PubMed Health⌕ Search

Biomedical subjects

S Bruster

Publications and source records attributed to S Bruster.

10 recordsLinked to original sources
PubMed2002

The coronary heart disease in-patient experience questionnaire (I-PEQ (CHD)): results from the survey of National Health Service patients.

OBJECTIVE: Analysis of data from the National Survey of Coronary Heart Disease patients to develop a core measure of patient experiences of health care. A secondary purpose was to determine whether a single summary index figure could be generated from the instrument. DESIGN: The data reported here comes from the survey of coronary heart disease (CHD) patients, which was the second in the programme of National Surveys of National Health Service (NHS) patients. It took place during 1999. After an in-patient episode for CHD, questionnaires were mailed out to patients with a covering letter and a pre-paid stamped addressed envelope. Those patients who did not reply within two weeks of the initial mailing were sent a reminder letter and, if this elicited no reply within two weeks, they were sent another copy of the questionnaire. SAMPLE: Of the 116,872 patients who were sent questionnaires, 3399 proved to be ineligible or out-of scope to the survey. Responses were gained from 84,310 (74.3% of eligible respondents). RESULTS: Reliability analysis supported the existence of seven dimensions which seem to be tapping distinct underlying phenomena: hospital environment, information and communication, patient involvement, coordination of care, discharge and transition, and pain. Higher order factor analysis indicated these dimensions constituted one factor and, consequently, can be summed to create an index figure. The construct validity of the measure was assessed, and it distinguished between groups as was hypothesised. CONCLUSIONS: The dimensions of the questionnaire have high internal reliability. Both the dimensions of the instrument and the index score were found to have high construct validity. The instrument provides a core set of issues that should be covered when assessing the quality of care for hospital patients with coronary heart disease.

Adult↗
PubMed2002

Patients' experiences and satisfaction with health care: results of a questionnaire study of specific aspects of care.

OBJECTIVE: To determine what aspects of healthcare provision are most likely to influence satisfaction with care and willingness to recommend hospital services to others and, secondly, to explore the extent to which satisfaction is a meaningful indicator of patient experience of healthcare services. DESIGN: Postal survey of a sample of patients who underwent a period of inpatient care. Patients were asked to evaluate their overall experience of this episode of care and to complete the Picker Inpatient Survey questionnaire on specific aspects of their care. SAMPLE: Patients aged 18 and over presenting at five hospitals within one NHS trust in Scotland. METHOD: 3592 questionnaires were mailed to patients' homes within 1 month of discharge from hospital during a 12 month period. Two reminders were sent to non-responders; 2249 (65%) questionnaires were returned. RESULTS: Almost 90% of respondents indicated that they were satisfied with their period of inpatient care. Age and overall self-assessed health were only weakly associated with satisfaction. A multiple linear regression indicated that the major determinants of patient satisfaction were physical comfort, emotional support, and respect for patient preferences. However, many patients who reported their satisfaction with the care they received also indicated problems with their inpatient care as measured on the Picker Inpatient Survey; 55% of respondents who rated their inpatient episode as "excellent" indicated problems on 10% of the issues measured on the Picker questionnaire. DISCUSSION: The evidence suggests that patient satisfaction scores present a limited and optimistic picture. Detailed questions about specific aspects of patients' experiences are likely to be more useful for monitoring the performance of various hospital departments and wards and could point to ways in which delivery of health care could be improved.

Adolescent↗
PubMed2001

An assessment of the construct validity of the SF-12 summary scores across ethnic groups.

BACKGROUND: The aim of the study was to determine the construct validity of the 12-item Short Form health survey questionnaire (SF-12) across ethnic groups in a large community sample of the United Kingdom. METHODS: A postal survey was carried out in English using a questionnaire booklet, containing the SF-12 and a number of other items relating to experiences of chronic illness and utilization of health care services. The dataset was the National Survey of NHS Patients. The sample consisted of 1000 residents within each Health Authority in England who were randomly selected from the electoral registers, giving an initial sample of 100000. RESULTS: A total of 61 426 (61.4 per cent) questionnaires were returned; 94.3 per cent of respondents classified themselves as white and 5.7 per cent classified themselves as members of other ethnic groups. Construct validity of the SF-12 was assessed by comparing results from the two summary scores (the Mental Health Component Summary (MCS) score and the Physical Health Component Summary (PCS) score) with overall self-assessed health and limiting longstanding illness. Although there were generally consistent patterns of association between overall self-assessed health or limiting longstanding illness and the MCS and PCS scores in all the ethnic groups, there were significant differences between the MCS and PCS scores of Indians, Pakistanis and Bangladeshis who understood English fluently and those who did not. Furthermore, there were differences in the completion rates of the SF-12 between ethnic groups and a reversal of the general pattern of increasing MCS scores with increasing age in Bangladeshis. CONCLUSION: The results indicate that the use of the SF-12 to measure the health of ethnic minorities seems acceptable in most instances, but may prove problematic in those instances where respondents complete the questionnaire via an untrained translator, such as a friend or family member. The systematic differences in MCS and PCS scores between ethnic minorities who understood English fluently and those who did not suggest that the meaning of specific SF-12 items may change when informally translated. Future research using the SF-12 to measure the health status of ethnic minorities in the United Kingdom via postal surveys must include questions on whether respondents completed the questionnaires via informal translations. In general, those wishing to measure the health of members of ethnic groups who are unable to read English might consider using different techniques to gain the information from these groups.

Adult↗
PubMed2000

Demand for and supply of out of hours care from general practitioners in England and Scotland: observational study based on routinely collected data.

OBJECTIVES: To determine the level of demand and supply of out of hours care from a nationally representative sample of general practice cooperatives. DESIGN: Observational study based on routinely collected data on telephone calls, patient population data from general practices, and information about cooperatives from interviews with managers. SETTING: 20 cooperatives in England and Scotland selected after stratification by region and by size. SUBJECTS: 899 657 out of hours telephone calls over 12 months. MAIN OUTCOME MEASURES: Numbers and age and sex specific rates of calls; variation in demand and activity in relation to characteristics of the population; timing of calls; proportion of patients consulting at home, at a primary care centre, or on the telephone; response times; hospital admission rates. RESULTS: The out of hours call rate (excluding bank holidays) was 159 calls per 1000 patients/year, with rates in children aged under 5 years four times higher than for adults. Little variation occurred by day of the week or seasonally. Cooperatives in Scotland experienced higher demand than those in England. Patients living in deprived areas made 70% more calls than those in non-deprived areas, but this had little effect on the overall variation in demand. 45.4% (408 407) of calls were handled by telephone advice, 23.6% (212 550) by a home visit, and 29.8% (267 663) at a centre. Cooperatives responded to 60% of calls within 30 minutes and to 83% within one hour. Hospital admission followed 5.5% (30 743/554 179) of out of hours calls (8 admissions per 1000 patients/year). CONCLUSIONS: This project provides national baseline data for the planning of services and the analysis of future changes.

Adult↗
PubMed1996

Listening to patients in the National Health Service: a selective review of literature on patients' views about outpatient services in British hospitals.

An increased emphasis on quality assurance in the National Health Service (NHS) became evident in the literature related to health following the Government's White Paper, "Working for Patients" (1989) and the Patients' Charter (1991). The latter included specific quality standards to which purchasers and providers of health care made a commitment. This review of published and un-published (grey) literature concentrates on patient views about outpatient services in British hospitals, with special emphasis on the role of nurses. Findings indicate central emphasis on easily measurable factors, such as waiting times in outpatient departments and comparative neglect of more qualitative aspects, which may be of greater importance to patients. Specific attention has been given to exploring the role of nurses working in the outpatient department, which appears to be under-researched, based on this selective literature review.

Health Services Research↗
PubMed1995

The management of quality assurance in nursing.

The results of a national survey of hospital patients as they relate to nursing are presented. A brief review of the literature locates the study in the context of developments in nursing quality assurance, examining, in particular, conceptual issues of how the nursing process may be measured, and the role of the nursing profession in quality assurance. Results of the study identify a number of problems with the process of nursing care, including pain management, discharge planning and physical care, with wide variation between hospitals on many issues. The implications of these results for managers of nursing are discussed.

Humans↗
PubMed1994

National survey of hospital patients.

OBJECTIVE: To survey patients' opinions of their experiences in hospital in order to produce data that can help managers and doctors to identify and solve problems. DESIGN: Random sample of 36 NHS hospitals, stratified by size of hospital (number of beds), area (north, midlands, south east, south west), and type of hospital (teaching or non-teaching, trust or directly managed). From each hospital a random sample of, on average, 143 patients was interviewed at home or the place of discharge two to four weeks after discharge by means of a structured questionnaire about their treatment in hospital. SUBJECTS: 5150 randomly chosen NHS patients recently discharged from acute hospitals in England. Subjects had been patients on medical and surgical wards apart from paediatric, maternity, psychiatric, and geriatric wards. MAIN OUTCOME MEASURES: Patients' responses to direct questions about preadmission procedures, admission, communication with staff, physical care, tests and operations, help from staff, pain management, and discharge planning. Patients' responses to general questions about their degree of satisfaction in hospitals. RESULTS: Problems were reported by patients, particularly with regard to communication with staff (56% (2824/5020) had not been given written or printed information); pain management (33% (1042/3162) of those suffering pain were in pain all or most of the time); and discharge planning (70% (3599/5124) had not been told about warning signs and 62% (3177/5119) had not been told when to resume normal activities). Hospitals failed to reach the standards of the Patient's Charter--for example, in explaining the treatment proposed and giving patients the option of not taking part in student training. Answers to questions about patient satisfaction were, however, highly positive but of little use to managers. CONCLUSIONS: This survey has highlighted several problems with treatment in NHS hospitals. Asking patients direct questions about what happened rather than how satisfied they were with treatment can elucidate the problems that exist and so enable them to be solved.

Adolescent↗
PubMed1991

Hospital comparisons using a Euro Health Data Base for resource management and strategic planning.

A European approach for resource management and strategic planning has been implemented in the HOSCOM project of AIM by defining information standards needed across countries, as well as a methodology to measure resources and costs at the institutional and interinstitutional level. A Euro Health Data Base (EHDB) has been obtained in order to test data availability and comparability as well as to validate models through macrocomparisons using case-mix (DRG's, refined grouping, disease staging) and microcomparisons based on three diseases (cardiac valve replacement, diabetes mellitus and hip fracture). The EHDB's presently based on 274 164 medical record summaries sampled from 7 countries allowed us to build prototypes (using Clipper, Prolog and SQL) in order to export uniform aggregates in the different countries, with standard software tools for statistical comparisons. It showed the present feasibility of using case-mix based on the European Minimum Basic Data Set (MBDS) and the difficulty of obtaining uniform data on resources and costs other than length of stay across countries. Medical data confidentiality was assured but not yet population-based representativity. Given the present state of the EHDB, problems have been clearly identified in order to be solved by international research and development projects in the near future.

Abstracting and Indexing↗