Skip to main content
eScholarship
Open Access Publications from the University of California

Scholarly Works (2 results)

  • Article
  • Peer Reviewed
Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, Volume 13, Issue 4 (2012)

Introduction: Patient satisfaction is an important measure of emergency department (ED) quality of care. Little is known about providers’ ability to estimate patient satisfaction. We aimed to measure providers’ ability to assess patient satisfaction and hypothesized that providers could accurately estimate overall patient satisfaction.

Methods: We surveyed ED patients regarding satisfaction with their care. Treating providers completed analogous surveys, estimating patients’ responses. Sexual assault victims and non-English-speaking or severely ill patients were excluded. Satisfaction responses were categorized as ‘‘satisfied’’ or ‘‘not satisfied.’’ Patient satisfaction scores were considered the ‘‘gold standard,’’ and providers’ perceptions of the patient satisfaction were considered tests. Measures of diagnosticaccuracy, such as positive predictive value (PPV) and sensitivity, were used to assess how accurately the provider could estimate his or her patient’s satisfaction.

Results: Here, 242/457 eligible patients (53%) completed the survey; 227 providers (94%) completed a corresponding survey. Subject-reported overall satisfaction was 96.6%, compared with a provider estimated rate of 94.4%. The sensitivity and PPV of the provider’s estimate of the patient’s satisfaction were 95.2 (95% confidence interval [CI] 91.4, 97.7) and 97.5 (95% CI 94.4, 99.2), respectively, for overall patient satisfaction. The PPV was similar for clarity of communication. The PPV was 78.9 for perceived length of ED stay (99% CI 70.8, 85.6) and 82.6 for quality of pain control (95% CI 68.6, 92.2). Accuracy of attending and resident estimates of patient satisfaction did not differ significantly. The agreement between patient-reported and provider-estimated patient satisfaction was not associated with age, gender, patient disposition, or ED divert status.

Conclusion: Providers are able to assess overall patient satisfaction and clarity of communication with a high accuracy. Physician estimates of pain control and perceived length of stay have a moderate accuracy. [West J Emerg Med. 2012;13(4):351–357.]

 

    Cover page: How Accurately Can Emergency Department Providers Estimate Patient Satisfaction?Creative Commons 'BY-NC' version 4.0 license
    • Article
    • Peer Reviewed
    UCLA Previously Published Works (2021)
    OBJECTIVES: Individuals with subjective memory complaints and symptoms of depression and/or anxiety are at high risk for further cognitive decline, and possible progression to dementia. Low-burden interventions to help slow or prevent cognitive decline in this high-risk group are needed. The objective of this study is to assess the feasibility of combining Mindfulness-Based Stress Reduction (MBSR) with transcranial direct current stimulation (tDCS) to increase putative benefits of MBSR for cognitive function and everyday mindfulness in depressed or anxious older adults with subjective cognitive decline. METHODS: We conducted a two-site pilot double-blind randomized sham-controlled trial, combining active MBSR with either active or sham tDCS. The intervention included weekly in-class group sessions at the local university hospital and daily at-home practice. Anodal tDCS was applied for 30 min during MBSR meditative practice, both in-class and at-home. RESULTS: Twenty-six individuals with subjective cognitive complaints and symptoms of depression and/or anxiety were randomized to active (n = 12) or sham tDCS (n = 14). The combination of MBSR and tDCS was safe and well tolerated, though at-home adherence and in-class attendance were variable. While they were not statistically significant, the largest effect sizes for active vs. sham tDCS were for everyday mindfulness (d = 0.6) and social functioning (d = 0.9) (F (1,21) = 3.68, p = 0.07 and F (1,21) = 3.9, p = 0.06, respectively). CONCLUSIONS: Our findings suggest that it is feasible and safe to combine tDCS with MBSR in older depressed and anxious adults, including during remote, at-home use. Furthermore, tDCS may enhance MBSR via transferring its meditative learning and practice into increases in everyday mindfulness. Future studies need to improve adherence to MBSR with tDCS. TRIAL REGISTRATION: ClinicalTrials.gov (NCT03653351 and NCT03680664). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12671-021-01764-9.
      Cover page: Enhancing Cognition in Older Persons with Depression or Anxiety with a Combination of Mindfulness-Based Stress Reduction (MBSR) and Transcranial Direct Current Stimulation (tDCS): Results of a Pilot Randomized Clinical Trial.
      Top