Journal of Patient Experience最新文献

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.

The study aimed to assess the effect of chronic diseases on health-related quality of life (HRQoL) among university students. A cross-sectional analytic study was conducted at King Abdulaziz University, involving 1173 students. Questionnaire on chronic diseases, HRQoL using the 36-item Short Form Health Survey (SF-36), alongside other factors was distributed electronically. Regression analysis was used to identify factors associated with HRQoL. The mean ± SD scores across SF-36 dimensions varied, with physical functioning scoring the highest (74.81 ± 27.82) and energy/fatigue the lowest (38.52 ± 24.03). The physical and mental component summary scores were 68.07 ± 18.67 and 49.20 ± 23.17, respectively. The study found a 23.1% prevalence of multimorbidity. Multimorbidity was associated with significantly lower HRQoL across all dimensions. Female sex, low family income, and lack of exercise were predictors of poor HRQoL. High-impact diseases were strongly associated with poorer physical health. The study revealed significant burden of multimorbidity that demands targeted interventions. Focus on modifiable risk factors, such as exercise and socioeconomic support, could enhance overall well-being and prevent negative health outcomes.

Play is crucial for childhood development and quality-of-life, but for children with medical complexity (CMC), availability of recreational programming is rare. A home healthcare organization in Toronto, Ontario collaborated with parents to co-design a novel 6-week playgroup that offered accessible, medically safe, and enjoyable play experiences for CMC. A mixed methods approach was undertaken to assess the early impact of the playgroup on participating CMC's quality-of-life functioning. The Pediatric Quality-of-Life Inventory was administered as a pre-post-measure followed by semi-structured interviews with parents. Sixteen parents corresponding to 18 registered CMC participated in the study. Early outcomes indicated an increase in overall quality-of-life functioning (27.4% n = 12) and psychosocial functioning (31.7% n = 12). Parents validated the positive quality-of-life scores by describing improved temperament, sleep, and expressions of happiness among their children post-program. Extended benefits were experienced by parents through much needed respite. The program demonstrated the value of co-designing person-centered interventions in addressing important health and social care gaps for CMC, while emphasizing the need for greater investments in social programming.

Missed appointments (no-shows) in primary care compromise timely access to care and contribute to higher healthcare costs. The expansion of patient portals, mandated by the 21st Century Cures Act, and the broader adoption of digital tools may transform how patients engage with their healthcare providers. We conducted a case-control study using electronic medical records from an academic family medicine clinic between April and May 2023. Eligible participants were patients 18 years and older. Cases were the no-shows. Two controls, patients who attended their appointments, were randomly selected for each case. Logistic regression was used to examine the association between patient portal access and no-shows, adjusting for sociodemographic and clinical covariates. Patients who missed appointments were less likely to have access to the patient portal (odds ratio: 0.43; 95% confidence interval: 0.30-0.59). Factors positively associated with no-shows included being non-Hispanic Black, Hispanic, and having public insurance or no insurance. Hypertension and osteoarthritis were negatively associated with no-shows. Access to patient portals was associated with lower odds of missed appointments, suggesting that digital engagement tools may improve adherence to primary care visits.

This descriptive qualitative study explores breast cancer survivors' lived experiences with exercise and body image following diagnosis and treatment. Ten women, aged 48 to 80, participated in individual Zoom interviews, sharing personal reflections on how breast cancer impacted their perception of their bodies and overall appearance. Through reflexive thematic analysis, three key themes emerged: exercise as a means of physical rehabilitation, emotional coping, and social connection. Participants commonly described walking and other forms of movement as helpful in improving both their physical well-being and self-image. Notably, many survivors reported feeling unprepared for the visible changes to their bodies, expressing shock and emotional distress when confronting these transformations. The study highlights the importance of incorporating anticipatory guidance and supportive interventions into survivorship care, particularly around appearance-related concerns. These insights underscore the value of patient-centered approaches that recognize exercise as a multidimensional tool for healing and adaptation, ultimately contributing to improved quality of life among breast cancer survivors.

This study investigates factors influencing women's childbirth experiences, aligning with World Health Organization guidelines emphasizing the importance of a positive pregnancy and childbirth journey. Conducted at the RigaMaternity Hospital between June 2022 and February 2024, the research included 133 women who completed 2 postpartum questionnaires-the short version of the Quality from the Patient's Perspective at discharge, and the Childbirth Experience Questionnaire (CEQ) 4 weeks later. Key findings emerged from the CEQ analysis. The contract either midwife or doctor was the main factor for higher satisfaction with labor across all CEQ domains. Unplanned medical interventions such as episiotomy were associated with lower scores in the domains "Own capacity" and "Perceived safety." In contrast, patients who experienced a spontaneous perineal tear reported significantly more positive answers on "Own capacity" and "Participation" scales. A moderate negative correlation was observed between postpartum blood loss and "Own capacity" (ρ = -0.331, P < .001). These findings highlight the central role of communication, individualized care, and minimized medical intervention in shaping women's childbirth experiences, underscoring the need for supportive and respectful maternity care practices.

Video-based care has become a routine part of outpatient care delivery, yet older adults continue to face barriers in accessing and engaging with this modality. This study analyzed the comments provided within 7155 patient experience surveys from adults aged ≥65 years across a large, multi-specialty medical practice to identify challenges experienced with video-based visits. Thematic analysis revealed the highest proportion of positive comments were related to experience with people (71%), while barriers were often related to technical issues with video tools (73%). Most comments related to processes were positive, often highlighting convenience (67%). Using design thinking, we mapped the patient journey and proposed both immediate solutions, such as testing environments and clearer instructions, and long-term innovations like voice-guided support and emotionally intelligent interfaces. Our findings suggest that while video visits offer convenience, they must be redesigned with older adults in mind to ensure equitable, effective, and human-centered care.

Diabetic retinopathy (DR) is a leading cause of blindness among people living with diabetes. Despite high diabetes prevalence in Bahrain, data on DR awareness remain limited. This cross-sectional study assessed the knowledge and awareness of DR among 676 participants who were undergoing fundus photography at 7 primary healthcare centers. A pretested self-administered questionnaire evaluated sociodemographics, knowledge, awareness, and sources of information. Medical records confirmed diabetes diagnoses and provided comorbidity and glycated hemoglobin test data. The mean knowledge score was 73.0% ± 16.7, with 449 participants (66.4%) scoring 70% or higher. About 82.1% participants were aware of diabetes-related vision loss, 85.9% were aware that diabetes can cause blindness, and 18.5% accurately identified DR. Higher education was significantly associated with greater knowledge (P < .001), with participants holding a bachelor's degree or higher showing the highest scores (78.4%) compared with those with no formal education (67.2%) or primary/intermediate education (65.8%). Higher knowledge was also associated with a longer diabetes duration (median 8 years; P = .026) and having a relative or friend with a diabetes-related eye disease (27.7% vs 15.4%; P < .05). The main sources of information were healthcare providers (66%) and the internet/social media (50%). The study revealed significant knowledge gaps, highlighting the need for targeted educational interventions. Programs tailored to diverse education levels and utilizing digital platforms can enhance awareness, support prevention and management efforts, and reduce the burden of DR in Bahrain.

Health-related quality of life (HRQOL) represents a central outcome following hip fracture surgery. This study examined whether psychological resilience and other factors predict HRQOL. In this prospective longitudinal study, patients ≥60 years undergoing hip fracture surgery in southern Taiwan were consecutively recruited. HRQOL was measured by the 36-item Short Form Health Survey (SF-36) and psychological resilience by the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). Both tools were administered at admission prefracture (at admission, based on recall), and at 6 and 12 weeks postoperatively. Changes and predictors of HRQOL within 12 weeks were analyzed using generalized estimating equations. Generalized estimating equations were used to analyze changes in these and predictors of HRQOL within 12 weeks after surgery. Among 50 participants (mean age 72.1 ± 9.6 years; 58% female), psychological resilience (CD-RISC-10) showed no significant changes across baseline, 6 weeks, and 12 weeks postoperatively, whereas HRQOL (SF-36 total, physical, and mental health domains) declined at 6 weeks but returned to baseline by 12 weeks (SF-36: b = -9.19, P < .001; physical health domain: b = -5.29, P < .001; mental health domain: b = -3.90, P = .001). Higher prefracture CD-RISC-10 scores significantly predicted better SF-36 total, physical, and mental health domains (all P < .001), whereas a hospital stay ≥8 days was associated with lower SF-36 and its mental health domain. In conclusion, psychological resilience supports postoperative HRQOL, underscoring its relevance as a perioperative care target. Larger, long-term studies are warranted to confirm these effects and elucidate their sustained impact.