The main objective of this cross sectional study was to assess the psychometric properties of a new research instrument. The secondary aim was to analyze patients' levels of dissatisfaction with the ...professionalism of medical staff.
A social survey questionnaire was created and administered online. The instrument consisted of two scales: the 30-item patient dissatisfaction scale and the 10 items institutional scale. In this article, we assessed only the patient dissatisfaction scale. The research population includes 1838 subjects. The statistical procedures used were descriptive statistics, Pearson's correlation, and factorial analyses with the SPSS.19 software. The internal consistency of the instrument was determined using the Cronbach's alpha coefficient. We used a principal component analysis to investigate the factorial validity of the scale.
The patients' scale of dissatisfaction obtained an alpha Cronbach score of 0.81. Three latent factors corresponding to three dimensions of dissatisfaction emerged from the data: medical staff's ability to communicate, medical staff's hygiene, as well as sanitary and privacy conditions within the hospital. The first factor explained 43.47% of the variance in patient dissatisfaction, the second factor explained 10.24%, and the third factor explained 7.59%; overall, the three factors explained 61.30% of the total variance.
The Romanian healthcare system has an organization and management structure which has shown few changes since the communist period. Our study indicates that although more than 25 years have passed since the political regime changed in Romania and the introduction of a different system of social care, there have been no corresponding changes in the medical staff's mentality or in the way that patients are approached. The present assessment of patient dissatisfaction is not a strictly theoretical exercise; it also represents a valuable instrument for healthcare system management.
Celotno besedilo
Dostopno za:
CEKLJ, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Lumbar disc herniation is a population and socio-economic health problem affecting patients worldwide. More than half of adults worldwide suffer from low back pain at some point in their lives, with ...varying degrees of severity, frequently associated with sciatic symptoms. The multifactorial mechanism of low back pain has not yet been fully elucidated and is aggravated by mechanical, traumatic, inflammatory factors and osteoporosis. Low back pain leads over time to disability and decreases quality of life. Material and method: Our research was carried out as a retrospective epidemiological study including a group of 944 patients with lumbar disc herniation admitted in the 3 Neurosurgery Departments of the Emergency Clinical Hospital “Prof. N.Oblu” in Iași during the period 1 January-31 December 2022. Results: The study reveals a somewhat equal distribution in both sexes: male (466- 49.36%) and female 478 (50.64%) and higher in urban areas (60%). According to the age histogram, the group 41-60 years predominates – 428 cases (45.43%), followed by the group 61-80 years – 309 (32.72%), the group 21-40 years – 193 (20.43%), and 8 patients (0.85%) were over 80 years and 6 (0.63%) under 20 years. The most affected professions were: drivers, civil servants, dentists, commercial workers. The most common comorbidities in females were: neuro-psychiatric diseases (68%); hypertension (31%), obesity (15%), diabetes mellitus (12%), osteo-articular diseases (4%). 3 patients although presenting with SARS CoV-2 virus infection, were operated with favourable outcome. Obesity and intense physical exertion were the main risk factors in both sexes. Regarding the type of therapeutic manoeuvres in the studied group, 715 patients (75.7%) underwent surgical interventions such as: discectomies – 640 (89.5%); spondylolisthesis – 36 (5%); decompression – 17 (2.4%) and other reparative manoeuvres – 22 (3.1%). Conservative medical treatment required 10.5% – 229 patients. Referral for functional recuperative treatment was followed by 664 patients (70.3%), at the Recovery Hospital or state or private specialist outpatient clinics. At the 6-month reassessment, 56% showed complete remission and 44% partial remission of symptoms. Conclusions: The study highlights some clinico-epidemiological features of lumbar disc herniation, which influence the evolutionary profile of the condition in the group of patients. Comorbidities are also triggering factors with an unfavourable influence on the quality of life of these patients. Proper health care management must approach the patient with degenerative pathology holistically.
Post-COVID-19 syndrome encompasses a variety of conditions that can affect people with a history of probable or confirmed SARS-CoV-2 infection, usually within 3 months of the onset of COVID-19, with ...symptoms that last at least 2 months and cannot be explained by an alternative diagnosis, with a major impact on daily and occupational activities. Material and methods: long-COVID symptoms among healthcare professionals in an emergency clinical hospital and the influence on work activities were assessed. Results: 42% had more than 2 long-standing symptoms. In the majority of cases the symptoms disappeared after 2-3 months, with 10% experiencing persistence of symptoms at 6 months, 5% even at 12 months. The most common symptom reported was fatigue, followed by sensory disorders (parosmia and dysgeusia), arthralgia, sleep disturbances, stress, headache, dizziness. Discussions: The work capacity of employees who experienced long-term symptoms were influenced. Difficulties in performing tasks, maintaining work rhythm and working night shifts led in some cases to temporary work/workplace adaptation measures to allow affected employees to recover. As for post-COVID-19 oral complications, they can affect not only comfort but also general health through their impact on nutrition, oral hygiene and psychological state. Conclusions: In the long term, post-COVID syndrome represents a significant challenge for the whole health system and society, where their health and well-being are essential to ensure the continued availability of quality health care.
Children diagnosed with life-limiting or life-threatening diseases are at risk of complex, chronic, multisystemic illnesses due to immune system deficiencies and significant organ fragility. There is ...little research on the dental care of children with such serious pathology, where oral and general health is compromised. Our study aims to investigate the impact of terminal illnesses on oral health, identifying oral and dental deficiencies present in a group of 35 children diagnosed with life-limiting diseases, between 2015-2022, in the palliative care services at the Palliative Care Center for Children – Lumina Association Bacau, Romania. Material and method: The study consists of retrospective analysis of data from medical records of children diagnosed with life-threatening illnesses. Results: The 35 children included in the study provided us with essential information about the types of dental conditions they face and the role of the dentist qualified for palliative care as an integral part of medical management. Against the backdrop of immunosuppression, the main odontogenic conditions encountered in the children in the study group were: Dental caries, gingival inflammation or bleeding, recurrent fungal and viral infections, malocclusion or dental alignment deficiencies; edentulism, dysfunctional tooth development, oral hygiene deficiencies, nutritional deficiencies, dysphagia, xerostomia, facial aesthetic deficiencies and compromised speech ability, all of which deteriorate quality of life and put it at risk. Conclusions: Pediatric patients diagnosed with life-limiting diseases are prone to premature loss of oral health through severe odontogenic dysfunction. The palliative care dentist must identify, assess and alleviate these difficulties through specific actions designed to alleviate symptoms and minimise pain and suffering. Psychological counselling must precede any medical, therapeutic and palliative care act.
Healthcare-associated infections (HAIs), also known under other names such as: nosocomial infections or intrahospital infections, are a major public health problem, affecting both patients, medical ...personnel involved in their care , and non-medical support personnel. Material and method: The study is retrospective, longitudinal, descriptive, observational, carried out in the Emergency Clinic Hospital, ” Prof.Dr. Nicolae Oblu” from Iași in 2022 and included a batch of 375 hospitalized patients who contracted one or more healthcare-associated infections during hospitalization. Results: The analysis of multiple variables regarding the clinical-epidemiological and statistical data reveals an annual incidence rate of 4.46 %. Wards at risk such as neurosurgery and intensive care showed higher incidence rates (6.58%), with surgical wound infections, mechanical ventilation-associated pneumonia and urinary infections predominating. The etiological palette involved in the genesis of these infections was represented by multidrug-resistant (MDR) bacteria, with increased pathogenicity on immunosuppressed organisms. Conclusions: Our study is comparable to nationally and worldwide recorded data for the neurosurgical profile. Post-operative infections make it difficult for the body to recover in general and the neuromotor level. Our research draws attention to the detection of AIAM, as a permanent concern and responsibility of the entire medical body, as well as to the phenomenon of microbial antibiotic resistance, which is gaining momentum. Correct health management care would definitely lead to a decrease in the incidence of intrahospital infections and the growing phenomenon of microbial antibiotic resistance.
The aim of this paper is to evaluate the extent of the practice of using informal payments for accessing the services of public clinics or hospitals across Europe and to explain the prevalence of ...this corrupt practice using the framework of institutional theory. To achieve this, a multi-level mixed-effect logistic regression on 25,744 interviews undertaken in 2020 with patients across 27 European Union countries is conducted. The finding is that the practice of making informal payments remains a prevalent practice, although there are large disparities in the usage of this practice in different European countries. However, informal payments by patients are more likely when there is a lower institutional trust and a higher degree of asymmetry between formal and informal institutions. The resultant proposal is that policy makers need to address the institutional environment to tackle such informal payments. How this can be achieved is outlined.
Diabetes is a condition associated with multiple systemic secondary risk factors, besides pancreatic dysfunctions, affecting the population worldwide and with high costs impacting the healthcare ...systems. This paper aims to identify the major issues in patients' adherence to injectable diabetes treatment. After the interrogation of the Web of Science database, a scientometric map was generated, from which six directions of approach were identified as essential factors influencing the patient's adherence. These directions yielded clusters of related articles. Glycemic control with the endocrinology metabolic implications, lifestyle adjustments, the healthcare services, medication therapy algorithm, healthcare services digitalization and healthcare policies seem to have a major impact on injectable diabetes therapy and patient adherence. Further research on every one of the six directions is needed to identify the potential of increasing injectable treatment adherence in diabetes patients.
Because of what happened in 1989, Romanian society has undergone a massive reform-based modernization process. Rethinking the Public Health System is a highly contested topic. Almost every shift in ...government personnel has renewed calls for widespread public health education and awareness. To put things in perspective, we analyzed the existing status in Romania, and appropriately emphasize prospective possibilities and viable courses of action in a European context .
Introduction. According to World Health Organization reports at a global level, the percentage of coverage for oral health services offered by different countries varies between 40% and 80% for ...adults and there is an inverse correlation between the national income level and the mean oral health care spending through public health insurance Public health insurance is available in Romania, as it is in many other European nations, and is paid for by taxes. All children and young people under the age of eighteen, all employees, and all retirees are required to have health insurance, and this insurance must cover medical care received at any public hospital or clinic, as well as any private hospital or clinic that chooses to work with the National Health Insurance House and submit claims for reimbursement through this agency.
Introduction: Functional rehabilitation of foot-drop syndrome due to lumbar disc herniation it is a problem that concerns many researchers. Study objective was to investigate if specialized manual ...therapy techniques and functional electrical stimulation alone and combined can influence the overall neuromotor outcome. Methods: 90 subjects were randomized to 3 groups, 30 subjects allocated to control group (CG) which received physical therapy, 30 subjects in functional electrical stimulation group (FES) and 30 subjects in combined FES with manual therapy techniques (FES-MT). All groups received a number of 20 sessions. We evaluated nerve conduction study, dynamometry, goniometry, functional ankle disability index (FADI), Oswestry Disability Index (ODI) and Numeric Rating Scale (NRS). Results: For Compound muscle action potential we have found significant modifications when comparing FES-MT vs CG (p<0.011). For dynamometry we registered as follows: FES-MT vs CG (0.0001), FES-MT vs FES (p<0.003). ODI and FADI scores were more significant in FES-MT and FES compare with CG. Conclusions: Manual therapy techniques utilized for increasing the excitability of neuromuscular spindle can increase the overall functionality of the tibialis muscle in case of foot drop syndrome. The combination between FES and MT showed better functional results than physical therapeutic exercises and FES alone.
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