ABSTRACT
BACKGROUND AND AIM OF THE WORK: Empowerment is very important to keep high staff motivation and attention on patient safety. The aim of this study was to produce a "Charter of Rights-Duties for Patients' Empowerment", by developing empowerment both of patients and professionals of the Hematology and Bone marrow transplant center Unit of Parma University Hospital. METHODS: The professionals were actively involved in meetings to complete the Italian version of the SESM Empowerment Questionnaire, draft the Charter and produce some communication tools to be implemented in the Unit. RESULTS: All professionals had participated to the research. The level of empowerment in the unit, both for doctors and non-medical staff, is very high. This result, the Charter and the others communication tools are now known and shared by all. CONCLUSIONS: Stimulating empowerment seems to be a winning choice. It is important to involve professionals right away in the process because a high level of staff empowerment can generate a good field for high degree of patients' empowerment, that can increase patient safety and reduce the risk of dangerous health choices. This approach aims to increase patient safety through the collaboration of patients, volunteer associations and professionals. Communication programs must include the development of empowerment: it motivates citizens to engage and the literacy enables them to make informed and reasoned choices. General Management is now evaluating how to realize the program in each ward, discussing the importance of carefully conceptualizing this approach for the design of health interventions.
Subject(s)
Bone Marrow Transplantation/methods , Hematology/organization & administration , Patient Participation/methods , Patient Rights , Surveys and Questionnaires , Communication , Female , Hospitals, University , Humans , Interdisciplinary Communication , Italy , Male , Physician's Role , Physician-Patient Relations , Professional Competence , Program EvaluationABSTRACT
OBJECTIVE: Assessment of the knowledge and application as well as perceived utility by doctors of clinical governance tools in order to explore their impact on clinical units' performance measured through mortality rates and efficiency indicators. METHODS: This research is a cross-sectional study with a deterministic record-linkage procedure. The sample includes n = 1250 doctors (n = 249 chiefs of clinical units; n = 1001 physicians) working in six public hospitals located in the Emilia-Romagna Region in Italy. Survey instruments include a checklist and a research-made questionnaire which were used for data collection about doctors' knowledge and application as well as perceived utility of clinical governance tools. The analysis was based on clinical units' performance indicators which include patients' mortality, extra-region active mobility rate, average hospital stay, bed occupancy, rotation and turnover rates, and the comparative performance index as efficiency indicators. RESULTS: The clinical governance tools are known and applied differently in all the considered clinical units. Significant differences emerged between roles and organizational levels at which the medical leadership is carried out. The levels of knowledge and application of clinical governance practices are correlated with the clinical units' efficiency indicators (bed occupancy rate, bed turnover interval, and extra-region mobility). These multiple linear regression analyses highlighted that the clinical governance knowledge and application is correlated with clinical units' mortality rates (odds ratio, -8.677; 95% confidence interval, -16.654, -0.700). CONCLUSION: The knowledge and application, as well as perceived utility by medical professionals of clinical governance tools, are associated with the mortality rates of their units and with some efficiency indicators. However, the medical frontline staff seems to not consider homogeneously useful the clinical governance tools application on its own clinical practice.
ABSTRACT
INTRODUCTION: The article presents a new instrument for the evaluation the Quality of Life, concerning patients on haemodialysis; IPPE tool has been created to be brief, multidimensional and also capable to considering, into the evaluation of patient Quality of Life, both familiar that hospital relational aspects. The purpose of this report is to explore the factor structure and the internal validity of the IPPE questionnaire. METHODS: The research involved three ASL on the territory of Salerno (57%), Verona (20.3%), Cuneo (22.7%). IPPE has been administered to 256 patients on Haemodialysis. RESULTS: As well as describing the IPPE's psychometric properties, the report offers a description of the normal distribution of the subjects in regard with risk and protection factors' (distinguishing the population by "age" and "gender"). The Exploratory Factor Analysis (EFA) of the definitive questionnaire (20 items) singles out six subscales ("perceived thirst", "body misperception", "dissatisfaction of therapeutic aspects", "perceived family support", "social daily life", "illness acceptance") that have an internal validity index alpha between .72 and .91. The Schmid-Leiman's solution confirms the existence of two macro-factors underlying as "risk factors" and "protection factors", reciprocally linked by a negative correlation (r = -.216, p < .001). SEM Analysis verifies the model "goodness of fit" and relations between risk and protection factors. CONCLUSION: The data show that when the factors of protection increase, the perception of the risk factors decreases, and vice versa. The IPPE questionnaire considers the interactions between risk and protection factors' (bio-psycho-social model), operationalizing the QoL in a new way. Based on the results observed on the literature and on this work it is possible to hypothesize that the bio-psycho-social model of QoL could be considered as a process of psycho-social adaptation.
