Journal of Patient Experience最新文献

Among 173 patients seeking musculoskeletal specialty care, we sought patient personal factors associated with patient experiences measured using the 7-item Trust and Experience with Clinicians Scale (TRECS-7) and Jefferson Scale of Patient's Perceptions of Physician Empathy (JSPPPE). Accounting for potential confounders, including demographics, visit-related information, mental health, and social health, we found no factors associated with TRECS-7, and only self-reported Hispanic/Latino ethnicity was associated with lower JSPPPE (regression coefficient = -2.8, 95% confidence interval = -4.9 to -0.63). In posthoc cluster analysis, statistical groupings of patients with generally worse mean social health and mental health were associated with worse patient experience (TRECS-7 and JSPPPE). The combination of an experience measure with lower ceiling effects and wider distribution of scores and cluster analysis may improve the ability to measure associations with patient personal factors.

The importance of effective doctor-patient communication is well established; however, rigorous evaluations of its association with patient-reported outcomes among seriously ill patients are needed. We analyzed 2 waves of survey data from adults with serious illnesses in primary care clinics. We administered the Consumer Assessment of Healthcare Providers and Systems (CAHPS^®) communication scale, Patient-Reported Outcomes Measurement and Information System (PROMIS^®) global health items, and the PROMIS-29 depression and anxiety scales. We evaluated a structural equation model to assess relationships between patient experience and self-reported global physical and mental health in 779 patients at baseline and 12 months later. Average age was 69, with 52% male, 18% Hispanic, 9% Asian, and 7% Black; 24% had a high school education or less. Better global health (PROMIS) at baseline was associated with better doctor-patient communication (CAHPS) at 12 months (β = 0.09, P = .005), and better doctor-patient communication at baseline was related to better mental health at follow-up (β = 0.07, P = .0105). The results suggest that patients' overall health may influence doctor-patient communication, and this communication may impact patients' mental health over time.

Nontuberculous mycobacterial lung disease (NTM-LD) is a chronic infection with increasing global incidence, which primarily affects individuals with preexisting lung conditions such as bronchiectasis and chronic obstructive pulmonary disease. Despite the availability of clinical guidelines and newly published Standards of Care, variability in healthcare professionals' (HCPs) familiarity with NTM-LD results in delayed diagnoses, inconsistent care, and suboptimal patient outcomes. Based on our own experiences as NTM-LD patients, we highlight key issues in the management of NTM-LD, including diagnostic inefficiencies, variable access to specialized care, mixed experience of empathy, and insufficient information provision. We provide recommendations that we hope will optimize the patient journey and improve outcomes for individuals with NTM-LD. These include improving HCP education, ensuring the involvement of a multidisciplinary team from the point of diagnosis, enhancing patient participation in decision-making, and promoting access to support networks. The challenges and solutions we propose are globally relevant and highlight the need for clear communication and integrated care pathways. A collaborative, patient-centered approach is crucial to effectively managing this complex disease in both primary and secondary care settings.

Trust in physicians is an important factor influencing patient engagement and health outcomes. While prior studies have explored the role of trust in cancer patients, there is limited research assessing trust in physicians regarding cancer-related information, including prevention, among the general population. This study aims to assess the impact of negative healthcare experiences, including poor provider communication and discrimination, on physician trust in cancer-related advice. This study utilized the Health Information National Trends Survey 6, a nationally representative survey. Binary logistic regression was performed to identify associations between covariates and trust in physicians' cancer information. Patients reporting dissatisfaction across all 7 patient-communication categories exhibited the lowest rates of trust among all covariates (aOR: 0.34, CI [0.28-0.42]). Respondents who experienced racial or ethnic discrimination in healthcare were less likely to express high trust (aOR: 0.65, CI [0.50-0.84]). Racial disparities were also identified, with non-Whites and Hispanics reporting lower levels of trust. This study highlights the significant association of negative healthcare interactions on trust in physicians' cancer-related advice and underscores the need for improved patient-centered communication.

The COVID pandemic disrupted healthcare systems worldwide, affecting medical care delivery, including transplant centers. As sites of tertiary healthcare delivery, living kidney donations were particularly impacted, with delays, communication challenges, and an increased burden on potential donors. This qualitative study explored the lived experiences of individuals navigating the predonation evaluation (PDE) during the pandemic. Through 25 semistructured interviews, the participants shared insights into delays in care, inconsistent communication, pandemic-related emotions, and unexpected facilitators. The constant comparative analysis method identified key themes, including (1) delays in care due to COVID, (2) inconsistent communication due to COVID, (3) pandemic-related emotions, and (4) pandemic-era shifts that facilitated living kidney donor (LKD) PDE. The data highlighted the importance of maintaining patient-centered care, effective communication and pointed to specific ways to improve the patient's experience. These themes highlight mitigating strategies to address future care for other types of LKD disruptions.

Person-centered care focuses on the needs of the individual receiving care, and involves cooperation between patients and health professionals to develop and monitor care. This research demonstrates that online patient reviews provide a rich, real-time, and detailed source of patient experience that can be used for this purpose. This study also shows that unstructured online data can be quantified using machine learning and natural language processing to automatically flag and rate patient reviews. We describe a supervised learning approach, training a model on a large dataset of manually annotated patient reviews. We report model scores of 99% accuracy in predicting overall score, and 93% to 99% in predicting relevance to seven domains of patient experience, such as Effective Treatment, Fast Access, and Emotional Support. Furthermore, we show statistically significant alignment between these aggregated online patient reviews and HCAHPS star ratings-a "gold-standard" measure of care quality for hospitals in the United States. This approach enables benchmarking between health systems and evaluating the impact of interventions on patient experience, while quantifying and enhancing the patient-centeredness of care.

Telemedicine is a growing treatment modality for opioid use disorder and can offer greater privacy, flexibility, and agency to patients who have experienced stigmatizing behavior in other treatment settings. Designing a welcoming and respectful virtual environment is one mechanism for creating a patient-centered experience, yet to date, patient preferences for telemedicine treatment for opioid use disorder have not been evaluated. We conducted a cross-sectional study to assess patient perspectives on Zoom backgrounds and provider attire among individuals receiving telemedicine treatment for opioid use disorder at a multi-state practice. A total of 601 patients participated in the study, of whom 60.4% were female and the average age was 41.4 years. Nearly 60% of respondents preferred real backgrounds during virtual visits. The majority of respondents did not have a preference for provider attire with the remaining respondents preferring casual attire to business casual or formal attire. Overall, we found that individuals with opioid use disorder prefer authenticity in backgrounds and personalized attire to establish trust and open communication in telemedicine.

People with advanced chronic obstructive pulmonary disease (COPD) experience a high physical burden which limits their activities and leads to social isolation, loneliness, and burdening social networks, with informal caregivers playing a crucial role in managing their condition. This study explored the views of people with COPD on informal caregiving, highlighting lifestyle adjustments and caregiver-patient dynamics. A qualitative study using semistructured interviews was conducted with 22 participants with advanced COPD recruited from palliative care services. Three themes emerged: patient autonomy, adapting to life under medical constraints and caregiver's understanding of patients' needs. Health deterioration caused patient dependency on caregivers, along with feelings of burden, frustration, and distress. Good information provision and education improve caregiver involvement and patients' self-management. Participants without informed caregiver support struggled with anxiety and disease management. Caregiver-patient relationship quality impacted the caregiver's involvement. In conclusion, patient dependency in advanced COPD leads to frustration and distress, highlighting the need for caregiver education and support. Effective information provision and early involvement of caregivers is essential to improving care quality, reducing distress, and supporting holistic palliative care.

Nonurgent emergency department (ED) visits continue to rise despite efforts to reduce ED overcrowding. This study aimed to explore factors influencing ED utilization and perceptions of alternative healthcare services among patients of nonurgent ED visits. Conducted at an academic, level-1 trauma center, the study identified nonurgent visits using the emergency severity index 5-level triage acuity scale and utilized a 3-part qualitative survey to gather data on demographics, reasons for ED visits, and perceptions of the ED, primary care physicians (PCPs), and urgent care centers (UCCs). Survey responses from 586 patients were analyzed, demonstrating common themes such as ED accessibility, physician qualifications, and the need for diagnostic testing. Although participants generally expressed satisfaction with PCPs and UCCs, the frequency of nonurgent ED visits remained high. The study suggests that many nonurgent cases could have been managed using alternative healthcare services; additionally, the findings align with existing literature and support the need for enhanced patient education on appropriate ED use and the benefits of utilizing alternative healthcare options.

Telemedicine has rapidly evolved as an essential element of healthcare delivery in Saudi Arabia. This study explored a current perspective on the extent of utilization and level of beneficiaries' satisfaction with telemedicine services in Saudi Arabia. A descriptive cross-sectional study was conducted in Saudi Arabia from January 2022 to June 2023. It used secondary data on telemedicine services extracted from 937-Medical call center and immediate virtual consultations (IVCs) via the Sehhaty health application, including offered, answered, abandoned, and non-assigned consultations; average talk time (ATT); and average waiting time or speed of answer (ASA). There were 7,481,259 offered calls to 937-Medical call center during the study period. The ASA was 13.2 ± 3.0 s, and the ATT was 2.04 ± 0.31 min. Around 97% of the offered calls were handled in the first half of 2023 with a shorter ASA of 10.5 ± 0.6 s. Most beneficiaries (94.9%) were satisfied with the 937-Medical call center. There were 712,984 offered IVCs during the study period. The ASA was 3.41 ± 1.07 min, and the ATT was 7.3 ± 0.7 min. Most beneficiaries (77.7%) were satisfied with the IVCs. This study provided an updated overview on the use of telemedicine services and beneficiaries' satisfaction via 937-Medical call center and Sehhaty health application in Saudi Arabia between January 2022 and June 2023. 937-Medical call center service could handle about 96% of its received calls. Notably, most health seekers were satisfied with the healthcare services provided via the 937-Medical call center and Sehhaty health application.