Journal of Patient Experience最新文献

This study aimed to characterize the cervical cancer diagnosis experience of Kenyan women undergoing treatment for cervical cancer. We analyzed qualitative interviews with 29 women living in rural Kenya who were currently undergoing cervical cancer treatment at Machakos Cancer Care and Research Centre at Machakos Level 5 Referral Hospital in eastern Kenya. Semistructured qualitative interviews were conducted in Kiswahili and English and then de-identified and translated to English during transcription. The main themes generated were identified through an inductive approach to determine how women experienced cervical cancer symptoms and their process of navigating healthcare. Three themes emerged from the qualitative interviews: (1) delaying seeking care, (2) misinterpreting or misdiagnoses, and (3) grappling with the costly diagnosis process. Women misattributed early signs of cervical cancer to benign conditions. Women sought care only after experiencing severe symptoms. When they sought care, women reported facing lengthy and costly screening processes before receiving a cervical cancer diagnosis. There is a need to educate women on the early symptoms of cervical cancer and to increase the institutional capacity and availability of cervical cancer screening resources in healthcare facilities.

In an online, survey-based experiment, musculoskeletal surgeon members of the science of variation group (n = 243) and a group of consult-liaison psychiatrists (n = 18) read 5 hypothetical scenarios of patients recovering from musculoskeletal trauma, each containing 5 randomized patient variables, and indicated their recommendation for psychiatry consultation or not. Factors associated with recommendation for psychiatry consultation included younger age, history of a psychiatric disorder, and pre-injury use of antipsychotic medications, and scenarios involving psychosis, suicidality, hallucinations in the setting of substance withdrawal, and questionable capacity for informed consent, but not with sadness alone. Musculoskeletal surgeons can collaborate with psychiatrists to develop comprehensive care for inpatients with musculoskeletal trauma starting with relatively pressing mental health needs and perhaps expanding into treatment of sadness or worry that can manifest as greater symptom intensity and a delayed recovery trajectory.

Completing self-administered patient experience surveys is challenging for many patients. We randomized adult patients receiving care from an urban safety net provider to complete the Consumer Assessment of Healthcare Providers and Systems (CAHPS^®) Clinician and Group Survey 3.1 (CG-CAHPS 3.1), or an "EZ" survey created using plain language principles. We compared response rates, item missingness, item-scale correlations, and reliability of patient experience scores based on 264 completed surveys (64% female, 66% Hispanic, 33% high school education or less). The CG-CAHPS 3.1 survey response rate was higher (20% vs 16%), and failure to follow skip instructions was more common for the EZ survey. Internal consistency reliability for multi-item scales was similar, but provider-level reliability was higher for the EZ than for the CG-CAHPS 3.1 survey measures. Cognitive interviews with patients are needed to assess whether the wording of the EZ survey is responsible for the lower response rates and more skip pattern errors. Future studies are also required to provide additional information about the psychometric properties of the CG-CAHPS 3.1 and EZ surveys.

Adaptive pacing (AP) is a self-management technique which seeks to balance energy and rest in individuals with chronic health conditions. Adaptive pacing can help people with myalgic encephalomyelitis/chronic fatigue syndrome learn how to manage their energy expenditure thereby reducing their risk of post-exertional malaise (PEM) and other symptoms. Given some symptom similarity, AP also has rehabilitation potential for people experiencing disability from long COVID. The purpose of this study was to explore patient experiences of an AP intervention (the "PaceMe" app) to determine its value for individuals experiencing long COVID. Twenty-five participants each took part in two narrative interviews (at intervention start point and at 3-6 months). Data were analyzed using narrative thematic analysis. Our analysis identified 4 themes relating to key benefits of the PaceMe app: (1) PEM management, (2) Support, (3) Validation, and (4) Control and Agency. By illuminating the critical facts and centring patient voices, these findings contribute a better understanding of the experiences and needs of those with long COVID and highlight the value of a digital health intervention as a vital component of rehabilitation.

Integrated and collaborative care models, in which mental/behavioral health providers work closely with primary care providers within a primary care setting, help support the quadruple aim of improved health outcomes, patient satisfaction, provider experience, and lower cost. In this paper, we describe patients' general perspectives of integrated care and their unique experiences accessing this care within one health system. Qualitative (interviews with patients) and quantitative (surveys with patients) methods were used to collect and analyze these results separately and together. The results highlight important features to the provision of integrated care from the perspective of patients using integrated care. They include the importance and experience of access, whole-person care and a team-based approach, the availability and use of telehealth when appropriate, having high quality mental health providers, scheduling and service usage suggestions, and means to connect with longer-term services for ongoing mental health care when needed.

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

While studies have evaluated the utility of telehealth in replacing in-person clinical encounters, there is a dearth of literature examining the quality of patient-physician communication with telehealth encounters. Accordingly, this study assessed the feasibility of using virtual cardiology clinical encounters to examine patient-physician interaction, communication, and perceptions of the clinical encounter. Telemedicine cardiology clinical encounters were audio- and video-recorded following the encounter, patients, and cardiologists completed an electronic survey to assess perceptions of the encounter. Qualitative analysis of the communication and statistical analysis of the survey data was conducted, providing descriptive data. The study included 11 patient-physician dyads; all patients were non-Hispanic White. Cardiologists were more racially and ethnically diverse (63% Asian). Most patients agreed telemedicine was comparable to in-person encounters (85.7%), with all cardiologists reporting that patients appeared satisfied with the encounter. We utilized an assessment tool to examine patient-physician communication in the recorded virtual encounters. This study suggests examining patient-physician communication using virtual clinical encounters is feasible, although there are barriers that need addressing for larger studies.

Customer satisfaction and enablement are key facets of healthcare quality. We examined their interplay within a large sample of predominantly working-age primary care patients. Our dataset encompasses 140 055 customer satisfaction reports, with concurrently gathered measures of patient enablement, delivered after doctor appointments. We used the customer satisfaction (CSAT) score and the patient enablement instrument (PEI). Additionally, we assessed 3 dimensions of customer satisfaction in conjunction with the CSAT score and calculated a sum score. Age and gender were included as covariates. Our findings from linear regression analyses are twofold: (1) customer satisfaction and enablement are interconnected, yet they maintain a degree of distinctiveness, as indicated by a beta coefficient of 0.45 on a 5-point scale, and (2) within the customer experience on a dichotomous scale, negative experiences exert a more substantial impact (betas between -0.77 and -0.97) on enablement than positive experiences (betas between 0.24 and 0.40). In addition, a dose-response relationship was observed between the sum of customer experiences and PEI. Ensuring that patients' voices are acknowledged, their queries are addressed, and they have comprehensible guidance regarding the progression of their treatment, are fundamental aspects of interactions with patients.

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

In Shared Traumatic Reality (STR), therapists and patients face similar threats, leading to increased stress and blurred personal-professional boundaries for healthcare providers. It impacts everyone in the community, as witnessed in the southern region of Israel. The challenge for caregivers aiding displaced individuals was unique-providing therapy while caring for their children. STR poses challenges but also growth opportunities. Experiencing trauma firsthand offers insights, fostering professional and personal development. Despite the difficulties of handling loss and traumatic stories, this reality demands new coping mechanisms for healthcare providers to grow through adversity. Community involvement aids professional empowerment amidst STR, reinforcing therapists' identification with patients. This new reality reveals remarkable resilience among those who endured tragedies, offering lessons in vicarious resilience. The concept of the wounded healer (WH) reflects how personal trauma can enhance therapeutic abilities by profoundly empathizing with patients' pain. Navigating personal hardships is crucial to avoid projecting onto patients during therapy. The WH's identification with patient trauma strengthens the therapeutic bond, leading to better outcomes.