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What Influences Patients Readiness for Discharge

2024-04-01T00:00:00Z

Title: What Influences Patients Readiness for Discharge Authors: Li, Na; Moreira, Paulo; Guo, Manjie; You, Simeng; Dsouza, Brayal; Ji, Hong Abstract: Aims and Objectives. To identify and explore assess factors that influence patients’ readiness for hospital discharge (RHD) after total knee arthroplasty (TKA). Background. Evidence has suggested that most clinical staff use clinical laboratory indicators to determine discharge times, while paying little attention to patients’ feelings and needs. Additional research findings have suggested a relationship between patients’ self-reported readiness for hospital discharge and postdischarge complication rates, readmission rates, mortality, as well as quality of life. RHD is strongly associated with patient health outcomes. Identifying relevant influencing factors can provide guidance for early individualized interventions by healthcare professionals. Design. A cross-sectional study. Methods. During 2022, a total of 320 post-TKA patients were selected for this study. The patients were divided into the low-RHD group (<7 points) and the high-RHD group (≥7 points) according to the mean score of the Readiness for Hospital Discharge Scale (RHDS). Established scales were used to collect patients’ information and to adopt univariate and binary logistic regression analysis to screen for independent factors. Results. In this study, the RHDS score of patients after TKA is 91.90 ± 7.05, of which 12.8% are in the low-RHD group (mean score <7). The binary logistic regression results reveal that age, educational level, postactivity pain, self-efficacy, and family care have to be considered risk factors generating low-RHD in TKA patients. Conclusions. The present study suggests that over 1/8 TKA patients are not ready at the time of discharge. Physicians and nurses can improve patients’ RHD by reducing postactivity pain and improving self-efficacy during their rehabilitation period. Relevance to Clinical Practice. The results of this study can help physicians and nurses early identify high-risk patients with low RHD and provide them with individualized interventions. In addition to this, it is important that nurses use RHDS to assess the readiness of TKA patients before they are discharged from the hospital.

Undiagnosed Long COVID‑19 in China Among Non‑vaccinated Individuals:

2022-11-07T00:00:00Z

Title: Undiagnosed Long COVID‑19 in China Among Non‑vaccinated Individuals: Authors: Zhang, Lin; Lei, Jie; Zhang, Jintao; Yin, Longlong; Chen, Yanjiao; Xi, Yan; Moreira, Joaquim Paulo Abstract: Is Long COVID-19 under-diagnosed? The definition of this new condition has received many contributions, and it is still under development as a great variety of symptoms have been associated to it. This study explores the possibility that there are non-diagnosed cases among individuals who have been infected by SARS-CoV-2 and have not been vaccinated. The long-term symptoms identified among a sample 255 individuals have been associated to Long COVID-19 by recent literature. The study relates these symptoms to risk factors and health-related quality of life (HRQoL) negative impacts. The individuals were screened 1 year after discharge to explore its potential relation to Long COVID-19. Patients diagnosed with COVID-19 and discharged from designated hospitals in a Chinese province between January and April 2020 were included in this study. They received computed tomography (CT) scans one month after discharge. One year after discharge, patients were invited to physical examination and interviewed with questionnaire on health-related quality of life (HRQoL) and post-COVID-19 symptoms. Tobit regression and Logistic regression were applied to evaluate the risk factors for health utility value and pain/discomfort and anxiety/depression. One year after discharge, 39.61% patients complained of several of the symptoms associated to Long COVID-19. More than half had abnormal chest CT. Previous studies focused on the post-COVID-19 symptoms and chest CT findings of patients, but few studies have assessed the COVID-19-associated risk factors for health-related quality of life.

The Effect of Total Quality Management, Perceived Service Quality and Expectation on Customer Satisfaction

2023-10-17T00:00:00Z

Title: The Effect of Total Quality Management, Perceived Service Quality and Expectation on Customer Satisfaction Authors: Nguyen, Thi Le Ha; Moreira, Paulo Abstract: Objects: Total Quality Management (TQM), Perceived Service Quality (PSQ), and expectations are key factors that improve Customer Satisfaction (CS). This study investigates an integrated model that includes total quality management, perceived service quality, and expectations related to consumer satisfaction. Methods: A survey was conducted at the highest Hospital, Vietnam, in April 2018. A self-administered questionnaire was delivered to respondents. A confirmatory factor analysis was used to test the structural equation modelling of the proposed hypotheses. Findings: The study’s hypotheses are supported. Total quality management, perceived service quality, and expectations directly influence customer satisfaction. Originality: These findings reveal that TQM plays a mediator role in the PE and PSQ, PSQ is a mediating factor in the relationship between TQM and PS. Practice Implications: Our study has implications for managers and policymakers when considering factors’ effects on satisfaction, including total quality management, perceived service quality, and expectations in strategic planning, and aims to improve customer satisfaction.

Impact of Educational Background on the Quality of Standardized Residency Training Program

2024-11-22T00:00:00Z

Title: Impact of Educational Background on the Quality of Standardized Residency Training Program Authors: Tu, Xiaoyu; Ding, Xiaoquan; Huang, Wanru; Xu, Xiangrong; Moreira, Paulo; Zhang, Runju Abstract: Objecti ves : Residency training is important worldwide and recent studies have put more emphasis on its quality evaluation. This study aims to first explore the impact of educational backgrounds on the quality of gynecology and obstetrics (OB-GYN) standardized resident training (SRT) program in China, which may provide crucial evidence for policy considerations to improve SRT quality. Met hods: A total of 397 OB-GYN resident graduates were enrolled in this retrospective cohort study. They were divided into three groups according to their educational background, that is Bachelor of Medicine (BM), Master of Medicine (MM), and Doctor of Medicine (DM) groups. The characteristics and the results of SRT graduation examination and annual assessment of these residents were collected and compared using one-way analysis of variance or Pearson’s chi-square test. A multivariable logistic regression analysis was performed to identify the association between sociodemographic variables and pass rates of SRT graduation examination. Besides, a subgroup analysis on training time for the DM group was performed. Strobe protocol was followed. Res ults : The residents were older in DM group than that in BM and MM groups (P < 0.001). There was significant difference of the training length and the proportion taking part in SRT graduation examination among three groups (P < 0.001). Although the written test scores of SRT graduation examination were the lowest in BM group (P = 0.015), there was no significant difference in other results among three groups. No significant variable was found associated with the pass rates of SRT examination. No significant difference was found in the subgroup analysis of DM group. Conclusio n: Overall, the SRT quality of OB-GYN residents with different educational backgrounds was good and comparable. However, residents with BM degrees had lowest written scores and need to be strengthened during training. The training time of residents with DM degrees can be shortened according to their own conditions.