Makale Arama

It is important to take into consideration of patient expectations and satisfaction in terms of the best utilization of required components that are necessary for the development of health services. The aim of this study was to evaluate the level of the patients’ satisfaction and detect factors affecting the satisfaction, who consulted to Department of Anesthesiology and Reanimation Clinic in Necmettin Erbakan University, Meram Faculty of Medicine. This study was performed on patients who were consulted to the Department of Anesthesiology and Reanimation Clinic, at the Necmettin Erbakan University, Meram Faculty of Medicine for time period of 4 months between November 2015 and February 2016. Within this period, 200 patients who applied to the clinic and accepted to participate in the study by approving informed consent form were included in the study. The survey form was filled by conducting face to face interview. The time duration between patients application to the clinic and their receiving anesthesia consent and ASA scores were recorded. Patient satisfaction coefficient was found as 90.32. Patients who indicated that they did not wait too long for the registration process and assay/analysis tests were 72% and 68.5%, respectively. 98% of the patients stated the physician and 96% of the patients stated the health staff were polite and respectful. The patients having university level and higher education illiterated lower satisfaction coefficients compared with the other levels of education (p = 0.01). The average time duration between patients application to the clinic and their receiving anesthesia consent was 3.00 ±1.014 hours. There was no statistically significant difference between the time duration for receiving anesthesia consent and the ASA score (p=0.08). It was determined that the patients who consulted to the anesthesiology clinic in our hospital had high satisfaction levels, and the patients with an education level of university and higher illutirated lower satisfaction levels compared with the other levels of education. It was concluded that studies that will shorten the waiting time for analysis / examination and the registration process would be useful to increase the level of satisfaction.

Objectives:

Customer satisfaction surveys are a routine device used to assess performance. Surveys are used in hospitals to check physician and patient satisfaction. Hamad Medical corporation’s (HMC) histopathology laboratory is College of American pathologists (CAP) accredited with highly trained pathologists and technical staff that routinely undertake various educational courses and are involved in research related activities. The lab has state of the art staining and immunohistochemistry service as well. However, it was felt that not all clinicians are very comfortable approaching pathologists and some many times experience problems either contacting lab staff or updating histopathology orders. Hence to narrow down the problems encountered by the clinicians and improve the specimen flow through the lab along with the communication between clinician and pathologist, that we deem vital, we designed this pilot survey.

Methods:

The survey questionnaire was made online with 15 questions in total and the link was electronically mailed to all Consultant and Specialist physicians in Hamad medical corporation (HMC). Around 3500 emails were sent out but only 105 surveys were filled in two months’ time. The survey included questions pertaining to multiple facets of quality of histopathology services and information regarding the participant.

Results:

The overall satisfaction was highest for Multidisciplinary presentations (96%) and lowest (77%) for timeliness of reporting. The satisfaction was above 90% for clarity and format, Diagnostic accuracy and pathologists’ responsiveness to problems. Thirty six percent of the people rated MDT presentations as excellent while 46% of the people thought overall quality of professional interaction was good. The areas of improvement, as per this survey, was timeliness of reporting and notifications of significant abnormal results (overall satisfaction 79%). Majority of the people who took the survey (36%) were from internal medicine and half were members of multidisciplinary meetings (49%). Seventy-one of percent of the participants were from Hamad General hospital (HGH), while rest were from the other hospitals under HMC.

Conclusion:

The response rate for the survey was low, hence another survey with a wider reach, preferably by paper, is required to get more representative data. In general, the clinicians at HGH are satisfied with the services provided by the histopathology laboratory. Areas of improvement include Turnaround time (TAT), avoidance of descriptive reports and better communication with the ordering clinician.

Keywords:

Quality control, quality improvement, survey, histopathology, Laboratory

Abstract

Aim: This study was designed to compare the effect of the classical bull horn excision pattern lip lift technique (group I) and the lip suspension technique (group II) which was performed using a dermal flap prepared on the upper lip with the same pattern incision, on patient satisfaction and scar appearance in lip lift surgeries.

Patients and Methods: Twenty-eight female patients aged 48-66 years, operated by the author between 2016 and 2023, were analyzed in two groups. The first group included 14 patients who were operated on with the classical bull horn excision pattern lip lift technique, and the second group included 14 patients who were operated with the lip suspension technique using a dermal flap prepared on the upper lip with the same pattern incision under local anesthesia. At the end of the 6th month, the patients in both groups, who were followed up for 6 months, were asked about their satisfaction with the overall aesthetic result using the global aesthetic improvement scale. In addition, an evaluator surgeon scored the postoperative scar using the Vancouver scar scale. All results were evaluated statistically.

Results: 9 of 14 patients (66%) stated very much improvement in the group 2 in which the dermal suspension flap was used, while 6 of 14 patients (%42.9) stated very much improvement with classical technique in Group 1, in the postoperative assessment at 6th month. Likewise, when the scar score performed by the evaluator surgeon was examined in 6th month. The scar scale was 14 in group 1 and 4 in group 2. In Group 1, the values of the patients ranged from 0 to 4, and the mean value was 1.0. In Group 2, the values ranged between 0-2 and the mean value was 0.3. Overall patient satisfaction was clinically significantly higher in group 2 when compared with group 1 and the scar was found to be clinically significantly less in group 2 when compared with group 1, even though there is no statistical significance (p>0.05) between 2 groups in overall patient satisfaction and scar score, probably due to limited number of patients in groups.

Conclusion:

It has been concluded that lip lift surgeries performed using the dermal suspension flap technique can contribute as a valuable alternative to the classical excision method, due to both higher overall aesthetic patient satisfaction and less scarring in our patients.

Almost 80% of the population in their lives are confronted with low back pain. One of the most important cause of low back pain is lumbar disc herniation. Treatment of lumbar disc herniation is primarily conservative but progressive neurologic deficits or cauda ekina syndrome constitutes an indication for definitive surgery. Extruded lumbar disc herniation in our case, spontaneous regression without surgical intervention are discussed in the literature. 27 years old female patient was admitted to our clinic with complaints of back pain. The patient has a a previous history of severe low back and right leg pain two years ago and surgery was recommended by an other neurosurgery clinic with the diagnosis of lumbar disc herniation L5-S1. The patient does not accept this surgery and the patient’s complaints were resolved with medical treatment and resting. At the patient’s neurological examination laseque test was bilateral negative and her motor and sensory examination was normal. Lumbar magnetic resonance imaging has shown spontaneously regression of the previous extruded disc herniation and the patient discharged with conservative treatment. Emergency surgical indications of extruded lumbar disk herniation should be treated outside the impatient. Spontaneous regression of extruded lumbar disc surgery procedures without surgical initiative have been shown by this case.

Aim: To evaluate the efficacy of a single döşe epidural corticosteroid injection in the treatment of lumbosacral radiculopathy secondary to lumbar disc herniation. Methods: We administered single dose epidural injection of steroid and local anestetic mixture in 31 patients with radicular pain due to lumbar disc herniations. Outcome was measured using a visual analog scale ranging from 0 to 10; straight leg raising test (SLR) values; a measurement of finger-to-floor distance; a patient satisfaction scale; and a Roland Morris low back pain questionnaire. Results: Thirty one patients were followed fors ix weeks. We found significant improvement in all parameters in patients at second day, second week and 6th. Week postinjection (p<0.05). Conclusions: We concluded that single-shot epidural corticosteroid injection is effective in the treatment of lumbar radicular pain due to lumbar disc herniations.

Aim: The aim of the study was to compare combined spinal-epidural (CSE) and epidural (EP) analgesia methods in labor analgesia. Material and Methods: The study was performed with 50 primigravid pregnant women who planned to have vaginal delivery. The patients were randomized into two equal groups: Group I: CSE analgesia group and Group II: EP analgesia group. A solution of 0.05% bupivacaine with 1.5 µg/ml fentanyl was prepared for using patient controlled epidural analgesia for both groups. Epidural catheters were introduced following the spinal administration of 1.25 mg bupivacain plus 12.5 µg fentanyl in patients in CSE analgesia group. Epidural solution infusion have been given to the EP analgesia group after the loading dose (10 ml 0.125% bupivacaine and 50 µg fentanil). Data were collected on maternal and fetal hemodynamic varibles, pain scores, motor blockade and total amount of consumed local anesthetic, the side effects. Results: Analgesia was effective in all patients. ‹nitiation time of analgesia in CSE group was much shorter than EP group (p<0.05). Better preserved maternal hemodynamics without hypotension, lower amounts of local anesthetics and beter patient satisfaction were observes in the CSE group compared with the EP group (p<0.05). Conclusion: Both CSE and EP analgesia methods used in this study were reliable and satisfactory for labor analgesia. Because of the faster initial analgesia, better maternal hemodynamics, shorter labor time in the first and second stage of labor and lower local anesthetic amounts, CSE analgesia method with lower doses of opioid and local anesthetic can be prefered to EP analgesia method.

 

Aim: The aim of this study was to primarily investigate the effects of selected anesthesia method on anxiety, patient satisfaction and pain level in elective caesarean section, and secondarily obtain information about quality of service.

Materials and Methods: The study was carried out as a prospective questionnaire in the Department of Anaesthesiology and Reanimation the Meram Medical Faculty Hospital of Necmettin Erbakan University between June 2017 and August 2017, on 160 volunteers aged between 18 and 45 years for whom elective cesarean section under General Anesthesia (GA) or Spinal Anesthesia (SA) was planned. Demographic data of the patients such as age, place of residence, education level, number of children, and cesarean experiences were recorded. In the preoperative and postoperative period, anxiety levels were measured by State-Trait Anxiety Inventory (STAI-D), pain levels were measured by Visual Analog Scale (VAS) scores and satisfaction levels were evaluated at postoperative 6th and 24th hours by (Quality of Recovery: QoR 40 T) questionnaire.

Results: There was no statistically significant difference between the patients' preoperative and postoperative anxiety scores and demographic data (p> 0.05). Patients with previous cesarean experience had lower preoperative anxiety levels (p <0.05). The STAI-D scores and the numbers of patients with anxiety in the GA and SA groups were similar (p> 0.05).Postoperative anxiety levels were significantly lower in both groups than in the preoperative period (p <0.05). VAS values of the SA group at the 6th and 24th hours were significantly higher than the group treated with GA.(p<0.05). The 24th hour VAS values of the SA group were higher than the VAS values at the 6th hour (p <0.05). In the GA group, VAS values at 24th hour were lower than the VAS values at 6th hour (p <0.05). The satisfaction levels of general anesthesia and spinal anesthesia were similar in the postoperative period (p> 0.05). Complaint of headache was high in SA group while complaint of sore throat was high in GA group(p<0.05). While there was no correlation between anxiety level, VAS values and satisfaction level (p> 0.05), there was a negative correlation between VAS values and pain parameters, which are the subgroup of satisfaction questionnaire, in both groups (p <0.05).

Conclusion: It is concluded that the preferred anesthesia method in elective cesarean section has no effect on anxiety and satisfaction, and the patient satisfaction level and service quality will be improved by providing effective analgesia by reviewing our postoperative pain algorithm.