Biomedical subjects

Stefano Tabolli

Publications and source records attributed to Stefano Tabolli.

8 recordsLinked to original sources

PubMed2006

Insufficient knowledge among psoriasis patients can represent a barrier to participation in decision-making.

Patient participation in treatment decisions can have positive effects on patient satisfaction, compliance and health outcomes. The objectives of this study were to examine attitudes of psoriasis patients regarding participation in treatment decisions and to evaluate the effect of a decision-aid for discussing treatment options. A "quasi experiment" was conducted in a large dermatological hospital in Italy: a questionnaire evaluating the decision-making process and treatment knowledge was self-completed by 231 consecutive psoriasis patients after routine clinical practice and by a second sample of 171 patients exposed to a decision-board. In routine clinical practice 67.9% of patients wanted to be involved in decision-making, 28.4% wanted to leave decisions entirely to the doctor and 3.7% preferred making decisions alone. 17.9% and 25.3% of the control and decision-board group had good knowledge. At multivariate analysis good knowledge increased the likelihood of preferring an active role (risk ratio (RR) = 2.21; 95% confidence interval (CI) 1.3-3.9; p = 0.006). The decision-board only marginally improved patient knowledge and doctor-patient communication. In conclusion, large proportions of psoriasis patients want to participate in decision-making, but insufficient patient knowledge can represent a barrier.

Adult↗

PubMed2004

[Job satisfaction, depressive and anxiety disorders among hospital personnel at IDI Sanità, Rome].

Job satisfaction and psychological well-being of healthcare personnel and staff represent relevant issues for continuous quality improvement in health care organisations. The aim of this study was to evaluate job satisfaction, as well as the frequency of psychiatric minor disorders, among the personnel working at IDI Sanità, Rome (IDI-IRCCS and S. Carlo Hospital). An anonymous questionnaire was distributed, with the following sections:1) a validated set of items regarding various aspects of job satisfaction; 2) a 0 to 10 analogue scale to express a total satisfaction score; 3) the GHQ-12 to evaluate psychiatric symptoms. Relationships with hierarchical authorities, development possibilities, and role recognition were identified as the main determinants of being satisfied. It was observed a 6.2 mean satisfaction score. About 1/3 of respondents showed a high likelihood to develop symptoms of depression and anxiety. A high level of job satisfaction appeared as a protective factor for that kind of symptoms. Analysing job satisfaction levels and psychological symptoms among hospital personnel allows to identify the most important problems to solve. These will be the main targets of intervention.

Adolescent↗

PubMedDate not supplied

Satisfaction with health care among dermatological inpatients.

Measuring patient satisfaction is regarded as one of the principal methods for obtaining patients' evaluation of services they receive. During the last decades more interest has been devoted to inpatients' preferences and needs. Surveys on patient satisfaction may provide information to hospitals about areas where improvement is needed. In this survey, 648 questionnaires were completed by dermatological inpatients and were analyzed for overall satisfaction and seven satisfaction determinants. Background factors and clinical parameters were considered. Emotional support was recognized as a critical area. "Coordination of care" and "information and education" were identified as the most relevant determinants for overall patient satisfaction. The Hospital Management, taking into account the results, planned training in order to improve personnel's communication skills. This study confirms that patient satisfaction analysis is a useful instrument also among dermatological inpatients, and satisfaction is a valid measure of quality of health care.

Adolescent↗

PubMedDate not supplied

[Health director and clinical governance].

Measures are needed to enhance health care quality. These measures should be implemented within the field of Clinical Governance. The authors have pointed out the skills required to the person in charge of Clinical Governance as well as the new role that the Health Director should play in case he intends to be in charge of Clinical Governance himself.

English Abstract↗

PubMedDate not supplied

[Organigraphs].

Explore the source record for details and available documents.

Commerce↗

PubMedDate not supplied

[Risk of inappropriateness and efficiency assessment of hospitals].

We evaluated with the Data Envelopment Analysis (DEA) 13 decision making units (DMU) at IDI -IRCCS for the years 2000 and 2001. Input variables were: cost for medical personnel, cost for non medical personnel and number of beds; output variables was the number of discharged patients weighted with DRG. Later in a second model we delete the cases considered to be at "high risk" to be inappropriate for treatment as inpatients. DEA instrument is confirmed useful in the efficiency evaluation for DMU at hospital level, ranking were different between the two models. The Health Direction can utilise the analysis to understand reasons of inefficiency and for incentive policy.

Diagnosis-Related Groups↗

PubMedDate not supplied

Prevalence of psoriatic arthritis and joint complaints in a large population of Italian patients hospitalised for psoriasis.

We investigated the prevalence of psoriatic arthritis and joint complaints in a large population of Italian patients hospitalised for psoriasis. A total of 936 patients were evaluated for psoriatic arthritis according to the European Spondyloarthropathy Study Group (ESSG) criteria. They were visited by a dermatologist who evaluated specific joint signs and symptoms (i.e. arthralgia, stiffness, swelling, ankylosis, paresthesia) and assessed skin disease severity. Information on socio-demographic variables and other factors of clinical interest was also collected. Seventy-one patients (7.7% of the sample) had psoriatic arthritis (PsA). Overall, 90% of patients with PsA referred arthralgia, 70.4% stiffness, 67.7% swelling, 25.4% paresthesia, and 23.9% had ankylosis. However, among patients with plaque psoriasis who did not fulfil the criteria for PsA, 12.3% referred paresthesias, 7% arthralgia, 4.2% stiffness, 3.7% swelling, and 1.2% had ankylosis. Among 114 patients referring arthralgia, 42 (39.6%) did not meet the ESSG criteria for PsA. Therefore, patients with plaque psoriasis refer joint symptoms quite frequently making it difficult to distinguish patients with psoriatic arthritis from patients with joint complaints.

Adolescent↗

PubMedDate not supplied

Health related quality of life assessment in the routine clinical practice of a dermatology unit.

A descriptive study in a Dermatological Research Institution in Rome, Italy, was conducted to test the feasibility and acceptability of health related quality of life (HRQoL) assessment in the daily routine. Quality of life, and psychosocial distress evaluations were obtained for each patient. Patients were invited to complete the Skindex-29, GHQ-12, and SF-36. Results were returned to the clinical staff using standardised feed-back forms with: a) "categories" of QoL scores to help interpreting Skindex-29 scores; b) "warnings" pointing out problems that patients experienced "all the time"; c) categories of GHQ-12 scores for minor psychiatric problems; d) the classical SF-36 graph depicting the patient's "QoL profile" with normative references. The clinical staff were trained, and then their attitudes and behaviours were surveyed using a standardised questionnaire. For all 170 participants enrolled (63% males, 35% age > 64 years), feed-back forms were provided within three hours from data collection. For patients with repeated hospitalisations time-trends in HRQoL measurements were also provided. The acceptability, both for patients and the clinical staff, was high but the actual impact on clinical activities was limited. The routine assessment of HRQoL in dermatology is feasible and well accepted both by patients and by the clinical staff. The application of these widely used questionnaires should be implemented in a larger scale and evaluated in different settings.

Adult↗