Eliciting patients’ healthcare goals and concerns: Do questions influence responses?

There is increasing interest in asking patients questions before their visits to elicit goals and concerns, which is part of the move to support the concept of coproducing care. The phrasing and delivery of such questions differs across settings and is likely to influence responses. This report describes a study that (i) used a three-level model to categorize the goals and concerns elicited by two different pre-visit questions, and (ii) describes associations between responses elicited and the phrasing and delivery of the two questions. The questions were administered to patients with rheumatic disease, and patients with inflammatory bowel disease (IBD). Paper-based responses from 150 patients with rheumatic disease and 338 patients with IBD were analyzed (163 paper, 175 electronic). The goals and concerns elicited were primarily disease or symptom-specific. The specific goal and concern examples featured in one pre-visit question were more commonly reported in responses to that question, compared to the question without examples. Questions completed electronically before the visit were associated with longer responses than those completed on paper in the waiting room. In conclusion, how and when patients’ goals and concerns are elicited appears to have an impact on responses and warrants further investigation.

Intervention to Reduce Anxiety Pre- and Post-Eye Surgery in Pediatric Patients in South Korea: A Preliminary Quasi-Experimental Study

In this study, we aimed to identify the effect of preoperative information on postoperative anxiety among children undergoing one-day eye surgery. We utilized a nonequivalent control group and a pretest–posttest quasi-experimental design. The participants were 15 children in the experimental group and 15 children in the control group. Preoperative information was provided to the experimental group in the waiting room. Anxiety level was measured using the Children’s Emotional Manifestation Scale and pulse rate. For pulse rate, there were no statistically significant differences between the groups. In the behavioral anxiety response, there were statistically significant differences between the experimental and control groups (Z = −4.15, p < 0.001). The results suggest that the provision of preoperative information can be an effective intervention for reducing postoperative anxiety and improving the health of children undergoing surgery.

Indoor air quality in wards of dental school clinic: Variations of VOCs, CO2 and airborne particle levels

Introduction: The indoor environment of dental clinics may endanger dental patients and personnel and due to a great variety of air pollutants throughout the usual dental operation. The purpose of the present cross-sectional study was the evaluation of Indoor Air Quality (IAQ) and factors affecting it in a dentistry faculty of Arak University of Medical Sciences. Material and methods: The IAQ of five dental active wards and the patient waiting room was evaluated. The concentrations of Total Volatile Organic Compounds (TVOC), CO2, particulate matter, and bioaerosols were measured. Results: The TVOCs concentration in sampling locations ranged between 817 to 3670 μg/m3 during dental work and exceeded the Leadership in Energy and Environmental Design (LEED) guideline in all sampling locations. The highest values of Particulate Matter (PM) for PM10, PM2.5, and PM1 were observed in the periodontics ward, while the lowest values were observed in the endodontics ward. The PM2.5 concentrations exceeded the WHO limit in periodontics and pediatric wards. TVOC levels had a significant positive correlation with temperature (r=0.374, p<0.01) and RH (r=0.265, p<0.05). The predominant bacterial genus of the patient waiting area was Bacillus (36%), while the dominant bacterial genus of the other sampling site was Micrococcus spp. Penicillium (35.5%) and Cladosporium (28%) were the predominant fungi detected. Conclusion: Controlling of airborne particles is to be standardized by the infection control actions of dental clinics and improved ventilation capacity in the air conditioning system was suggested for reducing VOCs and PM concentrations.

Indoor concentrations of particulate matter 2.5 in a pediatric emergency service

Objective: To evaluate air quality in the waiting room of a pediatric emergency service considering the serial concentrations of particulate matter (PM2.5), and to determine if the number of people present in the room can have an influence on the pollutant concentrations. Methods: Cross-sectional study, carried out in the waiting room of a reference pediatric hospital in the city of Porto Alegre, conducted in a one-year period, in a continuous-time sample including all of the four seasons of the year. The monitoring of PM2.5 was performed using a real-time aerosol monitor (DustTrak II). The number of people in the room was determined every hour and the climatic characteristics per daily mean. The concentration of PM2.5 and the number of people were expressed by mean and standard deviation. The means were compared by Analysis of Variance and Pearson's correlation coefficient. Results: There was a significant increase in the concentration of PM2.5 in the autumn, when compared to other seasons (p<0.001). The pollutant increase, in this season, was accompanied by the higher number of people in the emergency room (p=0.026). The association between PM2.5 and the number of people is confirmed by the positive correlation between these two variables (r=0.738; p<0.001). Conclusions: The pediatric emergency waiting room showed elevated PM2.5 in all seasons. The number of people in the room had a positive correlation with the concentration of the pollutant in the environment.

Między ziemią obiecaną a krainą rozczarowań – profile EUROPY we Wszystkich wojnach Lary Wojciecha Jagielskiego

The aim of the article is to point out and describe the profiles of the concept of EUROPE in Wojciech Jagielski’s non-fiction book All Lara’s Wars. Profiling in ethnolinguistics is a process of creating an individual image (profile) of a particular object. The profiles can be diverse, depending on what kind of aspects are important in shaping a particular subjective vision. Based on the linguistic analysis of the chosen quotes from the book, six profiles of EUROPE have been pointed out: promised land, open home, fortress, package, waiting room and land of disappointment. The common aspect which can be found in all the profiles is the geographical one. However, each profile is shaped differently and is dominated by one of the aspects: living, social or civilisational (cultural). Two of the profiles are positively valued (promised land and open home) and the other four are negatively valued, which leads to the conclusion that the image of EUROPE presented in the book is mostly characterised as pejorative.

Effective Optimisation of the Patient Circuits of an Oncology Day Hospital: Mathematical Programming Models and Case Study

In this paper, we first use the information we have on the patients of an oncology day hospital to distribute the treatment schedules they have in each of the visits to this centre. To do this, we propose a deterministic mathematical programming model in such a way that we minimise the duration of the waiting room stays of the total set of patients and taking into account the restrictions of the circuit. Secondly, we will look for a solution to the same problem under a stochastic approach. This model will explicitly consider the existing uncertainty in terms of the different times involved in the circuit, and this model also allows the reorganisation of the schedules of medical appointments with oncologists. The models are complemented by a tool that solves the problem of assigning nurses to patients. The work is motivated by the particular characteristics of a real hospital and the models are used and compared with data from this case.

Różewicz vs. Różewicz, czyli o noweli „Piwo” Tadeusza Różewicza i jej ekranizacji w reżyserii Stanisława Różewicza

The author of this article makes a comparative interpretation of Tadeusz Różewicz’s novella Piwo [Beer] and its film adaptation directed by Stanisław Różewicz. Among other things, the researcher asks the question: to what extent do the differences between the film material and the text material – in this particular case – stem from the specificity of the film language and its autonomy in relation to literature? He believes that this can be explained by the fact that the action of the film takes place only in the station’s waiting room; the movement between the inn and the station, undoubtedly justified in the case of the original text, would be for the viewer something illegible and disturbing to the sequence of events. The multilevel linguistic code forcing symbolic readings, so important in Różewicz’s prose, seems, however, not to be translatable (at least not in its entirety) into the language of the image, which enforces a number of other artistic solutions. It seems that the film work here speaks the language of symbols on a different level.

Humanizing the intensive care unit experience in a comprehensive cancer center: A patient- and family-centered improvement study

Objectives Improving family-centered outcomes is a priority in oncologic critical care. As part of the Intensive Care Unit (ICU) Patient-Centered Outcomes Research Collaborative, we implemented patient- and family-centered initiatives in a comprehensive cancer center. Methods A multidisciplinary team was created to implement the initiatives. We instituted an open visitation policy (OVP) that revamped the use of the two-way communication boards and enhanced the waiting room experience by hosting ICU family-centered events. To assess the initiatives’ effects, we carried out pre-intervention (PRE) and post-intervention (POST) family/caregiver and ICU practitioner surveys. Results A total of 159 (PRE = 79, POST = 80) family members and 147 (PRE = 95, POST = 52) ICU practitioners participated. Regarding the decision-making process, family members felt more included (40.5% vs. 68.8%, p < 0.001) and more supported (29.1% vs. 48.8%, p = 0.011) after the implementation of the initiatives. The caregivers also felt more control over the decision-making process in the POST survey (34.2% vs. 56.3%, p = 0.005). Although 33% of the ICU staff considered OVP was beneficial for the ICU, 41% disagreed and 26% were neutral. Only half of them responded that OVP was beneficial for patients and 63% agreed that OVP was beneficial for families. Half of the practitioners agreed that OVP resulted in additional work for staff. Significance of results Our project effectively promoted patient- and family-centered care. The families expressed satisfaction with the communication of information and the decision-making process. However, the ICU staff felt that the initiatives increased their work load. Further research is needed to understand whether making this project universal or introducing additional novel practices would significantly benefit patients admitted to the ICU and their family.

Perceived Usability of Seating in an Outpatient Waiting Area: A Combined Approach Utilizing Virtual Reality and Actual Seating Prototypes

Objective: This study proposed a combined methodology to evaluate the perceived usability of healthcare seats that were first selected in a virtual waiting room which provided the context of use for the seats. Background: There has been an increased interest in using virtual reality (VR) for evaluation of seating in interior environments. Although VR offers a less expensive approach compared to evaluating seats in situ, using VR has limitations as users cannot experience the actual seat prototypes. Method: Participants ( N = 92) experienced a virtual waiting room with various seat groupings and were prompted with four task-based scenarios through which they selected a seat. After the VR phase, they experienced their selected seats in a lab and used an online questionnaire to evaluate the seating. Semi-structured interviews were conducted to garner similarities and differences in participants’ experience of virtual and real seats. Results: Three categories including comfort, support, and flexibility were extracted from the questionnaire. While support and comfort categories were highly ranked by participants, the category rankings varied depending on participants’ age, gender, tasks, and seat types. Interviews revealed that there were differences in experience of the seating materials in VR versus reality, and therefore experiencing the real seats was useful in seating evaluation. Conclusions: The findings suggest that the combined methodology using VR and real seating in a lab is a reliable tool for designers and furniture manufacturers to obtain users’ perceived usability evaluation of seating during the design process while the actual context is absent.