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PubMedDate not supplied

Patients' satisfaction with a nurse-led oncology service.

This study reports the findings of a quantitative study determining the satisfaction levels of patients attending a nurse-led oncology day ward. A random sample of 100 patients was surveyed using an adapted version of the Leeds Satisfaction Questionnaire (Hill, 1997) to ascertain the satisfaction levels of patients attending the unit. Satisfaction levels were found to be favorable in general. However, the study did highlight that some aspects of patient information required attention. Moreover, issues with the use of the questionnaire emerged as the inclusion of both positive and negative statements in the Likert-style questionnaire presented contradictory findings.

Cross-Sectional Studies↗
PubMed2003

Can universal access to health care eliminate health inequities between children of poor and nonpoor families?: A case study of childhood asthma in Alberta.

STUDY OBJECTIVE: Children from poor families are much more likely to have emergency visits for asthma than those from nonpoor families, which may be related to financial access barriers to good preventive care for the poor. We sought to determine whether in a health-care system that provides free access to outpatient and hospital services, the disparities in the rates of emergency visits for asthma would be less apparent across the income gradient. DESIGN: Longitudinal, population-based study. SETTING: Alberta, Canada. PARTICIPANTS: All children born in Alberta, Canada between 1985 and 1988 (n = 90,845) were classified into three mutually exclusive groups based on the reported annual income of their parents from the previous year: very poor, poor, and nonpoor groups. MEASUREMENTS AND RESULTS: We compared the relative risk (RR) of emergency visits for childhood asthma among children of very poor, poor, and nonpoor families using a Cox proportional hazard model during a 10-year follow-up. We found that the very poor children were 23% more likely to have had an emergency visit for asthma than those from nonpoor families (RR, 1.23; 95% confidence interval [CI], 1.14 to 1.33), adjusted for a variety of factors. The poor group, however, had a similar risk of asthma emergency visits as the nonpoor group (RR, 0.97; 95% CI, 0.91 to 1.04). The average number of office visits for asthma was similar between the very poor and nonpoor groups. CONCLUSIONS: In a setting of universal access to health care, children of poor and nonpoor families had similar rates of asthma emergency visits; the very poor children, however, continued to experience an excess risk. These findings suggest that a universal health-care system can reduce, but not fully eliminate, the disparities in emergency utilization of asthma across income categories.

Adult↗
PubMed2005

Assessment of anxiety and quality of life in fibromyalgia patients.

CONTEXT: Fibromyalgia is a syndrome characterized by chronic, diffuse musculoskeletal pain, and by a low pain threshold at specific anatomical points. The syndrome is associated with other symptoms such as fatigue, sleep disturbance, morning stiffness and anxiety. Because of its chronic nature, it often has a negative impact on patients' quality of life. OBJECTIVE: To assess the quality of life and anxiety level of patients with fibromyalgia. TYPE OF STUDY: Cross-sectional. SETTING: Rheumatology outpatient service of Hospital das Clínicas (Medical School, Universidade de São Paulo). METHODS: This study evaluated 80 individuals, divided between test and control groups. The test group included 40 women with a confirmed diagnosis of fibromyalgia. The control group was composed of 40 healthy women. Three questionnaires were used: two to assess quality of life (FIQ and SF-36) and one to assess anxiety (STAI). They were applied to the individuals in both groups in a single face-to-face interview. The statistical analysis used Student's t test and Pearson's correlation test (r), with a significance level of 95%. Also, the Pearson chi-squared statistics test for homogeneity, with Yates correction, was used for comparing schooling between test and control groups. RESULTS: There was a statistically significant difference between the groups (p = 0.000), thus indicating that fibromyalgia patients have a worse quality of life and higher levels of anxiety. The correlations between the three questionnaires were high (r = 0.9). DISCUSSION: This study has confirmed the efficacy of FIQ for evaluating the impact of fibromyalgia on the quality of life. SF-36 is less specific than FIQ, although statistically significant values were obtained when analyzed separately, STAI showed lower efficacy for discriminating the test group from the control group. The test group showed worse quality of life than did the control group, which was demonstrated by both FIQ and SF-36. Even though STAI was a less efficient instrument, it presented significant results, showing that fibromyalgia patients presented higher levels of anxiety, both on the state and trait scales. Thus, patients with fibromyalgia had higher levels of tension, nervousness, preoccupation and apprehension, and higher propensity towards anxiety. CONCLUSION: The three instruments utilized showed efficiency in evaluating fibromyalgia patients. FIQ was found to be the most efficient instrument for discriminating and assessing the impact of fibromyalgia on their quality of life. It can be concluded that such patients have a worse quality of life and higher levels of anxiety.

Anxiety↗
PubMed2005

[Out-patient treatment for cancer patients at cancer chemotherapy centers in university hospitals].

At present, one-third of people die of cancer and the number is still increasing in Japan. A safe and effective treatment system is critically required. Recently, the discovery of new drugs and the development of medical oncology promotes out-patient treatment for cancer patients. Out-patient treatment in the cancer chemotherapy center of the University of Occupational and Environmental Health Hospital has been started, and many chemotherapy regimens were verified in this center. Not only different organ-specific chemotherapies but also summarizing the oncology team are necessary for performance of the mission. We describe in this review the characteristics of the cancer chemotherapy center.

Ambulatory Care↗
PubMedDate not supplied

Paradigm shift: phlebotomy belongs to nursing.

Defining, analyzing, and changing macro- and micro-processes has become almost a routine part of the TQM efforts of many laboratories as they strive to improve service and reduce costs. Scrutinizing each part of a process can reveal unnecessary steps that, if eliminated, would generate improvements with desired outcomes. This laboratory reviewed the processes associated with phlebotomy, especially for STAT tests, at the same time its administration was planning to establish 11 patient care centers where there previously had been three traditionally operated hospitals. Through process analysis, this laboratory transferred the entire function of in-patient phlebotomy from the laboratory to nursing. The results of an 8-month follow-up study show a significant favorable effect on laboratory turnaround time and related costs but not without some problems.

Blood Specimen Collection↗