In this review epidemiological studies concerning chronic benign pain among adults are discussed. To this end, studies focusing on chronic pain, reporting prevalences at a population or primary health care level, including subjects aged between 18 and 75 years have been collected and analyzed. Focus of analysis was on research methods, definitions of chronic benign pain used, and reported prevalences. Prevalences varied between 2% and 40% of the population. Nor method used (telephone survey, postal survey, nor definition of chronicity (>1 month; >3 months; >6 months) clearly explained the differences in prevalence in the various studies. Implications for future research are discussed.
Introduction Patient views on quality of care are of paramount importance with respect to the implementation of quality assurance (QA) and improvement (QI) programmes. However, the relevance of patient satisfaction studies is often questioned because of conceptual and methodological problems. Here, it is our belief that a different strategy is necessary. Objective To develop a conceptual framework for measuring quality of care seen through the patients' eyes, based on the existing literature on consumer satisfaction in health care and business research. Results Patient or consumer satisfaction is regarded as a multidimensional concept, based on a relationship between experiences and expectations. However, where most health care researchers tend to concentrate on the result, patient (dis)satisfaction, a more fruitful approach is to look at the basic components of the concept: expectations (or `needs') and experiences. A conceptual framework – based on the sequence performance, importance, impact – and quality judgements of different categories of patients derived from importance and performance scores of different health care aspects, is elaborated upon and illustrated with empirical evidence. Conclusions The new conceptual model, with quality of care indices derived from importance and performance scores, can serve as a framework for QA and QI programmes from the patients' perspective. For selecting quality of care aspects, a category‐specific approach is recommended including the use of focus group discussions.
Background and objectives: The study aim was to establish the incidence and characterize all encapsulating peritoneal sclerosis (EPS) cases in patients treated by peritoneal dialysis (PD).Design Conclusions: The incidence reported in this study may be used to inform patients of the minimum risk of developing EPS on PD.
Abstract--Preferences for physicians' gender is an obvious and well documented example of considerations of patients' attitudes. But research carried out in this field is rather limited to the domain of family medicine. This article describes preferences for 13 different health professions: surgeons, neurologists, anaesthetists, internists, general practitioners, psychiatrists, psychologists, social workers, hospital and district nurses, home helps, gynaecologists and midwives. Our investigation also concerns the reasons for people's preferences. In February 1993 a self-administered survey was completed and returned by 961 out of 1113 (response 86%) participants of the Dutch Health Care Consumers Panel, a panel resulting from a random sample of Dutch households. On a range of different health professions a varying minority of patients prefer a care provider of a particular gender. There are virtually no sex preferences for the more "instrumental" health professions (e.g. surgeons, anaesthetists). Gender preferences are stronger for those health professions more likely engaged in intimate and psychosocial health problems (e.g. gynaecologists and GPs). Preferences expressed do not relate to sex stereotypes of gender differences in instrumentality, expertise, efficiency, consultation length, and personal interest. The majority of persons who prefer female health professionals indicate that they talk more easily to females than to males, and feel more at ease during (internal) examination by females than by males. Persons who prefer male health professionals use the same reasons in favour of males. The discussion relates to gender differences in the communication style of male and female physicians. © 1997 Elsevier Science Ltd
Aims/hypothesisAn excess cancer incidence of 20–25% has been identified among persons with diabetes, most of whom have type 2 diabetes. We aimed to describe the association between type 1 diabetes and cancer incidence.MethodsPersons with type 1 diabetes were identified from five nationwide diabetes registers: Australia (2000–2008), Denmark (1995–2014), Finland (1972–2012), Scotland (1995–2012) and Sweden (1987–2012). Linkage to national cancer registries provided the numbers of incident cancers in people with type 1 diabetes and in the general population. We used Poisson models with adjustment for age and date of follow up to estimate hazard ratios for total and site-specific cancers.ResultsA total of 9,149 cancers occurred among persons with type 1 diabetes in 3.9 million person-years. The median age at cancer diagnosis was 51.1 years (interquartile range 43.5–59.5). The hazard ratios (HRs) (95% CIs) associated with type 1 diabetes for all cancers combined were 1.01 (0.98, 1.04) among men and 1.07 (1.04, 1.10) among women. HRs were increased for cancer of the stomach (men, HR 1.23 [1.04, 1.46]; women, HR 1.78 [1.49, 2.13]), liver (men, HR 2.00 [1.67, 2.40]; women, HR 1.55 [1.14, 2.10]), pancreas (men, HR 1.53 [1.30, 1.79]; women, HR 1.25 [1.02,1.53]), endometrium (HR 1.42 [1.27, 1.58]) and kidney (men, HR 1.30 [1.12, 1.49]; women, HR 1.47 [1.23, 1.77]). Reduced HRs were found for cancer of the prostate (HR 0.56 [0.51, 0.61]) and breast (HR 0.90 [0.85, 0.94]). HRs declined with increasing diabetes duration.ConclusionType 1 diabetes was associated with differences in the risk of several common cancers; the strength of these associations varied with the duration of diabetes.Electronic supplementary materialThe online version of this article (doi:10.1007/s00125-016-3884-9) contains peer-reviewed but unedited supplementary material, which is available to authorised users.
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