Patient-Centered Beliefs Among Patients and Providers in Kazakhstan.

BACKGROUND: Health services in Kazakhstan have undergone radical reforms since its independence in 1991, but levels of dissatisfaction among patients remain high. We investigated whether healthcare providers and patients at one hospital in Astana, Kazakhstan, believe the doctor-patient interaction should be doctor-centered vs patient-centered. METHODS: We conducted a cross-sectional study of the responses to various surveys of 200 patients (response rate, 74%) and 201 healthcare providers (response rate, 86%) in a general hospital in Astana, Kazakhstan. The participants completed a questionnaire containing the Patient-Practitioner Orientation Scale (PPOS) and scales assessing life and job satisfaction, job effort-job reward balance, and patient evaluation of communication. Analyses were restricted to those with valid data on the variables age, sex, and PPOS (147 providers and 150 patients). RESULTS: An overwhelming majority of doctors (80%), nurses (87%), and patients (93%) were doctor-oriented. Among patients, higher patient-oriented scores were statistically significantly associated with higher satisfaction with communication with healthcare providers (P=0.038) and with life satisfaction (P=0.009). CONCLUSION: Only a small percentage of doctors, nurses, and patients reported that their interaction should be patient-centered. This congruence between providers and patients does not explain dissatisfaction, but the finding that patient-centered patients were more satisfied suggests an area for improvement.

Acceptability and tolerability of liquid versus gel and standard versus virucidal alcohol-based hand rub formulations among dental students.

BACKGROUND: Hand hygiene is effective to prevent the transmission of microorganisms in health care settings, but compliance remains low, even when easy access to hand cleaning agents is provided. OBJECTIVE: Formulation of alcohol-based hand rub (ABHRs) may influence staff compliance to hand hygiene. The aim of this prospective longitudinal study (1 week) was to investigate possible differences of 4 different gel or liquid ABHR formulations, with or without virucidal claim among dental students. METHODS: Participants were randomly assigned to dental treatment cubicles, equipped with either a gel or a liquid based ABHRs, with our without a virucidal claim. Participants assessed the subjective acceptability and the tolerability of test formulations on their hands over a period of 1 week using the 14 item, 7-point Lickert scale World Health Organization questionnaire. RESULTS: All tested ABHRs passed the subjective acceptability criteria of ≥50% above 4 for the items "color and fragrance" and for all other items of >75% above 4 and may be regarded as "good." Significant differences were observed between the 2 gels but not between the 2 liquid ABHRs. For subjective skin tolerability, no significant difference was observed between the liquid formulations after 1 consecutive week of application. However, the difference between the 2 gels was highly significant. CONCLUSION: Virucidal ABHR formulations may be better accepted and tolerated over prolonged periods by dental students than anticipated. The user acceptability of ABHRs depend more on the specific product's formula than its general category.

Evaluation of communication between physicians and patients in Astana City Hospital №1.

INTRODUCTION: Communication between patients and health care providers is important for the effective functioning of health care systems. Miscommunication often stems from discrepancies in expectations of both healthcare professionals and patients due to cultural and historical influences. We investigated the degree to which health care providers (doctors and nurses) and patients in Kazakhstan believe that interaction between doctors and patients should be doctor- or patient-oriented. MATERIAL AND METHODS: We conducted a cross-sectional study of 163 patients and 176 health care providers (71 doctors and 105 nurses) in a general hospital in Astana, Kazakhstan. The subjects completed a structured questionnaire containing the Patient-Practitioner Orientation Scale (PPOS), and scales assessing life and job satisfaction, effort-reward balance of healthcare professionals, and the patients' perceptions of communication practices. RESULTS: An overwhelming majority of doctors (81.7%), nurses (88.1%), and patients (92.3%) were doctor-oriented. Among health care providers, PPOS was not associated with age, sex, life and job satisfaction, or effort-reward imbalance. Among patients, PPOS was not associated with age, sex, or specialty of health care provider. However, higher PPOS among patients (indicating preference for patient-oriented interaction) was associated with higher satisfaction with communication with health care providers and, less strongly, with their life satisfaction. CONCLUSION: The main finding of this study is the very small proportion of doctors, nurses and patients who believe that interaction should be patient-oriented. These results highlight the necessity of improvement of communication among health care providers towards patient-oriented approach in order to decrease miscommunication with patients. The fact that most patients prefer doctor-oriented interaction may reflect historical stereotypes; educational/information interventions among patients may also be needed.

ESR dosimetry study on population of settlements nearby Ust-Kamenogorsk city, Kazakhstan.

The method of electron spin resonance (ESR) dosimetry has been applied to human tooth enamel, to obtain individual absorbed doses of residents of settlements in vicinity of Ust-Kamenogorsk city, Kazakhstan (located about 400 km to the east from the epicenter of explosion at the Semipalatinsk Nuclear Test Site, SNTS). This region developed as a major mining and metallurgical center during the Soviet period (uranium production). Most of the investigated settlements (Ust-Kamenogorsk city, Glubokoe, Tavriya, Gagarino) are located near the central axis of the radioactive fallout trace that originated from the surface nuclear test on 24 August 1956, while the Kokpekty settlement (located 400 km to the Southeast from SNTS) was chosen as a control because it was not subjected to any radioactive contamination. In total, 44 samples were measured. It was found that the excess doses obtained after subtraction of natural background radiation ranged up to about 114 mGy for residents of Ust-Kamenogorsk city, whose tooth enamel was formed before 1956. For residents of Gagarino, excess doses did not exceed 47 mGy for all ages. For residents of Tavriya, the maximum excess dose was 54 mGy, while for residents of Glubokoe it was about 58 mGy. For the population of the Shemonaikha settlements located at a distance of about 70 km from the central axis of the radioactive fallout trace, highest excess doses were 110 mGy. These high doses may be due to the influence of uranium enterprises located in that region, but probably not due to dental X-ray irradiation. For a final conclusion on the radiological situation in this region, the number of samples was too small and, therefore, more work is required to obtain representative results.