RESEARCH QUESTION: What are the levels of patient-perceived and self-assessed physician empathy among internal medicine (IM) residents in two tertiary hospitals in Pasig City? Is there a significant difference in patient-perceived and selfassessed physician empathy levels between public and private tertiary hospitals? Background: Empathy is important because it has been speculated to have a positive effect on patient outcomes; it is a skill that can be learned and developed. OBJECTIVES: This study obtained quantitative measurements of patient-perceived and self-assessed physician empathy. Empathy levels between public and private tertiary hospitals were compared. GENERAL STUDY DESIGN : This study utilized a quantitative cross-sectional design, with surveys as the strategy for data collection. PARTICIPANTS: 162 out-patient department patients aged 19-75, and 69 IM residents were sampled from one private and one public tertiary hospital. OUTCOME MEASURES: The Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE) and the Jefferson Scale of Physician Empathy (JSE) were used to measure the empathy levels. ANALYSIS: Sample size calculation was done using OpenEpi. An alpha level of 0.05 was used for computing the independent samples t-test. RESULTS: Internal Medicine patients from the private hospital rated the physicians with higher empathy scores (mean=31.23) compared to their public hospital counterparts (mean=29.01), which is statistically significant (p=.0134). Residents from the private hospital also scored a higher self-assessed empathy score (mean=110.46) compared to physicians from the public hospital (mean=102.13), which is also statistically significant (p=.0147). CONCLUSION: This study provided preliminary information on the empathy levels of physicians in the Philippine setting between private and public hospitals, showing that physician empathy levels are consistently higher in the private hospital facility. The results can help hospitals incorporate or improve training in empathy in internal medicine residency programs, as empathy is known to affect patient health outcomes.
Patient Care

Objectives: A cross-sectional study was conducted to describe the relationship of the resident physicians' knowledge, attitudes and practices on end-of-life and demographic features, medical specialty, formal training on care of the dying, personal and clinical experience on care of the dying patients. Methods: A total of 67 resident trainees participated in the study. They were asked to answer the K-A-P questionnaire on end-of-life care. The data gathered were tallied using Microsoft Excel and analyzed using SPSS 10.0 statistical software. Results: More than half of the respondents have adequate knowledge (52.2 percent), positive attitude (53.7 percent), and have appropriate practices (53.7 percent). Nearly half (49.3 percent and 44.8 percent) of the resident physicians regarded themselves as satisfactory in knowledge and attitudes, nearly half (44.8 percent) and a third (38.8 percent) of the residents respectively assessed themselves as fair and satisfactory in end-of-life care practices. Using chi-square test, the relationship between the different physicians' characteristics and their knowledge, attitudes and practices was assessed. Males had adequate knowledge (68.2 percent) than females (44.4 percent) (p=0.068). More married individuals (77.7 percent) had positive attitude and appropriate practices than single individuals (50.0 percent) (p=0.167). Nearly two-thirds (63.3 percent) of third year and higher residents had positive attitude and appropriate practices than first and second year residents (45.9 percent) (p=0.156). More than two-thirds (66.7%) of those with formal training had more appropriate practices than those without formal training (46.5 percent) (p=0.113). No significant association between end-of-life care knowledge-attitudes-practices and these aforementioned physicians' characteristics was observed. In all other characteristics, relationship was far from being statistically significant. For knowledge, ENT-HNS, Family Medicine and Surgery residents had the most residents with adequate knowledge. The difference in the proportion of residents' knowledge across medical specialties was statistically significant (p=0.055). For attitude, Family Medicine, Obstetrics and Gynecology and Surgery had the most residents with positive attitude. The difference though was not statistically significant (p=0.156). For practices, Family Medicine, Child Health and Surgery had the most residents with appropriate practices. Here, the difference was statistically significant (p=0.010). Because of inadequate sample size however, chi-square test for these associations may not be valid. Those with personal experience with death of a loved one or a close friend (61.2 percent) had appropriate practice in end-of-life care than those without (33.3 percent). The difference was statistically significant (p=0.042). More of those with clinical experience on care of dying patients had appropriate practices (59.3 percent) than those without (30.8 percent). The difference was almost statistically significant (p=0.064). Among those residents with more than three years of clinical practice, 81.8 percent had positive attitude compared to only 45.5 percent both for less than two and 2-3 years of clinical practice. The difference likewise was of borderline significance (p=0.097). Lastly, relationship between the physician's own assessment of their knowledge, attitudes and practices and their actual knowledge, attitudes and practices Was also assessed using the same statistical test. Actual and personal assessment of end-of-life care, residents who rated themselves as either having a very satisfactory and satisfactory knowledge, attitudes and practices in end-of-life care had higher proportion of actual adequate knowledge, positive attitude and appropriate practices.
ATTITUDE ; PATIENT CARE ; TERMINAL CARE

No abstract available.
Humans ; Internet* ; Patient Care*

No abstract available.
Humans ; Patient Care*

PURPOSE: The purpose of this study was to identify the effects of violence experience, emotional labor and job stress on clinical nurses' depression and to provide suggestions for improving the quality of patient care. METHODS: This research involved 257 clinical nurses who were working at an acute care hospital with at least 200 beds in S city and K province. Data were collected from May 23 to June 7 in 2014 and were analyzed using IBM SPSS version 21.0. RESULTS: The results show that 98.1% of subjects had violence experience in the past year and the violence experience included 44.4% physical threat, 37.5% verbal violence and 18.1% physical violence. The average scores were emotional labor 3.57, job stress 3.54 and depression 21.16. There were positive correlations among violence experience, emotional labor, job stress and depression (p<.01). There were also significant co-relationships between depression and violence experience (r=.21, p=.001), between depression and emotional labor (r=.48, p<.001) and between depression and job stress (r=.31, p<.001). CONCLUSION: The results suggest that it is necessary to set up guidelines for clinical nurses to manage violence, emotional labor and job stress in order to create better working environment and to improve quality of patient care.
Depression* ; Patient Care ; Violence*

No abstract available.
Continuity of Patient Care*

Medicare items were introduced in 2005 to encourage general practitioners (GPs) to involve other healthcare providers in the management of patients with chronic disease. However, there appears to be barriers to converting financial incentives and the use of information technology as a communication tool to better patient outcomes. The aim of this study was to explore these barriers from the perspectives of practice nurses and allied health practitioners. Three focus groups were held, comprising a convenience sample of 10 practice nurses and 17 allied health professionals from south-east Melbourne. Findings were reported under five themes: (1) attitudes and beliefs, (2) communication using care planning documents, (3) electronic communication, (4) care planning and collaboration between healthcare professionals and (5) ongoing challenges. While allied professionals use care planning tools, there is confusion about the extent to which these tools are for the GPs to provide structured care to assist with communication or funding mechanisms for allied health services. Further research is needed on the contributions of these groups to the care planning process and how communication and collaboration between healthcare professionals can be strengthened.
Communication ; Patient Care Planning

Patient Care ; Nurses ; Communication

There is a strong correlation between stress and the quality of care provided by informal carers. In this regard, an accurate understanding about factors contributing to stress among informal carers is crucial in order to find appropriate interventions to solve their problems. A pilot study was conducted in October 2009 in the Klang Valley area, to test the instrument liability in the local context. In-depth interviews were conducted with two informal caregivers who are providing full-time care for their chronically-ill family members. Informal caregivers face multiple types of stress. A variety of factors such as financial problems, an unsupportive community, fatigue, the unavailability of social services to assist them and their inability to accept the fact that their loved ones are terminally ill, contribute to their stress. Differences in factors contribute to stress, and lead to the adoption of different styles of coping strategies: emotion and problem focused coping.
Patient Care ; Adaptation, Psychological

Client feedback is an integral part of the health care system’s quality and effectiveness. In health care operations, it is paramount as it serves as a vital tool for continuous improvement, ensuring patient-centric care delivery, and fostering trust and accountability within the health care system. Client feedback helps shape up new and existing policies and is, therefore, highly valued, considered, and acted upon. In health care institutions such as the Southern Philippines Medical Center (SPMC), incorporating client feedback into policy-making enhances health care operations and aligns services with patient needs and institutional goals. In SPMC, the Hospital Client Experience Survey is the primary feedback mechanism by which clients, both internal and external, can voice their opinions, concerns, and suggestions regarding its personnel, processes, and structure. Through directives from the Anti-Red Tape Authority (ARTA)1 and the Department of Health (DOH),2 SPMC uses the Hospital Client Experience Survey Tool (HCES) to enhance service delivery. Public Assistance and Complaints Desk (PACD) Officers conduct monthly surveys across 200 hospital areas. Each area expects 5 to 30 responses, based on a calculation by the HCES Online Report Generator (ORG). PACD officers actively engage staff within their designated areas, encouraging their participation in survey distribution per transaction and motivating clients to provide feedback during specified survey days. Highlighting the significance of these surveys, PACD Officers emphasize the invaluable insights gained from diverse client responses, which ultimately shape and validate the impact of service delivery initiatives within the hospital. At the end of each quarter, PACD officers analyze data using the HCES-ORG, collate comments and commendations, verify the accuracy of HCES results, and then post them for viewing by the different departments within the institution. Exceptional staff commendations are documented in the quarterly HCES results publication, prominently displayed within the hospital. These commendations contribute to individual performance evaluations. If a staff member receives negative feedback on the HCES form, their unit manager receives a photocopy of the form and may implement disciplinary action or enroll the staff in customer service seminars hosted by the Professional Education and Training Department (PETD). Consistent negative feedback over three consecutive months may trigger appropriate improvement plans or corrective actions among individual staff or even entire departments. The infographic displays the reports from the HCES for the first to the fourth quarters of 2023. Clients’ feedback comprises three domains: personnel, processes, and structures. Personnel covers attitude and character, processes involve system and organization, and structures include facilities and equipment. The feedback includes both positive and negative comments, with recommendations also identified. The HCES consists of statements rated on a scale from 1 (strongly disagree) to 5 (strongly agree). For this infographic, we computed the mean satisfaction scores for each domain and the proportion of clients who reported satisfaction with the service and timeliness of service they received. To summarize the recommendations from the HCES, we utilized the artificial intelligence (AI) chatbot-powered search engine Perplexity AI. We uploaded the recommendations in spreadsheet format and prompted Perplexity AI to "Summarize, in bullets, the recommendations into three categories: personnel, process, and structure," and then to "Count the times each of those summarized comments were mentioned in the file." We used the response of Perplexity AI to illustrate the results as a word cloud, with the sizes of the words in the cloud proportional to the frequency of mentions. In the HCES, the most frequently mentioned suggestion was to provide additional staff. Other suggestions included maintaining clean and functional restrooms, and improving overall cleanliness and sanitation. Infrastructure-related suggestions focused on better ventilation, air conditioning or fans, expanding wards and watchers’ areas, adding more hospital beds and chairs, ensuring a consistent water supply, and providing necessary diagnostic and therapeutic equipment and medicines. Process-related recommendations focused on reducing service delivery turnaround time, prioritizing senior citizens, PWD, and pregnant patients, improving billing and laboratory services, optimizing operation scheduling, and enhancing staff communication and coordination between and among offices. Personnel-related suggestions included improving staff interaction with patients, providing staff training, ensuring staff safety, and performing diligent patient checks. Client feedback helps SPMC retain positive responses, optimize health care delivery, and serve clients better through ongoing renovations, reorganizations, and transformations, affirming its vision of quality service.
Feedback ; Patient-Centered Care