Assessment of the Impact of Cardiac Implantable Electronic Devices on Patients' Quality of Life.

INTRODUCTION: Assessing the quality of life serves as a crucial metric during various therapeutic or surgical procedures. The rise in cardiac electronic device implantations in recent years underscores the significance of evaluating the quality of life among such patients. MATERIALS AND METHODS: We conducted a study focusing on the quality of life of 438 patients with cardiac implantable electronic devices (cardiac pacemakers, cardioverter-defibrillators, cardiac resynchronization therapy devices). These patients were diagnosed with sick sinus syndrome, high-degree atrioventricular (AV) block, or severe heart failure (New York Heart Association (NYHA) classes III- IV (NYHA III-IV)), with left ventricular ejection fraction (LVEF) ≤ 35%, with/without complete left bundle branch block (QRS ≥ 130 µs), or with a history of ventricular tachycardia/ventricular fibrillation. The study utilized the EuroQol 5-Dimension 5-level (EQ-5D-5L) questionnaire and the EQ visual analog scale, which patients completed both prior to cardiac device implantation and during six post-implantation follow-up visits. The analysis of the research findings was conducted using the IBM SPSS Statistics software program (Armonk, NY). RESULTS: Cardiac pacemaker implantation in patients with sick sinus syndrome and high-grade AV block demonstrated significant and highly reliable positive effects on quality of life concerning mobility, self-care, and usual activity. Similarly, cardiac resynchronization device implantation in individuals with severe heart failure with reduced LVEF and wide QRS showed significant positive effects in these areas. However, cardioverter-defibrillator implantation did not yield positive effects on these modules. Regarding pain/discomfort, neither pacemaker nor cardiac resynchronization device implantation resulted in improved quality of life, while there was a somewhat positive effect observed in the cardioverter-defibrillator group. In terms of anxiety/depression, pacemaker implantation in patients with sick sinus syndrome and high-degree AV block had a significant and highly reliable positive impact on quality of life. Additionally, relatively positive impacts were noted at various periods following cardioverter-defibrillator and cardiac resynchronization device implantations. CONCLUSIONS: Cardiac implantable electronic devices play a crucial role not only in saving lives but also in positively impacting the quality of life of patients when appropriately selected.

Job Satisfaction and Associated Factors among Physicians.

Job satisfaction of the employees represents the significant factor for the effective functioning of the medical facilities. The aim of this study is to examine job satisfaction of physicians and to explore its associated factors. Quantitative study method is applied in this study. Two hundred and nine physicians from the large medical facilities in Tbilisi (Georgia) are participated in the survey. The most important components of satisfaction were: relation with managers (78.5%), relations with colleagues (77%), communication with patients (73.5%), possibility of continuous medical education (74.2%), and service quality (66%). Younger physicians were more likely to be dissatisfied than older physicians. Women were less satisfied with workload rather than men, which can be related with burden of solving the family issues for them, besides the career. Majority of the inquired respondents are not satisfied with ongoing incomes and remuneration methods. Family physicians seemed to be especially dissatisfied with remuneration. Most of the interviewed physicians (76%) assessed work/life balance in range of 1-3 points. Particular dissatisfaction was stated by the doctor-specialists, referring that they do not work with normal work schedule and their work/life balance is infringed. Satisfaction level depends on multiple factors (communication with patients, intellectual stimulation, possibility of CME, relationship with colleagues and managers). The main recommendation is a need to address job satisfaction among physicians in order to improve the quality of health care. Attention to working conditions, career and professional development, and salary/incentives is critical for sustaining the continuity of quality health care in Georgia.

Introducing Critical Incident Reporting System as an Indicator of Quality Healthcare in Georgia.

Critical incident reporting systems (CIRS) have become the most common patient safety tools in healthcare. The purpose of this study was to present the development of CIRS in Georgia. A quantitative approach using a cross-sectional survey was adopted. Critical incidents were mainly derived from surgical disciplines. The highest number of cases was registered by nurses. The most common critical incidents were due to lack of personal attention. CIRS can be seen as an effective clinical risk management tool that can be used to identify potential sources of critical incidents and help ensure patient safety at a healthcare organization.

Emotional intelligence: predictor of employees' wellbeing, quality of patient care, and psychological empowerment.

BACKGROUND: The study explored the role of emotional intelligence (EI) on employees' perceived wellbeing and empowerment, as well as their performance, by measuring their quality of care. METHODS: The baseline data for the present project was collected from 78 staff of a Victorian aged care organization in Australia. Self-administered surveys were used to assess participants' emotional intelligence, general well-being, psychological empowerment, quality of care, and demographic characteristics. The model fit was assessed using structural equation modelling by AMOS (v 24) software. RESULTS: The evaluated model confirmed that emotional intelligence predicts the employees' psychological empowerment, wellbeing, and quality of care in a statistically significant way. CONCLUSIONS: The current research indicates that employees with higher EI will more likely deliver a better quality of patient care. Present research extends the current knowledge of the psychological empowerment and wellbeing of employees with a particular focus on emotional intelligence as an antecedent in an under-investigated setting like aged care setting in Australia.

Patients' informed consent to medical services in Georgia.

Informed consent requires that a patient understands the purpose, benefits and potential risks of a medical or surgical intervention and then agrees to it. It is important not only ethically and legally but for the effectiveness of care. Studies show that, in some cases, patients have no real information on the medical service to be provided so their informed consent is just a formality. This study aims to determine problems arising from a patient's informed consent. As part of a cross-sectional study, surgical patients were interviewed using a semi-structured questionnaire. 34% of patients (n = 68) did not know what the surgical intervention was; 57% (n = 114) received sufficient information on their diagnosis and methods of treatment; however, 26% (n = 52) agreed with it only partially; 62% (n = 124) of patients knew they needed surgery; 66% (n = 132) were adequately informed on risks and benefits of alternative ways of treatment; 58% (n = 116) were informed of potential risks during surgery. The study demonstrated patients need to be better informed about different treatment options, consequences of treatment refusal. Doctors have to provide information to patients in a manner understandable to them. Medical personnel need to be educated as to what constitutes informed consent and the importance of adhering to such requirements.

The Attitude of the Orthodox Parishioners Toward Euthanasia: Evidence From Georgia.

BACKGROUND: The right of euthanasia is the subject of worldwide discussion today, as it is one of the most controversial medical, religious, political, or ethical issues. This study aims to survey the attitudes of Orthodox parishioners toward the euthanasia. Methods: Within the quantitative study, the survey was conducted through a semistructured questionnaire. Respondents were the parishioners of the Orthodox Church. Within the qualitative study, the survey of the experts of the Orthodox Church, in particular the clergy, was conducted. During the survey of the experts, we used the snowball method. RESULTS: The majority of respondents (81%) were aware of euthanasia. The dominant opinion is that euthanasia is " the consent to life termination during the illness, when there is no way out and recovery is impossible" or " a terminally ill person voluntarily decides to end life painlessly." Those who disagree with euthanasia rely on the religious factors (why the church prohibits it). Those who agree with euthanasia action argue the legitimate human rights and free will of person. Most of the respondents (86%) have not heard about euthanasia practices in Georgia. Most of the respondents (71%) knew that the Orthodox Church prohibits euthanasia; 39% of the respondents believe that euthanasia is justified in medical terms. CONCLUSION: It is advisable to raise public awareness on euthanasia in religious, medical, cultural, social, and legal aspects.

Obstacles in the Development of Nonprofit Hospitals in Georgia.

The most common form of ownership of medical establishments worldwide is a nonprofit organization. In contrast, the number of nonprofit medical institutions in Georgia is very scarce, while private profit organizations hold about 90% of the medical market. The goal of the research is to study the factors that affect the development of nonprofit hospitals in Georgia. Since there are very few nonprofit medial institutions in Georgia, we hypothesize that there is not enough motivation for functioning of such institutions. For the purposes of this research, six in-depth interviews were conducted with managers and experts of nonprofit organizations. As the research demonstrated, there is no sufficient motivation for functioning of the nonprofit form of medical organizations. Although the Tax Code provides tax benefits, they exist only in a token way and do not support the development of nonprofit medical organizations. It is necessary to improve the tax benefits provided for nonprofit hospitals in the Tax Code and share the world experience in order to increase number of nonprofit organizations in Georgia. It is recommended for Government to give more support to nonprofit organizations, in order to increase their functioning efficiency and bring incentive for development of new nonprofit medical institutions.

Knowledge of Sexually Transmitted Infections Among Homeless People in a Municipal Shelter.

Health problems are substantially increased in homeless populations who have higher prevalence's of infectious diseases than do general population. They have relatively earlier onset of sexual activity, and due to lack of information, many facilities for the practice of unprotected sex and low level of condom usage increase the risk of sexually transmitted infections (STIs). This study aims to identify the knowledge and prevention of STIs among homeless people. An analytic cross-sectional study was conducted in a Tbilisi municipal shelter. Within the framework of the quantitative research, the beneficiaries were interviewed with a self-administered questionnaire. Most of the respondents (98%) have heard about STIs, but their health literacy is low. Although respondents knew the risk factors for STIs, they had a high degree of risk-taking sexual behavior evidenced by the very low percentage using condoms (15.2%) and a large proportion having multiple partners (54.3%). It is necessary to raise awareness about STIs and promote sexual education of respondents at the municipal shelter.