No abstract available.
*Anesthesia, General ; Female ; Humans ; Male ; *Patient Preference ; *Patient Satisfaction

Heat-sensitive moxibustion is the appropriate technique of the external treatment in traditional Chinese medicine and it is widely used in community because of its "easy learning, simple operation and clear curative effect". Pragmatic randomized controlled trial is a main intervention design in the real world study, which provides a high-level evidence for the effectiveness assessment of heat-sensitive moxibustion in community management. Focusing on the key links of randomization, e.g. block randomization, stratified randomization, cluster randomization, sample size allocation, allocation concealment and blinding, the paper elaborates the advantages, disadvantages and technical details of two-stage randomization with consideration of patient preference in pragmatic randomized controlled trials of heat-sensitive moxibustion in community. It facilitates improving the quality of evidence, reproducibility and methodological homogeneity among different trials.
Hot Temperature ; Humans ; Moxibustion ; Patient Preference ; Random Allocation ; Reproducibility of Results

PURPOSE: The purpose of this study was to identify preferences of persons with mental illnesses for mental health services. METHODS: Q-methodology, an approach designed to discover patterns in various subjective experiences, was used. Twenty-six participants classified 36 selected Q-statements on a nine-point scale to create a normal distribution. The collected data were analyzed using the PC Quanl program. RESULTS: Four types of preference in mental health services for persons with mental illnesses were identified by the participants: Type I Interaction preference type, Type II Patient right seeking type, Type III Clinical environment preference type, Type IV Treatment outcome seeking type. CONCLUSION: The results of this study provide an understanding that different types of preference for mental health services exist and each type has certain characteristics, which suggest a need to develop practical mental health practice nursing standards designed for each type of preference for mental health services.
Humans ; Mental Health ; Mental Health Services ; Patient Preference ; Patient Rights ; Treatment Outcome

BACKGROUND/AIMS: Patients may feel embarrassed during colonoscopy. Our study aimed to assess changes in patient preference, over the past decade, for the sex of their colonoscopist. METHODS: Prospective studies were performed at a single health center from July to September 2008, and from July to September 2016. Subjects included colonoscopy patients (2008: 354, 2016: 304) who were asked to complete a questionnaire before colonoscopy. RESULTS: In 2016, 69 patients (24.9%) expressed a sex preference, compared with 46 patients (14.6%) in 2008. By 2016, female patient preference for a female colonoscopist had significantly increased to 95% (odds ratio [OR], 2.678; 95% confidence interval [CI], 1.418– 5.057; P=0.002). In multivariate analysis, patient sex (OR, 4.404; P=0.000), patient age (OR, 0.977; 95% CI, 0.961–0.992; P=0.004), and year of procedure (OR, 1.674; 95% CI, 1.028–2.752) were statistically significant factors in sex preference. Between 2008 and 2016, female patients preferred a female colonoscopist because of embarrassment. Male patients also preferred a male colonoscopist, and the primary reason shifted from expertise to patient embarrassment (2008: 29%, 2016: 63%). CONCLUSIONS: Patients have an increased gender preference for the colonoscopist because of embarrassment. Taking this into account can increase patient satisfaction during colonoscopy.
Colonoscopy ; Female ; Humans ; Korea ; Male ; Multivariate Analysis ; Patient Preference ; Patient Satisfaction ; Prospective Studies

Background: Non-communicable diseases (NCDs) such as hypertension and diabetes mellitus, which are mainly primary care conditions, are ideally managed in local health centers (LHCs). However, majority of patients with NCDs utilize tertiary hospitals. Objectives: To determine factors associated with willingness of patients with NCDs consulting at the UP-PGH Family Medicine Clinic (FMC), a hospital-based primary care clinic, to transfer medical care to local health centers. Methods: A cross-sectional study using a 5-part, interview-assisted questionnaire was conducted among 380 patients with hypertension and/or diabetes mellitus. Data were analyzed using SPSS and STATA. Results: Respondents had a low degree of willingness to transfer medical care to health centers at 32% (SD ± 21). Significant predictors include being married, presence of hypertension, PhilHealth coverage, satisfaction with waiting time and perception of appropriate service delivery at FMC. Conclusion Patients with NCDs consulting at FMC had low willingness to transfer to local health centers. Moreover, there was low utilization of local health centers despite awareness of presence of LHCs in the community. Almost all viewed that NCDs are best managed in a hospital-based outpatient clinic rather than the health center, consistent with perceptions of higher quality of service delivery and higher service satisfaction in the FMC. Sociodemographic, economic and health system factors were identified to affect willingness to transfer.
Primary Health Care ; Patient Transfer ; Health Facilities ; Patient Preference ; Noncommunicable Diseases

Pancreatic cancer is one of the most lethal malignancies. Despite the availability of newer and better antineoplastic combinations, the 5-year survival rate for all stages of pancreatic cancer remains only 6%. Palliative care represents an important aspect of care in patient with pancreatic cancer. Thus, optimal palliation of symptoms to maximize remaining quality of life is of primary importance to most patients. This review discusses highlights the most significant problems faced when caring for patients with advanced pancreatic cancer. Common problems include pain, pancreatic insufficiency, anorexia-cachexia and depression. To provide optimal and meaningful supportive care for patients with advanced pancreatic cancer is complex and requires ongoing close monitoring of the physical and emotional aspects of the patient. Prompt management of the many symptoms and problems associated with pancreatic cancer is essential to minimize distress and improve quality of life for patients with this fatal disease. Recognizing end-of-life concerns and patient preferences during the dying process helps clinicians find ways to alleviate suffering for patients and families.
Depression ; Exocrine Pancreatic Insufficiency ; Humans ; Palliative Care ; Pancreatic Neoplasms ; Patient Preference ; Quality of Life ; Survival Rate

In patients with nonvalvular atrial fibrillation (AF), the risk of stroke is five times that of patients with a normal sinus rhythm. Antithrombotic therapy has a pivotal role for the prevention of stroke. With the advent of new oral anticoagulants (NOAC), the strategy of antithrombotic therapy has undergone significant changes due to its better efficacy, safety, and convenience when compared with warfarin or an antiplatelet regimen. Furthermore, new aspects of antithrombotic therapy in the prevention of stroke have revealed that the efficacy of antiplatelet regimens is weak while the risk of major bleeding is not significantly different to that of oral anticoagulant therapy, especially in the elderly. To reflect these pivotal changes, the previous guidelines for use of NOACs have been updated in recent years by various societies and associations. The Korean Heart Rhythm Society (KHRS) summarized the current evidence and updated its recommendations for stroke prevention in patients with nonvalvular AF. First of all, antithrombotic therapy must carefully consider and incorporate the clinical characteristics and circumstances of each individual patient, especially with regard to balancing the benefit of stroke prevention with the risk of bleeding. They recommend using the CHA2DS2-VASc score rather than the CHADS2 score to assess the risk of stroke, and suggest the HAS-BLED score be used to validate bleeding risk. In patients with truly low risks (lone AF, CHA2DS2-VASc score of 0), no antithrombotic therapy is recommended, whereas oral anticoagulant (OAC) therapy, including warfarin (INR 2-3) or NOACs, is recommended in patients with a CHA2DS2-VASc score > or = 2 unless contraindicated. In patients with a CHA2DS2-VASc score of 1, OAC therapy should be preferentially considered. When also factoring in the bleeding risk and patient preferences, antiplatelet therapy or no therapy could be the best treatment option.
Aged ; Anticoagulants ; Atrial Fibrillation* ; Heart ; Hemorrhage ; Humans ; Patient Preference ; Stroke ; Warfarin

PURPOSE: To compare the clinical efficacy and safety of three phosphodiesterase type 5 (PDE5) inhibitors in the treatment of mele erectile dysfunction according to patient preference. MATERIALS AND METHODS: Between January 2004 and August 2005, 113 male erectile dysfunctional patients were enrolled to this randomized, prospective, comparative, open-label, triple-crossover study of three PDE5 inhibitors. Patients were assigned to one of six medication schedules, and were prescribed a full dose of the drugs for 8 weeks, with a week of washout period prior to the next drug cycle. The International Index of Erectile Function (IIEF) scores and side effects related with each medication were obtained at the end of study. 48 patients finished all the medications, and completed the study with a global assessment questionnaire on their drug preference and reasons for that preference. RESULTS: The mean age of the patients was 54.6 (33-73) years. The mean pre-treatment IIEF and EF domain scores (+/-S.D.) were 28.2+/-14.7 and 10.6+/-6.6, respectively. The scores were significantly improved, to 47.9+/-14.6 and 19.9+/-6.6 with sildenafil, to 49.7+/-12.3 and 21.3+/-5.8 with vardenafil, and to 47.9+/-14.9 and 19.8+/-7.2 with tadalafil (p < 0.01). There were no significant differences in the scores or frequencies of side effects between the drugs. The preference percentages were 29.2, 29.2 and 35.4% for sildenafil, vardenafil and tadalafil, respectively. Patient preference was mainly due to improvement in erectile function (70.9%), such as rigid erection, prolonged erection and fast erection, and not to the infrequent rate of side effects (20.8%). CONCLISIONS: There were no significant differences of the efficacy and safety among the three PDE5 inhibitors. The preference for a drug for the treatment of erectile dysfunction was mainly related to the efficacy on the improvement of erectile function rather than the less frequent side effects.
Appointments and Schedules ; Erectile Dysfunction* ; Humans ; Male ; Patient Preference* ; Phosphodiesterase 5 Inhibitors* ; Phosphodiesterase Inhibitors ; Prospective Studies ; Questionnaires

BACKGROUND: This study aimed to investigate the preferences of patients scheduled for carpal tunnel release using conjoint analysis and also introduce an example of how to apply a conjoint analysis to the medical field. The use of conjoint analysis in this study is new to the field of orthopedic surgery. METHODS: A total of 97 patients scheduled for carpal tunnel release completed the survey. The following four attributes were predefined: board certification status, distance from the patient's residency, medical costs, and waiting time for surgery. Two plausible levels for each attribute were assigned. Based on these attributes and levels, 16 scenarios were generated (2 × 2 × 2 × 2). We employed 8 scenarios using a fractional factorial design (orthogonal plan). Preferences for scenarios were then evaluated by ranking: patients were asked to list the 8 scenarios in their order of preference. Outcomes consisted of two results: the average importance of each attribute and the utility score. RESULTS: The most important attribute was the physician's board certificate, followed by distance from the patient's residency to the hospital, waiting time, and costs. Utility estimate findings revealed that patients had a greater preference for a hand specialist than a general orthopedic surgeon. CONCLUSIONS: Patients considered the physician's expertise as the most important factor when choosing a hospital for carpal tunnel release. This suggests that patients are increasingly seeking safety without complications as interest in medical malpractice has increased.
Carpal Tunnel Syndrome ; Certification ; Hand ; Humans ; Internship and Residency ; Malpractice ; Orthopedics ; Patient Preference ; Specialization

OBJECTIVE: The purpose of this study was to describe the clinical features of myoma, treatment options, patient preference and to identify the clinical features which affect the management of myoma. METHODS: We retrospectively analyzed medical records of 577 patients who were diagnosed as uterine myoma on ultrasound exam between January 2006 and December 2006. Patients' characteristics, treatment methods and questionnaires for patient preference were evaluated. RESULTS: The mean age was 42.3 years and 90.8% of the patients were premenopausal status. Common symptoms were pain (58.6%), bleeding (51.3%) and compression symptom (30.2%). In our study, 183 of 577 patients (31.7%) planned to have regular follow-up without treatment. Non-hormonal medical treatment was used in 27.1% and hormonal treatment was used in 41.9% of the patients. One hundred eighty-two patients underwent surgical treatment, including myomectomy (57.1%), subtotal hysterectomy (19.8%) and total hysterectomy (23.1%). Among the patients who underwent surgery, 50.6% of patients (88/174) had surgery due to compression symptom, 42.6% (126/296) due to bleeding, and 34.6% (117/338) due to pain. According to the 100 patients who answered the questionnaires, 78 patients preferred medical therapy initially, but 22 patients chose surgical treatment. When the patient was asked to choose between myomectomy and hysterectomy, 94 patients wanted myomectomy, but only 6 patients chose hysterectomy. CONCLUSIONS: Many patients diagnosed as myoma prefer medical treatment initially. Medical treatment for myoma may be considered as the first line treatment for pain and bleeding symptoms before proceeding to surgical treatment.
Follow-Up Studies ; Hemorrhage ; Humans ; Hysterectomy ; Medical Records ; Myoma ; Patient Preference ; Surveys and Questionnaire ; Retrospective Studies