Cybermedlife - Therapeutic Actions Freedom To Choose

Expectant management versus surgical evacuation in first trimester miscarriage: health-related quality of life in randomized and non-randomized patients.

Abstract Title: Expectant management versus surgical evacuation in first trimester miscarriage: health-related quality of life in randomized and non-randomized patients. Abstract Source: Hum Reprod. 2002 Jun;17(6):1638-42. PMID: 12042291 Abstract Author(s): Margreet Wieringa-De Waard, Esther E Hartman, Willem M Ankum, Johannes B Reitsma, Patrick J E Bindels, Gouke J Bonsel Article Affiliation: Academic Medical Center-University of Amsterdam, Department of General Practice/Family Medicine, Amsterdam, The Netherlands. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: BACKGROUND: Expectant management, although less effective, is an alternative treatment option for surgical evacuation in women with a miscarriage. We assessed health-related quality of life (HRQL) differences over time between expectant and surgical management in women with a miscarriage. METHODS: Women with a miscarriage were randomized to either expectant (n = 64) or surgical (n = 58) management, and 305 eligible women who refused randomization because of a preference for either treatment option were managed according to their choice following the same clinical protocol (126 expectant, 179 surgical). The main outcome measures were score differences of HRQL during 12 weeks. Repeated measures analysis was applied. RESULTS: Out of a total of 427 women, 198 were excluded in the questionnaire follow-up, leaving 229 women who participated. Mental health of women allocated to expectant management improved more and earlier (treatment effect) than of women allocated to surgical evacuation. Mental health scores were significantly better in women who chose, rather than women who were randomized, to curettage. The groups managed according to their own preference showed no differences in mental health scores. CONCLUSION: Women with a miscarriage who chose their own treatment had the best HRQL over time, supporting the role of free choice from a clinical point of view. Women without a treatment preference should be encouraged to start with expectant management for psychological reasons. Article Published Date : Jun 01, 2002
Therapeutic Actions Freedom To Choose

NCBI pubmed

How Much Is Enough in a Perfect World? Cultural Variation in Ideal Levels of Happiness, Pleasure, Freedom, Health, Self-Esteem, Longevity, and Intelligence.

How Much Is Enough in a Perfect World? Cultural Variation in Ideal Levels of Happiness, Pleasure, Freedom, Health, Self-Esteem, Longevity, and Intelligence. Psychol Sci. 2018 Jun 01;:956797618768058 Authors: Hornsey MJ, Bain PG, Harris EA, Lebedeva N, Kashima ES, Guan Y, González R, Chen SX, Blumen S Abstract The maximization principle-that people aspire to the highest possible level of something good if all practical constraints are removed-is a common yet untested assumption about human nature. We predict that in holistic cultures-where contradiction, change, and context are emphasized-ideal states of being for the self will be more moderate than in other cultures. In two studies ( Ns = 2,392 and 6,239), we asked this question: If participants could choose their ideal level of happiness, pleasure, freedom, health, self-esteem, longevity, and intelligence, what level would they choose? Consistent with predictions, results showed that maximization was less pronounced in holistic cultures; members of holistic cultures aspired to less happiness, pleasure, freedom, health, self-esteem, longevity, and IQ than did members of other cultures. In contrast, no differences emerged on ideals for society. The studies show that the maximization principle is not a universal aspect of human nature and that there are predictable cultural differences in people's notions of perfection. PMID: 29889603 [PubMed - as supplied by publisher]

Hospital responsiveness and its effect on overall patient satisfaction.

Related Articles Hospital responsiveness and its effect on overall patient satisfaction. Int J Health Care Qual Assur. 2017 Oct 09;30(8):728-736 Authors: Ahmadi Kashkoli S, Zarei E, Daneshkohan A, Khodakarim S Abstract Purpose Hospital responsiveness to the patient expectations of non-medical aspect of care can lead to patient satisfaction. The purpose of this paper is to investigate the relationship between the eight dimensions of responsiveness and overall patient satisfaction in public and private hospitals in Tehran, Iran. Design/methodology/approach This cross-sectional study was conducted in 2015. In all, 500 patients were selected by the convenient sampling method from two public and three private hospitals. All data were collected using a valid and reliable questionnaire consisted of 32 items to assess the responsiveness of hospitals across eight dimensions and four items to assess the level of overall patient satisfaction. Data analysis was performed using descriptive statistics and multivariate regression was performed by SPSS 18. Findings The mean score of hospital responsiveness and patient satisfaction was 3.48±0.69 and 3.54±0.97 out of 5, respectively. Based on the regression analysis, around 65 percent of the variance in overall satisfaction can be explained by dimensions of responsiveness. Seven independent variables had a positive impact on patient satisfaction; the quality of basic amenities and respect for human dignity were the most powerful factors influencing overall patient satisfaction. Originality/value Hospital responsiveness had a strong effect on overall patient satisfaction. Health care facilities should consider including efforts to responsiveness improvement in their strategic plans. It is recommended that patients should be involved in their treatment processes and have the right to choose their physician. PMID: 28958198 [PubMed - indexed for MEDLINE]