Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial.Job Satisfaction: Personal satisfaction relative to the work situation.Personal Satisfaction: The individual's experience of a sense of fulfillment of a need or want and the quality or state of being satisfied.Consumer Satisfaction: Customer satisfaction or dissatisfaction with a benefit or service received.Questionnaires: Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.Physician-Patient Relations: The interactions between physician and patient.Quality of Health Care: The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.Hospital-Patient Relations: Interactions between hospital staff or administrators and patients. Includes guest relations programs designed to improve the image of the hospital and attract patients.Health Care Surveys: Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Professional-Patient Relations: Interactions between health personnel and patients.Health Facility Environment: Physical surroundings or conditions of a hospital or other health facility and influence of these factors on patients and staff.Outcome Assessment (Health Care): Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure).Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment; the overall condition of a human life.Pain Measurement: Scales, questionnaires, tests, and other methods used to assess pain severity and duration in patients or experimental animals to aid in diagnosis, therapy, and physiological studies.Pain, Postoperative: Pain during the period after surgery.Primary Health Care: Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192)Appointments and Schedules: The different methods of scheduling patient visits, appointment systems, individual or group appointments, waiting times, waiting lists for hospitals, walk-in clinics, etc.Ambulatory Surgical Procedures: Surgery performed on an outpatient basis. It may be hospital-based or performed in an office or surgicenter.Quality Indicators, Health Care: Norms, criteria, standards, and other direct qualitative and quantitative measures used in determining the quality of health care.Communication: The exchange or transmission of ideas, attitudes, or beliefs between individuals or groups.Family Practice: A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family.Nursing Administration Research: Research concerned with establishing costs of nursing care, examining the relationships between nursing services and quality patient care, and viewing problems of nursing service delivery within the broader context of policy analysis and delivery of health services (from a national study, presented at the 1985 Council on Graduate Education for Administration in Nursing (CGEAN) meeting).Outpatient Clinics, Hospital: Organized services in a hospital which provide medical care on an outpatient basis.Perioperative Nursing: Nursing care of the surgical patient before, during, and after surgery.Nursing Service, Hospital: The hospital department which is responsible for the organization and administration of nursing activities.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Cross-Sectional Studies: Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time.Esthetics: The branch of philosophy dealing with the nature of the beautiful. It includes beauty, esthetic experience, esthetic judgment, esthetic aspects of medicine, etc.Ambulatory Care: Health care services provided to patients on an ambulatory basis, rather than by admission to a hospital or other health care facility. The services may be a part of a hospital, augmenting its inpatient services, or may be provided at a free-standing facility.Attitude of Health Personnel: Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.Quality Assurance, Health Care: Activities and programs intended to assure or improve the quality of care in either a defined medical setting or a program. The concept includes the assessment or evaluation of the quality of care; identification of problems or shortcomings in the delivery of care; designing activities to overcome these deficiencies; and follow-up monitoring to ensure effectiveness of corrective steps.Ambulatory Care Facilities: Those facilities which administer health services to individuals who do not require hospitalization or institutionalization.Nurse-Patient Relations: Interaction between the patient and nurse.Medical Secretaries: Individuals responsible for various duties pertaining to the medical office routine.Continuity of Patient Care: Health care provided on a continuing basis from the initial contact, following the patient through all phases of medical care.Patient Participation: Patient involvement in the decision-making process in matters pertaining to health.Nursing Services: A general concept referring to the organization and administration of nursing activities.After-Hours Care: Medical care provided after the regular practice schedule of the physicians. Usually it is designed to deliver 24-hour-a-day and 365-day-a-year patient care coverage for emergencies, triage, pediatric care, or hospice care.Referral and Consultation: The practice of sending a patient to another program or practitioner for services or advice which the referring source is not prepared to provide.Workload: The total amount of work to be performed by an individual, a department, or other group of workers in a period of time.Factor Analysis, Statistical: A set of statistical methods for analyzing the correlations among several variables in order to estimate the number of fundamental dimensions that underlie the observed data and to describe and measure those dimensions. It is used frequently in the development of scoring systems for rating scales and questionnaires.Patient Education as Topic: The teaching or training of patients concerning their own health needs.Group Practice: Any group of three or more full-time physicians organized in a legally recognized entity for the provision of health care services, sharing space, equipment, personnel and records for both patient care and business management, and who have a predetermined arrangement for the distribution of income.Night Care: Institutional night care of patients.Analgesia, Patient-Controlled: Relief of PAIN, without loss of CONSCIOUSNESS, through ANALGESIC AGENTS administered by the patients. It has been used successfully to control POSTOPERATIVE PAIN, during OBSTETRIC LABOR, after BURNS, and in TERMINAL CARE. The choice of agent, dose, and lockout interval greatly influence effectiveness. The potential for overdose can be minimized by combining small bolus doses with a mandatory interval between successive doses (lockout interval).Hyperhidrosis: Excessive sweating. In the localized type, the most frequent sites are the palms, soles, axillae, inguinal folds, and the perineal area. Its chief cause is thought to be emotional. Generalized hyperhidrosis may be induced by a hot, humid environment, by fever, or by vigorous exercise.Outpatients: Persons who receive ambulatory care at an outpatient department or clinic without room and board being provided.Penile Implantation: Surgical insertion of cylindric hydraulic devices for the treatment of organic ERECTILE DYSFUNCTION.Pilot Projects: Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work.Psychometrics: Assessment of psychological variables by the application of mathematical procedures.Health Maintenance Organizations: Organized systems for providing comprehensive prepaid health care that have five basic attributes: (1) provide care in a defined geographic area; (2) provide or ensure delivery of an agreed-upon set of basic and supplemental health maintenance and treatment services; (3) provide care to a voluntarily enrolled group of persons; (4) require their enrollees to use the services of designated providers; and (5) receive reimbursement through a predetermined, fixed, periodic prepayment made by the enrollee without regard to the degree of services provided. (From Facts on File Dictionary of Health Care Management, 1988)United StatesNursing Staff, Hospital: Personnel who provide nursing service to patients in a hospital.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Reproducibility of Results: The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.Health Services Research: The integration of epidemiologic, sociological, economic, and other analytic sciences in the study of health services. Health services research is usually concerned with relationships between need, demand, supply, use, and outcome of health services. The aim of the research is evaluation, particularly in terms of structure, process, output, and outcome. (From Last, Dictionary of Epidemiology, 2d ed)Day Care: Institutional health care of patients during the day. The patients return home at night.Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data.Physicians: Individuals licensed to practice medicine.Mammaplasty: Surgical reconstruction of the breast including both augmentation and reduction.Patient-Centered Care: Design of patient care wherein institutional resources and personnel are organized around patients rather than around specialized departments. (From Hospitals 1993 Feb 5;67(3):14)Academic Medical Centers: Medical complexes consisting of medical school, hospitals, clinics, libraries, administrative facilities, etc.Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults.Cosmetic Techniques: Procedures for the improvement or enhancement of the appearance of the visible parts of the body.Conscious Sedation: A drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway. (From: American Society of Anesthesiologists Practice Guidelines)Nerve Block: Interruption of NEURAL CONDUCTION in peripheral nerves or nerve trunks by the injection of a local anesthetic agent (e.g., LIDOCAINE; PHENOL; BOTULINUM TOXINS) to manage or treat pain.Clinical Competence: The capability to perform acceptably those duties directly related to patient care.Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population.Outcome and Process Assessment (Health Care): Evaluation procedures that focus on both the outcome or status (OUTCOMES ASSESSMENT) of the patient at the end of an episode of care - presence of symptoms, level of activity, and mortality; and the process (ASSESSMENT, PROCESS) - what is done for the patient diagnostically and therapeutically.Length of Stay: The period of confinement of a patient to a hospital or other health facility.Empathy: An individual's objective and insightful awareness of the feelings and behavior of another person. It should be distinguished from sympathy, which is usually nonobjective and noncritical. It includes caring, which is the demonstration of an awareness of and a concern for the good of others. (From Bioethics Thesaurus, 1992)Interviews as Topic: Conversations with an individual or individuals held in order to obtain information about their background and other personal biographical data, their attitudes and opinions, etc. It includes school admission or job interviews.Nurse Practitioners: Nurses who are specially trained to assume an expanded role in providing medical care under the supervision of a physician.Nursing Evaluation Research: Research carried out by nurses that uses interviews, data collection, observation, surveys, etc., to evaluate nursing, health, clinical, and nursing education programs and curricula, and which also demonstrates the value of such evaluation.Health Services Accessibility: The degree to which individuals are inhibited or facilitated in their ability to gain entry to and to receive care and services from the health care system. Factors influencing this ability include geographic, architectural, transportational, and financial considerations, among others.Physicians, Family: Those physicians who have completed the education requirements specified by the American Academy of Family Physicians.Patient Care Team: Care of patients by a multidisciplinary team usually organized under the leadership of a physician; each member of the team has specific responsibilities and the whole team contributes to the care of the patient.EnglandRange of Motion, Articular: The distance and direction to which a bone joint can be extended. Range of motion is a function of the condition of the joints, muscles, and connective tissues involved. Joint flexibility can be improved through appropriate MUSCLE STRETCHING EXERCISES.Medical Staff, Hospital: Professional medical personnel approved to provide care to patients in a hospital.Hospitals: Institutions with an organized medical staff which provide medical care to patients.Personnel Turnover: A change or shift in personnel due to reorganization, resignation, or discharge.Patient Compliance: Voluntary cooperation of the patient in following a prescribed regimen.Arthroplasty, Replacement, Knee: Replacement of the knee joint.Office Visits: Visits made by patients to health service providers' offices for diagnosis, treatment, and follow-up.Office Management: Planning, organizing, and administering activities in an office.Remote Consultation: Consultation via remote telecommunications, generally for the purpose of diagnosis or treatment of a patient at a site remote from the patient or primary physician.Postoperative Complications: Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.Slovenia: Created 7 April 1992 as a result of the division of Yugoslavia.Emergency Service, Hospital: Hospital department responsible for the administration and provision of immediate medical or surgical care to the emergency patient.Personnel Staffing and Scheduling: The selection, appointing, and scheduling of personnel.SwitzerlandHospitalists: Physicians who are employed to work exclusively in hospital settings, primarily for managed care organizations. They are the attending or primary responsible physician for the patient during hospitalization.Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures.Hospitals, Public: Hospitals controlled by various types of government, i.e., city, county, district, state or federal.Dentist-Patient Relations: The psychological relations between the dentist and patient.Denture, Overlay: Removable prosthesis constructed over natural teeth or implanted studs.Inpatients: Persons admitted to health facilities which provide board and room, for the purpose of observation, care, diagnosis or treatment.Burnout, Professional: An excessive stress reaction to one's occupational or professional environment. It is manifested by feelings of emotional and physical exhaustion coupled with a sense of frustration and failure.Recovery of Function: A partial or complete return to the normal or proper physiologic activity of an organ or part following disease or trauma.Translating: Conversion from one language to another language.Telemedicine: Delivery of health services via remote telecommunications. This includes interactive consultative and diagnostic services.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Optometry: The professional practice of primary eye and vision care that includes the measurement of visual refractive power and the correction of visual defects with lenses or glasses.Pain: An unpleasant sensation induced by noxious stimuli which are detected by NERVE ENDINGS of NOCICEPTIVE NEURONS.Patient Preference: Individual's expression of desirability or value of one course of action, outcome, or selection in contrast to others.Metatarsophalangeal Joint: The articulation between a metatarsal bone (METATARSAL BONES) and a phalanx.Nurse's Role: The expected function of a member of the nursing profession.Breast Implantation: Surgical insertion of an inert sac filled with silicone or other material to augment the female form cosmetically.Hospitals, Teaching: Hospitals engaged in educational and research programs, as well as providing medical care to the patients.Employee Incentive Plans: Programs designed by management to motivate employees to work more efficiently with increased productivity, and greater employee satisfaction.Telephone: An instrument for reproducing sounds especially articulate speech at a distance. (Webster, 3rd ed)Physical Therapy Modalities: Therapeutic modalities frequently used in PHYSICAL THERAPY SPECIALTY by PHYSICAL THERAPISTS or physiotherapists to promote, maintain, or restore the physical and physiological well-being of an individual.Anesthesia, Local: A blocking of nerve conduction to a specific area by an injection of an anesthetic agent.Time Management: Planning and control of time to improve efficiency and effectiveness.Laryngopharyngeal Reflux: Back flow of gastric contents to the LARYNGOPHARYNX where it comes in contact with tissues of the upper aerodigestive tract. Laryngopharyngeal reflux is an extraesophageal manifestation of GASTROESOPHAGEAL REFLUX.Waiting Lists: Prospective patient listings for appointments or treatments.Communication Barriers: Those factors, such as language or sociocultural relationships, which interfere in the meaningful interpretation and transmission of ideas between individuals or groups.Anesthetics, Local: Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate.Efficiency, Organizational: The capacity of an organization, institution, or business to produce desired results with a minimum expenditure of energy, time, money, personnel, materiel, etc.Cost-Benefit Analysis: A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. Cost effectiveness compares alternative ways to achieve a specific set of results.Socioeconomic Factors: Social and economic factors that characterize the individual or group within the social structure.Emergency Nursing: The specialty or practice of nursing in the care of patients admitted to the emergency department.Hospital Units: Those areas of the hospital organization not considered departments which provide specialized patient care. They include various hospital special care wards.Benchmarking: Method of measuring performance against established standards of best practice.Interpersonal Relations: The reciprocal interaction of two or more persons.Great BritainPatient Acceptance of Health Care: The seeking and acceptance by patients of health service.Arthroplasty, Replacement: Partial or total replacement of a joint.Personnel Delegation: To entrust to the care or management of another, to transfer or to assign tasks within an organizational or administrative unit or structureDental Prosthesis, Implant-Supported: A prosthesis that gains its support, stability, and retention from a substructure that is implanted under the soft tissues of the basal seat of the device and is in contact with bone. (From Boucher's Clinical Dental Terminology, 4th ed)Rhinoplasty: A plastic surgical operation on the nose, either reconstructive, restorative, or cosmetic. (Dorland, 28th ed)Ontario: A province of Canada lying between the provinces of Manitoba and Quebec. Its capital is Toronto. It takes its name from Lake Ontario which is said to represent the Iroquois oniatariio, beautiful lake. (From Webster's New Geographical Dictionary, 1988, p892 & Room, Brewer's Dictionary of Names, 1992, p391)Netherlands: Country located in EUROPE. It is bordered by the NORTH SEA, BELGIUM, and GERMANY. Constituent areas are Aruba, Curacao, Sint Maarten, formerly included in the NETHERLANDS ANTILLES.Regression Analysis: Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable.Trust: Confidence in or reliance on a person or thing.Esthetics, Dental: Skills, techniques, standards, and principles used to improve the art and symmetry of the teeth and face to improve the appearance as well as the function of the teeth, mouth, and face. (From Boucher's Clinical Dental Terminology, 4th ed, p108)Pirinitramide: A diphenylpropylamine with intense narcotic analgesic activity of long duration. It is a derivative of MEPERIDINE with similar activity and usage.Pharmacy Service, Hospital: Hospital department responsible for the receiving, storing, and distribution of pharmaceutical supplies.Analgesia: Methods of PAIN relief that may be used with or in place of ANALGESICS.Hospital Administration: Management of the internal organization of the hospital.Practice Management, Medical: The organization and operation of the business aspects of a physician's practice.Medicine: The art and science of studying, performing research on, preventing, diagnosing, and treating disease, as well as the maintenance of health.House Calls: Visits to the patient's home by professional personnel for the purpose of diagnosis and/or treatment.Professional Autonomy: The quality or state of being independent and self-directing, especially in making decisions, enabling professionals to exercise judgment as they see fit during the performance of their jobs.Nurses: Professionals qualified by graduation from an accredited school of nursing and by passage of a national licensing examination to practice nursing. They provide services to patients requiring assistance in recovering or maintaining their physical or mental health.Feasibility Studies: Studies to determine the advantages or disadvantages, practicability, or capability of accomplishing a projected plan, study, or project.GermanyAttitude to Health: Public attitudes toward health, disease, and the medical care system.Attitude to Computers: The attitude and behavior associated with an individual using the computer.Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures.Program Evaluation: Studies designed to assess the efficacy of programs. They may include the evaluation of cost-effectiveness, the extent to which objectives are met, or impact.Statistics, Nonparametric: A class of statistical methods applicable to a large set of probability distributions used to test for correlation, location, independence, etc. In most nonparametric statistical tests, the original scores or observations are replaced by another variable containing less information. An important class of nonparametric tests employs the ordinal properties of the data. Another class of tests uses information about whether an observation is above or below some fixed value such as the median, and a third class is based on the frequency of the occurrence of runs in the data. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed, p1284; Corsini, Concise Encyclopedia of Psychology, 1987, p764-5)Patient Care Planning: Usually a written medical and nursing care program designed for a particular patient.Logistic Models: Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.Analgesics, Opioid: Compounds with activity like OPIATE ALKALOIDS, acting at OPIOID RECEPTORS. Properties include induction of ANALGESIA or NARCOSIS.Ancillary Services, Hospital: Those support services other than room, board, and medical and nursing services that are provided to hospital patients in the course of care. They include such services as laboratory, radiology, pharmacy, and physical therapy services.Propoxycaine: A local anesthetic of the ester type that has a rapid onset of action and a longer duration of action than procaine hydrochloride. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1017)Books, Illustrated: Books containing photographs, prints, drawings, portraits, plates, diagrams, facsimiles, maps, tables, or other representations or systematic arrangement of data designed to elucidate or decorate its contents. (From The ALA Glossary of Library and Information Science, 1983, p114)Postoperative Care: The period of care beginning when the patient is removed from surgery and aimed at meeting the patient's psychological and physical needs directly after surgery. (From Dictionary of Health Services Management, 2d ed)Urologic Surgical Procedures: Surgery performed on the urinary tract or its parts in the male or female. For surgery of the male genitalia, UROLOGIC SURGICAL PROCEDURES, MALE is available.Hospitals, Veterans: Hospitals providing medical care to veterans of wars.Hospital Administrators: Managerial personnel responsible for implementing policy and directing the activities of hospitals.Linear Models: Statistical models in which the value of a parameter for a given value of a factor is assumed to be equal to a + bx, where a and b are constants. The models predict a linear regression.State Medicine: A system of medical care regulated, controlled and financed by the government, in which the government assumes responsibility for the health needs of the population.Efficiency: Ratio of output to effort, or the ratio of effort produced to energy expended.Dental Clinics: Facilities where dental care is provided to patients.Triage: The sorting out and classification of patients or casualties to determine priority of need and proper place of treatment.Time and Motion Studies: The observation and analysis of movements in a task with an emphasis on the amount of time required to perform the task.Models, Organizational: Theoretical representations and constructs that describe or explain the structure and hierarchy of relationships and interactions within or between formal organizational entities or informal social groups.Hemorrhoids: Swollen veins in the lower part of the RECTUM or ANUS. Hemorrhoids can be inside the anus (internal), under the skin around the anus (external), or protruding from inside to outside of the anus. People with hemorrhoids may or may not exhibit symptoms which include bleeding, itching, and pain.Faculty, Nursing: The teaching staff and members of the administrative staff having academic rank in a nursing school.Hospitals, Military: Hospitals which provide care for the military personnel and usually for their dependents.Hallux Valgus: Lateral displacement of the great toe (HALLUX), producing deformity of the first METATARSOPHALANGEAL JOINT with callous, bursa, or bunion formation over the bony prominence.Hospital Departments: Major administrative divisions of the hospital.Process Assessment (Health Care): An evaluation procedure that focuses on how care is delivered, based on the premise that there are standards of performance for activities undertaken in delivering patient care, in which the specific actions taken, events occurring, and human interactions are compared with accepted standards.Anxiety: Feeling or emotion of dread, apprehension, and impending disaster but not disabling as with ANXIETY DISORDERS.Language Arts: Skills in the use of language which lead to proficiency in written or spoken communication.Patients: Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures.Internship and Residency: Programs of training in medicine and medical specialties offered by hospitals for graduates of medicine to meet the requirements established by accrediting authorities.Brachial Plexus: The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon.Tape Recording: Recording of information on magnetic or punched paper tape.Finger Injuries: General or unspecified injuries involving the fingers.Total Quality Management: The application of industrial management practice to systematically maintain and improve organization-wide performance. Effectiveness and success are determined and assessed by quantitative quality measures.Nurse Administrators: Nurses professionally qualified in administration.Activities of Daily Living: The performance of the basic activities of self care, such as dressing, ambulation, or eating.Medical Oncology: A subspecialty of internal medicine concerned with the study of neoplasms.Arthroplasty: Surgical reconstruction of a joint to relieve pain or restore motion.Research Design: A plan for collecting and utilizing data so that desired information can be obtained with sufficient precision or so that an hypothesis can be tested properly.Postoperative Nausea and Vomiting: Emesis and queasiness occurring after anesthesia.Adaptation, Psychological: A state of harmony between internal needs and external demands and the processes used in achieving this condition. (From APA Thesaurus of Psychological Index Terms, 8th ed)NorwayUrban Health Services: Health services, public or private, in urban areas. The services include the promotion of health and the delivery of health care.Patient Credit and Collection: Accounting procedures for determining credit status and methods of obtaining payment.Suburethral Slings: Support structures, made from natural or synthetic materials, that are implanted below the URETHRA to treat URINARY STRESS INCONTINENCE.Forehead: The part of the face above the eyes.Sympathectomy: The removal or interruption of some part of the sympathetic nervous system for therapeutic or research purposes.Hospitals, Special: Hospitals which provide care for a single category of illness with facilities and staff directed toward a specific service.Patient Discharge: The administrative process of discharging the patient, alive or dead, from hospitals or other health facilities.
Job satisfaction: Job satisfaction or employee satisfaction has been defined in many different ways. Some believe it is simply how content an individual is with his or her job, in other words, whether or not they like the job or individual aspects or facets of jobs, such as nature of work or supervision.Positivity offset: Positivity offset is a psychological term referring to two phenomena: People tend to interpret neutral situations as mildly positive, and most people rate their lives as good, most of the time. The positivity offset stands in notable asymmetry to the negativity bias.Beef aging: Beef aging is a process of preparing beef for consumption, mainly by breaking down the connective tissue.Closed-ended question: A closed-ended question is a question format that limits respondents with a list of answer choices from which they must choose to answer the question.Dillman D.Time-trade-off: Time-Trade-Off (TTO) is a tool used in health economics to help determine the quality of life of a patient or group. The individual will be presented with a set of directions such as:Pain scale: A pain scale measures a patient's pain intensity or other features. Pain scales are based on self-report, observational (behavioral), or physiological data.Halfdan T. MahlerHenry Whitelock Torrens: Henry Whitelock Torrens (1806–1852), son of Major Henry Torrens, was born on May 20, 1806. He received his B.PinnacleHealth System: $1 billion (2013)History of communication studies: Various aspects of communication have been the subject of study since ancient times, and the approach eventually developed into the academic discipline known today as communication studies.Therapy cap: In 1997 the Balanced Budget Act established annual per-beneficiary Medicare spending limits, or therapy cap, for outpatient therapy services covered under Medicare Part B. Medicare Provisions in Balanced Budget Act of 1997.University College of Applied Sciences: University College of Applied Sciences (UCAS) is a technical college in Gaza founded in 1998. It offers 40 majors in engineering, health, technology, administration, education and the humanities.Transitional care: Transitional care refers to the coordination and continuity of health care during a movement from one healthcare setting to either another or to home, called care transition, between health care practitioners and settings as their condition and care needs change during the course of a chronic or acute illness. Older adults who suffer from a variety of health conditions often need health care services in different settings to meet their many needs.Patient participation: Patient participation, also called shared decision-making, is a process in which both the patient and physician contribute to the medical decision-making process. Under this operating system, health care providers explain treatments and alternatives to patients in order to provide the necessary resources for patients to choose the treatment option that most closely aligns with their unique cultural and personal beliefs.Referral (medicine): In medicine, referral is the transfer of care for a patient from one clinician to another.García Olmos L, Gervas Camacho J, Otero A, Pérez Fernández M.Online patient education: Online Patient Education also known as Online Patient Engagement is a method of providing medical information and education to patients using Learning Management Systems delivered through the Internet.Evaluation of bariatric Centers of Excellence Web sites for functionality and efficacy.Float (liquid level): Liquid level floats, also known as float balls, are spherical, cylindrical, oblong or similarly shaped objects, made from either rigid or flexible material, that are buoyant in water and other liquids. They are non-electrical hardware frequently used as visual sight-indicators for surface demarcation and level measurement.HyperhidrosisBio Base EuropeDavid Budescu: David Budescu is a psychologist and academic. He is the Anne Anastasi Professor of Psychometrics and Quantitative Psychology at Fordham University.List of Parliamentary constituencies in Kent: The ceremonial county of Kent,Temporal analysis of products: Temporal Analysis of Products (TAP), (TAP-2), (TAP-3) is an experimental technique for studyingGeneralizability theory: Generalizability theory, or G Theory, is a statistical framework for conceptualizing, investigating, and designing reliable observations. It is used to determine the reliability (i.Isabella Geriatric Center: Isabella Geriatric Center is a non-profit, non-sectarian organization that has provided residential and community-based services for elderly residents of New York City since 1875. The main campus is located in the Washington Heights neighborhood of Manhattan at 515 Audubon Avenue at the corner of 190th Street.Samuel Bard (physician): Samuel Bard (April 1, 1742 – May 24, 1821) was an American physician. He founded the first medical school in New York.Mammaplasty: -, |American Osteopathic Board of Internal MedicineRestylaneProcedural sedation and analgesia: Procedural sedation and analgesia, previously referred to as conscious sedation, is defined as "a technique of administering sedatives or dissociative agents with or without analgesics to induce a state that allows the patient to tolerate unpleasant procedures while maintaining cardiorespiratory function."Nerve blockGlobal Health Delivery ProjectSimulation theory of empathy: Simulation theory of empathy is a theory that holds that humans anticipate and make sense of the behavior of others by activating mental processes that, if carried into action, would produce similar behavior. This includes intentional behavior as well as the expression of emotions.Psychiatric interview: The psychiatric interview refers to the set of tools that a mental health worker (most times a psychiatrist or a psychologist but at times social workers or nurses) uses to complete a psychiatric assessment.Eco-Runner Team Delft: Eco-Runner Team DelftRed Moss, Greater Manchester: Red Moss is a wetland mossland in Greater Manchester, located south of Horwich and east of Blackrod. (Grid Reference ).Oxford knee score: The Oxford Knee Score (OKS) is a Patient Reported Outcome questionnaire that was developed to specifically assess the patient's perspective of outcome following Total Knee Arthroplasty. The OKS has subsequently been validated for use in assessing other non-surgical therapies applied to those suffering from issues with the knee.Fremont College: Fremont College is a for-profit, degree-granting college that provides educational opportunities for working adults. The college is based in Cerritos, California with a second campus in Los Angeles, California, and a virtual campus online.List of birds of Slovenia: This is a list of the bird species recorded in Slovenia. The avifauna of Slovenia include a total of 376 species, of which four have been introduced by humans and five are rare or accidental.Senior Emergency Department: The senior emergency department is a recent hospital innovation to build separate geriatric emergency rooms for older adults akin to pediatric emergency rooms designed for children. The trend comes in response to the nation's rapidly growing population of older adults and overcrowding of emergency departments.Lausanne Marathon: The Lausanne Marathon or Marathon of Lausanne is an annual marathon race held in the Swiss city of Lausanne since 1993. This road running takes place in autumn (October) and the 20 km of Lausanne takes place in spring (April).Carteret General Hospital: Carteret General Hospital is a 135 bed, non-profit hospital in Morehead City, North Carolina. Carteret General was founded in 1967.Self-rated health: Self-rated health (also called Self-reported health, Self-assessed health, or perceived health) refers to both a single question such as “in general, would you say that you health is excellent, very good, good, fair, or poor?” and a survey questionnaire in which participants assess different dimensions of their own health.
(1/7251) Computer use by general practitioners in Scotland.
BACKGROUND: Despite the widespread adoption by general practitioners (GPs) of desktop computers, there has been very little evaluation of the way in which the computer is actually used during consultations and the way in which it affects patient satisfaction. AIM: To ascertain the extent to which the computer is used in the consultation and to investigate the possible relationship between computer use and patient satisfaction. METHOD: Six GPs completed a short questionnaire about the extent to which they use the computer during surgeries. Eighty-four consultations from the surgeries of these GPs were video recorded. Patient satisfaction data on these 84 patients were collected at the time of the surgery using the previously validated Consultation Satisfaction Questionnaire. RESULTS: All six GPs stated that they usually used the computer during consultations. However, video observation revealed that the computer was used in just 51% of surgeries. The proportion of time that the computer was used for varied from 0.03 to 0.4, with a mean value of 0.12. The commonest function for which the computer was used was prescribing. The consultations in which the computer was used (CU) were on average 148 seconds longer than the non-computerized consultations (NCU). There was no difference in patient satisfaction between the two groups. CONCLUSION: Despite this group of GPs having a self-declared interest in the use of computers, the extent to which the computer was used was much lower than expected from the GPs' self-reported use. This may be partly explained by the fact that using the computer takes up valuable time within the consultation and does not appear to contribute to patient satisfaction. If desktop computers are to be used to their full potential in general practice, more work is required to evaluate their impact on the consultation process itself. (+info)
(2/7251) Out-of-hours service in Denmark: the effect of a structural change.
BACKGROUND: In Denmark, the provision of out-of-hours care by general practitioners (GPs) was reformed at the start of 1992. Rota systems were replaced locally by county-based services. The new out-of-hours service resulted in a considerable reduction in the total number of GPs on call. AIM: To describe how the patients experienced the change from a satisfaction point of view, and how the pattern of patient contact and the fee for GPs changed with the new system. METHOD: The county of Funen was chosen as the geographical area where data were collected. A questionnaire measuring patient satisfaction was posted before the change, immediately after the change, and three years later to a random selection of patients who had been in contact with the out-of-hours service within two weeks before the mailing date. All primary care services for the Danish population are stored in a database (National Health Service Registry). From this continuously updated database, the contact pattern and the fee for GPs were extracted for 1991, 1992, and 1995. RESULTS: The total number of patient contacts was reduced by 16% in the first year, but by only 6% three years later. Three years after the change, there were more than twice as many telephone consultations as before the change, and there were only a third as many home visits. After three years, the GPs' fees were reduced by 20%. There was a significant decrease in patient satisfaction, although the overall level remained high. This decrease was lower three years after the change than immediately after the new system was introduced. CONCLUSION: The new service had a major cost-effectiveness benefit, but there was a price to pay in patient satisfaction. (+info)
(3/7251) Good health care: patient and professional perspectives.
Many health needs assessment exercises are professionally led, employing complex epidemiological methods. An alternative method that gives valuable information about patient preferences is a forced-choice questionnaire, which this study used in five practices in the West of Scotland. In each practice, patient-centred care was the most highly valued attribute of service provision. (+info)
(4/7251) Development of the physical therapy outpatient satisfaction survey (PTOPS).
BACKGROUND AND PURPOSE: The purposes of this 3-phase study were (1) to identify the underlying components of outpatient satisfaction in physical therapy and (2) to develop a test that would yield reliable and valid measurements of these components. SUBJECTS: Three samples, consisting of 177, 257, and 173 outpatients from 21 facilities, were used in phases 1, 2, and 3, respectively. METHODS AND RESULTS: In phase 1, principal component analyses (PCAs), reliability checks, and correlations with social desirability scales were used to reduce a pool of 98 items to 32 items. These analyses identified a 5-component model of outpatient satisfaction in physical therapy. The phase 2 PCA, with a revised pool of 48 items, indicated that 4 components rather than 5 components represented the best model and resulted in the 34-item Physical Therapy Outpatient Satisfaction Survey (PTOPS). Factor analyses conducted with phase 2 and phase 3 data supported this conclusion and provided evidence for the internal validity of the PTOPS scores. The 4-component scales were labeled "Enhancers," "Detractors," "Location," and "Cost." Responses from subsamples of phase 3 subjects provided evidence for validity of scores in that the PTOPS components of "Enhancers," "Detractors," and "Cost" appeared to differentiate overtly satisfied patients from overtly dissatisfied patients. "Location" and "Enhancer" scores discriminated subjects with excellent attendance at scheduled physical therapy sessions from those with poor attendance. CONCLUSION AND DISCUSSION: In this study, we identified components of outpatient satisfaction in physical therapy and used them to develop a test that would yield valid and reliable measurements of these components. (+info)
(5/7251) Evaluation of lidocaine as an analgesic when added to hypertonic saline for sclerotherapy.
PURPOSE: The efficacy of sclerosing agents for the treatment of telangiectasias and reticular veins is well established. The injection of these agents is often associated with pain, and it is not uncommon for sclerotherapists to include lidocaine with the sclerosants in an attempt to reduce the pain associated with treatment. However, there are concerns that this may reduce the overall efficacy of the treatment because of dilution of the sclerosant. Patient comfort and overall outcome associated with treatment using HS with lidocaine (LIDO) versus that using HS alone was compared. METHODS: Forty-two patients were prospectively entered into the study and randomized blindly to sclerotherapy with 23.4% HS or 19% LIDO. Study subjects and treating physicians were blinded to the injection solution used. Injection sites were chosen for veins ranging in size from 0.1 to 3 mm. Photographs of the area to be treated were taken, and the patients rated their pain. They were then observed at regular intervals for four months, and clinical data was collected. Thirty-five subjects completed the full follow-up period, and photographs of the injected area were taken again. Three investigators blinded to the treatment assignment then evaluated the photographs and scored the treatment efficacy according to a standardized system. RESULTS: In the HS group, 61.9% (13 of 21) patients rated their pain as none or mild, whereas 90.5% (19 of 21) of patients in the LIDO group had no or mild discomfort. This difference is significant, with a P value of.034. There was no difference in the overall efficacy of treatment between the two groups. The groups had similar rates of vein thrombosis and skin necrosis. CONCLUSION: Although lidocaine is often used with sclerosing agents, there are no previous reports in the literature to evaluate its effectiveness in reducing the pain experienced by the patient. In this study, patients receiving LIDO experienced significantly less discomfort at the time of injection than patients who received HS alone. There were no differences in the effectiveness of treatment or in the incidence of complications between the two groups. (+info)
(6/7251) Relief of obstructive pelvic venous symptoms with endoluminal stenting.
PURPOSE: To select patients for percutaneous transluminal stenting of chronic postthrombotic pelvic venous obstructions (CPPVO), we evaluated the clinical symptoms in a cohort of candidates and in a series of successfully treated patients. METHODS: The symptoms of 42 patients (39 women) with CPPVO (38 left iliac; average history, 18 years) were recorded, and the venous anatomy was studied by means of duplex scanning, subtraction venography, and computed tomography or magnetic resonance imaging. Successfully stented patients were controlled by means of duplex scanning and assessment of symptoms. RESULTS: The typical symptoms of CPPVO were reported spontaneously by 24% of patients and uncovered by means of a targeted interview in an additional 47%. Of 42 patients, 15 had venous claudication, four had neurogenic claudication (caused by dilated veins in the spinal canal that arise from the collateral circulation), and 11 had both symptoms. Twelve patients had no specific symptoms. Placement of a stent was found to be technically feasible in 25 patients (60%), was attempted in 14 patients, and was primarily successful in 12 patients. One stent occluded within the first week. All other stents were fully patent after a mean of 15 months (range, 1 to 43 months). Satisfaction was high in the patients who had the typical symptoms, but low in those who lacked them. CONCLUSION: Venous claudication and neurogenic claudication caused by venous collaterals in the spinal canal are typical clinical features of CPPVO. We recommend searching for these symptoms, because recanalization by means of stenting is often feasible and rewarding. (+info)
(7/7251) Reduced health-related quality of life among Hodgkin's disease survivors: a comparative study with general population norms.
BACKGROUND: Late complications after curative treatment of Hodgkin's disease are of special relevance because most of the cured are young adults. The aims of the present study were: (1) to compare health-related quality of life (HRQOL) in Hodgkin's disease (HD) survivors with normative data from the general Norwegian population and (2) to examine the relations between disease/treatment characteristics and HRQOL in the HD survivors. PATIENTS AND METHODS: 459 HD survivors aged 19-74 years (mean 44.0, SD 11.8) treated at the Norwegian Radium Hospital 1971-1991 were approached in 1994 and compared to norms from 2214 subjects approached in 1996. The norms are representative of the general Norwegian population. HRQOL was assessed by the Short Form 36 (SF-36), which measures HRQOL in eight separate scales (0 = worst health state, 100 = best health state). RESULTS: The HD survivors had lower scores than the normal controls on all scales after adjustment for age, gender and educational levels. Statistically significant differences (P < 0.01) were found in general health (10.4), physical functioning (6.1), role limitations (physical, 9.3), physical functioning (3.6) and in vitality (4.7). Patients with disease stage IB-IIB had the lowest scores on all scales. The differences in relation to stage/substage reached statistical significance (P < 0.01) in physical functioning and in role limitations (physical). Time since diagnosis, types of primary treatment or having relapsed were not associated with statistically significant differences in HRQOL. CONCLUSION: Long-term HD survivors have poorer HRQOL, primarily in physical health, than the general Norwegian population. (+info)
(8/7251) Psychosocial impact of genetic testing in familial medullary-thyroid carcinoma: a multicentric pilot-evaluation.
BACKGROUND: Many crucial problems are associated with the diagnosis of inherited cancer susceptibility. One of the most important is related to the psychosocial consequences of the knowledge by the patients and their relatives of their own genetical status. Little data are available in the literature, mainly from studies including small numbers of selected and motivated patients. PATIENTS AND METHODS: From January till December 1997, we studied the psychometric and quality of life parameters of 77 subjects followed in two French specialized centers. These subjects had been treated for either sporadic or familial or were at risk for medullary thyroid carcinoma. All patients had previously attended genetic counselling with detection of germline Ret-mutations, were informed on their own genetic risk, had good short-term prognosis and performance status and did not receive recent cancer treatment. Each patient was invited to answer two questionnaires, the hospital anxiety and depression scale (HADS) and the subjective quality of life profile (SQLP). RESULTS: We report herein the descriptive results of this study (HADS and SQLP scores and distributions) and describe the individual clinical covariates that might explain the observed differences between subgroups of individuals. Although psychometric scores appeared similar in these subgroups, quality of life scores were lower in Ret-mutation carriers. Genetically-predisposed patients were less satisfied and expressed more expectations for favourable change in their quality of life. CONCLUSION: This finding suggests a high level of frustration and latent unsatisfaction related either to the management of the genetic information given by the clinicians and its psychosocial consequences or simply to the knowledge of the genetic risk of cancer. Further studies on the individual consequences of genetic testing, information delivery and when necessary psychotherapeutic interventions, are needed to insure the quality of presymptomatic genetic testing in this field of oncology. (+info)