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

PURPOSE: This study was performed to explore the preference for care near the end-of-life of nurses who had been working in an acute hospital. s METHODS: Data were collected by using PCEOL-K which was originally developed in U.S. and standardized into Korean version. Two hundred nurses from one acute hospital who agreed to participate in the study filled out questionnaires and 177 questionnaires were analyzed for the study results. RESULTS: Relatively positive preference toward spirituality and pain control and negative preference toward decision making by health care professional were uncovered. CONCLUSION: Nurses consider patient's autonomy, pain control and spirituality as important factors at the end-of-life care. Further studies regarding the preference for the care near the end-of-life of diverse groups such as patients, doctors, and family members are called for.
Advance Care Planning ; Decision Making ; Delivery of Health Care ; Humans ; Patient Preference ; Spirituality ; Surveys and Questionnaires

OBJECTIVES: In an effort to improve hearing aid users’ satisfaction, recent studies on trainable hearing aids have attempted to implement one or two environmental factors into training. However, it would be more beneficial to train the device based on the owner’s personal preferences in a more expanded environmental acoustic conditions. Our study aimed at developing a trainable hearing aid algorithm that can reflect the user’s individual preferences in a more extensive environmental acoustic conditions (ambient sound level, listening situation, and degree of noise suppression) and evaluated the perceptual benefit of the proposed algorithm. METHODS: Ten normal hearing subjects participated in this study. Each subjects trained the algorithm to their personal preference and the trained data was used to record test sounds in three different settings to be utilized to evaluate the perceptual benefit of the proposed algorithm by performing the Comparison Mean Opinion Score test. RESULTS: Statistical analysis revealed that of the 10 subjects, four showed significant differences in amplification constant settings between the noise-only and speech-in-noise situation (P<0.05) and one subject also showed significant difference between the speech-only and speech-in-noise situation (P<0.05). Additionally, every subject preferred different β settings for beamforming in all different input sound levels. CONCLUSION: The positive findings from this study suggested that the proposed algorithm has potential to improve hearing aid users’ personal satisfaction under various ambient situations.
Acoustics ; Classification ; Hearing Aids* ; Hearing* ; Humans ; Noise ; Patient Preference ; Personal Satisfaction ; Signal Processing, Computer-Assisted

The Korean Diabetes Association (KDA) recently updated the Clinical Practice Guidelines on antihyperglycemic agent therapy for adult patients with type 2 diabetes mellitus (T2DM). In combination therapy of oral hypoglycemic agents (OHAs), general recommendations were not changed from those of the 2015 KDA guidelines. The Committee on Clinical Practice Guidelines of the KDA has extensively reviewed and discussed the results of meta-analyses and systematic reviews of effectiveness and safety of OHAs and many clinical trials on Korean patients with T2DM for the update of guidelines. All OHAs were effective when added to metformin or metformin and sulfonylurea, although the effects of each agent on body weight and hypoglycemia were different. Therefore, selection of a second agent as a metformin add-on therapy or third agent as a metformin and sulfonylurea add-on therapy should be based on the patient’s clinical characteristics and the efficacy, side effects, mechanism of action, risk of hypoglycemia, effect on body weight, patient preference, and combined comorbidity. In this review, we address the results of meta-analyses and systematic reviews, comparing the effectiveness and safety among OHAs. It will help to choose the appropriate drug for an individual patient with T2DM.
Adult ; Body Weight ; Comorbidity ; Diabetes Mellitus, Type 2* ; Humans ; Hypoglycemia ; Hypoglycemic Agents* ; Metformin ; Patient Preference

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

The Korean Diabetes Association (KDA) recently updated the Clinical Practice Guidelines on antihyperglycemic agent therapy for adult patients with type 2 diabetes mellitus (T2DM). In combination therapy of oral hypoglycemic agents (OHAs), general recommendations were not changed from those of the 2015 KDA guidelines. The Committee on Clinical Practice Guidelines of the KDA has extensively reviewed and discussed the results of meta-analyses and systematic reviews of effectiveness and safety of OHAs and many clinical trials on Korean patients with T2DM for the update of guidelines. All OHAs were effective when added to metformin or metformin and sulfonylurea, although the effects of each agent on body weight and hypoglycemia were different. Therefore, selection of a second agent as a metformin add-on therapy or third agent as a metformin and sulfonylurea add-on therapy should be based on the patient's clinical characteristics and the efficacy, side effects, mechanism of action, risk of hypoglycemia, effect on body weight, patient preference, and combined comorbidity. In this review, we address the results of meta-analyses and systematic reviews, comparing the effectiveness and safety among OHAs. It will help to choose the appropriate drug for an individual patient with T2DM.
Adult ; Body Weight ; Comorbidity ; Diabetes Mellitus, Type 2* ; Humans ; Hypoglycemia ; Hypoglycemic Agents* ; Metformin ; Patient Preference