplementation (IFAS) among pregnant women in eastern Sudan.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among pregnant women who obtained antenatal care (ANC) at Gadarif Maternal Hospital in eastern Sudan between May 1 and August 31, 2023. Face-to-face interview questionnaires were used to gather sociodemographic, obstetric, and clinical data (age, parity, education, residence, and previous medical diseases). Knowledge of anemia and IFAS was assessed. Multivariate analysis was performed to adjust for confounders.</p><p><strong>Results: </strong>A total of 568 pregnant women were enrolled in the present study. Among them, 449 (79.0%) adhered to the IFAS. The multivariate analysis showed that the adjusted odds ratio (AOR) of IFAS adherence increased with ANC visits > 4 (AOR = 1.68, 95.0% CI = 1.01-2.77) and knowledge of anemia (AOR = 2.06, 95.0% CI = 1.437-3.276). In the univariate analysis, maternal occupation and knowledge of IFAS adherence were the only factors associated with IFAS adherence. Maternal age, parity, gestational age, education, residence, occupation, medical insurance, medical disease, and husband's occupation were not associated with IFAS. Forgetfulness (71.0%), frustration from taking many drugs (54.6%), and unpleasant tests of the supplement (50.7%) were the main reasons for not taking the IFAS.</p><p><strong>Conclusion: </strong>About four out of five pregnant women adhered to the IFAS, indicating a good level of adherence, especially among women who attended more than four ANC visits and those with good knowledge of anemia. More attention is needed to encourage ANC to increase adherence to IFAS.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"18 ","pages":"1665-1674"},"PeriodicalIF":2.0,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-06eCollection Date: 2024-01-01DOI: 10.2147/PPA.S467724
Jeff Schein, Martin Cloutier, Marjolaine Gauthier-Loiselle, Maryaline Catillon, Yan Meng, Beatrice Libchaber, Fanny Jiang, Ann Childress
Background: Understanding patient preferences for treatments may facilitate shared decision-making. This study assessed adult patient preferences for attention-deficit/hyperactivity disorder (ADHD) treatments in a sample of 600 patients in the United States (US).
Methods: A web-based discrete choice experiment (DCE) survey was conducted among treated adults with ADHD. Participants were recruited from Dynata's US panel (06/22/2023-07/06/2023). Attributes and levels, identified based on clinical inputs and published data, included efficacy and safety. Participants' preferences were estimated using conditional logistic regression. Willingness to trade-off and attributes' relative importance were calculated. Overall preferences for treatment profiles approximating centanafadine, lisdexamfetamine, atomoxetine, and viloxazine were estimated using adjusted total utilities. Results were stratified by current treatment status. Sensitivity analyses including participants who passed validity tests were conducted.
Results: Among the 600 participants (mean age 37.9 years; 66.2% female; 50.8% treated), all attributes had a statistically significant impact on preferences for ADHD treatments (p < 0.001); the most important attribute was improvement in ADHD symptoms (36%), followed by risks of nausea (25%), insomnia (20%), anxiety (8%), dry mouth (6%), and feeling jittery (5%). Together, safety attributes accounted for >60% of relative importance in decision-making. Participants were willing to forgo 0.59, 0.57, 0.49, 0.32, and 0.17 percentage points of symptom improvement to achieve one-percentage-point reduced risk of insomnia, nausea, anxiety, feeling jittery, and dry mouth, respectively. Centanafadine profile had consistently higher adjusted total utilities than its comparators. Similar results were obtained in the subgroup and sensitivity analyses.
Conclusion: Efficacy was the most important attribute for patients when making treatment decision, but taken together, AEs had greater relative importance than efficacy alone. Accordingly, a profile resembling that of centanafadine would be preferred by an average patient compared to key competitors due to its favorable safety profile. These findings may help improve treatment decision-making, enhance treatment satisfaction, and foster adherence.
{"title":"Treatment Preferences of Adult Patients with Attention-Deficit/Hyperactivity Disorder - A Discrete Choice Experiment.","authors":"Jeff Schein, Martin Cloutier, Marjolaine Gauthier-Loiselle, Maryaline Catillon, Yan Meng, Beatrice Libchaber, Fanny Jiang, Ann Childress","doi":"10.2147/PPA.S467724","DOIUrl":"10.2147/PPA.S467724","url":null,"abstract":"<p><strong>Background: </strong>Understanding patient preferences for treatments may facilitate shared decision-making. This study assessed adult patient preferences for attention-deficit/hyperactivity disorder (ADHD) treatments in a sample of 600 patients in the United States (US).</p><p><strong>Methods: </strong>A web-based discrete choice experiment (DCE) survey was conducted among treated adults with ADHD. Participants were recruited from Dynata's US panel (06/22/2023-07/06/2023). Attributes and levels, identified based on clinical inputs and published data, included efficacy and safety. Participants' preferences were estimated using conditional logistic regression. Willingness to trade-off and attributes' relative importance were calculated. Overall preferences for treatment profiles approximating centanafadine, lisdexamfetamine, atomoxetine, and viloxazine were estimated using adjusted total utilities. Results were stratified by current treatment status. Sensitivity analyses including participants who passed validity tests were conducted.</p><p><strong>Results: </strong>Among the 600 participants (mean age 37.9 years; 66.2% female; 50.8% treated), all attributes had a statistically significant impact on preferences for ADHD treatments (p < 0.001); the most important attribute was improvement in ADHD symptoms (36%), followed by risks of nausea (25%), insomnia (20%), anxiety (8%), dry mouth (6%), and feeling jittery (5%). Together, safety attributes accounted for >60% of relative importance in decision-making. Participants were willing to forgo 0.59, 0.57, 0.49, 0.32, and 0.17 percentage points of symptom improvement to achieve one-percentage-point reduced risk of insomnia, nausea, anxiety, feeling jittery, and dry mouth, respectively. Centanafadine profile had consistently higher adjusted total utilities than its comparators. Similar results were obtained in the subgroup and sensitivity analyses.</p><p><strong>Conclusion: </strong>Efficacy was the most important attribute for patients when making treatment decision, but taken together, AEs had greater relative importance than efficacy alone. Accordingly, a profile resembling that of centanafadine would be preferred by an average patient compared to key competitors due to its favorable safety profile. These findings may help improve treatment decision-making, enhance treatment satisfaction, and foster adherence.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"18 ","pages":"1651-1664"},"PeriodicalIF":2.0,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-05eCollection Date: 2024-01-01DOI: 10.2147/PPA.S467587
Kirstin Kielhold, Erik D Storholm, Hannah E Reynolds, Wilson Vincent, Daniel E Siconolfi, Susan M Kegeles, Lance Pollack, Chadwick K Campbell
Background: Black sexual minority men (BSMM) in the Southern region of the United States experience a disproportionate burden of HIV. Research findings suggest that having supportive patient-provider relationships are critical for sustained HIV care engagement. The present study explores the role of supportive healthcare providers in the care engagement among BSMM living with HIV (BSMM+) in the US South.
Methods: Semi-structured qualitative interviews were conducted with BSMM+ in Texas (n=27) to explore perceived barriers and facilitators of sustained care engagement. Interviews lasted 60 minutes on average, were transcribed, coded, and analyzed using applied thematic analysis.
Findings: Participants described how important having relationships with engaged and supportive HIV care and service providers is to sustained engagement in care and positive HIV clinical outcomes. Supportive providers were characterized as non-judgmental, meeting patients' needs, and making patients feel "seen". Less supportive providers were described as making their patients "feel like a number" and having lack of follow through on proposed support and resources. Supportive providers were associated with increased care engagement of their patients while less supportive providers often led to patients switching providers, losing touch with services, and getting off track with their care.
Discussion: We found that among BSMM+ an important facilitator of sustained care engagement was having positive, affirming, and knowledgeable healthcare providers, while negative and dismissive experiences with providers was a notable barrier to care engagement. This work highlights the need for a scale up of comprehensive, ongoing trainings in patient-centered and person-first communication for providers. Further, manageable provider caseloads can facilitate more thorough patient interactions where tailored HIV care and education can be provided in a safe and non-judgmental environment.
背景：美国南部地区的黑人性少数群体男性（BSMM）承受着不成比例的艾滋病负担。研究结果表明，患者与医疗服务提供者之间的支持性关系对于持续参与 HIV 护理至关重要。本研究探讨了支持性医疗服务提供者在美国南部感染 HIV 的 BSMM+ 患者（BSMM+）参与护理过程中的作用：方法：对得克萨斯州的 BSMM+ 进行了半结构化定性访谈（n=27），以探讨持续参与护理过程中感知到的障碍和促进因素。访谈平均持续 60 分钟，采用应用主题分析法进行转录、编码和分析：参与者描述了与参与并提供支持的艾滋病护理和服务提供者建立关系对于持续参与护理和取得积极的艾滋病临床结果有多么重要。支持性服务提供者的特点是不做评判、满足患者需求并让患者感觉 "被看见"。而支持性较差的医疗服务提供者则会让病人 "感觉自己是个数字"，并且对病人提出的支持和资源建议缺乏跟进。支持性较强的医疗服务提供者会提高患者的护理参与度，而支持性较弱的医疗服务提供者往往会导致患者更换医疗服务提供者、与服务机构失去联系以及偏离护理轨道：我们发现，在 BSMM+ 中，拥有积极、肯定且知识渊博的医疗服务提供者是持续参与护理的重要促进因素，而与医疗服务提供者之间的负面和轻蔑经历则是参与护理的显著障碍。这项工作突出表明，有必要扩大对医疗服务提供者进行以患者为中心和以人为本的沟通方面的全面、持续培训的规模。此外，可控的医疗服务提供者工作量可以促进更全面的患者互动，从而在安全、无偏见的环境中提供量身定制的艾滋病护理和教育。
{"title":"\"I Don't Feel Judged, I Don't Feel Less of a Person\" - Engaged and Supportive Providers in the HIV Care Experiences of Black Sexual Minority Men Living with HIV.","authors":"Kirstin Kielhold, Erik D Storholm, Hannah E Reynolds, Wilson Vincent, Daniel E Siconolfi, Susan M Kegeles, Lance Pollack, Chadwick K Campbell","doi":"10.2147/PPA.S467587","DOIUrl":"10.2147/PPA.S467587","url":null,"abstract":"<p><strong>Background: </strong>Black sexual minority men (BSMM) in the Southern region of the United States experience a disproportionate burden of HIV. Research findings suggest that having supportive patient-provider relationships are critical for sustained HIV care engagement. The present study explores the role of supportive healthcare providers in the care engagement among BSMM living with HIV (BSMM+) in the US South.</p><p><strong>Methods: </strong>Semi-structured qualitative interviews were conducted with BSMM+ in Texas (n=27) to explore perceived barriers and facilitators of sustained care engagement. Interviews lasted 60 minutes on average, were transcribed, coded, and analyzed using applied thematic analysis.</p><p><strong>Findings: </strong>Participants described how important having relationships with engaged and supportive HIV care and service providers is to sustained engagement in care and positive HIV clinical outcomes. Supportive providers were characterized as non-judgmental, meeting patients' needs, and making patients feel \"seen\". Less supportive providers were described as making their patients \"feel like a number\" and having lack of follow through on proposed support and resources. Supportive providers were associated with increased care engagement of their patients while less supportive providers often led to patients switching providers, losing touch with services, and getting off track with their care.</p><p><strong>Discussion: </strong>We found that among BSMM+ an important facilitator of sustained care engagement was having positive, affirming, and knowledgeable healthcare providers, while negative and dismissive experiences with providers was a notable barrier to care engagement. This work highlights the need for a scale up of comprehensive, ongoing trainings in patient-centered and person-first communication for providers. Further, manageable provider caseloads can facilitate more thorough patient interactions where tailored HIV care and education can be provided in a safe and non-judgmental environment.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"18 ","pages":"1641-1650"},"PeriodicalIF":2.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11313489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-05eCollection Date: 2024-01-01DOI: 10.2147/PPA.S469579
Carlos De Las Cuevas, Omaira Benadero
Objective: This study aimed to elucidate the relationships among health locus of control, psychological reactance, attitudes toward psychiatric treatment, and patient decision-making preferences within a psychiatric outpatient population.
Methods: A total of 200 consecutive psychiatric outpatients from a community mental health center in Tenerife, Spain, were approached for participation between September 2023 and March 2024. Of these, 151 patients consented to participate in this cross-sectional study. Participants were selected based on their willingness to participate and were provided with informed consent forms. Data were collected using the Patient's Health Belief Questionnaire on Psychiatric Treatment (PHBQPT) and the Control Preferences Scale (CPS). The PHBQPT evaluates health beliefs impacting adherence to psychiatric treatment, while the CPS assesses the preferred level of involvement in medical decision-making. Sociodemographic data were also collected to contextualize the findings.
Results: Significant correlations were found between patients' control preferences and their attitudes towards medication, compliance with psychiatric advice, and perceptions of treatment control. A collaborative control preference was notably associated with positive attitudes toward medication and trust in the psychiatrist. These findings suggest that tailored treatment approaches prioritizing patient involvement could enhance adherence and outcomes.
Conclusion: The study underscores the importance of considering psychological constructs in psychiatric care to foster a holistic, patient-centered approach. Recognizing and integrating patients' control preferences, attitudes towards medication, and psychological reactance can improve the therapeutic relationship and treatment adherence. Future research should explore longitudinal and interventional studies to further understand the impact of aligning treatment approaches with patient preferences and psychological profiles.
{"title":"Exploring the Relationship Between Psychological Constructs and Decision-Making Preferences in Psychiatric Outpatients.","authors":"Carlos De Las Cuevas, Omaira Benadero","doi":"10.2147/PPA.S469579","DOIUrl":"10.2147/PPA.S469579","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to elucidate the relationships among health locus of control, psychological reactance, attitudes toward psychiatric treatment, and patient decision-making preferences within a psychiatric outpatient population.</p><p><strong>Methods: </strong>A total of 200 consecutive psychiatric outpatients from a community mental health center in Tenerife, Spain, were approached for participation between September 2023 and March 2024. Of these, 151 patients consented to participate in this cross-sectional study. Participants were selected based on their willingness to participate and were provided with informed consent forms. Data were collected using the Patient's Health Belief Questionnaire on Psychiatric Treatment (PHBQPT) and the Control Preferences Scale (CPS). The PHBQPT evaluates health beliefs impacting adherence to psychiatric treatment, while the CPS assesses the preferred level of involvement in medical decision-making. Sociodemographic data were also collected to contextualize the findings.</p><p><strong>Results: </strong>Significant correlations were found between patients' control preferences and their attitudes towards medication, compliance with psychiatric advice, and perceptions of treatment control. A collaborative control preference was notably associated with positive attitudes toward medication and trust in the psychiatrist. These findings suggest that tailored treatment approaches prioritizing patient involvement could enhance adherence and outcomes.</p><p><strong>Conclusion: </strong> The study underscores the importance of considering psychological constructs in psychiatric care to foster a holistic, patient-centered approach. Recognizing and integrating patients' control preferences, attitudes towards medication, and psychological reactance can improve the therapeutic relationship and treatment adherence. Future research should explore longitudinal and interventional studies to further understand the impact of aligning treatment approaches with patient preferences and psychological profiles.</p>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"18 ","pages":"1629-1640"},"PeriodicalIF":2.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11313499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: To investigate the influencing factors of self-management of diabetic retinopathy (DR) by constructing a structural equation model (SEM) to analyze the relationships among self-management behavior, perceived social support, and trait coping style as well as to determine the influencing path in order to provide a theoretical reference for exploring a multipath health management model that can be used to improve the quality of life of DR patients. Patients and Methods: A total of 388 patients with DR were enrolled in this cross-sectional study conducted from January 2020 to January 2023. All subjects completed a general questionnaire and were assessed by the Self-management Scale for Patients with Diabetic Retinopathy, the Perceived Social Support Scale, and the Trait Coping Style Scale. Structural equation modeling was employed to examine the relationship between self-management and its influencing factors. The bootstrap method was used to examine the path relationships among self-management, perceived social support, and trait coping styles in DR patients. Results: A total of 346 valid questionnaires were collected in this study, with a response rate of 89% (346/388). The average score of self-management of DR patients was 69.50± 18.32, and it was significantly positively correlated with perceived social support and positive coping (r=0.624, r=0.578, both P< 0.01). The total effect of perceived social support on DR self-management was 1.439, with a direct effect of 1.056 and an indirect effect of 0.384. Positive coping played a mediating role in perceived social support and self-management. Conclusion: The self-management of DR was at an intermediate level. Perceived social support and trait coping styles were important influencing factors for self-management behavior in DR patients. Therefore, improving perceived social support and trait coping styles can promote the self-management behavior of DR patients, reduce their psychological burden, and improve their compliance and quality of life.
Keywords: diabetic retinopathy, self-management, social support, coping style, structural equation model
目的：通过构建结构方程模型（SEM），分析糖尿病视网膜病变（DR）患者自我管理行为、感知社会支持和特质应对方式之间的关系，并确定影响路径，探讨糖尿病视网膜病变（DR）患者自我管理的影响因素，为探索可用于提高DR患者生活质量的多路径健康管理模式提供理论参考：这项横断面研究于 2020 年 1 月至 2023 年 1 月进行，共招募了 388 名 DR 患者。所有受试者都填写了一份普通问卷，并接受了糖尿病视网膜病变患者自我管理量表、感知社会支持量表和特质应对方式量表的评估。采用结构方程模型研究自我管理与其影响因素之间的关系。采用引导法检验 DR 患者自我管理、感知社会支持和特质应对方式之间的路径关系：本研究共收集了 346 份有效问卷，回收率为 89%（346/388）。DR患者自我管理的平均得分（69.50±18.32）分，与感知到的社会支持和积极应对呈显著正相关（r=0.624，r=0.578，P<均为0.01）。感知到的社会支持对 DR 自我管理的总效应为 1.439，其中直接效应为 1.056，间接效应为 0.384。积极应对在感知到的社会支持和自我管理中起到了中介作用：结论：DR 的自我管理处于中等水平。感知到的社会支持和特质应对方式是 DR 患者自我管理行为的重要影响因素。因此，改善感知社会支持和特质应对方式可促进 DR 患者的自我管理行为，减轻其心理负担，提高其依从性和生活质量。
{"title":"Influential Factors for Self-Management Among Patients with Diabetic Retinopathy: A Structural Equation Model Analysis","authors":"Rina Sa, Jingjing Zhang, Haiyang Xu","doi":"10.2147/ppa.s456947","DOIUrl":"https://doi.org/10.2147/ppa.s456947","url":null,"abstract":"<strong>Purpose:</strong> To investigate the influencing factors of self-management of diabetic retinopathy (DR) by constructing a structural equation model (SEM) to analyze the relationships among self-management behavior, perceived social support, and trait coping style as well as to determine the influencing path in order to provide a theoretical reference for exploring a multipath health management model that can be used to improve the quality of life of DR patients.<br/><strong>Patients and Methods:</strong> A total of 388 patients with DR were enrolled in this cross-sectional study conducted from January 2020 to January 2023. All subjects completed a general questionnaire and were assessed by the Self-management Scale for Patients with Diabetic Retinopathy, the Perceived Social Support Scale, and the Trait Coping Style Scale. Structural equation modeling was employed to examine the relationship between self-management and its influencing factors. The bootstrap method was used to examine the path relationships among self-management, perceived social support, and trait coping styles in DR patients.<br/><strong>Results:</strong> A total of 346 valid questionnaires were collected in this study, with a response rate of 89% (346/388). The average score of self-management of DR patients was 69.50± 18.32, and it was significantly positively correlated with perceived social support and positive coping (r=0.624, r=0.578, both <em>P</em>< 0.01). The total effect of perceived social support on DR self-management was 1.439, with a direct effect of 1.056 and an indirect effect of 0.384. Positive coping played a mediating role in perceived social support and self-management.<br/><strong>Conclusion:</strong> The self-management of DR was at an intermediate level. Perceived social support and trait coping styles were important influencing factors for self-management behavior in DR patients. Therefore, improving perceived social support and trait coping styles can promote the self-management behavior of DR patients, reduce their psychological burden, and improve their compliance and quality of life.<br/><br/><strong>Keywords:</strong> diabetic retinopathy, self-management, social support, coping style, structural equation model<br/>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"215 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141881613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tazeen H Jafar, Ngiap Chuan Tan, Rupesh M Shirore, Chandrika Ramakrishnan, Sungwon Yoon, Christina Chen, Amudha Aravindhan
Background: Hypertension is a major public health challenge, globally. Recently, we reported findings from cluster randomized trial in 8 primary care clinics in Singapore and showed that a multicomponent “SingHypertension” intervention comprising 1) motivational conversation by trained nurses, 2) telephone-based follow-ups, 3) standardized algorithm with single-pill combination (SPC) antihypertensive medications, and 4) subsidy on SPC antihypertensive drugs was effective on improving BP control. This paper presents the acceptability of SingHypertension multicomponent intervention among the key stakeholders. Methods: We conducted post-implementation interviews of 38 stakeholders, including 18 patients and 20 healthcare providers (HCPs) in 4 primary care clinics randomized to the multicomponent “SingHypertension” intervention in Singapore. We used Theoretical Framework for Acceptability (TFA) framework with a focus on affective attitude, burden, ethicality, intervention coherence, opportunity cost, perceived effectiveness and self-efficacy to assess stakeholders’ acceptability of the intervention. Results: SingHypertension multicomponent intervention had high perceived effectiveness and a good fit with the value system and ethics of patients and HCPs. Physicians appreciated the guidance from standardized training in hypertension management. Although workload was increased, the nurses felt rewarded for their positive interactions with the patients during motivational conversation sessions and the telephone follow-ups. Most patients reported high self-efficacy levels, improved lifestyles, and adherence to antihypertensive medications. The limited choice of SPC medication, lack of subsidy beyond the trial duration, and shortage of nurses were significant challenges to wide-scale implementation. All HCPs and patients supported scaling up the intervention across primary care clinics. Conclusion: SingHypertension multicomponent intervention is acceptable to the key stakeholders in Singapore. Taken together with the effectiveness of the intervention, our findings make a compelling case for scaling-up SingHypertension in primary care clinics in Singapore and possibly other countries with similar healthcare infrastructure.
{"title":"Post-Intervention Acceptability of a Multicomponent Intervention for Hypertension Management in Primary Care Clinics by Health Care Providers and Patients: A Qualitative Study of a Cluster RCT in Singapore","authors":"Tazeen H Jafar, Ngiap Chuan Tan, Rupesh M Shirore, Chandrika Ramakrishnan, Sungwon Yoon, Christina Chen, Amudha Aravindhan","doi":"10.2147/ppa.s469855","DOIUrl":"https://doi.org/10.2147/ppa.s469855","url":null,"abstract":"<strong>Background:</strong> Hypertension is a major public health challenge, globally. Recently, we reported findings from cluster randomized trial in 8 primary care clinics in Singapore and showed that a multicomponent “SingHypertension” intervention comprising 1) motivational conversation by trained nurses, 2) telephone-based follow-ups, 3) standardized algorithm with single-pill combination (SPC) antihypertensive medications, and 4) subsidy on SPC antihypertensive drugs was effective on improving BP control. This paper presents the acceptability of SingHypertension multicomponent intervention among the key stakeholders.<br/><strong>Methods:</strong> We conducted post-implementation interviews of 38 stakeholders, including 18 patients and 20 healthcare providers (HCPs) in 4 primary care clinics randomized to the multicomponent “SingHypertension” intervention in Singapore. We used Theoretical Framework for Acceptability (TFA) framework with a focus on affective attitude, burden, ethicality, intervention coherence, opportunity cost, perceived effectiveness and self-efficacy to assess stakeholders’ acceptability of the intervention.<br/><strong>Results:</strong> SingHypertension multicomponent intervention had high perceived effectiveness and a good fit with the value system and ethics of patients and HCPs. Physicians appreciated the guidance from standardized training in hypertension management. Although workload was increased, the nurses felt rewarded for their positive interactions with the patients during motivational conversation sessions and the telephone follow-ups. Most patients reported high self-efficacy levels, improved lifestyles, and adherence to antihypertensive medications. The limited choice of SPC medication, lack of subsidy beyond the trial duration, and shortage of nurses were significant challenges to wide-scale implementation. All HCPs and patients supported scaling up the intervention across primary care clinics.<br/><strong>Conclusion:</strong> SingHypertension multicomponent intervention is acceptable to the key stakeholders in Singapore. Taken together with the effectiveness of the intervention, our findings make a compelling case for scaling-up SingHypertension in primary care clinics in Singapore and possibly other countries with similar healthcare infrastructure.<br/><br/>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"24 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141870293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Holly Mansell, Nicola Rosaasen, Jenny Wichart, Patricia West-Thielke, David Blackburn, Juxin Liu, Rahul Mainra, Ahmed Shoker, Brianna Groot, Kevin Wen, Anita Wong, Bita Bateni, Cindy Luo, Paraag Trivedi
Abstract: Sub-optimal adherence to immunosuppressant medications reduces graft survival for kidney transplant recipients and adherence-enhancing interventions are resource and time intensive. We performed a multi-center randomized controlled trial to investigate the impact of an electronically delivered intervention on adherence. Of 203 adult kidney transplant recipients who received a de novo kidney transplant n = 173 agreed to participate (intent-to-treat population) and were randomized to the intervention (video education plus behavior contract n = 91) or the control (standard education, n = 82). No significant differences were found between the groups for medication adherence measured by the Basel Assessment of Adherence to Immunosuppressive Medications Scale, intrapatient variability in tacrolimus levels, time in therapeutic range for any immunosuppressant, knowledge, self-efficacy, QOL, or hospitalizations. Among a subgroup of 64 participants randomized to the intervention group who completed a post-intervention questionnaire, two-thirds (67%, n = 43) reported watching at least 80% of the videos and 58% (n = 37) completed the electronic goal setting exercise and adherence contract. An autonomous goal setting exercise and electronic behavioural contract added to standard of care did not improve any outcomes. Our findings reiterate that nonadherence in transplantation is a difficult multifactorial problem that simple solutions will not solve. Trial registration number NCT03540121.
Keywords: kidney transplant, solid organ transplant, medication adherence, immunosuppression
{"title":"Video Education and Behavior Contract to Improve Outcomes After Renal Transplantation (VECTOR): A Randomized Controlled Trial","authors":"Holly Mansell, Nicola Rosaasen, Jenny Wichart, Patricia West-Thielke, David Blackburn, Juxin Liu, Rahul Mainra, Ahmed Shoker, Brianna Groot, Kevin Wen, Anita Wong, Bita Bateni, Cindy Luo, Paraag Trivedi","doi":"10.2147/ppa.s467142","DOIUrl":"https://doi.org/10.2147/ppa.s467142","url":null,"abstract":"<strong>Abstract:</strong> Sub-optimal adherence to immunosuppressant medications reduces graft survival for kidney transplant recipients and adherence-enhancing interventions are resource and time intensive. We performed a multi-center randomized controlled trial to investigate the impact of an electronically delivered intervention on adherence. Of 203 adult kidney transplant recipients who received a de novo kidney transplant n = 173 agreed to participate (intent-to-treat population) and were randomized to the intervention (video education plus behavior contract n = 91) or the control (standard education, n = 82). No significant differences were found between the groups for medication adherence measured by the Basel Assessment of Adherence to Immunosuppressive Medications Scale, intrapatient variability in tacrolimus levels, time in therapeutic range for any immunosuppressant, knowledge, self-efficacy, QOL, or hospitalizations. Among a subgroup of 64 participants randomized to the intervention group who completed a post-intervention questionnaire, two-thirds (67%, n = 43) reported watching at least 80% of the videos and 58% (n = 37) completed the electronic goal setting exercise and adherence contract. An autonomous goal setting exercise and electronic behavioural contract added to standard of care did not improve any outcomes. Our findings reiterate that nonadherence in transplantation is a difficult multifactorial problem that simple solutions will not solve. Trial registration number NCT03540121.<br/><br/><strong>Keywords:</strong> kidney transplant, solid organ transplant, medication adherence, immunosuppression<br/>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"67 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141870295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Several treatment options are available for anemia associated with chronic kidney disease (CKD); however, there remains a lack of awareness of physician and patient preferences regarding these treatments. We aimed to explore physicians’ and patients’ perceptions and preferences regarding the management of anemia of CKD in Japan. Methods: A web-based survey, including best-worst scaling (BWS), was conducted with physicians who had treated ≥ 1 patient with anemia of CKD in the preceding year, and with patients with CKD who self-reported a clinical diagnosis of anemia of CKD or low hemoglobin levels. A three-step approach was used comprising cognitive interviews, a pilot survey, and a main survey. The BWS survey results were analyzed using multinomial logit and hierarchical Bayesian models. Results: The survey was completed by 906 participants: 103 patients (average age 60.6 years; 77.7% male) and 803 physicians (166 nephrologists, 214 cardiologists, 137 diabetologists, and 286 general internists). Almost all (96.0%) physicians surveyed considered anemia of CKD to be an important condition to treat. Hypoxia-inducible factor prolyl hydroxylase (HIF-PH) inhibitors had the highest treatment satisfaction among physicians, whereas patients had the highest satisfaction with both erythropoietin-stimulating agent therapy and HIF-PH inhibitors. Approximately one-third (35.9%) of patients surveyed indicated that they were receiving treatment. When comparing the relative importance of attributes and levels, physicians favored efficacy (particularly improvement in hemoglobin levels), whereas patients favored safety (particularly a lower rate of severe adverse events). Conclusion: Although a majority of physicians consider treatment of CKD-related anemia important, differences in the perceptions and usage of medications exist between medical specialties. Preferences for the management of anemia of CKD vary between physicians and patients; therefore, patient involvement in treatment decisions may help optimize outcomes.
{"title":"Physician and Patient Preferences for Treatment of Anemia Associated with Chronic Kidney Disease in Japan: A Survey Including Best-Worst Scaling","authors":"Sari Mishina, Yuichiro Ito, Takumi Lee, Toshiaki Murofushi, Yoshiyuki Uetake, Tadao Akizawa","doi":"10.2147/ppa.s450464","DOIUrl":"https://doi.org/10.2147/ppa.s450464","url":null,"abstract":"<strong>Background:</strong> Several treatment options are available for anemia associated with chronic kidney disease (CKD); however, there remains a lack of awareness of physician and patient preferences regarding these treatments. We aimed to explore physicians’ and patients’ perceptions and preferences regarding the management of anemia of CKD in Japan.<br/><strong>Methods:</strong> A web-based survey, including best-worst scaling (BWS), was conducted with physicians who had treated ≥ 1 patient with anemia of CKD in the preceding year, and with patients with CKD who self-reported a clinical diagnosis of anemia of CKD or low hemoglobin levels. A three-step approach was used comprising cognitive interviews, a pilot survey, and a main survey. The BWS survey results were analyzed using multinomial logit and hierarchical Bayesian models.<br/><strong>Results:</strong> The survey was completed by 906 participants: 103 patients (average age 60.6 years; 77.7% male) and 803 physicians (166 nephrologists, 214 cardiologists, 137 diabetologists, and 286 general internists). Almost all (96.0%) physicians surveyed considered anemia of CKD to be an important condition to treat. Hypoxia-inducible factor prolyl hydroxylase (HIF-PH) inhibitors had the highest treatment satisfaction among physicians, whereas patients had the highest satisfaction with both erythropoietin-stimulating agent therapy and HIF-PH inhibitors. Approximately one-third (35.9%) of patients surveyed indicated that they were receiving treatment. When comparing the relative importance of attributes and levels, physicians favored efficacy (particularly improvement in hemoglobin levels), whereas patients favored safety (particularly a lower rate of severe adverse events).<br/><strong>Conclusion:</strong> Although a majority of physicians consider treatment of CKD-related anemia important, differences in the perceptions and usage of medications exist between medical specialties. Preferences for the management of anemia of CKD vary between physicians and patients; therefore, patient involvement in treatment decisions may help optimize outcomes.<br/><br/>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"16 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141870299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jan Endrikat, Gilda Schmidt, Bhagyashree Oak, Viplav Shukla, Prakirti Nangia, Nicolas Schleyer, John Crocker, Ruud Pijnapppel
Purpose: Women with high breast density (HBD) carry an increased risk for breast cancer (BC). The aim of the study was to provide data on awareness and knowledge gaps among women with vs w/o HBD about BC risk factors (BCRFs), which is the basis for effective communication about screening. Patients and Methods: This was a web-based survey of 3000 women aged ≥ 30 and ≤ 70 from six countries. It comprised of 45 questions. T-tests and chi-square tests with False Discovery Rate adjustments were conducted as applicable, with significant differences reported at α=0.05. Results: Three-thousand women were included in the analysis, 733 (24.4%) had HBD. Overall, 39% of women were familiar with the concept of HBD in the context of BC. Thirty-one percent of women were aware of HBD as BCRF and for 24% of women HBD was personally applicable. A significantly higher proportion of women with HBD were aware of almost all BCRFs compared to women w/o HBD (p ≤ 0.05). Similarly, a significantly higher proportion of women with HBD have undergone screening procedures compared to women w/o HBD (p ≤ 0.05). Women with HBD were significantly better aware of basic facts about BC (p ≤ 0.05). A total of 1617 women underwent mammography, 904 ultrasound and 150 MRI during their last screening. The most relevant source of information about BC was the health care professional, as reported by 63% of women. Conclusion: Overall 39% of women were familiar with HBD as BCRF. Lack of BCRF awareness may contribute to delayed screenings, missed opportunities for early detection, and potentially poorer outcomes for individuals with dense breast tissue. Thus, this information should be communicated more widely.
Keywords: breast cancer risk factors, dense breast, screening, imaging modalities, sources of information
{"title":"Awareness of Breast Cancer Risk Factors in Women with vs. Without High Breast Density","authors":"Jan Endrikat, Gilda Schmidt, Bhagyashree Oak, Viplav Shukla, Prakirti Nangia, Nicolas Schleyer, John Crocker, Ruud Pijnapppel","doi":"10.2147/ppa.s466992","DOIUrl":"https://doi.org/10.2147/ppa.s466992","url":null,"abstract":"<strong>Purpose:</strong> Women with high breast density (HBD) carry an increased risk for breast cancer (BC). The aim of the study was to provide data on awareness and knowledge gaps among women with vs w/o HBD about BC risk factors (BCRFs), which is the basis for effective communication about screening.<br/><strong>Patients and Methods:</strong> This was a web-based survey of 3000 women aged ≥ 30 and ≤ 70 from six countries. It comprised of 45 questions. <em>T</em>-tests and chi-square tests with False Discovery Rate adjustments were conducted as applicable, with significant differences reported at α=0.05.<br/><strong>Results:</strong> Three-thousand women were included in the analysis, 733 (24.4%) had HBD. Overall, 39% of women were familiar with the concept of HBD in the context of BC. Thirty-one percent of women were aware of HBD as BCRF and for 24% of women HBD was personally applicable. A significantly higher proportion of women with HBD were aware of almost all BCRFs compared to women w/o HBD (p ≤ 0.05). Similarly, a significantly higher proportion of women with HBD have undergone screening procedures compared to women w/o HBD (p ≤ 0.05). Women with HBD were significantly better aware of basic facts about BC (p ≤ 0.05). A total of 1617 women underwent mammography, 904 ultrasound and 150 MRI during their last screening. The most relevant source of information about BC was the health care professional, as reported by 63% of women.<br/><strong>Conclusion:</strong> Overall 39% of women were familiar with HBD as BCRF. Lack of BCRF awareness may contribute to delayed screenings, missed opportunities for early detection, and potentially poorer outcomes for individuals with dense breast tissue. Thus, this information should be communicated more widely.<br/><br/><strong>Keywords:</strong> breast cancer risk factors, dense breast, screening, imaging modalities, sources of information<br/>","PeriodicalId":19972,"journal":{"name":"Patient preference and adherence","volume":"213 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141870314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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