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Background: Patient experience is an important factor in assessing the quality of healthcare. Numerous reports highlight the continued inconsistencies in healthcare and poor patient satisfaction affecting outcomes. This study aimed to assess patient satisfaction in a teaching hospital in Trinidad and Tobago.Methods: A cohort study was conducted among recently discharged patients from the largest teaching hospital in Trinidad and Tobago. The survey instrument was an adaptation of the Picker Patient Experience Questionnaire. Data were collected from January 1, 2017 to March 2017, using face-to-face interviews. SPSS version 21 was used for descriptive and inferential analysis of data.Results: The majority of the 300 participants was female (n=157; 53.3%), aged over 35 years (n=202; 67.3%) with secondary school education (n=137; 45.7%). Satisfaction levels ranged from 50% and 70% for management issues, treatment-related communication issues, environmental issues, and deportment of medical staff. Patient satisfaction with treatment-related support and hotel services was less than 50%. All satisfaction domains were inter-dependent with the highest correlation between treatment-related communication and management issues (r=0.691; p≤0.001) and the lowest between support services and hotel services (r=0.311; p≤0.001). Education was the only factor that was both associated with, and a predictor of, patient satisfaction. Satisfaction level decreased with increased education level.Conclusions: Low satisfaction was found with treatment-related support and hotel services with education level as the only predictor. Steps are needed to ensure periodical satisfaction monitoring and continuous improvement of services such as support and hotel services.
RESUMO
OBJECTIVE: To determine the relative contribution of known high-risk human papillomavirus (HPV) genotypes to the occurrence of cervical cancers in Trinidad. METHODS: The distribution of HPV genotypes in cases of invasive cervical squamous cell carcinoma in Trinidad was investigated. This study was a follow-up to an investigation of HPV genotypes in 310 nonsymptomatic women in Trinidad. The latter study showed that cervical HPV prevalence and heterogeneity of genotypes were high in the study population; notably, the genotypes targeted by the available HPV prophylactic vaccines were not the most common types. RESULTS: The current study of 85 cases of invasive cervical squamous cell carcinomas demonstrated that the previously observed heterogeneity in HPV genotype distribution is lost in cases of invasive cervical cancer, with the vaccine-targeted HPV types HPV 16 and HPV 18 becoming the most prevalent. CONCLUSIONS: HPV 16 and HPV 18 were the primary HPV genotypes associated with cases of invasive squamous cell carcinoma in the current Trinidad study. This strong association leads us to conclude that the HPV vaccines targeting HPV 16 and HPV 18 may contribute to reducing the cervical cancer burden in Trinidad.
OBJETIVO: Determinar la contribución relativa de los diferentes genotipos de virus de los papilomas humanos (VPH) conocidos como de alto riesgo para la aparición de cáncer cervicouterino en Trinidad. MÉTODOS: Se investigó la distribución de los genotipos de VPH en casos de carcinoma cervicouterino escamocelular invasor en Trinidad. Este estudio fue la continuación de una investigación de los genotipos de VPH presentes en 310 mujeres asintomáticas en Trinidad. Este último estudio reveló altas prevalencia de VPH en el cuello uterino y heterogeneidad de los genotipos en la población del estudio; cabe destacar que los genotipos a los que se dirigen las vacunas preventivas de la infección por VPH disponibles no fueron los tipos más frecuentes. RESULTADOS: El presente estudio, llevado a cabo en 85 casos de carcinoma cervicouterino escamocelular invasor, demostró que la heterogeneidad anteriormente observada en la distribución de genotipos de VPH no se mantiene en los casos de cáncer cervicouterino invasor, y que los tipos de VPH objeto de la vacuna, el VPH 16 y el VPH 18, pasan a ser los más prevalentes. CONCLUSIONES: En el presente estudio llevado a cabo en Trinidad, el VPH 16 y el VPH 18 fueron los principales genotipos de VPH asociados con los casos de carcinoma escamocelular invasor. Esta estrecha asociación nos lleva a la conclusión de que las vacunas contra el VPH dirigidas contra el VPH 16 y el VPH 18 pueden contribuir a la reducción de la carga de cáncer cervicouterino en Trinidad.