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This study aimed to explore the gap between patients' expectations of healthcare service quality in ‎Jordanian hospitals against their perceptions of service received using SERVQUAL model. The study used a cross-sectional design. The study data were collected randomly from 415 patients (participants) ‎who completed the SERVEQUAL questionnaire. The data were analyzed using ‎statistical procedures such as descriptive, -test, and ANOVA. The results showed ‎that there is a gap between mean score of patients' expectations of what should be available in the ‎hospital and patients' perceptions of the service received in the hospital. Patients' expectations were higher than their perceptions on all five SERVQUAL domains (Tangibles, Reliability, Responsiveness, Assurance, and Empathy). Hospital managers should take necessary actions to improve healthcare services in their hospitals with respect to all SERVQUAL domains. These actions should be directed to reduce the gap between patients' expectation and their perceptions in order to provide services meet patients' needs.

Background Meaningful patient engagement (PE) in medicines development and during the life cycle of a product requires all stakeholders have a clear understanding of respective expectations. Objective A qualitative survey was undertaken to understand stakeholder expectations. Design The survey explored 4 themes from the perspective of each stakeholder group: meaning, views, expectations and priorities for PE. Participants were grouped into 7 categories: policymakers/regulators; health‐care professionals (HCPs); research funders; payers/purchasers/HTA; patients/patient representatives; pharmaceutical/life sciences industry; and academic researchers. Results Fifty‐nine interviews were conducted across a range of geographies, PE experience and job seniority/role. There was consensus across stakeholders on meaning of PE; importance of promoting PE to a higher level than currently; need for a more structured process and guidance. There was little consensus on stakeholder expectations and roles. Policymakers/regulators were expected by others to drive PE, create a framework and facilitate PE, provide guidelines of good practice and connect stakeholders, but this expectation was not shared by the policymakers/regulators group. HCPs were seen as the link between patients and other stakeholders, but HCPs did not necessarily share this view. Discussion and conclusions Despite broad stakeholder categories, clear themes emerged: there is no “leader”; no stakeholder has a clear view on how to meaningfully engage with patients; there are educational gaps; and a structure and guidance for PE is urgently required. Given the diversity of stakeholders, there needs to be multistakeholder collaborative leadership. Effective collaboration requires consensus on roles, responsibilities and expectations to synergize efforts to deliver meaningful PE in medicines life cycle.

Background The holistic evolution of patient engagement in medicines development requires a more detailed understanding of the needs of all involved stakeholders, and one that better accounts for the specific needs of some potentially vulnerable patient populations and key stages in medicines development. Objective The purpose of this convergent mixed‐methods study was to better understand the needs of different stakeholders concerning patient engagement at three key stages in medicines development: research priority setting, clinical trial design and early dialogues with Health Technology Assessment bodies and regulators. Design This study brought together findings from three sources: i) an online questionnaire, ii) face‐to‐face consultations with two potentially vulnerable patient populations, a workshop with Health Technology Assessment bodies, and iii) three‐step modified Delphi methodology. Results Overall stakeholders still need additional varied support mechanisms to undertake, sustain or measure value of patient engagement. Health Technology Assessment bodies need better rationale for patient engagement in early dialogue and tools to support its implementation. Improved awareness and understanding of the need and value that involving patients, who are often considered as potentially vulnerable, can bring is needed, as is better accommodation of their specific needs. Similarly, weighted Delphi categories were as follows: aims and objectives, and sustainability. Several additional themes were common across the three key stages in medicines development. Conclusion This broad‐reaching study provides the blocks needed to build a framework for patient engagement in medicines development. Patient or Public Contribution Patients were involved in review and interpretation of data.

BackgroundClinical decision-making is often based on evidence of outcome after a specific treatment. Healthcare providers and patients may, however, have different perceptions and expectations of what to achieve from a certain healthcare measure.AimsTo evaluate patients’ expectations, perceptions and health related quality of life (HRQoL) before a care process including coronary angiography for suspected coronary artery disease and to evaluate the fulfilment of these expectations in relation to established patient reported outcome measures (PROMs) 6 months later. Furthermore, an aim was to try to define meaningful patient reported experience measures (PREMs) in this population.Methods544 patients planned for coronary angiography completed a newly developed questionnaire to assess expectations and perceptions of treatment, the expectation questionnaire (ExpQ) and two established HRQoL questionnaires together with the established generic Short-Form 36 (SF36) and the disease specific Seattle Angina Questionnaire (SAQ).ResultsPatients had before the intervention, in general, high expectations of improvement after investigation and treatment and there was a positive attitude towards life style changes, medication and participation in decision-making regarding their own treatment. Only, 56.4% of the patients, however, reported fulfilment of treatment expectations. Fulfilment of treatment expectations correlated strongly with improvement in HRQoL after the care process.ConclusionsTo measure patients ́ expectations and fulfilments of these may offer simple and meaningful outcomes to evaluate a healthcare process from a patient ́s perspective. To approach patients’ expectations may also strengthen patient involvement in the care process with the possibilities of both higher patient satisfaction and medical results of the treatment.

Aim To evaluate patients’ satisfaction with the quality of nursing care and examine associated factors. Design A cross‐sectional, descriptive survey study. Methods The sample was composed of 635 patients discharged from a private hospital. Data were collected using “Patient Satisfaction with Nursing Care Quality Questionnaire” with a total of 19 items, and a questionnaire designed to record socio‐demographic characteristics and medical histories between January 1–May 31, 2015. Results Patients were more satisfied with the “Concern and Caring by Nurses” and less satisfied with the “Information You Were Given.” Patients (63.9%) described nursing care offered during hospitalization as excellent. Patients who were 18–35 years old, married, college or university graduates, treated at the surgery and obstetrics–gynaecology units, and patients who stated their health as excellent and hospitalized once or at least five times were more satisfied with the nursing care. According to this study, the nurses needed to show greater amount of interest to the information‐giving process.

Background The aim of the study is to determine what the patients to be served in the cardiology clinic expect and from who they have expectations through healthcare service delivery. Methods In the research, a literature-based patient expectations model was used. A semi-structured interview form was used as a data collection tool in the study. The field application of the study was carried out on patients who would receive inpatient services from the cardiovascular from October 12 to November 13 in 2020. Data were collected from 19 patients and subjected to directed content analysis using the NVivo program. Results According to the findings of the study, patient expectations are consistent with the literature-based patient expectations model. In the study, patient expectations consist of four dimensions, seven themes and twenty-three categories. While the cost category in the model was not among the patient expectations, it was found that social well-being and communication with other healthcare professionals other than physicians and nurses were expected. Among the patient expectation categories, doctor-patient communication, emotional support, nurse-patient communication, medical care, competence, treatment follow-up, and information in the treatment process are the most emphasized categories by the patients. The least emphasized expectation categories are social well-being and coordination/consultation. Conclusions As a result, It is important to plan the service delivery by taking into account the patient’s expectations and to provide a service that meets the expectations. In this way, the patient’s compliance with the treatment and satisfaction with the health services can be increased. Clinical trial number Clinical trial number: not applicable.

The number of Internet users searching for health-related issues increases significantly every year. The aim of this study was to investigate whether and how the information about health and disease obtained from the Internet by patients influenced them and how different e-health services can affect the patients’ choice of the doctor. The research was based on a national survey conducted among 1000 Polish adults. The study was carried out with the use of the computer-assisted telephone interviews (CATI). The study showed that e-health facilities are increasingly affecting the patient’s choice of doctor. Among the highest rated factors, the possibility of setting the date of appointment online and practice’s own website were indicated. Information on health and disease obtained from the Internet influenced respondents in many areas. Almost half of health Internet users (HI-users) wanted to change their diet and increase healthy physical activity under the influence of health information obtained online. Regarding health decision making, health information obtained from the Internet caused 45% of HI-users to make an appointment to see a doctor, and 40% of them had questions concerning diagnosis and treatment. Information on health and disease obtained from the Internet undoubtedly affects patient behaviour and health decisions they make.

We aimed to evaluate the relationship between patient expectations and outcomes after knee arthroplasty (KA) in an Asian population in Singapore. We recruited consecutive patients with severe knee osteoarthritis (KOA) scheduled for KA. Pre-operatively, patients provided socio-demographic data and completed the Hospital for Special Surgery Knee Replacement Expectations Survey (HSS-KRES) for baseline pre-operative expectations and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for baseline pain and function. Telephone interviews were conducted at 6- and 12-months post-operatively to collect the WOMAC, satisfaction with KA, and the extent to which pre-operative expectations had been fulfilled. We included 1136 patients (mean age 65.9 years, 69.9% female), of which 1103 and 1089 completed the telephone interviews at 6- and 12-months post-KA respectively. In the multivariable models, expectation fulfilment was consistently associated with improvements in WOMAC pain and function at 6- and 12-months post-operatively, but not the baseline expectations. In the sensitivity analyses, expectation fulfilment was also found to be significantly associated with the achievement of minimal clinically important difference (MCID) for WOMAC pain and function at both 6- and 12-months. Expectation fulfilment was associated with patient satisfaction in the adjustment models at both 6- and 12-months after KA. The fulfilment of expectations, rather than pre-operative expectations, is associated with improvements in WOMAC pain, function and overall satisfaction at 6- and 12-months after KA.

Purpose Indications for total and unicondylar knee arthroplasty (KA) have expanded to younger patients, in which Patient-Reported Outcome Measures (PROMs) often show ceiling effects. This might be due to higher expectations. Our aims were to explore expectations of younger patients concerning activities in daily life, work and leisure time after KA and to assess to what extent PROMs meet and evaluate these activities of importance. Methods Focus groups were performed among osteoarthritis (OA) patients <65 years awaiting KA, in which they indicated what activities they expected to perform better in daily life, work and leisure time after KA. Additionally, 28 activities of daily life, 17 of work and 27 of leisure time were depicted from seven PROMS, which were rated on importance, frequency and bother. A total score, representing motivation for surgery, was also calculated. Results Data saturation was reached after six focus groups including 37 patients. Younger OA patients expect to perform better on 16 activities after KA, including highimpact leisure time activities. From the PROMs, daily life and work activities were rated high in both importance and motivation for surgery, but for leisure time activities importance varied highly between patients. All seven PROMs score activities of importance, but no single PROM incorporates all activities rated important. Conclusion Younger patients expect to perform better on many activities of daily life, work and leisure time after KA, and often at demanding levels. To measure outcomes of younger patients, we suggest using PROMs that include work and leisure time activities besides daily life activities, in which preferably scored activities can be individualized.

Purpose Unrealistic patient expectations have been shown to negatively influence patient-reported outcomes in orthopaedic surgery. Knowledge about patient expectations is important to associate preoperative expectations with the reasonable outcome of a specific procedure. The purpose of this study was to prospectively analyse and to compare patient expectations of primary and revision anterior cruciate ligament reconstruction (ACLR) and to assess the factors associated with patient expectations. Methods Preoperative expectations of 181 consecutive patients undergoing ACLR were assessed prospectively using a 5-item questionnaire. Primary ACLR (P-ACLR) was performed in 133 patients (73 %), whereas 48 patients (27 %) underwent revision ACLR (R-ACLR). The questionnaire assessed the expectation of the overall condition of the knee joint, return to sports, instability, pain, and risk of osteoarthritis. Results All patients expected a normal (38 %) or nearly normal (62 %) condition of the knee joint. Return to sports at the same level was expected by 91 %. With regard to instability (pain), no instability (pain) independent of the activity level was expected by 77 % (58 %). No or only a slightly increased risk of the development of osteoarthritis was expected by 98 %. The R-ACLR group showed a significantly lower expectation of the overall condition ( p  = 0.001), return to sports ( p  < 0.001), and pain ( p  = 0.002). No statistically significant difference was found between female and male patients (n.s.). In the P-ACLR group, patients with a history of previous knee surgery showed inferior expectations of return to sports ( p  = 0.015) and risk of osteoarthritis ( p  = 0.011). Age, number of previous knee surgeries, and pre-injury sports level significantly influenced patient expectations. Conclusions Overall, patient expectations of ACL reconstruction are high. Patients undergoing revision ACL reconstruction have lower but still demanding expectations. Younger patients, patients without a history of knee surgery, and highly active patients have higher expectations. Explicit patient information about realistic goals of ACL reconstruction seems to be necessary in order to prevent postoperative dissatisfaction despite a successful operation in the surgeons’ point of view. Level of evidence Prospective case series, Level IV.