Location
Philadelphia Campus
Start Date
7-5-2014 1:00 PM
Description
Abstract: Long QT Syndrome (LQTS) is a genetic condition affecting 1:2,500 that predisposes individuals to cardiac arrhythmias (Ellis et al., 2009). Life threatening symptoms are often unpredictable although there are known triggers to LQTS specific cardiac events. Triggers include physical exertion, emotional upset, and sleep. Events could be triggered by medications, dehydration, and other circumstances that affect cardiac rhythm. Treatments include betablockers, pacemakers, internal cardioverter defibrillators, and automated external defibrillator as precautionary measures. As such, LQTS patients often present to their emergency room (ER) when they become symptomatic. Research suggests that LQTS patients’ experience dissatisfaction in the ER and treatment is a concern (Felgoise et al., 2012). Cardiac training in emergency medicine specialties is limited. Given that ER physician training in cardiology is general, rarer cardiac arrhythmias such as LQTS are unknown by many ER physicians. Studies of ER patient satisfaction have shown that quality of communication and interactions between ER physician and patient, understanding of care, and wait times are related to patient satisfaction in pediatric and adult populations (Margaret et al., 2002). This study aims to learn why LQTS patients are dissatisfied by assessing doctor-patient relationship variables, patient satisfaction, patients’ perception of physicians’ knowledge, and problem-solving skills. The goal is to identify how to increase patients’ ability to be better consumers of ER care, use problem-solving strategies and advocate for appropriate treatment with regard to LQTS-related needs. This study fuses multidisciplinary perspectives for enhancement of patient satisfaction. This is a prospective cross-sectional study of pediatric and adult patients with LQTS and parent perceptions of ER care. A convenience sample of LQTS patients or their parent will complete an online survey. 150 participants will be recruited via announcements on websites focused on cardiac arrhythmias. Measures include Working Alliance Inventory, Personal Information Questionnaire, a standardized ER patient satisfaction questionnaire, and the Social Problem-Solving Inventory. Pearson product moment correlations and multiple regression analyses will be conducted to determine the relationship among the variables. Subscales of the WAI, average estimated wait times, problem-solving skills, and ratings of knowledge and communication from the and ER satisfaction questionnaire will be input as predictor variables and global patient satisfaction will be the criterion variable. Results will lead to understanding ER experiences that may be advantaged by introducing CBT strategies to promote better consumerism of services by LQTS patients. Data will provide physicians with an understanding of LQTS patients’ perceptions of ER care. Findings will determine what predicts satisfaction and whether patients have realistic expectations for ER care. Problem-solving skills training have been effective for helping other medical patients navigate the healthcare system (Nezu et al., 1998), and may be appropriate for LQTS patients. Results will provide guidance for cardiologists and psychologists to best prepare LQTS patients for ER experiences.
Included in
LQTS patients’ satisfaction with emergency room care
Philadelphia Campus
Abstract: Long QT Syndrome (LQTS) is a genetic condition affecting 1:2,500 that predisposes individuals to cardiac arrhythmias (Ellis et al., 2009). Life threatening symptoms are often unpredictable although there are known triggers to LQTS specific cardiac events. Triggers include physical exertion, emotional upset, and sleep. Events could be triggered by medications, dehydration, and other circumstances that affect cardiac rhythm. Treatments include betablockers, pacemakers, internal cardioverter defibrillators, and automated external defibrillator as precautionary measures. As such, LQTS patients often present to their emergency room (ER) when they become symptomatic. Research suggests that LQTS patients’ experience dissatisfaction in the ER and treatment is a concern (Felgoise et al., 2012). Cardiac training in emergency medicine specialties is limited. Given that ER physician training in cardiology is general, rarer cardiac arrhythmias such as LQTS are unknown by many ER physicians. Studies of ER patient satisfaction have shown that quality of communication and interactions between ER physician and patient, understanding of care, and wait times are related to patient satisfaction in pediatric and adult populations (Margaret et al., 2002). This study aims to learn why LQTS patients are dissatisfied by assessing doctor-patient relationship variables, patient satisfaction, patients’ perception of physicians’ knowledge, and problem-solving skills. The goal is to identify how to increase patients’ ability to be better consumers of ER care, use problem-solving strategies and advocate for appropriate treatment with regard to LQTS-related needs. This study fuses multidisciplinary perspectives for enhancement of patient satisfaction. This is a prospective cross-sectional study of pediatric and adult patients with LQTS and parent perceptions of ER care. A convenience sample of LQTS patients or their parent will complete an online survey. 150 participants will be recruited via announcements on websites focused on cardiac arrhythmias. Measures include Working Alliance Inventory, Personal Information Questionnaire, a standardized ER patient satisfaction questionnaire, and the Social Problem-Solving Inventory. Pearson product moment correlations and multiple regression analyses will be conducted to determine the relationship among the variables. Subscales of the WAI, average estimated wait times, problem-solving skills, and ratings of knowledge and communication from the and ER satisfaction questionnaire will be input as predictor variables and global patient satisfaction will be the criterion variable. Results will lead to understanding ER experiences that may be advantaged by introducing CBT strategies to promote better consumerism of services by LQTS patients. Data will provide physicians with an understanding of LQTS patients’ perceptions of ER care. Findings will determine what predicts satisfaction and whether patients have realistic expectations for ER care. Problem-solving skills training have been effective for helping other medical patients navigate the healthcare system (Nezu et al., 1998), and may be appropriate for LQTS patients. Results will provide guidance for cardiologists and psychologists to best prepare LQTS patients for ER experiences.