Aim: The study sought the answer to the question whether the psychological profile of patients after orthognathic surgery changed. Using a structured questionnaire, we measured the change in self-confidence and extroversion, and assessed the relationship between the change and the patients’ sex and age. We also assessed the most often cited pros and cons of orthognathic surgeries. The respondents also informed about whether they would undergo the surgery again. Material and method: The study follows from the study of MDDr. Borunská (2015) who used a questionnaire to assess the differences in self-confidence in patients without any therapy/ with orthodontic therapy/ after orthognathic surgery. In our study we worked with the sample of patients indicated for orthognathic surgery. The original sample included 88 patients who filled in the questionnaire of MDDr. Borunská 4 years ago. 30 patients underwent orthognathic surgery and 21 of them agreed to take part in our study. They were repeatedly sent the structured questionnaire, and the resulting scores of different values of the Rosenberg self-esteem test (change in self-esteem) and the NEO test (change in extroversion) were compared. Results: The comparison of difference in the Rosenberg test before and after surgery did not show significant change in the score. The comparison of the NEO test (extraversion values) proved statistically significant decrease of values. We also assessed the potential relationship between results of the Rosenberg and the NEO tests and patients’ sex. The comparison proved only decreased values in women. We also studied the correlation between the patients’ age and change of self-esteem. Statistically significant increase in values was found only in extroversion – the older the patient the higher value of extroversion. The most often cited cons of the surgery were postoperative pain (7 patients), numbness of chin and lower lip (6), liquid food and diet following the surgery (4), postoperative oedema (2). The most often cited benefits included appearance (including face profile) (12 patients), better occlusion (7), higher self-esteem (5), better socialization (2). 18 respondents would undergo the surgery again, 3 would not. Conclusion: There were not statistically significant changes in the respondents’ self-esteem. The relationship between patients’ selfesteem and their age was not statistically proved. In case of extroversion we can see the trend – the older the patients the more extrovert they are. The relationship between the change in self-esteem and the patients’ sex was not proved. The only statistically significant difference was found for the values of extraversion in women (the extraversion decreased after the surgery). The pros of orthognathic surgery: improved appearance (including face profile) (55% of respondents), improved occlusion (33%), increased self-esteem (24%), better social life and establishing relationships (10%). The cons of orthognathic surgery: postoperative pain (33%), numbness of chin and lower lip (29%), postoperative discomfort when eating (19%), and postoperative oedema (10%). 86% of the patients would undergo the surgery again, 14% would not. Statistically significant relationship between self-esteem and the most frequently reported pros and cons of orthognathic surgeries was not proved.
Východiska: Fibrilace síní (FiS) postihuje až 46,3 milionu osob, její prevalence se za posledních 50 let ztrojnásobila. FiS vede ke vzniku krevních sraženin a zvyšuje čtyřnásobně riziko cévní mozkové příhody. Preventivní antikoagulační léčba warfarinem je dobře zavedena po více než 50 let, má však účinnostní a bezpečnostní nedostatky. Nová antikoagulancia nevyžadují laboratorní monitoraci protrombinového času (INR), mají nízké riziko nežádoucích příhod, jsou však nákladnější. Metody: Tato neintervenční (Zákon č. 378/2007 Sb.) retrospektivně prospektivní jednoramenná kohortová studie sestávala ze tří návštěv. Primárním cílem bylo srovnání celkových přímých nákladů na léčbu warfarinem a apixabanem. Pacienti s nevalvulární FiS byli zařazeni v době ukončení léčby warfarinem a přechodu na apixaban. Náklady byly odvozeny od poskytnuté péče na základě seznamu zdravotních výkonů a dle vyhlášky 268 z roku 2019. Spokojenost byla stanovena pomocí dotazníku SAFUCA®. Výsledky: Mezi únorem 2017 a červnem 2019 bylo zařazeno 499 pacientů ve 29 interních ambulantních centrech v ČR. Průměrný věk pacientů byl 73,6 ± 10,2 let, 36,5 % pacientů mělo vysoké riziko krvácení (HAS‐BLED skóre). Předchozí léčba warfarinem trvala 5,9 ± 2,7 měsíců, 63 % pacientů nebylo schopno udržet cílové hodnoty INR, 18 % ukončilo léčbu kvůli nežádoucím účinkům. Nová léčba apixabanem byla sledována po prvních 6 měsíců. Období léčby warfarinem bylo spojeno s vyšším počtem závažných krvácení a nežádoucích příhod (22 vs. 2), CMP (17 vs. 0), ischemických srdečních příhod (11 vs. 0) a nezávažných krvácení (173 vs. 2). Průměrné denní náklady na léčbu při přechodu na léčbu apixabanem klesly z 65,2 na 4,8 Kč (p < 0,001). Při započítání ceny antikoagulační léčby došlo k nevýznamnému nárůstu z 68,1 na 71,7 Kč (p = 0,509). Spokojenost pacientů výrazně vzrostla již po 3 měsících, zejména pak v subjektivním hodnocení účinnosti, pohodlnosti, vlivu na kvalitu života a výskytu nežádoucích účinků. Závěr: Přechod na apixaban u pacientů, pro které nebyla léčba warfarinem uspokojivá, snížil riziko závažných ischemických příhod, krvácení a nežádoucích účinků a zvýšil spokojenost pacientů. Z farmakoekomického hlediska je u těchto pacientů apixaban lepší volbou, jelikož přináší vyšší účinnost a lepší bezpečnost v rámci srovnatelných celkových přímých nákladů.
Background: Atrial fibrillation (AF) affects 46.3 million people; its prevalence has tripled over the last 50 years. AF leads to formation of blood clots increasing four-fold the risk of a stroke. Preventive anticoagulant therapy with warfarin has been well established for over 50 years but has efficacy and safety limitations. New anticoagulants do not require laboratory monitoring of prothrombin time, have low risk of adverse events, yet are more costly. Methods: This non-interventional (Act 378/2007 Coll.) retrospective-prospective single-arm cohort study consisted of 3 visits. The primary objective was to compare the total direct cost of treatment with warfarin and apixaban. Patients with non-valvular AF were enrolled at the time of discontinuation of warfarin and switching to apixaban. Costs were derived from the care provided and the list of medical procedures (Decrees 268/ 2019 Coll.). Satisfaction was assessed using SAFUCA® questionnaire. Results: Between February 2017 and June 2019, 499 patients were enrolled in 29 Czech internal medicine clinics. The mean age of the patients was 73.6 ± 10.2 years, 36.5% were at high risk of bleeding (HAS-BLED score). Previous warfarin treatment lasted 5.9 ± 2.7 months, 63% were unable to achieve target prothrombin time, 18% switched due to adverse reactions. New apixaban treatment was followed for the first 6 months. Treatment with warfarin was associated with higher rates of major bleeding and adverse events (22 vs. 2), stroke (17 vs. 0), ischemic heart attack (11 vs. 0), and minor bleeding (173 vs. 2). The average daily cost following the switch to apixaban decreased from CZK 65.2 to CZK 4.8 (p <0.001). The price of anticoagulant treatment was considered, there was an insignificant increase from CZK 68.1 to CZK 71.7 (p = 0.509). Satisfaction increased significantly after 3 months, notably in the subjective evaluation of efficacy, comfort, impact on quality of life and the occurrence of side effects. Conclusion: Switching patients with unsatisfactory outcomes on warfarin to apixaban resulted in lower risk of serious ischemic events, bleeding and side effects, and higher patient satisfaction. From the pharmacoeconomic perspective, apixaban is a better choice in this population as it brings higher efficacy and better safety within comparable overall direct costs.
- Klíčová slova
- apixaban,
- MeSH
- antikoagulancia * ekonomika škodlivé účinky terapeutické užití MeSH
- fibrilace síní * ekonomika farmakoterapie MeSH
- inhibitory faktoru Xa ekonomika škodlivé účinky terapeutické užití MeSH
- kohortové studie MeSH
- krvácení prevence a kontrola MeSH
- lidé středního věku MeSH
- lidé MeSH
- prospektivní studie MeSH
- průzkumy a dotazníky MeSH
- retrospektivní studie MeSH
- rizikové faktory kardiovaskulárních chorob MeSH
- senioři MeSH
- spokojenost pacientů statistika a číselné údaje MeSH
- warfarin ekonomika škodlivé účinky terapeutické užití MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- Publikační typ
- práce podpořená grantem MeSH
- srovnávací studie MeSH
BACKGROUND: Taking patient centeredness into account is important in healthcare. The European Cancer Consumer Quality Index (ECCQI) is a validated tool for international benchmarking of patient experiences and satisfaction. This study aimed to further validate the ECCQI in larger and more uniform groups of high volume tumours such as breast and prostate cancer. A second objective was the verification of the influence of cultural factors of the country to determine its possible use in international benchmarking. METHODS: Data from two survey studies in eight European countries were combined. Socio-demographic correlations were analysed with Kruskall-Wallis and Mann-Whitney tests. Cronbach's alpha was calculated to validate internal consistency. Influences of masculinity (MAS), power distance (PD) and uncertainty avoidance (UA) were determined by linear regression analysis in a general model and subgroup models. RESULTS: A total of 1322 surveys were included in the analysis (1093 breast- and 348 prostate cancer patients). Cronbach's alpha was good (α ≥ 0.7) or acceptable (0.5 ≤ α ≤ 0.7) in 8 out of 9 questionnaire categories, except in the category 'Safety' (α = 0.305). Overall ECCQI scores ranged from 22.1 to 25.1 between countries on a 1-35 scale (categories had a 1-4 scale). In certain subcategories such as 'Organisation' (range 2.2 vs 3.0) and 'Supervision & Support' (range 3.0 vs 3.8) a large difference was observed between countries. Differences in 'Overall opinion' were however small: mean scores of 3.7 vs 3.9, whereas median scores were all the maximum of 4.0. Power distance was positively associated with higher patient satisfaction scores whereas Uncertainty avoidance was negatively associated with these scores. Masculinity was only associated with patient satisfaction scores in lower educated patients. We found the highest impact of culture on overall scores in Hungary and Portugal and the lowest in Romania. CONCLUSIONS: The ECCQI shows high internal consistency in all categories except 'Safety'. Especially in separate categories and overall ECCQI scores the questionnaire showed discriminative value. This study showed a positive correlation of power distance and a negative correlation for uncertainty avoidance in some countries. When using the ECCQI for international benchmarking these two dimensions of culture should be taken into account.
- MeSH
- benchmarking statistika a číselné údaje MeSH
- bezpečnost pacientů statistika a číselné údaje MeSH
- dospělí MeSH
- hodnocení výsledků péče pacientem * MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- nádory prostaty psychologie terapie MeSH
- nádory prsu psychologie terapie MeSH
- nejistota MeSH
- přežívající onkologičtí pacienti psychologie statistika a číselné údaje MeSH
- reprodukovatelnost výsledků MeSH
- senioři MeSH
- spokojenost pacientů statistika a číselné údaje MeSH
- srovnání kultur * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
Aim: Barcelona Hospital Campus Vall D'Hebron (Hospital A) and Hospital Mollet (Hospital B) provide women with humanized maternity care, but there are differences in dimension and complexity. This study describes the obstetrical results and women's childbirth satisfaction of these two Spanish hospitals. Design: A correlational descriptive study was conducted with 194 postpartum women. Methods: Satisfaction and birth experience were evaluated using the CEQ-E and the MCSRSS questionnaires. A bivariate and discriminant analysis was conducted to evaluate the relationship between satisfaction and the recorded variables. Results: There were significant differences between both hospitals in prenatal class attendance (p = 0.006), same midwife during all process (p = 0.000), and mode of delivery (p = 0.009). Significant association was found among overall satisfaction and immediate breastfeeding in the delivery room (p = 0.050), skin-to-skin contact (p = 0.004), beginning of labour (p = 0.031), and delivery mode (p = 0.011). The total questionnaires scores mean of CEQ-E and MCSRSS were Hospital A 66.97 and 130.64; Hospital B 67.98 and 129.98, respectively. Women at both hospitals were satisfied with different aspects. Conclusion: Despite obtaining similar results in both hospitals, there are better obstetrical outcomes in hospital B with less complexity. However, women's satisfaction scores are slightly different in certain questionnaires subscales between both hospitals.
- Klíčová slova
- childbirth, hospital, questionnaire, satisfaction, women,
- MeSH
- lidé MeSH
- porod * MeSH
- spokojenost pacientů statistika a číselné údaje MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Geografické názvy
- Španělsko MeSH
- MeSH
- lidé MeSH
- průzkumy a dotazníky MeSH
- spokojenost pacientů statistika a číselné údaje MeSH
- vedení porodu * metody statistika a číselné údaje MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Geografické názvy
- Česká republika MeSH
For six years, we monitored the rating of hospitalized elders to doctors' exper-tise, care and helpfulness of nurses, willingness of ambulance workers and behaviour of cleaners. Th e responses were monitored according to the elders' gender and age. We also monitored their satisfaction with the quality of food, quality of room equipment and free entry of visitors. Th e willingness to recommend the hospital to friends showed a statistically signifi cantly closer relationship (p < 0.0002) to most of the selected signs of health care than a feeling of improved health. Statistically signifi cantly more negative attitudes were expressed mostly by men (nwomen = 168, nmen = 89; F < 0.02; p < 0,05).
- MeSH
- dlouhodobá péče MeSH
- hodnocení výsledků péče pacientem MeSH
- lidé MeSH
- longitudinální studie MeSH
- nemocnice pro chronická onemocnění * MeSH
- personál nemocniční etika MeSH
- senioři MeSH
- spokojenost pacientů * statistika a číselné údaje MeSH
- statistika jako téma MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- hodnotící studie MeSH
Záměr studie: Cílem studie bylo na podkladě údajů od pacientů s diagnózou schizofrenie ověřit v českém kontextu: (a) strukturu a vnitřní konzistenci dotazníku Kvalita prožívání radosti a spokojenosti ze života (Q-LES-Q-SF), (b) míru závislosti úrovně kvality života na pohlaví, věku, délce trvání choroby, celkovém klinickém dojmu a spokojeností s léčbou a (c) vypracovat lokální percentilové normy pro pacienty s diagnózou schizofrenie. Metoda: Konsekutivní soubor pacientů s diagnózou schizofrenního okruhu (N = 726) byl vyšetřen 126 ambulantními psychiatry. Lékaři zaznamenali pacientův věk, pohlaví, délku choroby, globální klinický dojem; pacienti vyplnili dotazník Q-LES-Q-SF. Výsledky: Nálezy přinesly podklad pro (a) existenci jednodimenzionální struktury nástroje, (b) vnitřní konzistenci inventáře, (c) symetrickou distribuci hodnot a absenci podlahového i stropního efektu, (d) vztah mezi současným klinickým stavem pacienta, spokojeností s léčbou a kvalitou života nezávisle na věku, pohlaví a délce choroby. Závěr: Nástroj je možné akceptovat jako spolehlivý instrument pro odhad kvality života českých pacientů s diagnózou schizofrenie.
Objectives: The purpose of this paper is to test on responses from patients with schizophrenia (a) dimenzionality and internal consistency of the Quality of Life Enjoyment and Satisfaction Questionnaire Short Form questionnaire (Q-LES-Q-SF), (b) effect of gender, age, duration of illness, satisfaction with medication, Clinical Global Impression on patients´ wellbeing, and (c) develop local percentile norms for patients with schizophrenia. Methods: Consecutive patients with schizophrenia (N = 726) were interviewed by 126 outpatient care psychiatrists. The physicians recorded patients´ gender, age, duration of illness, the CGI- Clinical Global Impression scale, and patients filled up the Q-LES-Q-SF quality of life questionnaire. Results: The findings plausibly established (a) the instrument unidimensionality; (b) acceptable internal consistency; (c) symmetrical distribution of the questionnaire values and absence of floor and ceiling effect; (d) association of present clinical state of patients, satisfaction with medication and quality of life without the effect of age, gender, and duration of illness. Conclusion: The instrument appears to be a reliable instrument for assessment of wellbeing among Czech patients with schizophrenia.
- MeSH
- duševně nemocní psychologie statistika a číselné údaje MeSH
- interpretace statistických dat MeSH
- kvalita života * psychologie MeSH
- lidé MeSH
- průzkumy a dotazníky statistika a číselné údaje MeSH
- psychiatrické posuzovací škály statistika a číselné údaje MeSH
- psychometrie * metody MeSH
- schizofrenie * MeSH
- spokojenost pacientů statistika a číselné údaje MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- hodnotící studie MeSH
INTRODUCTION: Statin intolerance (SI) occurs in patients with dyslipidemia treated with statins. Statin-associated symptoms have been reported, but the overall patient experience is poorly understood. No instruments are available to collect this patient experience. Our aim is to develop a patient survey to define SI from the patient's perspective, inform clinical practice, and identify potential patient characteristics and barriers associated with discontinuing treatment when statin-related difficulties are encountered. METHODS: We conducted qualitative concept elicitation interviews with 65 patients across 12 European study sites. A semi-structured qualitative interview guide was developed based on literature review and clinician interviews. Concept elicitation interviews with patients were used to describe the patient experience and develop the conceptual framework for the survey. RESULTS: Symptoms experienced by patients included muscle and non-muscle-related pain and discomfort; other muscle-related symptoms; gastrointestinal, cardiovascular, cold-like, fatigue-related, and sensory and systems symptoms; mood changes; and cognitive and memory problems. Impacts included limitations on general physical functioning; physical activities; social functioning; emotional impacts; sleep disturbances; decreased productivity; and increased healthcare use. Conceptual framework elements to support survey goals include demographic and clinical characteristics, health information and beliefs, statin side-effect history, symptom severity, and impact severity. CONCLUSIONS: Symptoms and impacts described by patients showed a wider range of symptoms and impacts than usually discussed clinically. The patient survey is designed to capture information from patients who experience difficulties with statin therapy and may be useful in identifying patients who are at higher risk for giving up or discontinuing their treatment. FUNDING: Amgen Inc.
- MeSH
- anticholesteremika škodlivé účinky terapeutické užití MeSH
- bolest chemicky indukované MeSH
- dospělí MeSH
- dyslipidemie farmakoterapie epidemiologie MeSH
- kvalitativní výzkum MeSH
- lidé středního věku MeSH
- lidé MeSH
- průzkumy a dotazníky MeSH
- senioři MeSH
- spokojenost pacientů statistika a číselné údaje MeSH
- statiny škodlivé účinky terapeutické užití MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Evropa MeSH
BACKGROUND: Although the short- and long-term effectiveness of abobotulinumtoxinA (Dysport®/Azzalure®) for glabellar line (GL) treatment is well established, reporting of subject satisfaction over repeat treatment cycles is limited. The APPEAL study aimed to assess subject satisfaction with long-term GL treatment with abobotulinumtoxinA in a real-life setting. METHODS: APPEAL was a noninterventional, prospective, longitudinal study in subjects administered ≥ 3 abobotulinumtoxinA injection cycles for moderate-to-severe GL, according to routine clinical practice. Subjects completed a satisfaction questionnaire at 3 weeks (± 7 days) after each cycle. Primary endpoint included subjects' overall satisfaction with GL after three injection cycles. Secondary endpoints included satisfaction after Cycles 1 and 2 and factors associated with satisfaction after each cycle. Physician satisfaction was also assessed after Cycles 1 and 3. RESULTS: Of 150 subjects enrolled, 135 completed the overall subject satisfaction questionnaire after Cycle 3. At 3 weeks after Cycle 3, 99.3% of subjects were 'very satisfied' (74.1%) or 'satisfied' (25.2%) with GL. Levels of subject satisfaction and associated factors after Cycles 1 and 2 were as large and significant as after Cycle 3 (83-100%, depending on question). Physicians' satisfaction with GL appearance, facial expression, and overall satisfaction was almost complete after the first injection (≥ 97.4%) and unanimous after the third (100%). CONCLUSIONS: In the APPEAL study, overall satisfaction was high after three abobotulinumtoxinA injection cycles for GL based on both subjects' (99.3%) and physicians' (100.0%) assessments. High levels of subject satisfaction reported after Cycle 1 were maintained with repeated injections. No new safety signals were observed. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 . Trial registration NCT02353897.
- MeSH
- botulotoxiny typ A aplikace a dávkování MeSH
- čelo MeSH
- dospělí MeSH
- estetika MeSH
- injekce subkutánní MeSH
- lékaři * MeSH
- lidé středního věku MeSH
- lidé MeSH
- longitudinální studie MeSH
- mladý dospělý MeSH
- omlazení fyziologie MeSH
- osobní uspokojení MeSH
- prognóza MeSH
- prospektivní studie MeSH
- průzkumy a dotazníky MeSH
- rozvrh dávkování léků MeSH
- spokojenost pacientů statistika a číselné údaje MeSH
- stárnutí kůže MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
