BACKGROUND

Telemedicine as a response to the need for consultation amidst limited face to face interaction during the pandemic became part of the services of most tertiary hospitals in Davao City. In order to ensure the client’s needs are addressed by existing telemedicine services, it is important to look at the level of client satisfaction and identify factors that influence it.

OBJECTIVE

The main objective of the study was to determine the level of satisfaction and the factors influencing it among the patients of the Family Medicine Department of a tertiary hospital in Davao City on the telemedicine services they received.

METHODS

The study employed a descriptive cross-sectional design utilizing a self-administered telemedicine satisfaction questionnaire developed from the Clinician and Group Adult Visit Survey 4.0 (beta) and Telehealth Usability Questionnaire (TUQ). Participants were 18 years old and above and sought teleconsultation in the institution during the pandemic. Excluded were those who did not give consent. The data gathered were analyzed using an Epi-Info software to determine what factors were associated with level of satisfaction, a chi-square test was done for nominal and ordinal data while a t-test or ANOVA as applicable was used for continuous data.

RESULTS

A total of 278 patients were surveyed. More than ninety-five percent of the respondents perceived high satisfaction rating on the telemedicine service while less than five percent were dissatisfied. Eight factors were identified that seem to affect level of satisfaction. These include employment status, network connection and frequency of telemedicine.

CONCLUSION

The study identified that the telemedicine in SPMC DFCM provides high level of satisfaction among patients availing the service. It was also identified that factors such as employment status, network connectivity and frequency of using the service affects the level of satisfaction.

Human ; Telemedicine ; Patient Satisfaction

BACKGROUND

Globally, cancer remains to be one of the leading causes of mortality and poses significant burden to patients and families. A growing body of evidence suggests that early palliative care results in more favorable patient and caregiver outcomes compared to standard oncology care alone. 

OBJECTIVES

This study aims to determine the effects of early palliative care on caregivers of adult cancer patients in terms of quality of life, psychological distress, and satisfaction with care. 

METHODS

Systematic database searches in PubMed, Google Scholar, Cochrane library and Clinicaltrials.gov registry was conducted to select eligible studies for this review. Keywords, limit fields and Boolean operators were used for the search. Qualitative and quantitative analyses through the Review manager 5.4 software were done to compare quality of life, psychological distress, and satisfaction with care among caregivers given early palliative care vs. caregivers given standard oncology care. 

CONCLUSION

This review revealed inconclusive evidence on the benefits of early palliative care on caregiver outcomes when compared to standard care. We reviewed outcomes of early palliative care including quality of life, psychological distress, and satisfaction with care, but evidence remains unclear due to paucity of studies. Larger, high-caliber trials with more robust evidences, refinement of measurement tools catered to caregivers with higher sensitivity, and standardization of EPC protocol are needed to detect effect of EPC. 

Human ; Caregivers ; Cancer ; Neoplasms ; Quality Of Life ; Systematic Review

Background: Uninvestigated dyspepsia is a common complaint in family practice in the Philippines. Patients usually seek consult due to severity of symptoms which affect their quality of life. The goals of management are short- and long-term symptom control, with reversal of possible underlying mechanisms, achievable through a combination of pharmacologic and non-pharmacologic interventions. Objective: The main objective of this pathway is to guide family physicians and primary care physicians in the assessment, diagnosis and management of adult patients with uninvestigated dyspepsia through a shared decision-making process. Method: This clinical pathway is an update of the PAFP’s Clinical Pathways for the Management of Dyspepsia in Adults (2016). The current panel utilized the ADAPTE method and prioritized reviewing relevant clinical practice guidelines from 2017 to present. Grading of recommendation was achieved through a mixture of strength of available evidence and a consensus from a panel of experts. Summary of Recommendations: The main changes in the recommendations in this update are as follows: symptom-based classification of dyspepsia, screening for anxiety and depression, family and SCREEM assessment; initiation of therapeutic trial for most patients to whom H. pylori testing is not available; extension of initial PPI treatment to 4-8 weeks, consideration of antacids/alginates for immediate symptom relief, consideration of tricyclic antidepressants for non-responders to initial treatment; symptom-based non-pharmacologic advice, consideration of counseling and other psychosocial interventions; empowerment for self-treatment and as-needed therapy for those who have completed the initial treatment regimen Dissemination and Implementation This guideline shall be disseminated and implemented at the clinic and organizational level. It will be published in the “The Filipino Family Physician” journal, social media platforms and will be disseminated through PAFP local chapters, training institutions and during the national convention. Non-FCM primary care physicians will also be reached through relevant agencies. It shall be included in the references required during training activities and national exams of accredited training institutions, in coordination with the PAFP committee on Residency Training. It shall be incorporated in checklists for compliance in audits and QA cycles, with support from the PAFP committee on Quality Assurance and that on Standards for Family Practice. Feedback on utility and applicability will be actively sought from the intended users and other stakeholders.
Dyspepsia ; Community Health Services ; Critical Pathways

BACKGROUND: Dyspepsia is any chronic or recurrent discomfort in the epigastric area described as bloatedness, fullness, gnawing or burning continuously or intermittently for at least 2 weeks. About 40% of the adult population may suffer from dyspeptic symptoms but most of them are un-investigated because only about 2% consult their physician.
OBJECTIVE: The general objective of this clinical pathway is to improve outcomes of patients with dyspepsia in family and community practice
METHOD: The PAFP Clinical Pathways Group reviewed the previous Clinical Practice Guideline for the Treatment of Dyspepsia in Family Practice, a local guideline developed by the Family Medicine Research Group and adopted as policy statement by the Philippine Health Insurance Corporation. The reviewers then developed a time-related representation of recommendations on patient care processes, in terms of history and physical examination, laboratory tests, pharmacologic and non-pharmacologic interventions as well as social and community strategies to treat hypertension and prevent complications.
RECOMMENDATION: All patients with gastrointestinal pain or discomfort should have a detailed history focusing on weight loss, hematemesis, hemetochezia, melena, dysphagia, odynophagia, vomiting, NSAID intake, alcohol intake, smoking, frequent medical complaints, depression, anxiety, personal or family history of gastrointestinal disease using family genogram. Physical examination findings provide minimal information but should be done to rule out an organic pathology and to look for alarm clinical features like anemia, abdominal tenderness or mass, jaundice, melena etc. If the patient is with history of previous dyspepsia treatment, more than 45 years old or long-term use of NSAID, the physician may request for non-invasive H. pylori test. Upper abdominal ultrasound, liver function test, pancreatic amylase may be done if organic problem is considered. Start therapeutic trial of prokinetic treatment for 1-2 weeks or proton-pump inhibitor depending on the symptoms. Fixed drug combination may be used if symptoms are undifferentiated. The patient should be educated about upper gastrointestinal disorders and dyspepsia, risk factors and complications. If medications were prescribed, explain the dose, frequency, intended effect, possible side effects and importance of medication adherence. Lifestyle modifications focusing on low fat meals, weight reduction, avoidance of alcohol intake and smoking cessation, eating way before bedtime, elevated head while sleeping, etc. may also be done. Recommendations were also made on subsequent visits.
IMPLEMENTATION: Quality improvement strategy is recommended for implementation of this pathway. This will involve pre- and post-intervention data collection using records review. Intervention strategies may be feedback, group consensus or incentive mechanisms.

Human ; Dyspepsia ; Smoking ; Smoking Cessation ; Hematemesis ; Melena ; Weight Loss ; Deglutition Disorders ; Medication Adherence ; Gastrointestinal Diseases ; Helicobacter Pylori ; Hypertension

This article discusses some methods by which the facilitator can evaluate effectiveness of small groups in promoting learning. The paper focuses on evaluation of the small group process using the sociogram and Bales' checklist. Additionally, it presents checklists for evaluating facilitation skills. Combination of the tools presented in this article and revision of the content of the checklists to make it more context-specific and attuned to the realities of your small group settings is suggested to maximize the evaluative potential of these tools.

Human ; Male ; Female ; Checklist ; Group Processes ; Learning ; Evaluation Studies As Topic