Objective: To develop and validate an instrument for measuring patient satisfaction with physical therapy, and to identify the most important satisfaction indicators. Method: The sample was composed of 834 outpatients of both sexes with mean age of 46.7 years who were health plan users at 45 private health clinics in Natal and Mossoró, State of Rio Grande do Norte, Brazil, and who answered a questionnaire. The study covered the process of developing the instrument as well as the analysis of its psychometric properties. Qualitative analysis on the initial sample of items in the questionnaire was performed by a panel of specialists. A pilot study preceded refinement of the questionnaire and was carried out prior to data collection. Psychometric analysis (evaluation of the test that was developed) was performed by means of studying the reliability and validity of the measures obtained with the instrument. Results: The results achieved in relation to reliability, by means of Cronbach's alpha coefficient (α= 0.94), and content, simultaneous, and construct validities showed high internal consistency and satisfactory validity according to psychometric standards for patient satisfaction with physical therapy. Factorial analysis indicated the existence of four dimensions in which patient-therapist interaction, especially regarding the physical therapist's communication skills, seem to be the best indicators of satisfaction. Aspects related to personal convenience, such as location of the clinic and availability of parking, were not strongly predictive of satisfaction with the care received. Conclusions: This study makes available a new tool to contribute to management and to the planning process necessary for improving the quality of physical therapy services.Key words: patient satisfaction; reliability; validity. resumo Desenvolvimento e Validação de um Instrumento de medida da satisfação do Paciente com a FisioterapiaObjetivo: Desenvolver e validar um instrumento de medida da satisfação do paciente com o tratamento fisioterapêutico e também identificar seus principais indicadores. Método: A amostra foi composta por 834 pacientes ambulatoriais de ambos os sexos, com idade média de 46,7 anos e usuários de planos de saúde, que responderam o questionário em 45 clínicas da rede privada de saúde nos municípios de Natal e Mossoró/RN -Brasil. A pesquisa ocorreu desde o processo de desenvolvimento do instrumento até o estudo das suas propriedades psicométricas. A análise qualitativa da amostra inicial de itens do questionário ocorreu por meio de sua apreciação por especialistas. Um estudo piloto precedeu o refinamento do questionário previamente à coleta dos dados. A análise psicométrica (avaliação do teste desenvolvido) foi realizada por meio do estudo da confiabilidade e validade das medidas obtidas com o instrumento. Resultados: Os resultados alcançados para a confiabilidade, por meio do Coeficient alfa de Cronbach (α= 0,94), e validades de conteúdo, simultânea e de construto, demonstraram elevada consistência intern...

Objectives: To investigate the main dimensions with respect to the satisfaction of geriatric patients undergoing outpatient physical therapy and assess the internal consistency of the measures obtained in the assessment instrument. Methods: An assessment instrument measuring patient satisfaction with physical therapy was used. The instrument contains a 23-item patient satisfaction scale and was developed and validated for the Brazilian population by Mendonça and Guerra (2007)*. The data were collected in the waiting room of 29 private physical therapy clinics in Natal, the capital of the state of Rio Grande do Norte, Brazil. The non-probability sample consisted of 221 cognitively healthy patients aged 60 years and older, who possessed health insurance and who had undergone between 5 and 60 physical therapy sessions at the participating clinics. Results: Four factors with an autovalue greater than 1 were retained in the factorial analysis: patient-therapist interaction; access and assistance by the receptionist and support personnel; physical environment and overall satisfaction; and convenience. The items related to patient-therapist interaction showed the highest reliability and highest complete satisfaction scores, especially the respect and courtesy of the physical therapist (85.5%). The reliability of the measures obtained with the instrument, using Cronbach's alpha coefficient and directed toward the geriatric population, was α=0.943. Conclusions: Physical therapists must give support to these patients, not only through their technical skills, but also by emphasizing an attentive and favorable interpersonal relationship, which were the most reported aspects of older adult patient satisfaction with health care.Keywords: patient satisfaction; physical therapy; quality of health care; age. ResumoObjetivos: Investigar as principais dimensões relacionadas com a satisfação do paciente geriátrico com o tratamento fisioterapêutico ambulatorial e avaliar a consistência interna das medidas obtidas no instrumento de avaliação. Métodos: Foi utilizado o instrumento de avaliação da satisfação do paciente com a fisioterapia, desenvolvido e validado para a população brasileira por Mendonça e Guerra (2007)*, com escala de avaliação da satisfação de 23 itens. Os dados foram coletados na sala de espera de 29 clínicas de Fisioterapia da rede privada de Natal, capital do RN/Brasil. A amostra do estudo foi selecionada de forma não-probabilística e constou de 221 pacientes com idade igual ou superior a 60 anos, com realização de 5 a 60 sessões de fisioterapia naqueles estabelecimentos, sendo usuários de plano de saúde e com condições cognitivas preservadas. Resultados: Quatro fatores com autovalor maior que 1 foram retidos na análise fatorial: interação paciente-terapeuta; acesso e atendimento de recepcionista e pessoal de apoio; ambiente físico e satisfação global e conveniência. Os itens relacionados com a interação paciente-terapeuta apresentaram as mais altas confiabilidades, assim como mais elevados escores de satis...

A wide spectrum of oral lesions has been associated with human immunodeficiency viral infection (HIV), or AIDS. This report describes the case of an HIV-infected patient who developed a case of disseminated sporotrichosis whose first clinical sign was the presence of orofacial lesions. A histopathological study of this patient's biopsy specimens taken from the oropharyngeal lesions revealed a number of rounded and/or oval free-spore forms of Sporothrix schenkii, the identification of which was corroborated by culturing skin lesion exudate on Sabouraud's glucose agar. To the best of our knowledge to date, this is the first time a case of the oral manifestation of sporotrichosis in association with HIV infection has been described in the dental literature.

Objectives:To determine the cost-effectiveness of mechanical thrombectomy, compared with standard treatment, from the perspective of the UK NHS and PSS. MethOds: We undertook a cost-effectiveness analysis alongside the Pragmatic Ischaemic Stroke Thrombectomy Evaluation (PISTE) trial. In addition, a decision-analytic model was developed to estimate the long-term cost-effectiveness of thrombectomy using all available trial evidence. Meta-analysis was used to estimate the clinical effectiveness; resource use and costs were sourced from the PISTE study and the broader literature. Value of implementation analysis was used to estimate the potential value of implementing this treatment into routine clinical practice within the UK NHS. As health budget responsibility is devolved within the UK, we plan to estimate the five-year budget impact of introducing mechanical thrombectomy into routine practice within the devolved NHS in Scotland. Results: Compared with standard treatment, thrombectomy was not shown to be cost-effective within-trial/90-day period. However, the reverse was observed with the long-term model (ICER £3,857 per QALY gained). We estimate that 42,525 patients are potentially eligible to receive this treatment in the UK over a five year period. The net monetary benefit (health benefit in monetary terms) is £13,704 per patient. Assuming a five-year time horizon and full implementation, the value of implementation was £542 million. We estimate the "break-even" value of implementation activity point at approximately 26% implementation. cOnclusiOns: Based on a lifetime horizon, mechanical thrombectomy is cost-effective compared with standard care. If implementation is greater than 26%, the value of implementation is greater than the cost of implementation.Objectives: VTE prophylaxis implementation remains to be a challenge at KFSH with deterrent patient risk and death. The purpose of this study is to measure the degree of physician compliance to KFSH 2013 VTE prophylaxis protocol and to identify the percentage of patients at risk of VTE. MethOds: 103 patients admitted to various medical wards were reviewed of which 69 were included in our study. Their risk was measured using the risk assessment sheet in accordance to KFSH VTE prophylaxis protocol. Physicians' compliance was assessed on their degree of compliance to KFSH 2013 VTE prophylaxis policy. Results: The overall compliance rate with 2013 VTE prophylaxis among physicians was 1.4% in the 69 hospital admissions that were reviewed. The majority of our patients 56.5% received prophylaxis but not in accordance to policy. 41.7% of our patients had highest risk of VTE (> 5) according to their calculated risk. The highest risk 66.7% was observed in the Intensive Care Unit. cOnclusiOns: There is no adherence to VTE protocol among KFSH physicians which stresses the importance of awareness of VTE implications to patient well-being across KFSH medical staff. Patient risk of VTE is high and proper implementation is a must to reduce overall risk.Objectives: Several out...

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