BACKGROUND:Patient satisfaction is an important indicator for assessing the quality of health care because it affects the timely, efficient, and patient-centered delivery of quality health care, and patient satisfaction is associated with the clinical outcomes. This study aimed to examine the relationship between waiting time and patient satisfaction in a tertiary hospital in Saudi Arabia.MATERIALS AND METHODS:A cross-sectional study was conducted at family medicine and other specialized clinics. Data were collected through a structured, self-administered questionnaire distributed to patients seen at the outpatient clinics. Variables collected were sociodemographic information and patient satisfaction scores to evaluate the association between waiting time and satisfaction.RESULTS:A total of 406 patients participated in the study. Half of the patients reported being satisfied with the waiting time, while the remaining were dissatisfied (mean satisfaction score 38.4 ± 6.63). Family medicine clinic scored better in waiting time than other specialized clinics; between arrival and registration (P < 0.01), between registration and consultation (P < 0.01), consultation time (P < 0.01), and overall waiting time (P < 0.01). Patients treated at the family medicine clinic were more likely to be satisfied than those seen in other specialized clinics (61.2% vs. 40%, P < 0.01).CONCLUSION:Overall satisfaction was lower than shown in previous literature. Gender and clinic type were significantly associated with satisfaction score; those who attended the family medicine clinics were more satisfied than those attending other specialized clinics. Findings may be used to inform researchers, clinicians, and policy-makers' decisions on quality improvement programs.
BACKGROUNDChild sexual abuse (CSA) has serious consequences that can affect the physical, social and mental health of a child. In the last two decades, concern about CSA has increased around the world including Saudi Arabia.OBJECTIVEEvaluate factors associated with parental perceptions and knowledge of CSA.DESIGNCross-sectional survey.SETTINGSPrimary health care clinic.SUBJECTS AND METHODSSimple random sampling was used to select participants. The main tool for data collection was a self-administered questionnaire.MAIN OUTCOME MEASURESFactors associated with knowledge and perceptions of CSA.SAMPLE SIZE400.RESULTSMost respondents (69%) had good knowledge of the signs of sexual abuse in children. For perception scores, statistically significant variables were age (P=.004), educational level (P=.005), income (P<.001), number of wives (P=.004), number of male children (P=.021), and number of female children (P=.027). For knowledge scores, statistically significant variables were income (P=.008), number of wives (P<.005), number of male children (P=.003) and number of female children (P<.003). Logistic regression showed that the older age group was significantly associated with a good perception score (P<.046).CONCLUSIONSRisk factors for parental lack of knowledge and poor perception associated with CSA are poverty and low education. Protective factors included the older parent age, size of the family and families with more than one wife. Education should be designed for parents and the community to increase the knowledge and perception of CSA.LIMITATIONSSingle-center study and short study period.
Background:Establishing rapport is an important step in physician–patient communication resulting in a positive effect on patient satisfaction and overall clinical outcomes. However, there is a dearth of studies on the condition of doctor–patient relations in Saudi Arabia. This study was performed to estimate the proportion of physicians who have a good rapport with patients in their practice and the proportion of satisfied attendees.Materials and Methods:A cross-sectional study was conducted at a Primary Health Care Center, Dammam, KSA. The data were collected through a structured self-administered questionnaire given to samples of attendees and physicians to estimate patient satisfaction and the practice of rapport by physicians.Results:A total of 374 attendees and 27 physicians participated in the study. The percentage of physicians who had good rapport was 51.9%. Factors that showed significant relationship with rapport practice were: Physician's age (p = 0.016), physician's experience (p = 0.043), and professional status (p = 0.031). The attendees satisfied with their physician's rapport with them were 50.5%. Factors that showed significant relationship with satisfaction were: Attendee's age (p < 0.0001), educational level (p < 0.0001), having a chronic illness (p < 0.0001), having appointment (p < 0.0001), physicians' professional status (p < 0.0001), and a nonsurgical specialty (p < 0.0001).Conclusion and Recommendation:Physicians' rapport with patients and patients' satisfaction with physicians' empathy is not high. Training is required to optimize physician–patient communication.
BackgroundVancomycin therapeutic drug monitoring (TDM) is based on achieving 24-h area under the concentration–time curve to minimum inhibitory concentration cure breakpoints (AUC24/MIC). Approaches to vancomycin TDM vary, with no head-to-head randomized controlled trial (RCT) comparisons to date.ObjectivesWe aimed to compare clinical and pharmacokinetic outcomes between peak–trough-based and trough-only-based vancomycin TDM approaches and to determine the relationship between vancomycin AUC24/MIC and cure rates.MethodsA multicentered pragmatic parallel-group RCT was conducted in Hamad Medical Corporation hospitals in Qatar. Adult non-dialysis patients initiated on vancomycin were randomized to peak–trough-based or trough-only-based vancomycin TDM. Primary endpoints included vancomycin AUC24/MIC ratio breakpoint for cure and clinical effectiveness (therapeutic cure vs therapeutic failure). Descriptive, inferential, and classification and regression tree (CART) statistical analyses were applied. NONMEM.v.7.3 was used to conduct population pharmacokinetic analyses and AUC24 calculations.ResultsSixty-five patients were enrolled [trough-only-based-TDM (n = 35) and peak–trough-based-TDM (n = 30)]. Peak–trough-based TDM was significantly associated with higher therapeutic cure rates compared to trough-only-based TDM [76.7% vs 48.6%; p value = 0.02]. No statistically significant differences were observed for all-cause mortality, neutropenia, or nephrotoxicity between the two groups. Compared to trough-only-based TDM, peak–trough-based TDM was associated with less vancomycin total daily doses by 12.05 mg/kg/day (p value = 0.027). CART identified creatinine clearance (CLCR), AUC24/MIC, and TDM approach as significant determinants of therapeutic outcomes. All patients [n = 19,100%] with CLCR ≤ 7.85 L/h, AUC24/MIC ≤ 1256, who received peak–trough-based TDM achieved therapeutic cure. AUC24/MIC > 565 was identified to be correlated with cure in trough-only-based TDM recipients [n = 11,84.6%]. No minimum AUC24/MIC breakpoint was detected by CART in the peak–trough-based group.ConclusionMaintenance of target vancomycin exposures and implementation of peak–trough-based vancomycin TDM may improve vancomycin-associated cure rates. Larger scale RCTs are warranted to confirm these findings.
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