Older adults' self-advocacy in patient safety: a cross-sectional study.

BACKGROUND: patient advocacy is a major nursing role, which is linked to supporting, encouraging and reinforcing self-advocacy in patients. Patient safety is an important nursing outcome, especially in older adults. AIMS: older adults' self-advocacy regarding patient safety behaviour and its relationship with some demographic characteristics were assessed. METHODS: a valid older adult patients' self-advocacy questionnaire, which included subscales of behaviour, self-efficacy, attitude and outcome efficacy (range of scores=0-63), was used. In this cross-sectional study, 230 patients aged over 60 years were selected using a stratified sampling method. FINDINGS: an association was found between total self-advocacy score (mean=40.16; SD=9.6) and rural living (ß=-0.168; P=0.016) using multiple linear regression analysis. Similar findings were found between questionnaire subscales and sex, rural living, occupation and age. CONCLUSION: older adults, especially women, those of advanced age and those in rural areas, may benefit from nursing interventions to improve their self-advocacy in patient safety.

Customers' satisfaction about prehospital emergency medical services in Lorestan, Iran.

INTRODUCTION: Patient's satisfaction with health care in ambulance services is an important quality indicator and a helpful tool for managers of prehospital emergency services. This study aimed to measure patient satisfaction with health provided by prehospital emergency medical services (EMS) in Lorestan, Iran. METHODS: This cross-sectional study was conducted on patients (n=450) transferred by EMS to hospitals of Lorestan University of Medical Sciences in a two-year period (2013-2014). Data collection was performed by patient questionnaire, which is a standard LKFR tool. Validity and reliability of the instrument was confirmed by scientific method. Collected data were analyzed by SPSS Version 19. Descriptive and inferential statistics such as Chi-square, paired-samples t-test, independent-samples t-test, ANOVA, Pearson's product-moment correlation coefficient, and Fisher's exact test were used. RESULTS: One hundred ninety-two (42.8%) and 257 (57.2%) patients were female and male, respectively (mean: 41 years, r: 37-83). Patient satisfaction of the dispatcher was good, and satisfaction level in regards to the technicians' performance, physical situation, and facilities inside the ambulance was moderate. The Wilcoxon test did not show any significant difference between pain severity before and after arriving EMS in the cardiac and respiratory patients (p=0.691), but severity of pain in orthopedic patients after arriving EMS was decreased (p=0.001). Cardiac and respiratory patients had low satisfaction of EMS, and the Chi-square test was significant (p=0.001). Orthopedic patients had the most satisfaction of EMS. CONCLUSION: Generally, patients' satisfaction of EMS was low. Satisfaction with pain relief in orthopedic patients was better than pain relief in cardiac and respiratory patients. It is recommended to take necessary actions to improve the level of patient satisfaction of EMS.