Patient perceptions of urgency of their pelvic floor disorders during the COVID-19 pandemic.

INTRODUCTION AND HYPOTHESIS: During the COVID-19 pandemic, many surgical societies released guidelines that included cancellation of elective cases. The aim of this study was to better understand our patients' perceptions of the severity of their pelvic floor disorders (PFDs) and to determine what factors influenced this perception. We also aimed to better understand who might be amenable to telemedicine visits and what factors influenced this decision. METHODS: This is a cross-sectional quality improvement study that included women at least 18 years of age diagnosed with a pelvic floor disorder being evaluated within a university Female Pelvic Medicine and Reconstructive Surgery clinic during the COVID-19 pandemic. Patients whose appointments and procedures were being cancelled were queried on whether they would be willing to answer a telephone questionnaire developed by the clinical and research teams. We gathered descriptive data from 97 female patients with PFDs using a primary phone questionnaire. The data were analyzed using proportions and descriptive statistics. RESULTS: Of the 97 patients, the majority (79%) viewed their conditions as non-urgent. Factors that influenced patients' perception of urgency included race (p=0.037), health status (p≤0.001), a history of diabetes (p=0.011), and willingness to attend an in-person appointment (p=0.010). Further, 52% of respondents were willing to attend a tele-health appointment. Statistically significant factors influencing this decision were ethnicity (p=0.019), marital status (p=0.019), and willingness to attend an in-person appointment (p=0.011). CONCLUSION: The majority of women did not view their conditions as urgent during the COVID-19 pandemic and were amenable to a telehealth appointment.

Patient perceptions of care quality and discharge information following same-day cardiac catheterization laboratory procedures: A mixed-methods study.

AIMS: To examine patients' perceptions of care quality following a same-day procedure in the cardiac catheterization laboratory and understand the extent to which they were prepared for discharge. DESIGN: Single-centre, mixed-methods study. METHODS: Postdischarge, online survey of patients who underwent a same-day procedure in the cardiac catheterization laboratory (n = 150) and one-on-one interviews with 13 of these patients. RESULTS: Survey responses were positive with mean scores between 4.39-4.83 out of five and 63.3% of respondents (n = 95) extremely likely to recommend the service to others. Interview data analysis identified three themes: the care experience, information and education for safe discharge, and follow-up needs. Participants spoke highly of their interactions with clinicians and were satisfied with their care experience. Mode and content of information delivered varied, with some participants lacking guidance about postdischarge health management and clarity about follow-up plans. PATIENT OR PUBLIC CONTRIBUTION: Participants were patients.

The Impact of Elective Surgical Restriction during the COVID-19 Pandemic in Shoulder and Elbow Surgery: patient perceptions.

INTRODUCTION: In late 2019 and early 2020 a novel coronavirus (Covid-19) spread across the world creating a global pandemic. In the state of Pennsylvania, non-emergent, elective operations were temporarily delayed from proceeding with normal standard of care. The primary purpose of this study was to determine the proportion of patients who required prescription pain medication during the surgical delay. Secondarily, we sought to determine the proportion of patients who perceived their surgery as non-elective and evaluate how symptoms were managed during the delay. MATERIALS AND METHODS: A single institutional database was used to retrospectively identify all shoulder and elbow surgeries scheduled between March 13, 2020 and May 6, 2020. Charts were manually reviewed. Patients who underwent non-shoulder and elbow related procedures and patients of surgeons outside of Pennsylvania were excluded. Patients whose surgeries were "postponed" or "canceled" were administered a survey evaluating how symptoms were managed and perceptions regarding the delay. Preoperative functional scores were collected. Statistical analysis was performed to determine associations between procedure status, preoperative functional scores, perception of surgery, and requirement for prescription pain medication. RESULTS: 338 patients were scheduled for shoulder/elbow surgery at our practice in Pennsylvania. 89 patients (26.3%) underwent surgery as initially scheduled. 179 patients (71.9%) had their surgeries postponed. 70 patients (28.1%) canceled surgery. The average delay in surgery was 86.7 days (range, 13-299 days). 176 (70.7%) patients who were postponed or canceled responded to the survey. 39 patients (22.2%) required prescription pain medication during the delay. 73 patients (41%) considered their procedure to be elective in nature. 137 patients (78%) would have moved forward with surgery if done safely under appropriate medical guidelines. Lower preoperative ASES and SANE scores (r= -0.36, p<0.001; r=-0.26, p=0.016, respectively), and higher preoperative VAS scores were correlated with requiring prescription pain medication (r=0.28, p=0.009). Higher preoperative ASES score was positively correlated with perception of surgery as elective (r=0.4; p<0.001). CONCLUSION: Patients undergoing elective shoulder and elbow surgery during the Covid-19 pandemic experienced a delay of nearly 3 months on average. Fewer than half of patients perceived their surgeries as elective procedures. Nearly a quarter of patients surveyed required extra prescription pain medicine during their delay. This study elucidates the fact that while orthopedic shoulder and elbow surgery is generally considered "elective" it is more important to a majority of patients. These findings may also be applicable to future potential mandated surgical care delays by other third- party organizations.

Telehealth during the pandemic: Patient perceptions and policy implications.

INTRODUCTION: Telehealth's potential to improve access to specialty health care, increase favorable patient outcomes, and save money demands attention. Unfortunately, patients often fail to embrace telehealth. The COVID-19 pandemic fueled greater telehealth usage globally. Little is known about patient perceptions of telehealth in the context of a pandemic. Therefore, we sought to understand patient perceptions of telehealth during the COVID-19 pandemic and explore relevant policy implications. DESIGN: Researchers used a cross-sectional, non-experimental design to survey 366 patients across two telehealth programs at a Mississippi academic health sciences center between November 1, 2021 and November 15, 2021. METHODS: As part of a larger, psychometric study on patient acceptance of telehealth, participants rated the item, "The COVID-19 pandemic has made me more open to using telehealth" on a 5-point Likert scale (1 = strongly disagree; 5 = strongly agree). Means of the different groups were analyzed using independent t-test and one-way ANOVA with Bonferroni post-hoc multiple comparisons. RESULTS: Of the total participants, 73% (n = 366) either agreed or strongly agreed that the COVID-19 pandemic had made them more open to using telehealth. Significant differences existed by age (p = 0.016), race/ethnicity (p = 0.015), and sex (p < 0.001), however, groups did not differ by age during post-hoc analysis. A significant difference in the mean responses was observed between black participants (M = 4.29) and white participants (M = 3.91; p = 0.011). In addition, female participants (M = 4.11) rated the item higher than male participants (M = 3.65). CONCLUSION: As access to telehealth increased due to the COVID-19 pandemic, patients' perceptions to telehealth seem to have shifted in the positive direction as well. Findings may be used to support expansion of telehealth and advocacy for patients in a variety of settings. CLINICAL RELEVANCE: Study findings indicate that participants of telehealth are more open to using telehealth due to the COVID-19 pandemic. Implementing telehealth should be a priority to increase access to care for those who have limited access to specialty care, and policymakers should advocate to decrease barriers to telehealth within their institutions.

Pharmaceutical services department strategies and patient perception to maintain healthcare services during COVID-19 crisis.

Background: In March 2020, the World Health Organization (WHO) declared Severe Acute Respiratory Syndrome Coronavirus 2 (SARS2-CoV-2) as global pandemic. This health crisis has overwhelmed the healthcare system, leading to unprecedented morbidity and mortality rates. During this pandemic, pharmacies tried to maintain their services either through remote services or face-to-face dispensing and consultation. Objectives: This study aimed to share the strategies and plans adopted by the pharmaceutical services department to maintain the healthcare services during the SARS2-CoV-2 crisis and evaluate the patient's perspective. Methods: A cross-sectional analytical survey was conducted among patients/patient relatives who attended King Hamad University Hospital (KHUH) outpatient pharmacies in the Kingdom of Bahrain between February 2021 and May 2021. Patients have two options: either to submit the survey online through barcode scanning or to fill it as a physical paper and submit it to the pharmacy staff (Online-based and paper-based). A total of 641 responses were received. Hospital applied safety logistics to ensure staff and patient safety. Results: Post-hoc analysis revealed that patients aged between 20 and 39 years had less agreement than patients ≤ 19 years old in terms of preferring to continue the same services after the pandemic (p = 0.009). More level of understanding of pharmacy services was seen among patients with higher educational levels compared to elementary and secondary levels in cases of services related to adverse events (p = 0.038) and wrong/missed medication rectification (p = 0.018). Unemployed patients were more in agreement than employed ones regarding continuing the same procedure after the pandemic, services related to wrong/missed medication rectification, and safety while staying in the pharmacy waiting area. Conclusion: Most patients were satisfied with the face-to-face counseling, pharmacy-adapted strategies, and services during the SARS2-CoV-2 pandemic. Face-to-face service during the pandemic was equally comfortable across all age groups and gender.

Patient Perceptions of Dermatologic Photography: Scoping Review

Background: Medical photography is used extensively in dermatology to record disease progression, measure treatment response, and help teach patients about skin disease;such photos are also commonly utilized in teledermatology, medical education, research, and medical reference websites. Understanding patient perceptions of medical photographs obtained during dermatologic care in the clinic or hospital setting is critical to enable the delivery of high-quality, patient-centered medical care. Objective: The aims of this study were to elucidate patient perceptions of skin photos in dermatology and to explore possible next steps in improving the patient experience with medical photography in the hospital or clinic setting. Methods: A scoping review of the literature was performed using the PubMed database, with clinic- or hospital-based full-text publications in English spanning the last 10 years considered for inclusion. Results: The majority of included studies (10/11, 91%) found positive patient attitudes toward medical photographs. The majority of patients (1197/1511, 79.2%) felt that medical photographs could improve medical care in the clinic setting. Written consent detailing all photo uses, including secondary uses (such as research or teaching), was preferred, apart from in 1 study. Patients preferred or found it acceptable for the photographer of their medical photos to be a physician (1301/1444, 90.1%). Clinic-owned cameras with departmental record storage were the preferred modality. Latinx and African American patients expressed less trust in the utility of medical photographs to improve care, compared with Asian and White patients. The minimal number of available publications on this topic and the inclusion of articles older than 5 years are limitations, since patient perceptions of medical photography may have rapidly changed during this time span, particularly in light of the COVID-19 pandemic and the subsequent increase in teledermatology visits. Conclusions: Patients reported positive perceptions of dermatologic photography for improving their medical care. Ethnic disparities in patient perceptions require further exploration to better elucidate nuances and develop interventions to improve the experience of marginalized patients. Building patient trust in nonphysician photographers may enhance clinic efficiency. Although clinic-owned cameras are well-accepted by patients, improved patient education surrounding the safety of electronic medical record phone applications is needed.

The Impacts of COVID-19 on a Statewide Population With Mental Illness.

OBJECTIVE: This survey examined the experiences of individuals receiving treatment in a large public mental health system during the early months of the COVID-19 pandemic. METHODS: The survey, conducted between May and June 2020, assessed four domains: impacts on mental health, experiences with telehealth, access to care and resources, and sources and adequacy of support. Descriptive analyses were conducted. RESULTS: Of 4,046 respondents, 70% reported increases in their anxiety and stress because of the pandemic. A majority (55%) reported experiencing challenges related to the social determinants of health and functional needs. Most respondents reported that their care went undisrupted, with 92% using telehealth and 90% reporting feeling adequately supported. CONCLUSIONS: The pandemic substantially affected individuals with mental illness, particularly with regard to mental health related to the social determinants of health and functional needs. However, respondents felt that their mental health care was maintained and that they were adequately supported.

COVID-19 Concerns Among Persons With Mental Illness.

OBJECTIVE: The coronavirus disease (COVID-19) pandemic has been recognized as causing a wide variety of behavioral health problems. Society must mitigate this impact by recognizing that COVID-19 can trigger people's fears of exacerbating an existing mental illness. A survey about COVID-19 for people with mental illness was developed. METHODS: Two hundred fourteen people responded to the survey, of whom 193 self-identified as living with a mental illness. RESULTS: Almost all participants living with a mental illness (98%) said they had at least one major concern regarding the COVID-19 pandemic, and 62% said they had at least three major concerns. CONCLUSIONS: People living with a mental illness are very concerned about disruption of services, running out of medication, and social isolation during this pandemic. Providers and mental health services could address these fears by connecting with people living with mental illness through text messaging and social media.

Patients Perceptions of Telemedicine Visits Before and After the Coronavirus Disease 2019 Pandemic.

Purpose: This study sought to determine whether the necessitated use of telemedicine due to coronavirus disease 2019, and limited choice of both the provider and patient, impacts the perceptions of telemedicine by patients who experienced telemedicine prepandemic and those who first experienced telemedicine during the pandemic. Methodology: Participants for this survey were a convenience sample. An invitation to participate was shared through social media and e-mail listservs. To participate, individuals had to be at least 18 years of age and gave consent to their data being used. The online survey took ∼10-15 min to complete, the survey was available from March 31 to April 20, 2020. Results: Two hundred sixty-four (n = 264, 60.8%) individuals had used telemedicine on or before December 2019 and 170 (39.2%) individuals used telemedicine for the first time January 2020 or later. There were no significant differences in demographics between groups, except that new users were more likely to have a primary care physician [F(407) = 13.51, p < 0.001]. Satisfaction of telemedicine was measured using a 10-item scale, demonstrating that all participants were overall satisfied with their telemedicine experience(s), (mean = 1.67, standard deviation = 0.61). Broadly, the differences in perceptions between the groups included the reasons for using telemedicine, perceptions of quality of in-person care, continuity of care, and a technical issue. Conclusions: Overall, patients are satisfied using telemedicine, however, for new users, both providers and patients, some acclimation needs to occur.

Patient Perceptions on Barriers and Facilitators to Accessing Low-acuity Surgery During COVID-19 Pandemic.

BACKGROUND: The onset of the COVID-19 pandemic led to the postponement of low-acuity surgical procedures in an effort to conserve resources and ensure patient safety. This study aimed to characterize patient-reported concerns about undergoing surgical procedures during the pandemic. METHODS: We administered a cross-sectional survey to patients who had their general and plastic surgical procedures postponed at the onset of the pandemic, asking about barriers to accessing surgical care. Questions addressed dependent care, transportation, employment and insurance status, as well as perceptions of and concerns about COVID-19. Mixed methods and inductive thematic analyses were conducted. RESULTS: One hundred thirty-five patients were interviewed. We identified the following patient concerns: contracting COVID-19 in the hospital (46%), being alone during hospitalization (40%), facing financial stressors (29%), organizing transportation (28%), experiencing changes to health insurance coverage (25%), and arranging care for dependents (18%). Nonwhite participants were 5 and 2.5 times more likely to have concerns about childcare and transportation, respectively. Perceptions of decreased hospital safety and the consequences of possible COVID-19 infection led to delay in rescheduling. Education about safety measures and communication about scheduling partially mitigated concerns about COVID-19. However, uncertainty about timeline for rescheduling and resolution of the pandemic contributed to ongoing concerns. CONCLUSIONS: Providing effective surgical care during this unprecedented time requires both awareness of societal shifts impacting surgical patients and system-level change to address new barriers to care. Eliciting patients' perspectives, adapting processes to address potential barriers, and effectively educating patients about institutional measures to minimize in-hospital transmission of COVID-19 should be integrated into surgical care.

Understanding attitudes, concerns, and health behaviors of patients with inflammatory bowel disease during the coronavirus disease 2019 pandemic.

BACKGROUND AND AIM: The coronavirus disease 2019 (COVID-19) pandemic has led to a rapid shift in care delivery models for patients with inflammatory bowel disease (IBD); however, little is known about patient perceptions during this period. We aimed to prospectively evaluate the attitudes, concerns, and health behavior of IBD patients during COVID-19. METHODS: An online survey was sent to patients from a tertiary IBD Service. The survey included demographic information and questions about the impact of COVID-19, levels of concern caused by COVID-19, perceived risk of IBD medications, medication cessation, and care delivery preferences. RESULTS: Of 97 respondents (39%), 95 (98%) reported concern about the impact of COVID-19 on their health, and 43% felt their risk of contracting COVID-19 was above average; 62% reported concern about medication-induced COVID-19 risk, and 11% stopped medications because of COVID-19. Patients considered all medications to increase the risk of COVID-19 susceptibility and severity; 45% preferred telehealth while 16% preferred face-to-face clinic reviews. Preference for IBD monitoring tools in decreasing order was blood testing, stool collection, gastrointestinal ultrasound, magnetic resonance enterography, and then colonoscopy. CONCLUSIONS: Patients with IBD are demonstrated to experience concern related to their diagnosis and medications. The insights provided by the survey are informative for a possible "second-wave" of COVID-19 and routine care, including acceptance of telemedicine, preference for non-invasive investigations, and a need for dissemination of information and education.