Journal of Patient Experience最新文献

This project aims to assess the early impact of value-based healthcare (VBHC) implementation in a Bulgarian cancer center, focusing on lung cancer treatment, and to improve care coordination, expand capacity, and introduce outcome measurement through integrated practice units (IPUs), optimized pathways, and patient-reported outcome measures (PROMs). The approach included (i) 90 h of direct observation, (ii) structured stakeholder interviews, and (iii) time-driven activity-based costing (TDABC) to map resource use. Process maps guided workflow redesign. PROM implementation, based on the International Consortium for Health Outcomes Measurement lung cancer set, involved staff training and licensing. One year post-implementation, day hospital capacity doubled (50-100 patients/day). An external call center reduced physicians' administrative load. Interdisciplinary meetings and optimized referrals enhanced communication. PROMs now cover part of the lung cancer cohort. TDABC revealed opportunities for staff reallocation and streamlined diagnostics. Early results suggest VBHC is feasible in Eastern Europe, with measurable gains in efficiency. Future steps include PROM digitization, telemedicine expansion, and adapting the IPU model to other cancer types.

Despite broadening treatment options for rheumatoid arthritis (RA), challenges and unmet needs remain. This study aimed to characterize patient preferences with current pharmacologic treatments and impressions of an implantable neuroimmune modulation device. A patient survey was conducted, combined with a discrete choice experiment that included 12 choice sets, containing a device profile and drug profile, featuring 8 attributes specific to each. In total, 354 completed surveys were included, 74% female, 79% <60 years, stratified into Biologic Naïve (n = 103); Biologic-Experienced-I (n = 151); and Biologic-Experienced-II (n = 100). Lack of efficacy was the primary reason for treatment discontinuation of conventional disease-modifying antirheumatic drugs (DMARDs) and biologic or targeted synthetic DMARDs. Initial impression of device-based treatment was "Positive" or "Extremely Positive" by 45% and preference ranked higher than current drug treatment options for both Biologic Experienced groups. Key drivers of treatment preference included out-of-pocket cost, symptom improvement, physical function and fatigue, and irreversible joint damage protection. RA patients were accepting of a novel neuroimmune modulation approach, including a surgically implanted device, meeting identified attributes and expectations of safety and efficacy as observed in controlled trials.

Geographical differences exist in patients being offered percutaneous coronary intervention (PCI). Whether such differences are also present in patient experiences with hospital care and treatment is not well-known. This study assesses urban and rural differences in patient-reported experiences with hospital stays, and factors related to satisfaction with care and experienced treatment benefits. A prospective observational study was conducted with patients undergoing PCI (n = 479) who responded to a standardized questionnaire at discharge and after 3 months. Urban and rural grouping was based on travel time by road to PCI-hospitals (less than or ≥1 h). There were no significant geographical differences in patient-reported experiences. Patients reported the lowest scores on information about postdischarge ailments and relapse management, involvement in treatment decisions, and collaboration between the hospital and general practitioner. Healthcare personnel competency, organization, information, admission type, delayed/incorrect diagnosis, among others, predicted satisfaction with care and perceived treatment benefits. These findings offer insight into patient perspectives, areas of improvement in specialized healthcare, and further research on follow-up and collaboration following PCI, all of which are important in ensuring equal and accessible healthcare services within large PCI-hospital catchment areas.

This article introduces the longevity medicine patient experience framework (LMPEF), a seven-domain model for optimizing patient experience in longevity medicine. Each domain, from fostering personalized patient-provider partnerships to cultivating an optimal care environment, contributes to a comprehensive system designed to enhance patient experience, support sustained behavior change, and achieve meaningful health outcomes. The framework highlights the crucial role of interdisciplinary teams in delivering comprehensive care. Addressing the complexities of an aging global population necessitates collaborative efforts among healthcare professionals. The LMPEF promotes tailored interventions designed to address diverse patient needs while fostering resilience and independence. By operationalizing a patient-experienced, person-centered approach, this framework offers potential solutions to common challenges in longevity medicine, including care fragmentation, accessibility barriers, and poor patient engagement. It positions a high quality patient experience to be achieved through the multidisciplinary team skillfully enabling the patient to identify and enact the goals that will extending both their healthspan and lifespan.

Venous thromboembolism (VTE) has been associated with reduced quality of life. However, few studies have explored patients' accounts of its psychological impact. This patient-oriented qualitative study aimed to explore the experiences of individuals with VTE to better understand its psychological impact and identify strategies to support patient well-being. We conducted semi-structured interviews with 11 individuals diagnosed with VTE. Data were analyzed using reflexive thematic analysis. Most participants described significant emotional and psychological challenges, including anxiety about recurrence and uncertainty around the cause and management of their condition. The use of anticoagulants often required lifestyle changes, influenced by concerns about bleeding. While early care was generally described as reassuring, many participants felt unsupported after discharge. For some, the end of acute treatment marked the beginning of new emotional struggles. Participants emphasized the need for care that continues beyond the acute phase and includes mental health support. These findings highlight the need for patient-centered VTE care that addresses both physical and psychological needs throughout the care journey.

Humility is one of the most powerful and sometimes least understood virtues we can possess. It is often misinterpreted as a sign of weakness, especially today, where self-promotion is encouraged and celebrated. Many people view humility as "thinking less of ourselves." In truth, humility is not thinking less of oneself; rather it is appropriately thinking less about oneself. Our ability as caregivers in putting the needs of the patient at the center of all we do is enhanced through our humility. A steady focus on the needs of the patient helps us gain an honest assessment of both our strengths and limitations. Studies have shown that patient outcomes and experiences are strongly associated with provider humility. This article aims to shine a light on the power of humility and its impact on patient experience, psychological and cultural safety, and the provider-patient relationship.

Surgical complications increase morbidity, mortality, and costs, underscoring the need for effective postoperative follow-up. Digital tools can reduce complications, but their usability remains unexplored in Ecuador. This study evaluated the usability of a postoperative monitoring app among 62 patients from a public hospital using the System Usability Scale (SUS). The mean SUS score was 65.69 (SD = 18.68), indicating moderate usability. Participants rated ease of use (M = 3.31) and confidence (M = 3.40) favorably but reported challenges with complexity (M = 1.85) and need for support (M = 1.56). Younger and more educated users scored higher, though differences were not statistically significant; no gender-based variations emerged. Positive perceptions were associated with ease of use and system integration, while perceived complexity and need for support negatively impacted the user experience. These findings suggest that optimizing the interface and strengthening user education may equip younger adults with digital tools that facilitate long-term engagement and adoption across future generations.

Female cancer survivors (FCS) have a higher risk of infertility compared to women without a history of cancer. Consuming healthful diets could improve female fertility and promote healthy cancer survivorship. As an initial step to intervention development, this study explores FCS and healthcare provider (HCP) perspectives regarding nutrition and fertility. We conducted semi-structured interviews with 11 HCPs and a secondary analysis of qualitative data from 20 FCS. Data were analyzed using directed content analysis. Two broad themes were identified with several interrelated subthemes: (1) Barriers to Optimal Nutrition: Subthemes: Time Constraints (Both HCPs and FCS); Absence of Standardized Guidelines due to perceived lack of Research and Education (HCPs); Unclear and Insufficient Dietary Guidance (FCS) and (2) Ideas and Opinions about Fertility Nutrition: Subthemes: Skeptic Acknowledgment of Potential (HCPs); Motivation to Change Nutrition Behavior (FCS). Healthful nutrition may improve fertility in women and would be of particular importance for FCS who are at an increased risk of infertility. Addressing the challenges in adopting a healthful diet is essential for creating effective interventions.

Background: Nipple-sparing mastectomy (NSM) followed by implant-based breast reconstruction (IBR) is a widely accepted for early-stage breast cancer, supporting esthetic preservation and enhancing quality of life. The BREAST-Q is the gold standard patient-reported outcome measure PROM for evaluating satisfaction and post-operative wellbeing. This study employed the newly adapted Vietnamese BREAST-Q version 2.0, to assess patient satisfaction after NSM with IBR and explore influencing factors within a Vietnamese cohort.

Methods: A pilot linguistic validation of the BREAST-Q version 2.0 was first conducted in 20 patients from July 2021 to May 2022, demonstrating internal consistency and convergent validity. A subsequent cohort of 55 post-operative patients undergoing NSM with immediate IBR (July 2022-July 2024) participated in satisfaction assessment across eight BREAST-Q domains. Statistical significance was defined at P < .05.

Results: The tool demonstrated acceptable internal reliability (Cronbach's α = 0.70) and strong convergent validity with objective esthetic scoring (r = 0.912; P < .001). Among 55 participants (mean age (43.2 ± 7.4 years), notable post-operative outcomes included Physical wellbeing-Back & Shoulder (62.3 ± 7.9), Physical Wellbeing-Chest (84.5 ± 18.6), Psychological Wellbeing (73.9 ± 15.7), and high Implant Satisfaction (81.9 ± 22.0). However, esthetic satisfaction declined significantly post-operatively (75.9 vs 65.8; P < .001). Patients ≥40 years reported higher psychological wellbeing (76.2 vs 66.3; P = .04). Reduced esthetic results correlated with lower overall satisfaction.

Conclusion: The Vietnamese BREAST-Q shows acceptable internal consistency and strong convergent validity, supporting its clinical utility. The decline in post-operative esthetic satisfaction highlights rising patient expectations, emphasizing the need for improved cosmetic outcomes and individualized care planning in Vietnam.

Healthcare decision-making (DM) has shifted from a paternalistic model to shared DM, where professionals contribute with clinical expertise and patients share their values and preferences. Simultaneously, access to online health information influences how patients engage in decisions concerning care. This study examined perceived DM experiences during doctor's appointments and online health information-seeking among older adults and individuals with long-term conditions. A total of 736 Finnish respondents (mean age 68 years) completed an online survey. The Shared Decision-Making Questionnaire (SDM-Q-9-FIN) assessed involvement in clinical decisions. Most participants reported feeling involved, with a mean SDM-Q-9 score of 25.96/36. Longer appointment duration (β = .50, P < .001), higher education attainment, and better health status were positively associated with perceived involvement. Adherence to treatment also enhanced DM experiences. Nearly half (48.6%) did not seek online health information before appointments. Respondents from patient associations reported more frequent information-seeking. The findings suggest that adequate consultation time and tailored communication can enhance DM. Support should be prioritized for patients with lower health status or limited health literacy.