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A method commonly used in health care research is the waiting room (WR) survey. While patients are waiting for their appointment, they are asked to complete a questionnaire measuring their attitudes, behaviors and other characteristics. In this paper we synthesize practical guidelines for WR surveys by comparing the method with two similar approaches: public intercept (PI) surveys and drop-off-pick-up (DOPU) surveys. In this comparison we use the Total Survey Error approach Groves (Survey Methodology, Wiley, New York, 2004); (Groves in Public Opinion Quarterly 74(5): 849-879, 2010) and apply it to three case examples in which one of the three surveys is used. We take into account measurement (validity, measurement- and processing error) and representation (coverage-, sampling- and nonresponse error). From our review, we conclude that waiting room surveys, though limited to patients and their caregivers, can provide useful information on patients’ perspective on health care. Response rates in waiting rooms are usually high, but often not even reported. We recommend adjustment for sampling bias by taking into account the number of visits to the hospital per respondent and sample times proportionate to the number of sample members expected on a particular time. These surveys also allow for collection of para-data; i.e., relevant information in the circumstances of a request to participate in survey research, and behavior of surveyors can easily be controlled, or investigated in an experimental design.

Today, across the most critical problems faced by hospitals and health centers are those caused by the existence of patients who do not attend their appointments. Among others, this practice generates waste of resources and increases the patients’ waiting list. To handle these problems, hospitals are actively trying to implement methods to reduce the idle time caused by patient no-shows. Many scheduling systems developed require predicting whether a patient will show up for an appointment or not. Although, a challenging problem resides in obtaining these estimates precisely. The goal of this work is to analyze how objective factors influence a patient not to attending their appointment, to identify the main causes that contribute to a patient’s decision, and to be able to predict whether or not the patient will attend the scheduled appointment. As a result, the obtained model is tested on a real dataset collected in a health center linked to the University of Vale do Itajaí (UNIVALI), which includes 25 features and about 5000 samples. The algorithm that produced the best results for the available dataset is the Random Forest classifier. It reveals the best recall rate (0.91), since it measures the ability of a classifier to find all the positive instances and achieves a receiver operating characteristic curve rate of 0.969.

Patient perceptions influence biosimilar uptake in non-mandatory transitions. Companions (support people) are often actively involved in the patient’s medical journey and are likely to have unique perceptions of biosimilars, which may shape patient attitudes. This study explores the congruence between patient and companion perceptions towards biosimilars and their information needs. Patients taking bio-originators for rheumatic diseases (59% for rheumatoid arthritis) and their companions received an explanation about biosimilars. Participants (N = 78) completed questionnaires assessing their familiarity with biosimilars, perceptions, concerns, and benefits of being accompanied. Contingency tables and paired sample t-tests were used to explore differences in familiarity, confidence in knowledge, and perceptions. Intra-class correlation coefficients were calculated to assess the degree of congruence for perceptions towards biosimilars. Companions were significantly less familiar with biosimilars (p = 0.014, Cramer’s V = 0.28) and reported lower confidence in their knowledge (p = 0.006, Cohen’s d = 0.47) than patients. Companions and patients had moderate to good congruency for perceptions toward confidence in biosimilar use and safety, efficacy, and side-effect expectations (intra-class correlation coefficients ranging from 0.75 to 0.81). Companions and patients were most concerned about safety and effectiveness. Companions also reported concerns about cost savings driving the transition, while patients had concerns about uncertainty and testing. Patients reported the ability for discussion, improved understanding, and validation as benefits of being accompanied. Companions and patients have similar levels of perceptions and expectations towards biosimilars but report some unique information needs. Future educational interventions should involve companions and address their concerns to help improve biosimilar acceptance.

Background COVID-19 has profoundly impacted the healthcare education environment and telemedicine has been used to augment face-to-face learning and support social-distancing. There is little evidence which examines how patients feel about participating in teaching with this technology. Method A prospective survey of 229 surgical inpatients/outpatients was conducted at a university hospital between August–September 2020. The survey consisted of 31 questions (7-point Likert scales, quantitative items, and free-text answers) to explore: general attitudes towards teaching, attitudes towards COVID-19, perceptions of face-to-face teaching and perceptions of telemedicine teaching. Relationships between demographics and areas of interest were analysed qualitatively and quantitatively. Results Patients reported a positive attitude towards both face-to-face (mean 5.5 [1.1SD]) and telemedicine teaching (5.4 [1.2]) however there was a preference for the face-to-face approach (mean difference [MD]=.16, p = 0.14). Face-to-face teaching was found to be less bothersome (MD=.32, p=.002) and more rewarding (MD.33, p Conclusions Despite reporting a favourable impression of telemedicine teaching, patients prefer traditional face-to-face styles as they find telemedicine more bothersome and less rewarding. Educators should take this into consideration during planning of teaching during the pandemic.

Common self-limiting infections can be self-managed by patients, potentially reducing consultations and unnecessary antibiotic use. This qualitative study informed by the Theoretical Domains Framework (TDF) aimed to explore healthcare professionals’ (HCPs) and patients’ needs on provision of self-care and safety-netting advice for common infections. Twenty-seven patients and seven HCPs participated in semi-structured focus groups (FGs) and interviews. An information leaflet was iteratively developed and reviewed by participants in interviews and FGs, and an additional 5 HCPs, and 25 patients (identifying from minority ethnic groups) via online questionnaires. Qualitative data were analysed thematically, double-coded, and mapped to the TDF. Participants required information on symptom duration, safety netting, self-care, and antibiotics. Patients felt confident to self-care and were averse to consulting with HCPs unnecessarily but struggled to assess symptom severity. Patients reported seeking help for children or elderly dependents earlier. HCPs’ concerns included patients’ attitudes and a lack of available monitoring of advice given to patients. Participants believed community pharmacy should be the first place that patients seek advice on common infections. The patient information leaflet on common infections should be used in primary care and community pharmacy to support patients to self-manage symptoms and determine when further help is required.

One of the major problems in cardiology practice is poor adherence to antihypertensive medication. This study aimed to evaluate medication adherence, we also aim to investigate the predictors of intentional and unintentional non-adherence. We issued a survey containing questions about patient demographics, blood pressure control, pharmaceutical care, and adherence level to medication. Retrospective analysis of the prescription database of the National Health Service of the Republic of Latvia was performed. The prevalence of non-adherence was 45.9%. The lowest adherence rate (38.2%) was found among patients taking medication for 2–4.9 years. Even though 84.7% of respondents had a blood pressure monitor at home, only 25.3% of them reported measuring blood pressure regularly. There were differences between the groups of adherent patients in terms of the patients’ net income (p = 0.004), medication co-payments (p = 0.007), and whether the pharmacist offered to reduce the costs of drug therapy (p = 0.002). Roughly half of the prescriptions (50.4%) containing perindopril were purchased by patients from pharmacies. The medication adherence level and blood pressure control at home were assessed as low. Intentionally non-adherent respondents discontinued their medication because of fear of getting used to medicines. The pharmacists’ behaviour in terms of offering to reduce the costs of medications used was influenced by socio-economic factors.

Background: The impact of left ventricular assist device (LVAD) complications on the individual patient, overall sentiment, and its effect on referral patterns, is not fully understood. We sought to better understand patient attitudes towards LVAD therapy using a computational sentiment analysis approach. Methods: Posts, comments, and titles were parsed from MyLVAD.com’s HTML as a text file using custom Python scripts (version 3.6). Individual word frequency was computed with word classification as ‘positive’, ‘negative’, or ‘neutral’. Data transformation and cleaning, sentiment determination, and analysis was performed with a binary dictionary package using R software (version 3.6). Results: Sixty-six thousand eight hundred and twenty-one unique words were noted, including 4,623 (6.9%) with positive sentiment and 3,248 (4.8%) with negative sentiment. Net sentiment ratio [(number of positive words – number of negative words)/(number of total words)] was 2.1%. Positive sentiment dominated the 20 most commonly used words. Odds ratio of non-neutral words [(number of positive words/number of negative words)] was 1.42, indicating a less obvious disparity in sentiment when expanding analysis beyond the top 20 words. Word cloud analysis of positive and negative sentiments was performed, indicating common use of “infection” (208 mentions) compared to other complications such as “stroke” (29 mentions), “bleeding” (30 mentions), and “thrombosis” or “clot” (32 mentions). Conclusions: Positive sentiment dominates the most frequently used words, yet this disparity decreases when considering the totality of words. “Infection” is mentioned a disproportionate number of times compared to other LVAD complications. Further research is required to address analysis limitations, including selection bias.

Background Clinical data in social media are an underused source of information with great potential to allow for a deeper understanding of patient values, attitudes, and preferences. Objective This tutorial aims to describe a novel, robust, and modular method for the sentiment analysis and emotion detection of free text from web-based forums and the factors to consider during its application. Methods We mined the discussion and user information of all posts containing search terms related to a medical subspecialty (oculoplastics) from MedHelp, the largest web-based platform for patient health forums. We used data cleaning and processing tools to define the relevant subset of results and prepare them for sentiment analysis. We executed sentiment and emotion analyses by using IBM Watson Natural Language Understanding to generate sentiment and emotion scores for the posts and their associated keywords. The keywords were aggregated using natural language processing tools. Results Overall, 39 oculoplastic-related search terms resulted in 46,381 eligible posts within 14,329 threads. Posts were written by 18,319 users (117 doctors; 18,202 patients) and included 201,611 associated keywords. Keywords that occurred ≥500 times in the corpus were used to identify the most prominent topics, including specific symptoms, medication, and complications. The sentiment and emotion scores of these keywords and eligible posts were analyzed to provide concrete examples of the potential of this methodology to allow for a better understanding of patients’ attitudes. The overall sentiment score reflects a positive, neutral, or negative sentiment, whereas the emotion scores (anger, disgust, fear, joy, and sadness) represent the likelihood of the presence of the emotion. In keyword grouping analyses, medical signs, symptoms, and diseases had the lowest overall sentiment scores (−0.598). Complications were highly associated with sadness (0.485). Forum posts mentioning body parts were related to sadness (0.416) and fear (0.321). Administration was the category with the highest anger score (0.146). The top 6 forum subgroups had an overall negative sentiment score; the most negative one was the Neurology forum, with a score of −0.438. The Undiagnosed Symptoms forum had the highest sadness score (0.448). The least likely fearful posts were those from the Eye Care forum, with a score of 0.260. The overall sentiment score was much more negative before the doctor replied. The anger, disgust, fear, and sadness emotion scores decreased in likelihood, whereas joy was slightly more likely to be expressed after doctors replied. Conclusions This report allows physicians and researchers to efficiently mine and perform sentiment analysis on social media to better understand patients’ perspectives and promote patient-centric care. Important factors to be considered during its application include evaluating the scope of the search; selecting search terms and understanding their linguistic usages; and establishing selection, filtering, and processing criteria for posts and keywords tailored to the desired results.

Background: Faecal sample collection is crucial for gut microbiome research and its clinical applications. However, while patients and healthy volunteers are routinely asked to provide stool samples, their attitudes towards sampling remain largely unknown. Here we investigate the attitudes of 780 Dutch patients, including participants in a large Inflammatory Bowel Disease (IBD) gut microbiome cohort, and population controls, to identify barriers to sample collection and provide recommendations for gut microbiome researchers and clinicians. Methods: We sent questionnaires to 660 IBD patients and 112 patients with other disorders who had previously been approached to participate in gut microbiome studies. We also conducted 478 brief interviews with participants in our general population cohort who had collected stool samples. Statistical analysis of the data was performed using R. Results: 97.4% of respondents reported that they had willingly participated in stool sample collection for gut microbiome research, and most respondents (82.9%) and interviewees (95.6%) indicated willingness to participate again, with motivations for participating being mainly altruistic (57.0%). Responses indicated that storing stool samples in the home freezer for a prolonged time was the main barrier to participation (52.6%), but clear explanations of the sampling procedures and their purpose increased willingness to collect and freeze samples (P=0.046, P=0.003). Conclusions: To account for participant concerns, gut microbiome researchers establishing cohorts and clinicians trying new faecal tests should provide clear instructions, explain the rationale behind their protocol, consider providing a small freezer, and inform patients about study outcomes. By assessing the attitudes to, motives for and barriers to participation in faecal sample collection, we can provide important information that will contribute to the success of gut microbiome research and its near-future clinical applications.

Background As we enter a second wave of the COVID-19 pandemic, a framework for safe provision of elective orthopaedic surgery must be developed in order to restore and maintain activity. The aim of this study was to explore patient attitudes to surgery and theatre efficiency in light of the COVID-19 pandemic and assess a potential framework for the delivery of such services. Methods Prospectively collected data on theatre timings and procedures completed per session used to assess theatre efficiency using 40 patients from June 2019 and 85 patients from June 2020. Information on patient compliance with 14-day household isolation and attitudes to surgery were collected prospectively over a 7-week period using a questionnaire (37 patients included). Follow up data was collected via telephone consultation a minimum of 2 weeks after discharge. Results Significant reduction in the number of points per session (p = 0.02) with a mean of 3.19 in 2019 and 2.42 in 2020. Only 18 of 31 patients were compliant with pre-operative isolation with individual failures accounting for 4 of 13 and failures by household members accounting for 9. Impact on COVID-19 and precautions on patient anxiety was mixed. No patients required symptomatic COVID-19 swab. Interpretation With the restrictions of COVID-19 there are significant problems with theatre efficiency, in effect losing an operation a list. Furthermore, compliance with pre-operative isolation was poor. Additional strategies will be required to re-instate an effective elective orthopaedic service, especially as the nation heads into a second wave.

Highlights • Patients strongly wanted to pursue alternative treatments before starting a statin. • Attitudes about taking statins based on risk differ from scientific recommendations. • 52% of patients did not tell their prescriber that they might not take the statin. • The existing literature likely underestimates rates of primary nonadherence., Statin medications reduce cardiovascular events, but many patients never start taking their prescribed statin (primary nonadherence). Limited knowledge exists about the attitudes and beliefs of those with primary nonadherence. In this study, patients with primary nonadherence to statin medications (n = 173) completed a self-administered cross-sectional survey that assessed their attitudes and beliefs related to primary nonadherence and to potential motivators for statin use. Patients were recruited in 2019 from two academic health systems and nationwide internet advertisements. Only 49 of 173 (28.3%) patients with primary nonadherence reported having cardiovascular disease (CVD). Ninety-nine patients (57.2%) never filled their prescription, and 74 (42.8%) filled but never took any statin. Over half failed to initially inform their prescriber they might not take the statin. Patients strongly or somewhat agreed that they desired alternate treatment plans such as diet and/or exercise (n = 134; 77.4%) or natural remedies/dietary supplements (n = 125; 72.3%). Ninety-eight (56.6%) stronglyor somewhat worried about the possibility of statin dependence or addiction. Twenty-seven (15.6%) patients noted that they would not take a statin based solely on CVD risk estimates; 50 (28.9%) selected a CVD risk threshold of >20%; and 23 (13.3%) a threshold of >50% as motivating factors to take statins. Patients with primary nonadherence have attitudes about taking statins based on CVD risk that differ from scientific recommendations, may not tell providers about their hesitation to take statins, and likely prefer alternative initial approaches to cholesterol lowering. Early shared decision-making and assessment of patient attitudes about statins could potentially better align initial approaches for CVD risk reduction.

Background The Western Australian Preterm Birth Prevention Initiative was officially launched in November 2014. It demonstrated an initial decrease in the preterm birth rate in Western Australia. One of the key points of this initiative is the routine ultrasound measurement of the cervical length in mid-pregnancy. Aim The aim of this study was to evaluate the perceptions and attitudes of Western Australian women regarding transvaginal cervical length (TVCL) screening for preterm birth prevention. Materials and methods Self-administered questionnaires were completed by pregnant women before and after their mid-trimester obstetric ultrasound. Maternal demographical and medical data were collected in addition to opinions of TVCL screening. Results A total of 598 women participated with the maternal age range representative of the Western Australian obstetric population. There was a high rate of acceptance of TVCL imaging, with 2% of the 149 women declining a transvaginal ultrasound (TVU) offered in this study, 1.5% refusing a TVU in the past and 5.7% reporting that they would have a concern in having a TVU in the future. Women stated that they either had declined TVCL in the past (11%) or would decline in the future (30.7%) as they wanted to discuss the procedure with their clinician first, had been advised not to have a TVU by their clinician (11% in the past and 47.7% in the future) or felt uncomfortable with the operator (22% at a previous TVU and 34.4% in the future). Conclusion Pregnant women participating in this study had a high acceptance of TVCL screening for preterm birth prevention.

BACKGROUND: The opioid crisis catalyzed a national drive to better utilize non-pharmacologic pain management. To our knowledge, no study has examined staff, parent, or patient perspectives on acupuncture implementation in pediatric emergency departments (PED). OBJECTIVE: To understand staff, parent, and patient attitudes and barriers related to PED acupuncture. METHODS: We conducted 2 studies at 2 PEDs within a single children’s health system (125,000 visits/year). In Study 1, English-speaking patients (12-18 years), parents, and ED staff (child life specialists, nurses, physicians) completed anonymous surveys exploring factors associated with acceptability of PED …

OBJECTIVE: Investigate factors that influence the decision to accept or decline diagnostic testing for pregnant women referred for genetic counseling. METHODS: Cross sectional anonymous survey of pregnant women undergoing genetic counseling at a tertiary care referral center. Subjects' perceived risk of procedure related loss and fetal chromosomal problem were obtained via survey where patients rated risk from 0 (no risk) to 10 (highest risk). RESULTS: There were no differences in sociodemographic factors between women undergoing a diagnostic procedure compared to those not undergoing a procedure. As the perceived risk for having a baby with genetic problem increased by one point, the estimated odds of having the diagnostic procedure increased by 43% controlling for the perceived risk of procedure related loss (p

Background: Advances in gene therapeutic approaches to treat sensorineural hearing loss (SNHL) confront us with future challenges of translating these animal studies into clinical trials. Little is known on patient attitudes towards future innovative therapies. Objective: We aimed to better understand the willingness of patients with progressive SNHL and vestibular function loss of autosomal dominant (AD) inheritance to participate in potential gene therapy trials to prevent, stabilize, or slow down hearing loss. Methods: A survey was performed in carriers of the P51S and G88E pathogenic variant in the COCH gene (DFNA9). Various hypothetical scenarios were presented while using a Likert scale. Results: Fifty three participants were included, incl. 49 symptomatic patients, one presymptomatic patient, and three participants at risk. Their attitude towards potential trials studying innovative therapies was overall affirmative, even if the treatment would only slow down the decline of hearing and vestibular function, rather than cure the disease. Among the different potential scenarios, the less invasive and less frequent treatments increased the likelihood to enroll. Daily oral medication and annual intravenous infusion were awarded the highest scores. The more invasive, more frequent, and more at-risk treatments were still likely to be accepted but decreased the willingness to participate. The presence of a placebo arm was met with the lowest scores of willingness to participate. Conclusions: Overall, most symptomatic DFNA9 patients would likely consider participation in future innovative inner ear therapy trials, even if it would only slow down the decline of hearing and vestibular function.

Aims: This project aims to address the question of whether patients were satisfied with using a video visit for prechemotherapy evaluation during the COVID-19 pandemic. Methods and materials: This project used a survey tool with patients undergoing prechemotherapy evaluation that was administered at the time of chemotherapy; 70 surveys were collected. Descriptive statistics of survey questions are presented. Results: 73% of patients reported satisfaction with their video visit experience. 65% of patients reported that they prefer in-person visits as their preferred choice for prechemotherapy evaluation. Conclusion: Patient satisfaction was favorable, but not consistent with results from prior published studies. Patients also mostly preferred an in-person visit for prechemotherapy evaluation. Further research is needed to determine patient attitudes to telemedicine for different types of consultations., Lay abstract In this study we looked at how satisfied patients were with video visits to consult with their physicians prior to receiving chemotherapy. We collected 70 surveys from June to July 2020 in the clinic’s infusion center. Most patients were satisfied with using video visits, but maybe were not as satisfied with using video visits as has been reported in other studies. Most patients also still preferred an in-person visit to a video visit. Patients may have preferred in-person visits because that is what they were used to. More research is needed to find why satisfaction with video visits can be so varied.

OBJECTIVE: To compare effectiveness of a narrative-based educational video versus an informational pamphlet for increasing patients’ self-efficacy and intention to taper their opioid use. METHODS: Five thousand participants recruited from MTurk were screened to identify eligible patients. Eligible participants (n = 365, 49.9% female, mean age = 37 years) were randomized to either watch the narrative video or read the pamphlet. Linear regression models were used for the main analysis. RESULTS: Participants’ perceptions of tapering effectiveness were higher in the video group (mean = 4.06) than the pamphlet group (mean = 3.67), adjusted mean difference = 0.34, 95%CI 0.13 – 0.54, P < 0.001. Participants’ perceptions of tapering self-efficacy were also higher in the video group (mean = 3.97) than the pamphlet group (mean = 3.60), adjusted mean difference = 0.32, 95%CI 0.09 – 0.55, P < 0.001. Perceived tapering effectiveness and self-efficacy were both positively associated with post-intervention tapering intention (Spearman rank correlation coefficient = 0.38 and 0.53, respectively, both P < 0.001). CONCLUSION: A narrative-based video about opioid tapering enhanced patients’ perceptions of the effectiveness of tapering and their tapering self-efficacy. PRACTICE IMPLICATIONS: Narrative-based videos may be effective for changing patient attitudes about opioid tapering.

Patient access to electronic health records gives rise to ethical questions related to the patient-doctor-computer relationship. Our study aims to examine patients’ moral attitudes toward a shared EHR, with a focus on autonomy, information access, and responsibility. A de novo self-administered questionnaire containing three vignettes and 15 statements was distributed among patients in four different settings. A total of 1688 valid questionnaires were collected. Patients’ mean age was 51 years, 61% was female, 50% had a higher degree (college or university), and almost 50% suffered from a chronic illness. Respondents were hesitant to hide sensitive information electronically from their care providers. They also strongly believed hiding information could negatively affect the quality of care provided. Participants preferred to be informed about negative test results in a face-to-face conversation, or would have every patient decide individually how they want to receive results. Patients generally had little experience using patient portal systems and expressed a need for more information on EHRs in this survey. They tended to be hesitant to take up control over their medical data in the EHR and deemed patients share a responsibility for the accuracy of information in their record.

Purpose In light of the COVID-19 pandemic, a framework for safe provision of elective orthopaedic surgery must be developed in order to restore and maintain activity. The aim of this study was to explore patient attitudes to surgery and theatre efficiency as a result of the COVID-19 pandemic and assess a potential framework for the delivery of such services. Methods Prospectively collected data on theatre timings and procedures completed per session used to assess theatre efficiency comparing June 2019 to June 2020. Information on patient compliance with 14-day household isolation and attitudes to surgery were collected prospectively over a seven-week period using a questionnaire. Follow-up data were collected via telephone consultation a minimum of two weeks after discharge. Results Significant reduction in the number of points per session (p = 0.02) with a mean of 3.19 in 2019 and 2.42 in 2020. Only 18 of 31 patients were compliant with pre-operative isolation with individual failures accounting for four of 13 and failures by household members accounting for nine. Impact of COVID-19 and precautions on patient anxiety was mixed. No patients required symptomatic COVID-19 swab post-operatively. Conclusion With the restrictions of COVID-19, there are significant problems with theatre efficiency, in effect losing an operation a list. Furthermore, compliance with pre-operative isolation was poor but to the best of our knowledge no patients became unwell from COVID-19 post-operatively. Additional strategies will be required to reinstate an effective elective orthopaedic service, especially as the nation heads into another wave.

Teledermatology has become critical for maintaining patient access to dermatologic services since the eruption of the COVID-19 pandemic. This survey of first-time synchronous teledermatology patients (n = 100) seen by providers of the University of Mississippi Medical Center during Spring 2020 was designed to learn more about patient experiences associated with the technical challenges of synchronous teledermatology. Our patient population had considerable experience with various social media including Facebook (82%) and hardware platforms, such as Apple devices (66%). We found that the majority of patients were satisfied (88.9%) with their synchronous teledermatology encounter and 81.8% of patients did not experience a technical difficulty with their consult. About 15% of patients lost connection with their provider during their consultation. Furthermore, about 30% of patients rated “showing their skin” to their provider as “hardest” on a ten scale. However, about 34% of patients sent “store-and-forward”-type images to supplement their encounter. Despite overwhelming satisfaction with synchronous teledermatology, a majority prefer an in-person consultation for their next visit (68.7%). Synchronous teledermatology offers a critical service to patients to expand access to specialty consultation. It is well-received by patients despite technical barriers, especially during a global health crisis. Electronic supplementary material The online version of this article (10.1007/s00403-020-02170-2) contains supplementary material, which is available to authorized users.

Bakgrund Sömn är ett mänskligt grundläggande behov och essentiellt för upplevd hälsa. Under sömnen sker kroppens fysiska och psykiska återhämtning. Inom slutenvård är det vanligt att patienter drabbas av sömnbrist och sjuksköterskans roll blir viktig för att hjälpa patienter till förbättrad sömn. Genom att sammanställa kunskap från patienters upplevelser av olika sömnrelaterade omvårdnadsåtgärder kan viktig kunskap för sjuksköterskans profession genereras. Syfte Syftet var att beskriva patienters upplevelse av omvårdnadsåtgärder vid sömn inom slutenvård. Metod Studien bestod av en icke-systematisk litteraturöversikt där artiklar inhämtats genom systematiska databassökningar i två databaser. Studiens resultat baseras på 17 vetenskapliga originalartiklar som analyserats utifrån Sophiahemmet Högskolas bedömningsunderlag för kvalitetsgranskning. Genom integrerad analys som vald metod för dataanalys presenterades resultatet översiktligt utifrån kategorier. Resultat I resultatet redovisades tre huvudkategorier med sju subkategorier. Inom slutenvård framkom det att icke-farmakologiska omvårdnadsåtgärder som dämpar ljud och ljus förbättrar sömnkvaliteten. Likväl även personcentrerade omvårdnadsåtgärder. Genom att lyssna på den enskilda och individanpassa sömnrelaterade omvårdnadsåtgärder kan en förbättrad sömnkvalitet inom slutenvården uppnås. Utifrån patienters upplevelser inom slutenvård är även upplevt välbefinnande av betydelse för sömnkvaliteten. Vidare betonades sjuksköterskans rutinmässiga omvårdnadsåtgärder. Från patienters upplevelser anses nattliga observationer/rutinkontroller försvåra en sammanhängande sömn. Därför är det viktigt att omvårdnadsåtgärder planeras tillsammans med patienten och därefter utförs med dennes kännedom och delaktighet. Slutsats Från den här litteraturstudien framkom det att det finns utmärkande sömnrelaterade omvårdnadsåtgärder som patienter gemensamt anser förbättra sömnen inom slutenvård trots att både sömnbehov och sömnrutiner har en stor individuell spridning. Genom att sjuksköterskan ser och tar del av patienters upplevelser av sömn inom slutenvård, kan en ökad medvetenhet och kunskap gällande vilka sömnrelaterade omvårdnadsåtgärder som patienter anser främja sömn leda till att de prioriteras. Därmed kan sjuksköterskan öka patienternas möjligheter till förbättrad sömnkvalitet inom slutenvården och bidra till ökat välmående och förbättrad hälsa. Background Sleep is a basic human need and essential for perceived health. During sleep, physical and mental recovery takes place. It is common among inpatients to suffer from sleep deprivation and the nurse's role becomes important in helping patients improve sleep. By listening to inpatients' experience of sleep-related nursing interventions, important knowledge for the nurse's profession can be generated. Aim The aim was to describe patients' experience of nursing interventions regarding sleep in inpatient care. Method The study consisted of a non-systematic literature review. The results of the study are based on 17 original scientific articles, which have all been analyzed according to Sophiahemmet University's assessment basis for quality review. Through integrated analysis, results were presented in an overview based on main- and subcategories. Results The result reported three main categories with seven subcategories. In inpatient care, it was found that non-pharmacological nursing interventions that reduce sound and light improve sleep quality. Among the non-pharmacological nursing interventions was also personcentered care mentioned as helpful for inpatients sleep. From patients' experiences, it also clarified that experience well-being is important for the quality of sleep. Furthermore, the routine regarding nursing interventions were emphasized including that nocturnal observations were considered disturbing for coherent sleep and involving the patient in the planning of their care was mentioned as sleep-promoting. Conclusions From this literature study, it became evident that whilst both sleep needs and routines have a significant individual spread there are various sleep-related nursing interventions that patients unanimously consider as sleep-promoting. By listening to patients’ experiences of sleep in inpatient care, an increased knowledge regarding sleep-related interventions can be gained and interventions that promote sleep can be prioritized. With more knowledge, the nurse can increase patients' opportunities for improved sleep quality in inpatient care and contribute to increased well-being and improved health.

Background Patient portals are becoming increasingly popular worldwide even though their impact on individual health and health system efficiency is still unclear. Objective The aim of this systematic review was to summarize evidence on the impact of patient portals on health outcomes and health care efficiency, and to examine user characteristics, attitudes, and satisfaction. Methods We searched the PubMed and Web of Science databases for articles published from January 1, 2013, to October 31, 2019. Eligible studies were primary studies reporting on the impact of patient portal adoption in relation to health outcomes, health care efficiency, and patient attitudes and satisfaction. We excluded studies where portals were not accessible for patients and pilot studies, with the exception of articles evaluating patient attitudes. Results Overall, 3456 records were screened, and 47 articles were included. Among them, 11 studies addressed health outcomes reporting positive results, such as better monitoring of health status, improved patient-doctor interaction, and improved quality of care. Fifteen studies evaluated the impact of digital patient portals on the utilization of health services with mixed results. Patient characteristics were described in 32 studies, and it was reported that the utilization rate usually increases with age and female gender. Finally, 30 studies described attitudes and defined the main barriers (concerns about privacy and data security, and lack of time) and facilitators (access to clinical data and laboratory results) to the use of a portal. Conclusions Evidence regarding health outcomes is generally favorable, and patient portals have the potential to enhance the doctor-patient relationship, improve health status awareness, and increase adherence to therapy. It is still unclear whether the use of patient portals improves health service utilization and efficiency.

Diverse groups in urban settings demonstrate poor participation in health care and low levels of literacy. It is possible the method of health information delivery (eg, spoken vs. written) in these settings could impact health care related communication and understanding, though little is known on this topic. The objective of this study was to uncover the advantages and disadvantages of spoken survey administration in a low-income urban setting. The data for this study were collected via spoken survey with eighty patients in 9 surgery clinics at Temple University Hospital (TUH) in North Philadelphia. Survey responses were coded into various groups until categories and relationships among them emerged to produce themes relevant in demonstrating the advantages and disadvantages of spoken survey. 69% (55) of respondents preferred a spoken survey format. Of the 55 patients who preferred the spoken format, 33% (18) possessed some level of college education and 47% (26) had finished high school. Of the 23 patients who primarily spoke Spanish or another language at home, 78% (18) preferred a spoken interview format. Overall, 53% (42) of patients experienced at least 1 instance of poor understanding throughout the survey. Patients were better able to understand questions in a spoken survey compared to written ones that they had completed in the past due to the opportunity for surveyors to explain questions when needed. It is possible that question explanation is necessary in low-income urban settings due to low-literacy levels or improved feelings of survey intimacy and efficiency.

Objective To evaluate clinical characteristics associated with patient attitudes toward surgical treatment of Peyronie's disease (PD) prior to consultation in a high-volume male sexual health clinic. Methods : From 2014-2018 a prospective database was created of patients presenting to the sexual health clinic at our institution. Multivariable regression analysis was conducted to determine factors associated with pre-visit consideration of surgery. Results : Of 1359 men presenting to clinic, 342 had a chief complaint of PD. Prior to consultation, 79% of patients (n = 270) stated they were willing to consider surgery to correct their PD symptoms. Factors associated with consideration of surgery included younger patient age (mean 55.8 vs 60.0 years; P = .008), history of depression/anxiety (21% vs 8%, P = .01), greater penile curvature (43.3 vs 34.6 degrees; P = .002), penile shortening (64% vs 44%; P = .003), pain with erections (46% vs 33%; P = .05) and decreased ability to have penetrative intercourse (51.9% vs 65.3%, P = .04). On multivariable analysis, age, history of depression, penile shortening, and mean curvature remained significantly associated. Symptom duration and relationship factors were not associated with a difference in the stated preference to consider surgery prior to consultation (P >.05 for all). Conclusion : Nearly 4 out of 5 patients reported willingness to consider surgical intervention for their PD-related symptoms prior to urologic consultation. On multivariable analysis, younger age, history of depression/anxiety, penile shortening, and curvature were associated with a greater likelihood of considering surgery. This information provides important insight into patient attitude toward undergoing surgery and will help drive patient counseling for men with PD.

BackgroundMultimorbidity and polypharmacy are very common in older adults in primary care. Ideally, general practitioners (GPs), should regularly review medication lists to identify inappropriate medication(s) and, where appropriate, deprescribe. However, it remains challenging to deprescribe given time constraints and few recommendations from guidelines. Further, patient related barriers and enablers to deprescribing have to be accounted for. The aim of this study was to identify barriers and enablers to deprescribing as reported by older adults with polypharmacy and multimorbidity.MethodsWe conducted a survey among participants aged >= 70years, with multimorbidity (>= 3 chronic conditions) and polypharmacy (>= 5 chronic medications). We invited Swiss GPs, to recruit eligible patients who then completed a paper-based survey on demographics, medications and chronic conditions. We used the revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire and added twelve additional Likert scale questions and two open-ended questions to assess barriers and enablers towards deprescribing, which we coded and categorized into meaningful themes.ResultSixty four Swiss GPs consented to recruit 5-6 patients each and returned 300 participant responses. Participants were 79.1years (SD 5.7), 47% female, 34% lived alone, and 86% managed their medications themselves. Sixty-seven percent of participants took 5-9 regular medicines and 24% took >= 10 medicines. The majority of participants (77%) were willing to deprescribe one or more of their medicines if their doctor said it was possible. There was no association with sex, age or the number of medicines and willingness to deprescribe. After adjustment for baseline characteristics, there was a strong positive association between willingness to deprescribe and saying that because they have a good relationship with their GP, they would feel that deprescribing was safe OR 11.3 (95% CI: 4.64-27.3) and agreeing that they would be willing to deprescribe if new studies showed an avoidable risk OR 8.0 (95% CI 3.79-16.9). From the open questions, the most mentioned barriers towards deprescribing were patients feeling well on their current medicines and being convinced that they need all their medicines.ConclusionsMost older adults with polypharmacy are willing to deprescribe. GPs may be able to increase deprescribing by building trust with their patients and communicating evidence about the risks of medication use.

Email between patients and physicians can be an effective means of communication and health care delivery, but concerns over security, privacy, fea- sibility, and legality prevail. This paper reviews the limited literature in this area, highlighting our current understanding of the prevalence of email in clinical prac- tice, patient attitudes toward email communication, and the impact of email communication on patient outcomes. While there is a paucity of data on the role, benefts, and risks of email communication, patients and physicians alike should consider secure email as a convenient tool for communication. Physicians require further guidelines on appropriate uses of email in clinical practice to best enhance patient autonomy, preserve patient confdentiality, and comply with current medico-legal standards.

Background: Low back pain (LBP) is one of the most frequent diseases for which patients seek advice in a community pharmacy. The study aimed to evaluate the feasibility of the administration by community pharmacists of questionnaires to assess the LBP intensity and disability degree in patients entering community pharmacies and the attitudes they have toward pain management by pharmacological and non-pharmacological strategies. Methods: An explorative, cross-sectional, observational, and quantitative study was performed. Twelve Italian community pharmacists were asked to submit a questionnaire on LBP to patients visiting their pharmacies. The questionnaire included a pain intensity scale, and two validated tools: the Roland and Morris Disability Questionnaire (RMDQ) and the Start Back Screening Tool (SBST) to determine the degree and risk of patient disability, respectively. Results: 872 patients filled out the questionnaires in 6 months. No statistical differences between genders (p &gt, 0.30) were recorded for pain intensity (Female: median score 6, IQR 4&ndash, 7, Male: median scores 5, IQR 4&ndash, p &gt, 0.30) and disability associated with LBP (RMDQ high-disability level: Females, 14.7%, Males, 15.0%, 0.90). Most of the patients (69%) reported a low degree of disability, but the risk of disability was medium and high in 36% and 18% of them, respectively (p &lt, 0.05). About 14% of patients declare to never seek for physician&rsquo, s advice despite their medium-high degree of disability. Conclusion: The study demonstrated the feasibility of validated tools for assessing the degree and risk of disability in LBP patients administrable in community pharmacies. Moreover, the community pharmacy resulted in an important care portal for patients suffering from moderate LBP and for intercepting patients who suffered from severe LBP but had never reported their problem to their physician.

Introduction Medical photography is a noninvasive technique used for diagnostic, monitoring, and educational purposes. It is important to understand the patient's attitude to all or part of their body being photographed. The objective of this study was to analyze the attitudes of patients towards medical photography at a district hospital in Tarragona, Spain. Methodology This exploratory study used a questionnaire to evaluate attitudes to medical photography among outpatients at Pius Hospital de Valls. The questionnaire explored the patients’ beliefs about the usefulness of medical photography, the circumstances in which they would agree to be photographed and by whom, as well as their prior experience of medical photography. They were also asked whether they would authorize the use of photography and, if not, to explain their motives. Results The questionnaire was completed by 134 patients. The results showed that patients had a clearly positive attitude to being photographed for medical purposes (94.8%), treatment follow-up (88.1%), and consultation of their case with other physicians (86.6%). Acceptance was 88.8% if the lesion was malignant and 85.1% if it was extensive. For facial lesions, only 78.4% were willing to be photographed and in the case of genitals the percentage fell to 70.2%. Most patients (95.5%) would agree to being photographed by their doctor. The rate of acceptance was 66.4% in the case of a nurse, 64.9% for another doctor, and 21.6% for a professional photographer. Conclusions Our study revealed that patients have a positive attitude to being photographed for medical purposes, particularly when they have a malignant lesion, when the photograph is taken by their specialist, and when they cannot be identified.

Objective To explore patients’ attitudes and acceptability of universal screening for COVID-19 in a maternity population. Design Pre-screening and post-screening patient surveys Setting London Population Women admitted to the Maternity Unit at Newham Hospital during a two-week trial period of universal screening. Methods Cluster random sampling was used to select participants to complete the pre-screening questionnaire. Post-screening questionnaires were performed over the telephone. Main outcome measured Agreement to statements regarding patient’s acceptability of the SARS-CoV-2 screening test and the impact screening had on the care provided to themselves and their babies. Results During the two-week period, 180 women underwent universal screening. 81 participants completed the pre-screening questionnaire and 79 participants completed the post-screening survey (72-85% completion rate). More than 70% of women agreed that routine screening resulted in a positive effect on their care, the care of their babies and on their families. More than 80% of women agreed that they would be happy with their care if all pregnant women were offered testing for COVID-19 on admission to hospital. However, 50.62% of women agreed that having a COVID-19 screening swab test taken was uncomfortable and 35.80% were worried about the test results. Nulliparous women were more likely to perceive the positive impacts of screening on their care, their babies care, and their families as compared to multiparous women. Conclusion Our study provides evidence that patient acceptability and tolerance to COVID-19 screening is high, which is key for future implementation of universal screening across maternity services in the UK.

The purpose of this study was to determine patient attitudes about mammographic reporting of breast arterial calcification (BAC), result communication, and action.A self-administered survey was created for this project and was offered to mammography patients presenting for screening or diagnostic mammography over a 1-month period.Among those who accepted questionnaires, 61.8% (419/678) responded with varying response rates to specific questions. A large percentage (95.8% [363/379]) preferred to have BAC reported. All 107 patients who were unaware of a personal history of heart disease wanted notification about BAC. There were 552 communication responses from 354 women. Among these responses, 62.5% (345/552) indicated a preference for notification from the radiology department by letter or telephone call. Among those who had a single preference, 76.6% (180/235) preferred notification by the radiology department in the patient results letter or by telephone call. Of those who chose one action option, 87.4% (181/207) indicated that they would undergo coronary artery CT before making a decision. Among those who selected multiple options, 53.2% (272/511) expressed a desire for coronary artery CT before making a decision. Age, level of education, and race were not associated with patients' attitudes toward BAC.Patients had an overwhelming preference to be informed about BAC found at mammography. Given the ease of reporting BAC and the calls by preventive cardiologists to have the information, the widespread adoption of BAC reporting on mammography reports can promote prevention, diagnosis, and if needed, treatment of cardiovascular disease.

Background: Videodermatoscopy (VD) is a useful device for supporting dermatologists in the distinction between benign and malignant lesions. However, only few patients have access to VD in daily practice. Objectives: To investigate patient attitudes towards VD. Method: A cross-sectional study was conducted between May and June 2018. Patients were asked to complete a self-administered questionnaire on the popularity of VD. Descriptive analysis was performed including contingency tables and χ2 tests to investigate associations between sociodemographic data and the popularity of VD. Results: A total of 61.2% (123/201) of the patients had not heard of VD at the time of assessment or were unsure. Of the 38.8% of patients (78/201) who already knew of VD, 64.1% (50/78) reported that they had already been investigated by VD; 57.5% (111/193) were willing to pay an extra fee for VD. A high level of education and private insurance status had a statistically significant association with the popularity of VD (p = 0.036 and p = 0.026, respectively). Conclusions: There was a strong information deficit, especially in patients with lower education and statutory health insurance. Nevertheless, the willingness to pay an extra fee for a VD-assisted skin examination was high. Dermatologists should actively offer and inform their patients about VD when performing skin cancer screening.

Family studies to reclassify clinically ascertained variants of uncertain significance (VUS) can impact risk assessment, medical management, and psychological outcomes for patients and their families. There are limited avenues for patients and their families to actively participate in VUS reclassification, and access to family studies at most commercial laboratories is restricted by multiple factors. To explore patient attitudes about participation in family studies for VUS reclassification, we conducted semistructured pre- and post-participation telephone interviews with 38 participants in a family-based VUS reclassification study that utilized a patient-driven approach for family ascertainment and recruitment. Participants had VUS from multigene panel testing performed at multiple clinical laboratories for cancer or other disease risk. Inductive thematic analysis of transcribed interviews highlighted four major themes: (a) Participants' study goals were driven by the desire to resolve uncertainty related to the VUS, (b) Participants had mixed reactions to the VUS reclassification outcomes of the study, (c) Personal, public, and familial knowledge increased through study participation and (d) Participants used study participation to actively cope with the uncertainty of a VUS. As personalized genomic medicine becomes more prevalent, clinicians, clinical laboratories, and researchers could consider creating more opportunities for active partnership with patients and families, who are motivated to contribute data to familial VUS studies.

DOI: https://doi.org/10.3126/jpahs.v5i2.23989 Introductions: Medical students need to understand patients’ perspectives about illness and its impact on their lives and family, to evolve as truly socially accountable physicians. Methods: Medical students were assigned in pairs to regularly visit a chronically sick patient over 6 months. They completed a portfolio exploring patient attitudes towards their illness, medication, concerns and beliefs. Themes were coded and portfolios were reviewed independently by two tutors and four students extracting data that matched the themes. New themes were added during the review. Data was later compiled and discussed by the team to refine key themes and portfolios were again reviewed to check for frequency. Results: Fifty-eight students interviewed twenty-nine patients with a variety of chronic conditions. Areas identified included the important role of family and community. A major concern of 18/29 (62%) patients was the impact on the family emotionally, socially and financially of their illness. Other concerns were loneliness (5/29), uncertainty about the illness and deteriorating function. Spiritual issues were important, together with prayer. Some patients (7/29) viewed their illness as a punishment or curse and wanted to die. Other patients believed their illness was due to diet, physical or emotional stress, contagion or exposure to environmental factors. Two believed the oxygen for their COPD was addictive, so restricted its use. Conclusions: As part of providing patient-centered care in the context of Nepal it is important to explore the level of family and community support available to the patient as well as the current impact on the family. Keywords: chronic illness, non-communicable disease, perspectives