A mixed method analysis of patients' complaints: Underpinnings of theory-guided strategies to improve quality of care

Purpose:Patients'complaints can be predictors of patient care quality and safety.Understanding patients'complaints could help healthcare organizations target the areas for improvements.The purpose of this study is to use a mixed method analysis to a)examine the characteristics and categories of patients'complaints,b)explore the relationships of patients'complaints with professions and units,and c)propose theory-based strategies to improve care quality.Methods:This is a descriptive mixed method study.Data examined are patients'complaints filed at a university-affiliated hospital in China from January 2016 to December 2017.A qualitative content analysis was conducted to categorize complaints.A TwoStep cluster analysis was performed to provide an overall profile of patients'complaints.Chi-Square tests were conducted to investigate the relationships among complaints,professions,and units.Results:838 complaints were filed,with 821 valid cases for analysis.Six categories surfaced from the qualitative analysis:uncaring attitudes,unsatisfactory quality of treatment or competence,communication problems,the process of care,fees and billing issues,and other miscellaneous causes.Physicians received most of the complaints(56.6%).The unit receiving the most complaints were outpatient clinics and medical support units(52.7%).The cluster analysis indicated four distinct clusters.Significant relationships existed between complaints and professions(x2(20)=178.82,P<0.01),and between complaints and units(x2(15)=42.72,P<0.01).Conclusions:Patients'complaints are valuable sources for quality improvements.Healthcare providers should be not only scientifically knowledgeable,but also humanistic caring.Caring-based theories may provide guidance in clinical practice.

Blockchain Implications in the Management of Patient Complaints in Healthcare

Blockchain is an emerging technology that has recently been the focus for many researchers who have highlighted its diverse applications including healthcare. Transparency in managing unsolicited patient complaints is important in healthcare for both patients and healthcare providers;in addition, patient complaints analysis is significant to the continued quality improvement. Accordingly, the purpose of this study is to understand the nature of patient complaints management in the healthcare settings, explore the implications of blockchain on the management of patient complaints, and identify limitations in the usage of blockchain. Structured qualitative review and content analysis of the literature methods were used through multiple inclusion and exclusion phases for the scope of this research. Blockchain technology characteristics have been analyzed and approximated with desired features in the patients’ complaint management. Patient complaints provide valuable information to drive continuous improvements in healthcare. Blockchain is described as transparent, decentralized, immutable and anonymous. Results of this research found that a complaint Management system that is built on blockchain technology might have desired features that involve data integrity, security and transparency. Blockchain does have certain limitations that involve cybersecurity, scalability, confidentiality, readiness to adopt it, and is uncertainty about its impact. As a conclusion, implementing a system to manage patient complaints that is based on blockchain technology is promising, due to its desired possible features.

Relationship between Stress and Psychosomatic Complaints among Nurses in Tabarjal Hospital

This research was conducted to examine the relationship between stress and psychosomatic complaints among nurses in Tabarjal hospital. To achieve this aim, the researcher used the descriptive method and selected a sample consisting of (56) nurses working in hospital through the simple random sampling technique. The respondents were requested to complete a questionnaire for rating of stress and the most common psychosomatic diseases. The collected data were analyzed statistically by using SPSS. The results revealed that the stress was dominant among nurses in Tabarjal hospital, the prevalence of psychosomatic complaints was significantly higher in nurses, and there was significant correlation between stress and psychosomatic complaints among nurses. Conclusion: This research confirmed the effect of strains on the prevalence of psychosomatic symptoms among nurses in Tabarjal hospital. Further, implications of the results were discussed on the light of some related researches.

Complaints

Complaining about faulty goods or bad service isnever easy. Most people dislike making a fuss. But ifsomething you have bought is faulty or does not do whatwas claimed for it, you are not asking for a favour toget it put right. It is the shopkeeper’s responsibilityto take the complaint seriously and to replace or repair afaulty article or put right poor service, because he is

Frequency of Hemorrhoidal Complaints in a Real-Life Population and Possible Concomitance between Hemorrhoidal Disease and Chronic Venous Disease: Going Further in Our Understanding of Hemorrhoidal Disease

Introduction: Hemorrhoids, more commonly known as piles, are swollen veins, similar to varicose veins in the lower rectum. Hemorrhoids can develop both inside and outside the rectum, and oftentimes, the cause of hemorrhoids remains unknown. This is an extremely common ailment faced by three out of four adults in their lifetime. Hemorrhoids can cause various kinds of complications, but the most common and serious ones are perianal thrombosis and incarcerated prolapsed internal hemorrhoids with subsequent thrombosis. They are accompanied by severe pain in the perianal region, and possible bleeding. Data on the coexistence of hemorrhoids with other conditions are sparse. Some data are consistent with a common pathophysiological link between straining at stool, constipation, and obstetrical events such as pregnancy and delivery. These events are also involved in the development of Chronic Vein Disease (CVD) or Chronic Vein Insufficiency (CVI). CVI is a condition that occurs when the venous walls or valves in the leg veins stop working properly, causing difficulty in blood returning to the heart from the legs. The present study was conducted with an aim to determine the frequency of complaints in hemorrhoidal patients and to assess the possible concomitance between hemorrhoidal disease and chronic venous disease. Methods: This was a multicenter, cross-sectional, observational study that enrolled patients spontaneously consulting for hemorrhoids in 17 different hospitals of different regions of Bangladesh from 1st June 2018 to 31st July 2018. Patients’ demographic and lifestyle characteristics were recorded, information on hemorrhoidal grade and signs of chronic venous disease was collected. Types of prescribed treatments were also recorded by the physicians. Results: A total of 499 patients were enrolled and analyzed. Reported frequencies of hemorrhoidal symptoms were: bleeding (80.8%), pain (66.3%), swelling (51.7%), prolapse (28.9%), itching (37.7%), soiling (12%), fecal incontinence (13.4%). 13.8% of the hemorrhoidal patients presented concomitant chronic venous disease. The Clinical-Etiological-Anatomical-Pathophysiological (CEAP) classification was used to classify the clinical signs and symptoms of the patients as C0—no visible or palpable signs of venous disease (6.2%), C1—telangiectasias or reticular veins (4.4%), C2—varicose veins (1.4%), C3—edema (2.6%), C4a—pigmentation or eczema (2%), C4b—lipodermatosclerosis or Atrophie Blanche (0.2%), C5 & C6—venous ulcer (0.6%). Commonly prescribed treatments were dietary fiber (89.8%), veno-active drugs (74.7%), topical treatments (63.7%), painkillers (11.2%), and surgical procedures (30.3%). Conclusion: The study provides small-scale data on patient profiles, risk factors, and commonly prescribed treatments in hemorrhoidal patients. The concomitance of chronic venous disease in 13.8% of the hemorrhoidal patients highlights the importance

US Action on China Subsidies May Invite Cotton Co Complaints

News that the U.S. will allow companies to pursue anti-subsidy action against Chinese imports paves the way for companies within the textile industry to seek trade protection,though it remains to be seen how the situation may affect the U.S. cotton industry,analysts

People's Complaints System in China——Chinese way of human rights relief

The people＇s complaints system is a mechanism of democracy and human rights relief under the traditional legal system of China. It has displayed positive roles during different historical periods after 1949 when the new China was founded.

Multifactor analysis of patients with oral sensory complaints in a case-control study

Background:There are an increasing number of patients with oral sensory complaints(OSCs)presenting to our dental clinic.For most dentists,it is difficult to distinguish burning mouth syndrome(BMS)from other oral mucosal diseases that may cause symptoms such as burning mouth.It is beneficial to effectively distinguish OSC patients to reduce misdiagnosis and eliminate burning symptoms as much as possible.Methods:Patients with oral burning sensations in the oral mucosal disease clinic were collected from the Peking University Hospital of Stomatology between September 1,2014 and December 31,2018.After excluding oral candidiasis,anemic stomatitis,dental material allergy,and other diseases from patients with oral sensory complaints,basic conditions such as gender,age,education level,job status,hyperglycemia,hypertension,hyperlipidemia,history of brain abnormalities,history of cervical spondylitis,history of thyroid disease,history of thyroid disease and insomnia were obtained.The BMS patients were compared with the control group.The t test and Chi-square test were used for statistical analysis to compare the clinical symptoms of these diseases and explore the risk factors for BMS.Results:In this case-control study,395 patients(321 females and 74 males,mean age 55.26±10.51 years)with oral sensory complaints and 391 healthy controls(281 females and 110 males,mean age 47.11±13.10 years)were enrolled,among which,8.4%(33/395)had oral candidiasis,1.3%(5/395)had dental material allergy,0.8%(3/395)had anemic stomatitis and 0.5%(2/395)had lichen planus.A total of 352 patients were eventually diagnosed with BMS.Anxiety and depression were more severe in BMS patients,as were the incidences of sleep disorders and brain abnormalities.Logistic regression analysis showed that age(odds ratio[OR]=2.79,95%confidence interval[CI]:1.61-4.83,P<0.001),total cholesterol level(OR=2.92,95%CI:1.32-6.50,P=0.009)and anxiety score(OR=1.75,95%CI:1.01-2.77,P=0.017)significantly increased the incidence of BMS.Patients with hyperglycemia(OR=0.46,95%CI:0.23-0.89,P=0.022),low body mass index(BMI:OR=0.57,95%CI:0.34-0.93,P=0.026)and low education level(OR=3.43,95%CI:1.91-6.15,P<0.001)were more likely to suffer from BMS.Conclusions:Oral candidiasis,anemic stomatitis,and dental material allergy with burning symptoms should be excluded from patients with BMS.It is recommended to conduct a questionnaire survey(including anxiety and depression),blood cell analysis,and salivary fungus culture for all patients with an oral burning sensation.It is necessary to conduct a patch test on patients with oral burning sensations and metal restorations.

Characterization of patients and its relationship with medical complaints

Background Patient characteristics may be an internal factor influencing patient complaints, but in China patient characterization is restricted to patient satisfaction surveys, and few studies have considered the relationship between patient characteristics and patient complaints. The aim of this research was to determine the reasons for complaints. Methods In this study, we analyzed the characteristics of hospitalized patients and explored their relationship with medical complaints. Results The significant factors were age （P=0.045）, hospital cost （P=0.003）, household nature （P 〈0,001）, and education （P 〈0.001）. The complaint rate decreased when the patients＇ age increased （regression coefficient, -0.606; OR, 0.545, and 95%C/, 0.301-0.987）. The complaint rate increased with an increase in hospital cost （regression coefficient, 0.818; OR, 2.266; and 95%C/, 1.320-3.889）. Patients from non-agricultural households had a higher complaint rate （regression coefficient, 1.051; OR, 2.861; and 95%C/, 1.611-5.082）. Patients with higher education levels had lower complaint rates （regression coefficient, -0.944; OR, 0.389; and 95%C/, 0.234-0.647）. Conclusion The survey confirms that older patients and patients with higher education levels had lower complaint rates, while non-agricultural population and patients with higher hospital expenses had higher complaint rates.

Association of Source of Memory Complaints and Increased Risk of Cognitive Impairment and Cognitive Decline： A Community-Based Study

Background： Memory complaint is common in the elderly. Recently, it was shown that self-report memory complaint was predictive of cognitive decline. This study aimed to investigate the predictive value of the source of memory complaints on the risk of cognitive impairment and cognitive decline in a community-based cohort. Methods： Data on memory complaints and cognitive function were collected among 1840 Chinese participants （aged ≥55 years old） in an urban community at baseline interview and 5-year follow-up. Incident cognitive impairment was identified based on education-adjusted Mini-Mental State Examination score. Logistic regression model was used to estimate the association between the source of memory complaints and risk of cognitive impairment conversion and cognitive decline, after adjusting for covariates. Results： A total of 1840 participants were included into this study including 1713 normal participants and 127 cognitive impairment participants in 2009. Among 1713 normal participants in 2009, 130 participants were converted to cognitive impairment alter 5 years of follow-up. In 2014, 606 participants were identified as cognitive decline. Both self- and informant-reported memory complaints were associated with an increased risk of cognitive impairment （odds ratio [OR] - 1.60, 95% confidence interval [CI]： 1.04 2.48） and cognitive decline （OR = 1.30, 95% CI： 1.01-1.68）. Furthermore, this association was more significant in males （OR = 2.10, 95% CI： 1.04-4.24 for cognitive impairment and OR - 1.87, 95% CI：1.20-2.99 for cognitive decline） and in higher education level （OR - 1.79, 95% CI： 1.02-3.15 for cognitive impairment and OR = 1.40, 95% CI：1.02-1.91 for cognitive decline）. Conclusions： Both self- and informant-reported memory complaints were associated with an increased risk of cognitive impairment conversion and cognitive decline, especially in persons with male gender and high educational background.

Environmental complaint insights through text mining based on the driver,pressure,state,impact,and response(DPSIR)framework:Evidence from an Italian environmental agency

Individuals,local communities,environmental associations,private organizations,and public representatives and bodies may all be aggrieved by environmental problems concerning poor air quality,illegal waste disposal,water contamination,and general pollution.Environmental complaints represent the expressions of dissatisfaction with these issues.As the timeconsuming of managing a large number of complaints,text mining may be useful for automatically extracting information on stakeholder priorities and concerns.The paper used text mining and semantic network analysis to crawl relevant keywords about environmental complaints from two online complaint submission systems:online claim submission system of Regional Agency for Prevention,Environment and Energy(Arpae)(“Contact Arpae”);and Arpae's internal platform for environmental pollution(“Environmental incident reporting portal”)in the Emilia-Romagna Region,Italy.We evaluated the total of 2477 records and classified this information based on the claim topic(air pollution,water pollution,noise pollution,waste,odor,soil,weather-climate,sea-coast,and electromagnetic radiation)and geographical distribution.Then,this paper used natural language processing to extract keywords from the dataset,and classified keywords ranking higher in Term Frequency-Inverse Document Frequency(TF-IDF)based on the driver,pressure,state,impact,and response(DPSIR)framework.This study provided a systemic approach to understanding the interaction between people and environment in different geographical contexts and builds sustainable and healthy communities.The results showed that most complaints are from the public and associated with air pollution and odor.Factories(particularly foundries and ceramic industries)and farms are identified as the drivers of environmental issues.Citizen believed that environmental issues mainly affect human well-being.Moreover,the keywords of“odor”,“report”,“request”,“presence”,“municipality”,and“hours”were the most influential and meaningful concepts,as demonstrated by their high degree and betweenness centrality values.Keywords connecting odor(classified as impacts)and air pollution(classified as state)were the most important(such as“odor-burnt plastic”and“odor-acrid”).Complainants perceived odor annoyance as a primary environmental concern,possibly related to two main drivers:“odor-factory”and“odorsfarms”.The proposed approach has several theoretical and practical implications:text mining may quickly and efficiently address citizen needs,providing the basis toward automating(even partially)the complaint process;and the DPSIR framework might support the planning and organization of information and the identification of stakeholder concerns and priorities,as well as metrics and indicators for their assessment.Therefore,integration of the DPSIR framework with the text mining of environmental complaints might generate a comprehensive environmental knowledge base as a prerequisite for a wider exploitation of analysis to support decision-making processes and environmental management activities.

Topic-Aware Abstractive Summarization Based on Heterogeneous Graph Attention Networks for Chinese Complaint Reports

Automatic text summarization(ATS)plays a significant role in Natural Language Processing(NLP).Abstractive summarization produces summaries by identifying and compressing the most important information in a document.However,there are only relatively several comprehensively evaluated abstractive summarization models that work well for specific types of reports due to their unstructured and oral language text characteristics.In particular,Chinese complaint reports,generated by urban complainers and collected by government employees,describe existing resident problems in daily life.Meanwhile,the reflected problems are required to respond speedily.Therefore,automatic summarization tasks for these reports have been developed.However,similar to traditional summarization models,the generated summaries still exist problems of informativeness and conciseness.To address these issues and generate suitably informative and less redundant summaries,a topic-based abstractive summarization method is proposed to obtain global and local features.Additionally,a heterogeneous graph of the original document is constructed using word-level and topic-level features.Experiments and analyses on public review datasets(Yelp and Amazon)and our constructed dataset(Chinese complaint reports)show that the proposed framework effectively improves the performance of the abstractive summarization model for Chinese complaint reports.

Seaweed Dietetic Food for the Functional Gastrointestinal Complaint Treatment

Despite the common nature of dyspeptic complaints, the treatment is still a problem. There is very little research done on the impact of dietary nutrition on the general health of the patients with dyspeptic complaints and overall nutritional safety. Study Objective: To evaluate the clinical effectiveness of the brown seaweed dietary product “Vitamarine” for the treatment of dyspepsia, as well as product safety. Material and Methods: An open, uncontrolled pilot study with questionnaires before and after the vitamarine course with the patient’s self-perception reports. Data were processed with multivariate analysis. Results: The study included 46 patients with 45 valid end result questionnaires for data processing. After 8 to 10 days use of vitamarine, 33 (76.8%) patients noted symptom disappearance or significant improvement, no improvement of symptoms or their increase was noted by 10 patients (23.2%). Complaints about weakness, fatigue and rapid tiredness significantly decreased or disappeared entirely (p = 0.04), including months long epi-gastric pain (p = 0.02) and constipation (p = 0.01). Conclusions: 1) Use of the dietetic food product “Vitamarine” with a dose of 50 - 60 g per day in two cases out of three improve the general well-being of the patients: months long dyspeptic abdominal pain and constipation disappear or significantly decrease. 2) In the first 8 - 10 days of the vitamarine course clinical effectiveness already can be noted. 3) Use of vitamarine is safe, including patients with a history of allergies to medications, elderly and patients with concomitant diseases.

Nocturia: Impact on quality of life in an Egyptian adult population

OBJECTIVE: To estimate the effects of nocturia on quality of life (QoL) and to assess the associated effects of sleep problems. Background: Nocturnal urination (nocturia) is such a commonplace occurrence in the lives of many older adults that it is frequently overlooked as a potential cause of sleep disturbance. Methods: The current study was carried out to assess the prevalence of nocturia in elderly males and its impact on sleep quality and QoL. The study enrolled 200 elderly males aged 60 years old and above. All participants were recruited from geriatric clubs in Cairo. All participants in the study were subjected to: comprehensive geriatric assessment, American Urological Association (AUA) score used to measure the severity of nocturia ,assessment of sleep quality using Pittsburgh Sleep Quality Index (PSQI) and assessment of QoL using “SF-12 Short Form Health Survey”. Results: The study showed that the prevalence of nocturia in elderly males aged ≥60 years old was 68% with significant association between nocturia and diabetes mellitus, heart failure, stroke, prostatism, recurrent UTI and diuretic use. As regard sleep quality, the current study showed that the prevalence of poor sleep in the studied subjects is 70.5% with significant association between nocturia and poor sleep quality. Nocturia significantly affects sleep latency, sleep efficiency and daytime dysfunction, high significantly affecting sleep disturbance. Also diabetes mellitus, ischemic heart disease, heart failure, prostatism, recurrent UTI, osteoarthritis and diuretic use are significantly associated with poor sleep quality. As regard quality of life, the current study showed significant association between nocturia and physical and mental health components of HRQL in the univariate analysis. But after multivariate analysis, nocturia is not an independent risk factor for poor quality of life. Nocturia affects QoL through its effect on sleep quality which is an independent risk factor for poor physical and mental health components of QoL. Conclusion: Nocturia may lead to sleep insufficiency and consequently to a decrease in mental and physical health. Patients who consult a doctor for nocturia should thus be treated adequately. In addition, it is worthwhile for doctors to routinely check if patients’ who contact them for sleep problems also have nocturia.

Emergency department use among patients from residential aged care facilities under a Hospital in the Nursing Home scheme in public hospitals in Queensland Australia

BACKGROUND: Hospital emergency department(ED) use by patients from residential aged care facilities(RACFs) is not always appropriate, and this calls for interventions to avoid some unnecessary uses. This study aims to compare patterns of ED use by RACF patients with and without a Hospital in the Nursing Home(Hi NH) program.METHODS: RACF patients presenting to EDs of a hospital with and a hospital without this program during pre- and post-intervention periods were included. Data on patient demographics and ED presentation characteristics were obtained from the Emergency Department Information System database, and were analysed by descriptive and comparative statistics.RESULTS: In both hospitals, most RACF residents presenting to EDs were aged between 75–94 years, female, triaged at scale 3 to 5, and transferred on weekdays and during working hours. Almost half of them were subsequently admitted to hospitals. In accordance with the ICD-10-AM diagnostic coding system, diagnoses that consistently ranked among the top three reasons for visiting the two hospitals before and after intervention included Chapter XIX: injury and poisoning and Chapter X: respiratory diseases. Associated with the intervention, significant decreases in the numbers of presentations per 1 000 RACF beds were identified among patients diagnosed with Chapter XI: digestive diseases [rate ratio(95%CI): 0.09(0.04, 0.22); P<0.0001] and Chapter XXI: factors influencing health status and contact with health services [rate ratio(95%CI): 0.22(0.07, 0.66); P=0.007].CONCLUSION: The Hi NH program may reduce the incidence of RACF residents visiting EDs for diagnoses of Chapter XI and Chapter XXI.

ACUPUNCTURE TREATMENT OF TRIGEMINAL NEURALGIA

Case History Name: Liu; Sex: female; Age: 51; Occupation: housewife; Date of first visit: Nov. 4, 1985. Chief complaint: Right-side facial pain for 6 months. In the beginning the patient suspected it to be toothache which was later ruled out by the dentist. The attack was characterized by paroxysmal pain and

ACUPUNCTURE TREATMENT OF ASTHMA

Case History Ms. Shi ××, 61 years of age,researchfelloW in Chinese Academy of Sciences,ViS-ited on 27 November 1979. Chief complaint:Cough and asthma fora week. A cold caught ten years before had re-sulted in asthma which led to repeated fol-lowing attacks were more severe during au-tumn and winter.The present attack wascaused by invasion of cold due to suddenchange of weather.The patient sufferedfrom dyspnea。oppressed feeling in the chest.

TREATMENT OF 1000 CASES OF LUMBAR SOFT TISSUE INJURY WITH ACUPUNCTURE PLUS EXERCISE

Soft tissue injury of the lumbar regionis a common complaint in the outpatientclinic.The malady is due mostly to improperposture during exertion of the lumbar mus-cles,manifested by sudden lumbar pain andlimitation of movement.Since 1976,the au-thor has adopted acupuncture combinedwith local exercises in treatment of

TREATING SUBLUXATION OF SACROILIAC JOINT BY MANIPULATION -A Report of 100 Cases

Subluxation of the sacroiliac joint is afrequently encountered condition in theorthopedic clinic. The patient comes to thedoctor with the chief complaint of severepain in the region of the sacroiliac joint ra-diating to the buttock and leg on the affect-ed side, and marked limitation to themovement of the joint. Its symptoms areeasily mixed up with those of acute lumbarsprain, protrusion of lumbar

Can subjective sleep quality, evaluated at the age of 73, have an influence on successful aging? The PROOF study

Objective: Sleep complaints are recurrent in Geriatrics and are often attributed to physiological aging. The aim of this work is to describe subjective sleep quality and its impact on successful aging. Methods: Subjective sleep quality was evaluated by using the Pittsburgh subjective sleep quality questionnaire. Two visual analogical scales (graduate from 0 to 10) were used to quantify perceived state of health and life satisfaction. Objective respiratory sleep parameters were also collected. Results: 370 data were analysed (46.2% of males). The average age was 73.2 +/- 1. The level of perceived state of health was 6.9 +/- 2, and life satisfaction level was 7.7 +/-2. Subjective sleep quality was significantly related to perceived health status (p = 0.034) and life satisfaction (p = 0.005). There was no significant association between sleep quality and objective respiratory sleep parameters. Conclusion: The assessment of sleep quality plays an important role in the management of elderly persons and can help them to age more successfully.