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  • 文章类型: Journal Article
    揭示与乳腺癌患者满意度相关的变量,以改善加纳乳腺癌护理的政策选择和行动。
    我们采用了定量方法的横截面设计。
    放射治疗,科勒布教学医院肿瘤科和外科,阿克拉.
    住院和门诊乳腺癌患者。
    使用描述性和推断性统计分析来衡量住院和门诊满意度。Shapiro-Wilk检验用于评估正常性,而Heckman选择模型评估了感兴趣的结果的显著性。
    共有636名参与者,平均年龄52.64±14.07岁,被招募。在100人中,住院和门诊的满意度分别为74.06±7.41和49.99±1.00,而自我报告的满意度分别为4.22±0.63和4.11±0.85。住院患者满意度水平受年龄影响显著,婚姻状况,收入水平,以及以前访问过的设施数量(p<0.05)。门诊满意度与居住地和收入水平显著相关(p<0.05)。
    该研究提供了在加纳最大的三级转诊中心和教学医院接受住院和门诊服务的乳腺癌患者的满意度。以及影响出勤率和满意度的因素。了解和提高乳腺癌患者的满意度水平是提供者保护他们情绪健康的一种方式。在门诊患者中提高我们机构的患者满意度是未来增长的领域。
    Gardner-Holt妇女健康补助金计划,2021年全球外科中心。
    UNASSIGNED: To uncover variables linked to breast cancer patient satisfaction in order to improve policy choices and actions for breast cancer care in Ghana.
    UNASSIGNED: We employed a cross-sectional design using a quantitative approach.
    UNASSIGNED: The Radiotherapy, Oncology and Surgery Departments of the Korle Bu Teaching Hospital, Accra.
    UNASSIGNED: Inpatient and outpatient breast cancer patients.
    UNASSIGNED: The level of inpatient and outpatient satisfaction was measured using descriptive and inferential statistical analyses. The Shapiro-Wilk test was employed to assess normality, while the Heckman selection model assessed significance with outcomes of interest.
    UNASSIGNED: A total of 636 participants, with a mean age of 52.64±14.07 years, were recruited. The measured inpatient and outpatient levels of satisfaction out of 100 were 74.06±7.41 and 49.99±1.00 respectively, while the self-reported satisfaction levels out of 5 were 4.22±0.63 and 4.11±0.85 respectively. The level of inpatient satisfaction was significantly influenced by age, marital status, income level, and number of previous facilities visited (p<0.05). Outpatient satisfaction level was significantly associated with place of residence and income level (p<0.05).
    UNASSIGNED: The study offers insight into the satisfaction levels of breast cancer patients receiving inpatient and outpatient services at the largest tertiary referral centre and teaching hospital in Ghana, as well as the factors influencing attendance and satisfaction levels. Understanding and improving breast cancer patients\' levels of satisfaction is a way that providers can safeguard their emotional well-being. Improvement in patient satisfaction at our institution among outpatients is an area for future growth.
    UNASSIGNED: Gardner-Holt Women\'s Health Grant program, Centre for Global Surgery 2021.
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  • 文章类型: Journal Article
    背景:改良早期预警评分(MEWS)是疾病严重程度的客观衡量指标,可促进对危重患者临床恶化的早期识别。它的主要用途是促进更快的干预或提高护理水平。尽管它在一些非洲国家被采用,MEWS不是加纳的标准护理。为了便于使用这种工具,我们评估了MEWS是否,或当前临床实践中常规收集的更有限的数据的组合,可用于预测阿克拉Korle-Bu教学医院危重住院患者的死亡率,加纳。
    目的:本研究的目的是确定MEWS对有死亡风险的内科住院患者的预测能力及其与常规测量生理参数(有限MEWS[LMEWS])的可比性。
    方法:我们对内科住院患者进行了回顾性研究,年龄≥13岁,于2017年1月至2019年3月入住Korle-Bu教学医院。对入院后48小时的常规生命体征进行编码以获得LMEWS值。从病历中估算意识水平,并与LMEWS结合以获得完整的MEWS值。使用多元逻辑回归设计了一个预测模型,比较MEWS值显著或LMEWS≥4与非显著MEWS值或LMEWS<4患者的死亡率,并对其预测准确性进行了内部验证。使用接收器工作特性(ROC)曲线。
    结果:共112例患者纳入研究。与具有显著MEWS的患者和具有非显著MEWS的患者相比,调整后的死亡几率为6.33(95%CI1.96-20.48)。同样,比较LMEWS值显著和不显著的患者的校正后死亡几率为8.22(95%CI2.45~27.56).每个分析的ROC曲线的C统计量分别为0.83和0.84。
    结论:LMEWS是死亡率的良好预测因子,与MEWS相当。现在可以使用当前可用的数据来实施LMEWS,以识别有死亡风险的医疗住院患者,以改善护理。
    BACKGROUND: The modified early warning score (MEWS) is an objective measure of illness severity that promotes early recognition of clinical deterioration in critically ill patients. Its primary use is to facilitate faster intervention or increase the level of care. Despite its adoption in some African countries, MEWS is not standard of care in Ghana. In order to facilitate the use of such a tool, we assessed whether MEWS, or a combination of the more limited data that are routinely collected in current clinical practice, can be used predict to mortality among critically ill inpatients at the Korle-Bu Teaching Hospital in Accra, Ghana.
    OBJECTIVE: The aim of this study was to identify the predictive ability of MEWS for medical inpatients at risk of mortality and its comparability to a measure combining routinely measured physiologic parameters (limited MEWS [LMEWS]).
    METHODS: We conducted a retrospective study of medical inpatients, aged ≥13 years and admitted to the Korle-Bu Teaching Hospital from January 2017 to March 2019. Routine vital signs at 48 hours post admission were coded to obtain LMEWS values. The level of consciousness was imputed from medical records and combined with LMEWS to obtain the full MEWS value. A predictive model comparing mortality among patients with a significant MEWS value or LMEWS ≥4 versus a nonsignificant MEWS value or LMEWS <4 was designed using multiple logistic regression and internally validated for predictive accuracy, using the receiver operating characteristic (ROC) curve.
    RESULTS: A total of 112 patients were included in the study. The adjusted odds of death comparing patients with a significant MEWS to patients with a nonsignificant MEWS was 6.33 (95% CI 1.96-20.48). Similarly, the adjusted odds of death comparing patients with a significant versus nonsignificant LMEWS value was 8.22 (95% CI 2.45-27.56). The ROC curve for each analysis had a C-statistic of 0.83 and 0.84, respectively.
    CONCLUSIONS: LMEWS is a good predictor of mortality and comparable to MEWS. Adoption of LMEWS can be implemented now using currently available data to identify medical inpatients at risk of death in order to improve care.
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