Patient satisfaction and follow-up adherence to glaucoma case management clinic in China

AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.

Patient Satisfaction with Primary Health Care Services in Riyadh City, Saudi Arabia

Patient satisfaction is a crucial measure of healthcare quality and plays a vital role in ensuring effective healthcare systems. This study aims to assess the level of patient satisfaction with primary healthcare services in Riyadh, Saudi Arabia, identify social factors affecting satisfaction, and determine the reasons behind dissatisfaction and how to improve satisfaction. The study employed a cross-sectional observational design and included a random sample of 400 patients from primary healthcare centers in Riyadh. Data were collected using an electronic questionnaire and analyzed using SPSS software. The study found that patients were generally satisfied with the primary healthcare services provided in Riyadh, with high levels of satisfaction reported for booking appointments, triage services, and emergency care. However, some aspects of the healthcare experience, such as long waiting times and the physical design of healthcare centers, need improvement. These findings can be used to inform the development of policies and interventions aimed at enhancing healthcare quality in Saudi Arabia.

Disposable circumcision suture device： clinical effect and patient satisfaction

In our experience patients undergoing circumcision are mostly concerned about pain and penile appearances. We conducted a prospective randomized trial to assess the benefits of a new disposable circumcision suture device （DCSD）. A total of 942 patients were equally divided into three groups （conventional circumcision, Shang ring and disposable suture device group）. Patients in the DCSD group were anesthetized with compound 5% lidocaine cream, the others with a 2% lidocaine penile block. Operation time, intra-operative blood loss, incision healing time, intra-operative and post-operative pain, the penile appearance and overall satisfaction degree were measured. Operation time and intra-operative blood loss were significantly lower in the Shang ring and suture device groups compared to the conventional group （P 〈 0.001）. Intra-operative pain was less in the suture device group compared With the other two groups （P 〈 0.001）; whereas post-operative pain was higher in the conventional group compared to the other two groups （P 〈 0.001）. Patients in the suture device （80.57%） and Shang ring （73,57%） groups were more satisfied with penile appearances compared with the conventional circumcision group （20.06%, P 〈 0.05）. Patients in suture device group also healed markedly faster than the conventional group （P 〈 0.01）. The overall satisfaction rate was better in the suture device group （78.66%） compared with the conventional （47.13%） and Shang ring （50.00%） groups （P 〈 0.05）. The combination of DCSD and lidocaine cream resulted in shorter operation and incision healing times, reduced intra-operative and post-operative pain and improved patient satisfaction with the cosmetic appearances.

How to improve patient satisfaction during midazolam sedation for gastrointestinal endoscopy?

To determine the procedure-related factors that affect sedation satisfaction and to make a suggestion to improve it.METHODSWe prospectively enrolled a total of 456 patients who underwent outpatient endoscopy procedures with midazolam sedation between March 2014 and August 2014. All patients completed both pre- and post-endoscopy questionnaires about sedation expectations and satisfaction.RESULTSThe study cohort included 167 (36.6%) patients who underwent esophagogastroduodenoscopy (EGD), 167 (36.6%) who underwent colonoscopy, and 122 (26.8%) who underwent a combined procedure (EGD and colonoscopy). Over 80% of all patients were satisfied with sedation using midazolam. In univariate and multivariate analyses, total procedure time in the EGD group, younger age (≤ 50 years), and longer colonoscopy withdrawal time in the colonoscopy group were related to decreased satisfaction with sedation. However, in active monitoring and intervention group, there was no decrease in grade of satisfaction despite longer procedure time due to more procedures during colonoscopy. Younger age (≤ 50 years), longer inter-procedure time gap, and colonoscopy withdrawal time were related to decreased satisfaction in the combined EGD and colonoscopy group.CONCLUSIONMidazolam is still a safe and effective sedative for gastrointestinal endoscopy. Satisfaction with sedation depends on several factors including age (≤ 50 years) and procedure time duration. To improve patient satisfaction with sedation, active monitoring of sedation status by the endoscopist should be considered for patients who require long procedure time.

Surgical outcome and patient satisfaction after Z-epicanthoplasty and blepharoplasty

AIM: To evaluate surgical outcomes of modified Z-epicanthoplasty with blepharoplasty that we previously reported from the patient’s perspective using patient-reported outcome measures(PROMs) and patient satisfaction scores.METHODS: A total of patients(n=180) who underwent the surgery between January 2013 and June 2016 were randomly selected. Standardized patient satisfaction forms(total score, 40) and validated PROMs questionnaires(total score, 12) were sent to patients for completion. PROMs assesses the severity of scarring, pain and asymmetry, as well as functional and appearance issues.RESULTS: All patients were female, ranging from 18 to 35 years old(mean=24). The response rate was 73.3%(n=132). The majority of patients reported good or excellent outcomes based on PROM analysis. Patients reported minimum or non-visible scarring at both the double eyelid surgical scar(85.6%) and the inner canthus(80.3%). Issues concerning function and appearance were minimal as 80.3% reported satisfaction with both domains. Notably, the majority of patients reported either a high or very high satisfaction rate to yield a mean score of 104 out of 120(P<0.05).CONCLUSION: Integration of our modified Z-epicanthoplasty with blepharoplasty produces good outcomes based on PROM results, which shows a positive linear relationship with patient satisfaction scores.

Factors Affecting Patient Satisfaction with Community Health Service under the Gatekeeper System:A Cross-sectional Study in Nanjing,China

The gatekeeper policy has been implemented for approximately ten years on a pilot population in China. It is necessary to assess the satisfaction of patients utilizing community health service（CHS） under the gatekeeper system. Our study showed that the cognition of gatekeeper policy was associated with four dimensions including doctor‐patient relationships, information and support, organization of care, and accessibility（P 〈 0.001）. One or more factors such as gender and self‐perceived health scores also affected their satisfaction. General practitioners must be prepared to focus on these aspects of information and support, organization of care, and accessibility as indicators of potential opportunities for improvement. Additionally, policymakers can improve patients＇ satisfaction with CHS by strengthening their awareness of the gatekeeper policy.

Comparison of Patient Satisfaction between Brachial Plexus Block (Axillary Approach) and General Anesthesia for Surgical Treatment of Distal Radius Fractures: A Historical Cohort Study

Background: Distal radius fracture surgery is performed under general (GA) or regional anesthesia with brachial plexus block (NB). Whether anesthesia type affects patient outcomes is unclear. This study retrospectively compared patient satisfaction between GA and NB after surgery. Methods: This was a historical cohort study of 80 (34 GA and 46 NB) patients who underwent volar plate fixation of distal radius fractures. Propensity score analysis was used to generate a set of matched cases (NB) and controls (GA), yielding 14 matched patient-pairs. The simplified patient satisfaction scale was compared for primary outcomes. Secondary outcomes were anesthesia and surgery duration, hospital stay length, adverse events, postoperative analgesic requirement, and wrist range of motion (ROM) 2 weeks and 3 months postoperatively. Results: After propensity score matching, patients in almost all cases in both groups were “Satisfied” (effect size: 0.1, p = 0.572), indicating little significant difference. Significant differences in adverse events and postoperative analgesic use observed before matching disappeared after matching. Anesthesia duration and hospital stay length were significantly shorter in the NB group (effect size: -1.27 and -0.77, p = 0.00074 and p = 0.0388, respectively), as was surgery duration (effect size: -0.84, p = 0.0122) after matching. Similar to before matching, wrist ROM significantly improved in the NB group (effect size: 1.11, p = 0.0279) in the early postoperative period, but the difference disappeared at 3 months postoperatively. Conclusions: Patient satisfaction between distal radius fracture surgery under GA and NB was similar. Nerve block could help shorten hospital stay length and surgery duration and improve postoperative functional recovery.

The Patient Satisfaction Scale： Validation of a Portuguese Version in Women Receiving Obstetric Care

Satisfaction of the obstetric patient is an indicator taken in account in health reports. Previous studies point towards several dimensions. In order to better evaluate health care services, it is curtail to have Portuguese language tools of easy appliance. The aim of the study is to validate the PSS in Portuguese. This is a descriptive study using a convenience sample of ninety one mothers. Participants were primary healthcare clients with children aged of I or less. The analysis regarded sensitivity, reliability, as well as concurrent, discriminant, converging and factorial validity. After Promax rotation, three factors were extracted explaining 82.13% of the variance. Reliability analysis was observed by split-half method showing a Spearman-Brown correlation coefficient of 0.91. Cronbach＇s alpha of the Portuguese PSS total scale and subscales were satisfactory with coefficients between 0.829 and 0.941. Concurrent validity was supported by a continuous variable of support from nurses. Discriminant validity showed in women with a normal vaginal delivery, a higher satisfaction both globally and on the three dimensions. The properties observed at the PSS have shown to be satisfactory. PSS reveals itself as a valid measure of the obstetric client＇s satisfaction.

Better Glycaemic Outcome, Low Levels of Acute Severe Complications, and High Patient Satisfaction in Routine Practice in Type 1 Diabetes Treated with an Insulin Pump

Treatment of patients with Type 1 diabetes with continuous subcutaneous insulin infusion (CSII) was re-introduced in Denmark in this millennium and initiated in the diabetes clinic, Fredericia Hospital, in 2005. The aim of the present study was to present yearly data of quality from 2005 to 2013 from a clinical database of patients treated with CSII in routine practice. Methods: A database was established in 2009-2010. Data from 2005 to 2009 are retrospective, data from 2009 to 2013 prospective. From 2009, patient satisfaction was measured by validated questionnaires. Results: By 31 December 2013, the database contained data from 143 active patients. HbA1C (median and range) decreased from 64 (40 - 126) mmol/mol (8.0 (5.8 - 13.7)%) (n = 104) to 60 (36 - 98) mmol/mol (7.6 (5.4 - 11.1)%) (n = 134) (p < 0.001) before and latest year on CSII. The improved glycaemic control was maintained each year until ≥5 years after initiation of CSII (p < 0.01). There was no change in weight. The number of attacks of severe hypoglycaemia was reduced from 60 attacks in 21 patients (n = 104) the year before CSII to only 5 attacks in 5 patients in 2013 (n = 134) (p < 0.01), corresponding to an incidence of 3.7 episodes per 100 patient years. Each year after initiation of CSII until ≥5 years, the number of episodes of severe hypoglycaemia was reduced (p < 0.01). Since 2005, nine episodes of ketoacidosis have been registered in eight patients corresponding to an incidence of 1.4 episodes per 100 patient years. Patient satisfaction was high one year after initiation of CSII (p < 0.01). Conclusion: Change of treatment to CSII is accompanied by an improvement in glycaemic control, very pronounced reduction in severe hypoglycaemia, low levels of diabetic ketoacidosis, and pronounced patient satisfaction.

Patient Satisfaction after Elective Major Gynaecological Surgery in 2 Reference Hospitals in Yaounde: A Cross-Sectional Study

Introduction: Patient satisfaction is a quality-of-care measure and reveals patients’ appreciation of healthcare delivery. We sought to measure patient satisfaction following major gynaecological surgeries in 2 University Teaching Hospitals in Yaounde, Cameroon. Methods: This study was a cross-sectional, prospective study over 9 months (October 1st, 2018, to June 30th, 2019) at the Yaounde Gynaeco-Obstetric and Paediatric Hospital (YGOPH) and the Yaounde Central Hospital (YCH). By administering a modified Surgical Satisfaction Questionnaire (SSQ-8) via phone call 6 months after surgery, we appreciated and scored key aspects linked to patient satisfaction and obtained information on post-operative complications. Data were analysed using Microsoft Excel 18 and SPSS 21 setting significance at p Results: We recruited 72 patients aged 24 to 68 years. Our participants had a mean satisfaction score of 26 ± 7.854 (59.7% satisfied and 40.3% dissatisfied). All aspects tested on the SSQ-8 questionnaire influenced patient satisfaction. Patients who said they were satisfied with pain control after surgery (OR = 0.207 CI = 0.070 - 0.609, p = 0,003), and with surgical results in the SSQ-8 questionnaire (OR = 0.053, CI = 0.011 - 0.254, p < 0.001) achieved statistically significant post-operative satisfaction. Contrarily, patients who were dissatisfied with surgery results (OR = 132.000, CI = 15.256 - 114.131, p < 0.001) and those who developed complications (OR = 7.922, CI = 2.241 - 28.004, p < 0.001) were significantly dissatisfied with surgery. Additionally, 47.2% declared a poor post-operative current health status versus 52.8% who claimed a good post-operative current health status. Following multivariate analysis, satisfaction with the results of surgery (OR = 0.071, CI = 0.008 - 0.657, p = 0.020) and the occurrence of complications (OR = 7.284, CI = 1.146 - 46.273, p = 0.035) were the main determinants of patient satisfaction. Patient current health status evolved similarly to patient satisfaction and especially by satisfaction with time taken to resume work (OR = 0.039, CI = 0.004 - 0.398, p = 0.006) and pre-operative exercise routine (OR = 0.038, CI = 0.002 - 0.678, p-value = 0026). Conclusion: Patient satisfaction with elective gynaecological surgery is low and determined by post-operative experiences and the occurrence of complications. Also, patients self-reported current health status tends to evolve similarly to satisfaction following surgery.

Patient Satisfaction Related to Their Eye Health Examination at Lúrio University Clinic in Nampula, Mozambique during COVID-19

Introduction: Patient satisfaction is defined as the extent of agreement between what a patient expects to receive from his or her health experience and the perception of the level of care he or she actually receive. With the COVID-19 pandemic, many practices have to adapt to provide health ensuring patients’ safety in first instance. Eye care procedures may be delayed during the pandemic, so eye safety is more important than ever, and it doesn’t only focus on the examination room, all the clinic compartments must be adjusted to ensure that no patient is infected by COVID-19 within the clinic. The aim of this study was to assess the satisfaction of patients who attended the Lúrio University Clinic for eye care during COVID-19. Material and Methods: This is a quantitative, descriptive and cross-sectional study conducted from December 30th, 2020 to April 30th, 2021. A systematic random sampling method was used to enrol 173 participants. Data were collected using an identification form and the patient satisfaction survey. Ethical clearance was obtained from the Lúrio University Bioethical Committee review board, and informed consent term was also received from the participants before data collection. Results: 173 participants (84 women, 48.6% and 89 men, 51.4%) completed the survey with the mean age of 31.14 and standard deviation of ±14.6 years. We found that 98.3% of the participants were satisfied (63.6% satisfied and 34.7% extremely satisfied) with the eye care provided in Lúrio University Clinic. Conclusion: Most of the patients were satisfied with the eye health examination provided in Lúrio University clinic, thus the directions for future research of the study are now opened.

Patient Satisfaction in Croatian Nationwide Mammography Screening Program

Mammographic screening programs are essential in timely detection and effective treatment of breast cancer. Since 2006, Croatia implemented a national MSP which asks for a regular biannual mammography for all women 50 - 69 years of age. First-visit screening attendance in the country is estimated at 58.3% with the trend of gradually decreasing re-attendance rates. Since patient satisfaction with the screening procedure may influence subsequent adherence, this study aimed to assess patient satisfaction in order to predict and improve patient re-attendance rate, a first-time effort of such kind in Croatia. 201 random patients undergoing mammography screening procedure at four facilities in Croatia were asked to complete an anonymous questionnaire which specifically evaluated the following aspects of patient experience: patient attitude, facility surroundings, staff attitude and pre-examination information transfer, associated physical pain, psychological discomfort, and finally overall patient impressions and satisfaction. The majority of our examinees expressed high satisfaction with MSP and an intention to re-screen;patient attitude, facility environment and staff attitude were deemed overly positive, whereas the majority of patients estimated the physical and psychological pain associated tolerable. These results suggest that patient satisfaction is not a critical factor influencing future adherence rate in MSP, and other components of the program should be evaluated and improved.

Construction of an intelligent patient satisfaction assessment system and its application in emergency management

Hospital emergency management work is of great importance which not only related to the life and health of the people but also related to social stability.It is necessary to construct and improve the patient satisfaction assessment system so that doctors and patients can interact in a timely and effective manner,and the hospital can alert or respond promptly.This study constructs a closed-loop emergency management system consisting of patient-end,data center and decision-making-end,and apply the feedback information to hospital emergency management.In the preliminary applications,the system has a significant effect on the hospital emergency management mechanism.The researchers will improve the system in the follow-up study。

Expectations and Level of Satisfaction of the Patient with Parkinson’s Disease Undergoing Deep Brain Stimulation Surgery at the National Institute of Neurology and Neurosurgery

Background: Deep brain stimulation (DBS) is an established treatment for patients with advanced Parkinson’s disease (PD). Reports show continued patient satisfaction after surgery despite not maintaining clinical improvement as measured by evolution scales. Objectives: The present study sought to explore expectations and level of satisfaction in patients after DBS surgery with a semi-structured questionnaire and subsequent correlation with functional scales, Quality of Life (QoL), and motor and non-motor symptoms. Methods: We performed descriptive statistics to represent demographic data, Wilcoxon rank tests to determine significant differences, and Spearman correlation between the applied scales. Results: We evaluated 20 patients with a history of DBS surgery. 45% were female, with a mean age of 55.7 ± 14.15 years, a mean disease duration of 13.42 ± 8.3 years, and a mean time after surgery of 3.18 ± 1.86 years. Patients reported surgery meeting expectations in 85.5% and continued satisfaction in 92%. These two variables showed a significant correlation. Conclusions: This sample of patients remained satisfied after DBS surgery, although we found no differences in motor and non-motor clinimetric scales. Further studies are needed to confirm the importance of assessing quality of life in patients with DBS.

Subjective scar assessment scales in orthopaedic surgery and determinants of patient satisfaction: A systematic review of the literature

Purpose:Scar assessment tools can be utilized during the post-operative period to monitor scar progress.The primary aim of this systematic review was to evaluate current subjective scar assessment scales utilized in orthopaedic surgery.The secondary aim was to identify determinants of patients'satisfaction with their scars and evaluate current measurement scales.Methods:The preferred reporting items for systematic reviews and meta-analyses checklist was followed.Electronic databases,curently registered studies,conference proceedings and the reference lists of included studies were searched.There were no constraints based on language or publication status.A narrative synthesis provided a description and evaluation of scales utilized in orthopaedic surgery.Determinants of patient satisfaction were identified along with the scales used to measure satisfaction.Results:A total of 6059 records were screened in the initial search.Twenty-six articles satisfied the inclusion criteria,assessing 7130 patients.In the literature,six validated subjective scar scales were identified,including the Vancouver scar scale,patient and observer scar assessment scale,Manchester scar scale,Stony Brook scar evaluation scale,visual analogue scale,and Hollander wound evaluation scale.Studies utilizing these scales to evaluate scars following orthopaedic procedures did so successfully.These were total hip arthroplasty,total knee arthroplasty,and limb reconstruction.The scales demonstrated satisfactory validity.Functional outcomes such as restoration of movement ranked among patients'highest concerns.Scar cosmesis was found to be amongst patients'lowest priorities.Conclusions:Subjective scar assessment scales identified in the literature were not designed specifically for orthopaedic surgery.However,these were able to appropriately assess scars in the studies identified in this review.Current evidence suggests the effect of scar cosmesis on patient satisfaction with orthopaedic procedures is limited.

Clinical efficacy of intradermal type Ⅰ collagen injections in treating skin photoaging in patients from high-altitude areas

BACKGROUND Photoaging,a result of chronic sun exposure,leads to skin damage and pigmentation changes.Traditional treatments may have limitations in high-altitude areas like Yunnan Province.Intradermal Col Ⅰ injections stimulate collagen production,potentially improving skin quality.This study aims to assess the efficacy and safety of this treatment for photoaging.AIM To evaluate the efficacy and safety of intradermal typeΙcollagen(ColΙ)injection for treating photoaging.METHODS This prospective,self-controlled study investigated the impact of intradermal injections of ColΙon skin photodamage in 20 patients from the Yunnan Province.Total six treatment sessions were conducted every 4 wk±3 d.Before and after each treatment,facial skin characteristics were quantified using a VISIA skin detector.Skin thickness data were assessed using the ultrasound probes of the Dermalab skin detector.The Face-Q scale was used for subjective evaluation of the treatment effect by the patients.RESULTS The skin thickness of the right cheek consistently increased after each treatment session compared with baseline.The skin thickness of the left cheek significantly increased after the third through sixth treatment sessions compared with baseline.The skin thickness of the right zygomatic region increased after the second to sixth treatment sessions,whereas that of the left zygomatic region showed a significant increase after the fourth through sixth treatment sessions.The skin thickness of both temporal regions significantly increased after the fifth and sixth treatment sessions compared with baseline(P<0.05).These findings were also supported by skin ultrasound images.The feature count for the red areas and wrinkle feature count decreased following the treatment(P<0.05).VISIA assessments also revealed a decrease in the red areas after treatment.The Face-QSatisfaction with Facial Appearance Overall and Face-Q-Satisfaction with Skin scores significantly increased after each treatment session.The overall appearance of the patients improved after treatment.CONCLUSION Intradermal ColΙinjection improves photoaging,with higher patient satisfaction and fewer adverse reactions,and could be an effective treatment method for populations residing in high-altitude areas.

Impact of hepatitis B immunoglobulin mode of administration on treatment experiences of patients after liver transplantation: Results from an online survey

BACKGROUND Hepatitis B immunoglobulin(HBIG)in combination with a potent nucleos(t)ide analog is considered the standard of care for prophylaxis against hepatitis B virus(HBV)reinfection after liver transplantation for HBV-associated disease.AIM To evaluate patients’satisfaction,preferences,and requirements for subcutaneous(SC),intramuscular(IM),and intravenous(IV)HBIG treatments.METHODS A self-completion,cross-sectional,online,22-question survey was conducted to examine perceptions and satisfaction with current HBIG treatment in adults receiving HBIG treatment following liver transplantation for HBV-associated disease in France,Italy,and Turkey.Hypothetical HBIG products with different administration modes were evaluated using target product profile assessment and a conjoint(trade-off)exercise.RESULTS Ninety patients were enrolled;32%,17%,and 51%were SC,IM,and IV HBIG users,respectively.Mean duration of treatment was 36.2 months.SC HBIG had the least negative impact on emotional well-being and social life and was perceived as the most convenient,easiest to administer,least painful,and had the highest self-rating of treatment compliance.More IM HBIG users than SC or IV HBIG users reported that administration frequency was excessive(67%,28%,and 28%,respectively).In the target product profile assessment,76%of patients were likely to use hypothetical SC HBIG.In the conjoint exercise,administration route,frequency,and duration were key drivers of treatment preferences.CONCLUSION Ease,frequency,duration,and side effects of HBIG treatment administration were key drivers of treatment preferences,and SC HBIG appeared advantageous over IM and IV HBIG for administration ease,convenience,and pain.A hypothetical SC HBIG product elicited a favorable response.Patient demographics,personal preferences,and satisfaction with HBIG treatment modalities may influence long-term treatment compliance.

Competency-based management effects on satisfaction of nurses and patients

Purpose:To evaluate the effect of competency-based management in improving nurse and patient satisfaction.Methods:According to the competency-based management objectives and principles,821 nurses were classified into different levels based on clear nurse qualifications and post responsibilities.According to the different levels of nursing staff and training plans with different emphases,the goal was for the nursing staff to gradually achieve the corresponding level.Targeted training programs for different levels of nurses were formulated to enable nurses to gradually increase their competency levels.Results:After implementation of competency-based management,nurse job satisfaction and patient satisfaction increased significantly(P<0.01).Additionally,the reported nurse job burnout decreased(P<0.01).Conclusion:Competency-based management can promote nurses’enthusiasm,reduce job burnout,improve job satisfaction,as well as improve patient satisfaction.

Employment and Patient Satisfaction after Liver Transplantation

Background and Aims:This study serves to revisit the effects of liver transplantation(LT)on employment in an era of improving survival outcomes post-transplant,and to identify areas of improvement in the transplant process to better optimize post-LT employment and patient satisfaction.Methods:Prospectively,patients who had undergone LT at a single tertiary LT center were surveyed in person and by e-mail.Primary outcomes included employment rate pre-and post-LT,annual salary,weekly hours worked,barriers to re-employment,and patient satisfaction.Results:Responses were collected and analyzed from 121 patients who underwent LT.Pre-LT,68(56.1%)reported full-time employment,13(10.7%)part-time employment,and 40(33.1%)unemployment.Post-LT,26(21.4%)reported continued full-time employment,18(14.9%)part-time employment,and 77(63.6%)unemployment.Average weekly work hours decreased post-LT(16.1 h/week vs.39.9 h/week).Mean annual salaries decreased post-LT(17 earning salary≥$40,000 vs.56 earning salary≥$40,000).These outcomes differed from patient pre-LT expectations,with 81.0%of previously employed patients believing they would return to employment,resulting in decreased patient satisfaction.Patients working physically demanding jobs pre-LT were less likely to return to work.Reasons cited for lack of return to full employment included early fatigue and difficulty regaining physical strength.Conclusions:Re-employment rates remain low post-LT,which is particularly true for patients working physically active jobs.Fatigue is a significant barrier to re-employment and increased physical rehabilitation post-LT may prove to be beneficial.Patients should be given realistic expectations about return to employment prior to their LT.

Satisfaction about Patient-centeredness and Healthcare System among Patients with Chronic Multimorbidity

The aim of the present study was to measure the prevalence of multimorbidity in Bangladesh,India and China,and to assess the relationship between multimorbidity and patient's opinion regarding their involvement in healthcare decision-making and overall satisfaction of healthcare system.Cross-sectional data on 18696 men and women aged 18 and above were collected from the World Health Survey of World Health Organization(WHO).Outcome variables were subjective rating of(1)healthcare system's ability to involve patients in decision-making,and(2)satisfaction with the way healthcare system runs in the country.Self-reported chronic conditions were used to measure the prevalence of multimorbidity.Out of 9 chronic conditions,back pain,arthritis,and chronic cough appeared to be the most prevalent ones among majority of the participants.About one-third of the participants in China(30.7%)and two-thirds in Bangladesh(66.1%)and India(66.6%)reported having at least one chronic illness.Prevalence of multimorbidity was highest in India(34.3%)followed by Bangladesh(28.8%)and China(14.3%).In Bangladesh,India and China,respectively 70.5%,41.7%,61.3%women and 54.5%,42.8%and 58.8%men expressed dissatisfaction regarding the way healthcare system runs in their country.In Bangladesh and India,men who were living with multimorbidity were more likely to rate the patient-centeredness as"bad"than those who had no disease illness.This study suggests that the prevalence of multimorbidity was remarkably high especially in Bangladesh and India.Higher likelihood of dissatisfaction about healthcare system among multimorbid patients might be indicative of inadequacy in the provision of care in qualitative and quantitative terms.