Journal of Patient Experience最新文献

Although differences between males and females in the diagnosis and management of cardiovascular diseases are well recognized, there is a paucity of studies evaluating the impact of sex on the perception and satisfaction of cardiovascular care. The purpose of this study is to evaluate potential sex-based disparities in patient experiences with their postoperative care after cardiac surgery. Responses from Hospital Consumer Assessment of Health Care Providers and Systems surveys from patients who underwent open cardiac surgery at a single institution were compared based on sex. Propensity-score matching was performed based on age, race, and type of operation. Answers to survey items were compared between male- and female-matched cohorts. Female patients gave lower overall hospital rankings than their male counterparts (P = .005). Female patients also gave lower scores for questions regarding room cleanliness (P = .02), staff working together (P = .01), and health management education for discharge (P = .02) compared to male patients. Our study demonstrates that there is a disparity in patient satisfaction between males and females among patients undergoing cardiac surgery. Females undergoing cardiac surgery report worse experiences than their male counterparts.

Patient and family advisory councils (PFACs) serve as structured collaborative groups where patients and caregivers partner with healthcare professionals to shape policies, service delivery, and research. Despite guidelines emphasizing the need for diverse representation, PFACs often remain socio-demographically homogenous, excluding vulnerable populations from critical discussions that shape healthcare outcomes. This scoping review examines barriers and facilitators influencing the recruitment and engagement of diverse populations in PFACs. A systematic search identified studies focusing on recruitment and engagement barriers and facilitators targeting under-represented groups. Forty-three studies that met the inclusion criteria were included in the review. Findings reveal that while race/ethnicity, socioeconomic status, and age are commonly considered diversity factors, other key populations such as individuals with disabilities, migrants, and those with lived experiences of homelessness, are often overlooked. Facilitators that can improve reach to these vulnerable populations include culturally tailored outreach, relationship-building with community leaders, and reducing logistical barriers. This review provides actionable recommendations for improving diversity in PFACs, ensuring equitable patient engagement that reflects the full spectrum of healthcare experiences.

In my second year of medical school, I found myself on the other side of the hospital bed after a cat bite led to emergency hand surgery. Despite my familiarity with hospitals and medicine, the experience left me feeling disoriented, vulnerable, and emotionally isolated. I was surrounded by caring clinicians, but I often felt more like a diagnosis than a person. One morning, an internal medicine physician sat beside me and gently placed a hand on my shoulder. That simple gesture broke through the noise; it reminded me that I was seen, not just treated. It comforted me in a way no medication or procedure had. In this narrative, I reflect on how that moment reshaped my understanding of healing and the role of intentional touch in clinical care. Drawing on literature and personal experience, I argue that therapeutic touch should be embraced by physicians as a tool of empathy and connection. Especially in the wake of COVID-19, we must remember that presence and touch remain essential parts of healing.

Among 203 patients presenting for musculoskeletal specialty care between November 2023 and January 2024, we measured the relationship of openness to mindset exercises such as cognitive behavioral therapy (training the mind to default to healthier thoughts and feelings about bodily sensations) with levels of personal health agency accounting for other personal factors. Factors associated with greater openness to mindset exercises in linear regression included greater personal health agency (RC = 0.17), younger age (RC = -0.030), and 4-year college education (RC = 1.5). In a second linear regression, greater personal health agency was associated with older age (RC = 0.053), greater trust in the clinician (RC = 0.25), injury diagnosis (RC = 1.8), less distress regarding symptoms (RC = -0.25), less unhelpful thinking regarding symptoms (RC = -0.43), and retirement (RC = -1.7). In cluster analysis, we found that increasingly lower openness to mindset exercises was associated with increasingly worse levels of distress and unhelpful thoughts, lower personal health agency, and slightly varying social health and trust in clinician. The finding that greater responsibility for one's health, including openness to mindset exercises, corresponds with a healthy understanding and emotional response to bodily sensations, greater social security, and greater trust in the clinician directs specialists to prioritize building trust, gently reorienting common misconceptions about bodily sensations, and assistance with social stressors.

Patient and Family Advisory Councils (PFACs), comprised of patients who have used the hospital's services and their family members, provide hospitals with input on a wide range of initiatives. This qualitative study aims to uncover the facilitators that accelerate and the barriers that inhibit councils and provide hospitals with a blueprint to help them start and strengthen PFACs. Grounded in partnership theory, this exploratory qualitative study used a thematic analysis framework to examine first-person accounts of launching and sustaining a PFAC. The sampling was derived from three groups of potential participants. Participants from 20 hospitals and systems agreed to discuss their councils. Five key themes emerged from the interviews: The PFAC landscape improved after the pandemic, garnering support across the organization is necessary, recruiting ideal members and diversifying the council is critical, effective PFAC operation takes planning, and process and outcome measures can identify the impact and the value of PFACs. Evidence supports patient engagement through PFAC partnerships. However, to ensure a thriving PFAC, the councils require intentional design, diverse participation representing hospital demographics, broad organizational commitment, and systematic evaluation to ensure sustainability and meaningful impact on patient experience and care delivery.

Those on transplant journeys must try to understand and navigate a complex healthcare system. Little is known about whether the challenges they face differ based on their individual characteristics. This study was done to understand the experiences of those on transplant journeys in Canada. Using an online 57-question cross-sectional survey developed in collaboration with a patient-advisory committee, data was captured on transplant patients, caregivers, and living donors (n = 935). Descriptive statistics and logistic regression analyses are reported. This article includes analyses not previously reported from this larger mixed-methods project. Most participants were female (70.1%), English speaking (92.6%), and white (87.8%). The top 3 concerns identified by participants included financial (42.6%), coordination of care (37.7%), and mental health (37.2%), which affected journey types, organ types, and sociodemographic groups differently. Understanding the perspectives of those going through transplant journeys is critical to inform system change. Further, identifying how individual characteristics influence transplant journeys is essential to person-centered care that creates a lasting impact on the organ donation and transplant system and health outcomes.

Patients living with chronic kidney disease (CKD) suffer significantly higher readmission rates after discharge than the national all-hospital 30-day rate. Federal-based programs have introduced payment models incentivizing prevention-oriented activities, like transitional care management (TCM) programs, that help patients safely transition from one care facility to their homes. In this quality improvement case study, we assessed our value-based kidney care organization's TCM clinical program, which empowers patients in their post-hospitalization journey by promoting increased awareness of their condition, adherence to medications, and care navigation, ultimately minimizing the likelihood of complications or readmission. CKD patients with moderate to high risk for readmission were included in the analysis. The findings demonstrated that enrollment in the TCM program reduced total hospital readmission rates compared to those who declined enrollment at 7-, 14-, and 30-days postdischarge (P < .01; 7-days, 42% lower; 14-days, 37% lower; 30-days, 25% lower). To reduce patient utilization and increase quality of care after a hospitalization, healthcare organizations should deploy a patient-centered transitional care approach in their care models.

Maternal mortality and morbidity do not adequately represent women's healthcare experiences. Traditional clinical outcomes must be complemented with tools that assess patients' subjective experiences to provide a comprehensive view of care effectiveness. The proposed Antenatal Patient-Reported Experience Measures (PREM) tool, developed with input from women who have experienced maternity care, highlights relevant aspects for pregnant mothers and ensures reliability and cross-cultural validation. A multiphase study conducted in 15 Indian hospitals employed purposive sampling. Phase 1 involved forming an expert group, conducting focus group discussions, establishing a standard operating procedure, and creating the PREM Questionnaire. Phases 2 and 3 included a pilot study with 220 participants and a field study with 518 respondents. A PREM tool with 22 expert-sourced questions achieved an internal consistency value of 0.7205, indicating acceptable reliability. The mean content validity index was 0.998, demonstrating high validity, and the content validity ratio was 0.95. Experts deemed 21 out of 22 questions essential. The PREM tool displayed good reliability and strong content validity. The validated PREM enhances antenatal care outcomes by prioritizing women's perspectives.

Empathy is crucial in forming a good relationship between patients and healthcare providers. Research on empathy in health care has largely focused on healthcare providers and students and less on the patient's perspective. This study's aim was to investigate patients' experience of empathy in healthcare interactions, to better understand and accommodate to patients' needs. Semi-structured interviews with patients were analyzed inspired by constructivist Grounded Theory. Three categories were formed-"I need you to focus on me," "I am more than my disease" and "I know myself and the disease" and the core category: "I want to be known as a whole human being." This study has provided a deeper insight on how empathy can be operationalized in healthcare interactions from a patient perspective. Patients experience health care interactions as dependent on empathic engagement and hampered by inequity due to knowledge hierarchies and lack of personal sharing. This study emphasizes patientś need for doctors to be more personal, and to experience a mutual sharing with their doctors to not feel vulnerable or left out in the consultation.

Active surveillance is a preferred strategy for patients with low-risk prostate cancer to delay and/or avoid side effects of treatment. While its impact on health-related quality of life (HRQOL) has been studied, factors influencing follow-up adherence and patient involvement in active surveillance protocols remain less understood. This study aimed to explore patient perspectives on testing modalities, frequencies, and satisfaction with active surveillance. HRQOL surveys and active surveillance-specific questions assessed patients undergoing active surveillance at a US academic medical center between 2019 and 2021 after Institutional Review Board approval. Respondents were invited to interviews and thematic analysis identified key themes. Forty-six participants completed surveys and 12 were interviewed. Satisfaction with active surveillance was reported by 93.3%, and 97.7% indicated a willingness to opt for the same treatment again. Anxiety and urinary function were key factors influencing quality of life. Trust in the doctor's recommendations, avoiding side effects, and feeling it is a good way to monitor their cancer were common reasons for choosing active surveillance. Addressing organizational factors, treatment equity, and evolving patient perspectives can refine active surveillance protocols. Understanding patient experiences can inform tailored protocols and improve patient-provider communication, enhancing patients' well-being and adherence.