BACKGROUND AND OBJECTIVE

Long-term treatment of people living with HIV (PLHIV) encounters various challenges, such as medication adherence, stigma, discrimination, and healthcare access. Patient satisfaction with healthcare services is vital for maintaining treatment adherence. Therefore, understanding the factors influencing patient satisfaction is crucial. We conducted a qualitative study to explore these factors in primary HIV care facilities in Metro Manila, Philippines.

In this qualitative study, we interviewed PLHIV aged 18-59 receiving antiretroviral therapy (ART) in primary HIV care facilities in Metro Manila. Data saturation was reached after 19 in-depth interviews. We transcribed all audio files verbatim in Filipino and analyzed the data using deductive and inductive thematic analysis, guided by the SERVQUAL model as a theoretical framework. We employed MAXQDA, a qualitative data analysis software for coding and data management. We illustrated themes and sub-themes with quotes derived from the data.

Six key themes emerged regarding factors influencing patient satisfaction: tangibles, reliability, responsiveness, assurance, empathy, and location. The first five themes aligned with the SERVQUAL model, while location emerged as a new theme. PLHIV preferred accessible clinics, a clean and pleasant ambiance, and positive interactions with healthcare providers. Moreover, they suggested facility improvements, including expansion, better ventilation, enhanced service delivery, and increased healthcare staff.

Enhanced service delivery and positive healthcare interactions, along with favorable physical attributes of primary HIV care facilities, drive patient satisfaction and long-term retention. These modifiable factors contribute to the continuous care of PLHIV, ultimately improving their quality of life.

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.

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.

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.

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.

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.

BACKGROUND

Chronic Kidney Disease (CKD) patients often face critical treatment decisions that significantly affect their quality of life, making Shared Decision-Making (SDM), a collaborative approach between patients and healthcare providers, an essential component of patient-centered care.

This study aimed to investigate the impact of SDM on decisional readiness and patient satisfaction among CKD patients undergoing hemodialysis (HD) at Southern Isabela Medical Center (SIMC).

An analytical cross-sectional design was utilized. The Tagalog Version of SDM Q-9 questionnaire, Decision survey and CSAT survey tool were given to HD patients of SIMC from September – October 2024. Descriptive statistics, Pearson product-moment correlation and chi square test were used to report and analyze data.

One hundred eight (108) CKD patients on HD were included in the study. Shared decision-making score was high and overall satisfaction on health services was outstanding. Higher decisional readiness was associated with greater odds of reporting outstanding satisfaction (OR = 3.47, 95% CI: 2.563–4.688, p = 0.009). There was no significant association between patient satisfaction and SDM (r= 0.111, p =0.253.). Shared decision-making had a significant but weak positive correlation with decisional readiness (r =0.2043, p 0.035).

This study showed that fostering SDM positively enhances patients’ preparedness to make healthcare decisions. Decisional readiness is strongly associated with patient satisfaction, as confident patients are more likely to be satisfied with their care. The findings underscore the need for improved patient education to boost decisional readiness and support ongoing SDM practices. Integrating SDM into clinical workflows is essential to advancing patient-centered care and improving health outcomes for CKD patients undergoing hemodialysis.

BACKGROUND AND OBJECTIVE

Long-term treatment of people living with HIV (PLHIV) encounters various challenges, such as medication adherence, stigma, discrimination, and healthcare access. Patient satisfaction with healthcare services is vital for maintaining treatment adherence. Therefore, understanding the factors influencing patient satisfaction is crucial. We conducted a qualitative study to explore these factors in primary HIV care facilities in Metro Manila, Philippines.

In this qualitative study, we interviewed PLHIV aged 18-59 receiving antiretroviral therapy (ART) in primary HIV care facilities in Metro Manila. Data saturation was reached after 19 in-depth interviews. We transcribed all audio files verbatim in Filipino and analyzed the data using deductive and inductive thematic analysis, guided by the SERVQUAL model as a theoretical framework. We employed MAXQDA, a qualitative data analysis software for coding and data management. We illustrated themes and sub-themes with quotes derived from the data.

Six key themes emerged regarding factors influencing patient satisfaction: tangibles, reliability, responsiveness, assurance, empathy, and location. The first five themes aligned with the SERVQUAL model, while location emerged as a new theme. PLHIV preferred accessible clinics, a clean and pleasant ambiance, and positive interactions with healthcare providers. Moreover, they suggested facility improvements, including expansion, better ventilation, enhanced service delivery, and increased healthcare staff.

Enhanced service delivery and positive healthcare interactions, along with favorable physical attributes of primary HIV care facilities, drive patient satisfaction and long-term retention. These modifiable factors contribute to the continuous care of PLHIV, ultimately improving their quality of life.

INTRODUCTION: Medical errors commonly occur in medical imaging departments. These errors are frequently influenced by patient safety culture. This study aimed to develop a suitable patient safety culture assessment tool for medical imaging departments. METHODS: Staff members of a teaching hospital medical imaging department were invited to complete the generic short version of the Safety Attitude Questionnaire (SAQ). Internal consistency and reliability were evaluated using Cronbach's α. Confirmatory factor analysis (CFA) was conducted to examine model fit. A cut-off of 60% was used to define the percentage positive responses (PPR). PPR values were compared between occupational groups. RESULTS: A total of 300 complete responses were received and the response rate was 75.4%. In reliability analysis, the Cronbach's α for the original 32-item SAQ was 0.941. Six subscales did not demonstrate good fit with CFA. A modified five-subscale, 22-item model (SAQ-MI) showed better fit (goodness-to-fit index ≥0.9, comparative fit index ≥ 0.9, Tucker-Lewis index ≥0.9 and root mean square error of approximation ≤0.08). The Cronbach's α for the 22 items was 0.921. The final five subscales were safety and teamwork climate, job satisfaction, stress recognition, perception of management and working condition, with PPR of 62%, 68%, 57%, 61% and 60%, respectively. Statistically significant differences in PPR were observed between radiographers, doctors and others occupational groups. CONCLUSION The modified five-factor, 22-item SAQ-MI is a suitable tool for the evaluation of patient safety culture in a medical imaging department. Differences in patient safety culture exist between occupation groups, which will inform future intervention studies.
Humans ; Surveys and Questionnaires ; Patient Safety ; Attitude of Health Personnel ; Diagnostic Imaging ; Reproducibility of Results ; Male ; Female ; Adult ; Job Satisfaction ; Factor Analysis, Statistical ; Middle Aged ; Hospitals, Teaching ; Safety Management ; Organizational Culture ; Medical Errors/prevention & control*

Objective To gain insights into the care service preferences and willingness of patients with severe mental disorders in Beijing,analyze the main factors affecting their participation in care services,and provide data support and decision-making reference for the optimal design of care services for patients with severe mental disorders and the improvement of relevant policies.Methods In July 2022,a questionnaire survey was conducted for a part of Beijing community patients with severe mental disorders selected by multi-stage stratified sampling,including the basic personal information and the preferences of discrete choice experiment.A mixed Logit model was used to perform regression analysis on the care service preferences,and the trade off between general and monetary attributes was quantified by willingness to pay(WTP).Results A total of 242 questionnaires were distributed,and 181 valid questionnaires were collected,with a response rate of 74.79%.The regression coefficients for the four attributes-service type,service content,service frequency,and service cost-all showed statistical significance(all P<0.05).Patients' most preferred attribute level was a service frequency covering about 90% of the time per month/year( β=1.059),while the least preferred was full-time residential care( β=-1.025).Increasing the service frequency from 30% to 90% corresponded to a WTP of 492.5 yuan,while changing the service type from home-based care to full-time residential care resulted in a WTP of -476.6 yuan.Moreover,there were differences in care service preferences and WTP among patient groups with different characteristics(all P<0.05).Conclusions Service type,service content,service frequency,and service cost all significantly affect the care service preferences of patients with severe mental disorders.There is heterogeneity in care service preferences among patient groups with different characteristics.
Humans ; Mental Disorders/therapy* ; Patient Preference ; Beijing ; Surveys and Questionnaires ; Male ; Female ; Choice Behavior ; Adult ; Middle Aged

OBJECTIVE

This study aimed to translate and validate the Telehealth Usability Questionnaire in Filipino (TUQ-F) among users of the Department of Family and Community Medicine Facebook Page.

This study focused on translating and validating the Telehealth Usability Questionnaire (TUQ) into Filipino (TUQ-F) for patients consulting using the Facebook Page of the Department of Family and Community Medicine at the Batangas Medical Center. The said study was conducted from April to September 2024. This involved a methodological study in two phases: translation and validation, followed by reliability testing. The first phase was done via forward and backward translation conducted by experts and subsequently by content validation using a 5 point-Likert scale. The second phase was testing the reliability of the questionnaire using Cronbach’s alpha. 

In the first phase, the final translated Telehealth Usability Questionnaire–Filipino (TUQ-F) was reviewed for content validity by three experts, all of whom rated every item as important or relevant, yielding an I-CVI of 1.00 for all items and for the overall tool.

In the second phase, reliability testing was conducted among 128 respondents, most of whom were aged 25–54 years (92.97%) and female (78.13%). Cronbach’s alpha values for all domains exceeded 0.80, indicating good to excellent internal consistency: usefulness (0.793–0.794), ease of usability and learnability (0.856–0.884), interface quality (0.854–0.888), interaction quality (0.819–0.900), reliability (0.797–0.881), and satisfaction (0.880–0.910). The overall Cronbach’s alpha for the TUQ-F was 0.858, demonstrating good reliability of the translated tool.

The translated telehealth Questionnaire in Filipino (TUQ-F) was found to be a valid and reliable tool which can be used within the Philippine setting. This study supported its objective in adapting and validating the questionnaire in local use. The outcome of the validation study proved that the TUQ-F has a potential as a standard tool which may help improve the country’s health service delivery in different settings. However, further studies may have to be conducted such as its applicability in other local dialects. This may further broaden the tool’s accuracy in determining the validity and reliability further when applied among different users across the country who are not native Filipino speakers.

OBJECTIVE: To investigate effectiveness of the modified edge resection technique for composite labia minora and clitoral hood reduction with preserved microstructures. METHODS: A retrospective analysis was conducted on 36 female patients, who were diagnosed with composite hypertrophy of the labia minora and clitoral hood and admitted between September 2022 and December 2024. The patients' ages ranged from 18 to 45 years (mean, 27.4 years). The primary surgical motivations included poor appearance alone (8 cases), functional impairment alone (14 cases), both poor appearance and functional impairment (12 cases), and psychological factors (2 cases). All patients were treated with the modified edge resection technique for composite labiaminora and clitoral hood reduction with preserved microstructures. The surgical technique emphasized precise adjustments to the clitoral-labial junction and optimization of the anterior labial structure to ensure a natural postoperative appearance and functional integrity. Postoperative follow-up assessed improvements in appearance and function of clitoral hood and labia minora, complications, and overall patient satisfaction. RESULTS: One patient exhibited suboptimal wound healing, while the remaining patients experienced no complications such as postoperative bleeding, hematoma, wound dehiscence, suture cutting, or labial edema and enlargement. Thirty patients were followed up with a duration of 1-6 months (mean, 2.4 months). In the early postoperative period, 2 patients perceived asymmetry of the bilateral labia minora; 1 underwent labial revision surgery, while the other achieved near-symmetry without intervention. At last follow-up, 25 patients experienced varying degrees of relief from preoperative functional impairments, while the remaining patients showed no improvement; 27 patients reported varying degrees of improvement in appearance, 2 reported no change, and 1 reported a worse appearance compared to preoperatively. Sixteen patients were very satisfied with the surgical results, 8 were satisfied, 5 were moderate satisfied, and 1 was dissatisfied, with a satisfaction rate of 80% (24/30). CONCLUSION The modified edge resection technique for composite labia minora and clitoral hood reduction with preserved microstructures which preserves and optimizes fine anatomical structures through precise adjustments at the clitoral-labial junction, achieves high patient satisfaction with both aesthetic and functional outcomes while minimizing postoperative complications.
Humans ; Female ; Adult ; Retrospective Studies ; Vulva/pathology* ; Clitoris/pathology* ; Middle Aged ; Plastic Surgery Procedures/methods* ; Adolescent ; Patient Satisfaction ; Young Adult ; Treatment Outcome ; Hypertrophy/surgery*

OBJECTIVE: To describe a novel arthroscopic technique of modified tri-anchor double-pulley suture-bridge in repairing medium-sized supraspinatus tendon tears and evaluate the early effectiveness. METHODS: Between June 2021 and January 2024, 26 patients with medium-sized supraspinatus tendon tears who underwent arthroscopic modified tri-anchor double-pulley suture-bridge repair and met the selective criteria were included. There were 11 males and 15 females with an average age of 61.4 years (range, 43-74 years). Five patients had a significant history of trauma, while the remaining 21 patients had no apparent cause. The time from symptom onset to hospitalization was 3-25 months (mean, 7.9 months). The effectiveness was evaluated during follow-up, including the scores of University of California at Los Angeles (UCLA), American Shoulder and Elbow Surgeons (ASES), visual analogue scale (VAS), the range of forward flexion, abduction, external rotation, and internal rotation, and patient's satisfaction. Either MRI or ultrasound examination were used to evaluate structural integrity of the tendon. RESULTS: The operation time was 65-110 minutes (mean, 81.8 minutes). All patients were followed up 12-43 months (mean, 23.0 months). At 3 and 12 months after operation, the shoulder range of flexion, abduction, external rotation, and internal rotation, and the scores of VAS, UCLA, and ASES significantly improved when compared with those before operation ( P<0.05). The improvement was further observed at 12 months compared to 3 months ( P<0.05). At last follow-up, 13 patients were very satisfied with the effectiveness, 11 patients were satisfied, 1 was relatively satisfied, and 1 was dissatisfied. During follow-up, 15 patients underwent imaging examination and imaging reexamination showed that the re-tear rate of tendon was 6.6%(1/15). The remaining 11 patients refused imaging examination. Complications included partial anchor withdrawal in 1 case, shoulder stiffness in 5 cases, and mild pain in shoulder joint in 2 cases in physical activity or heavy physical activity. CONCLUSION Arthroscopic modified tri-anchor double-pulley suture-bridge technique is a novel surgical technique that uses double-loaded suture anchors as medial- and lateral-row anchors. In repairing medium-sized supraspinatus tendon tears, 6 sets of double-pulley suture-bridges can be created from one medial-row anchor; knotless medial-row can reduce re-tear rate of the tendon; good early effectiveness is obtained.
Humans ; Female ; Male ; Middle Aged ; Arthroscopy/methods* ; Adult ; Rotator Cuff Injuries/surgery* ; Aged ; Suture Techniques ; Treatment Outcome ; Suture Anchors ; Rotator Cuff/surgery* ; Range of Motion, Articular ; Tendon Injuries/surgery* ; Patient Satisfaction

OBJECTIVE: To evaluate the functional and aesthetic evaluation of external fixator lengthening through plantar approach for fourth brachymetatarsia. METHODS: A retrospective analysis was conducted on 20 patients (23 feet) with fourth brachymetatarsia who met the selection criteria between January 2016 and January 2024, including 3 males and 17 females, with 8 left, 9 right, and 3 bilateral cases. The mean age was 24.7 years (range, 14-51 years). The preoperative metatarsal shortening length was (13.8±3.2) mm. The preoperative American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score was 79.5±3.9, the visual analogue scale (VAS) score of appearance satisfaction was 1.7±0.8, and the appearance index (AI) score was 13.6±0.9. All patients underwent external fixator lengthening through plantar approach. The lengthening length of metatarsal bone, lengthening ratio, healing time, and healing index were recorded. Functional outcomes were assessed using the AOFAS forefoot score, VAS score of appearance satisfaction, and quality-of-life impact with AI questionnaire. RESULTS: All 20 patients were followed up 14-55 months with an average of 36.3 months. During the follow-up, complications occurred in 4 cases (17.4%), including 2 cases of metatarsophalangeal joint stiffness, which had no significant effect on the function and appearance. Delayed union of osteotomy occurred in 1 case (healed at 12 weeks after operation). Pin loosening occurred in 1 case and recovered after outpatient reinforcement. No complications related to plantar scar occurred. At last follow-up, the lengthening length of metatarsal bone was (13.9±3.1) mm, and the lengthening ratio was 25.8%±5.6%. All cases achieved bony union, with a mean healing time of (64.3±12.5) days and a healing index of (46.9±4.8) d/cm. At last follow-up, AOFAS score was 98.9±2.1, the VAS score of appearance satisfaction was 9.3±0.7, and the AI score was 0.6±0.8, which significantly improved when compared with those before operation ( t=27.398, P<0.001; t=32.994, P<0.001; t=56.135, P<0.001). CONCLUSION External fixator lengthening through plantar approach is a safe and effective technique for fourth brachymetatarsia, achieving satisfactory functional and aesthetic outcomes.
Humans ; Male ; Female ; Adult ; External Fixators ; Retrospective Studies ; Bone Lengthening/instrumentation* ; Middle Aged ; Metatarsal Bones/abnormalities* ; Adolescent ; Young Adult ; Treatment Outcome ; Patient Satisfaction ; Esthetics ; Osteotomy/methods* ; Foot Deformities, Congenital/surgery*