Waiting for a liver transplant: the experience of patients with familial amyloidotic polyneuropathy

Liver transplant is a new treatment for familial amyloidotic polyneuropathy. The purpose of this phenomenological study is to describe the experience of waiting for a liver transplant from the familial amyloidotic polyneuropathy patients' perspective. Unstructured and open-ended interviews were conducted with 14 familial amyloidotic polyneuropathy patients and the analysis of data was inspired by Colaizzi's method. Waiting was found to involve two theme categories: waiting for a decision; and waiting for the operation. Seven themes were identified: bargaining with oneself; no influence/powerlessness; relief and joy; impatience; agony; time to prepare; and need for information and support. Implications for nursing practice, such as informational and emotional support, are discussed.     

Waiting for healthcare: a concept analysis

Title. Waiting for healthcare: a concept analysis Aim. This paper is a report of an analysis of the concept of waiting for health care from the client’s perspective. Background. Waiting is commonplace in many areas of health care and has become a topical and politically important issue in the provision of healthcare services. Whilst managers and governments search for solutions to this problem, it is important that this aspect of clients’ healthcare experience is examined to evaluate its impact and implications for nursing practice. Methods. The PubMed and CINAHL databases (dating from 1950 and 1982 to 2007 respectively) were searched using the keywords ‘health care’ and ‘waiting’. The reference lists of papers identified were also checked and this revealed literature from a number of other disciplines related to the concept. Results. Waiting for health care is identified as an unspecified yet measurable period of time between identification of a healthcare problem and its diagnosis and treatment, when clients experience uncertainty and powerlessness whilst anticipating a disease outcome. The critical attributes of waiting for health care are: a period of measured time, subjective interpretation of the perceived significance of the measured time, feeling uncertain and powerless and anticipation of a response to the healthcare need. Conclusion. Strategies that facilitate contact with clients through pre‐assessment clinics and giving written information and a contact point may seem obvious but are currently overlooked in busy healthcare environments. This is an area where nurses can lead in the delivery of person‐centred care and could potentially increase satisfaction with how waiting is managed.     

Waiting for the flu

Whether the problem is swine-based, fowl-dependent or civet-cat-related;epidemics of infectious respiratory diseases are in the news.Many of the informed take the problem of potential future pandemicsvery seriously—I have been involved with an exhumationin the month in which I write this in order to look for tissueto discover sequences that might inform us about what made the1918 pandemic so devastating. Are you OK on this at parties?(flu, not exhumation). Here is a guide. Influenza viruses are typed by their haemagglutinin (H) andneuraminidase (N) surface glycoproteins. It is the H2, H5, H6,H7 and H9 sub-types of influenza virus that are thought mostlikely to be transmitted to human beings from their multipleanimal hosts (there are many of these and many     

Support for a Waiting Room Time Tracker: A Survey of Patients Waiting in an Urban ED

Background

Emergency Department (ED) crowding and inpatient boarding lead to lengthy wait times for patients, which may cause them to choose to leave without being seen. A new initiative to improve communication with patients is to provide an estimated wait time with a “time tracker” display, but it is unclear whether ED patients would welcome this.

Objective

To estimate the proportion of ED patients who would favor a time tracker display.

Methods

This survey-based study was conducted from March to July 2010 at an urban academic center. After being triaged, patients were asked to answer a multiple-choice questionnaire, asking their preference toward a time tracker display.

Results

Of the 375 patients who were approached, 340 (91%) participated. Two hundred fourteen of them (63%) preferred an ED with a time tracker, 53 (16%) were unsure, and 73 (21%) did not prefer an ED with a time tracker. Patients with low-acuity conditions (Emergency Severity Index [ESI] 4 or 5) were 1.2 times more likely (95% confidence interval 1.0–1.4) to favor a time tracker than those with higher acuity (ESI 3). Preference was not related to race, age, insurance status, or employment.

Conclusions

The majority of patients in our study preferred an ED with a time tracker display (63% for vs. 21% against). Support for a time tracker was higher among patients triaged with lower ESI levels (4 or 5). A time tracker is viewed positively by many patients and may be a beneficial addition in the ED waiting room.     

Waiting for a Pediatric Chronic Pain Clinic Evaluation: A Prospective Study Characterizing Waiting Times and Symptom Trajectories

Chronic pain during childhood is prevalent and costly, but the access to interdisciplinary pain care is limited. Studies investigating adults waiting for pain clinic evaluation found that symptoms and quality of life deteriorate over the waiting period, but little is known about the experience of adolescents. Therefore, we aimed to determine wait list times and the longitudinal trends of pain and physical, mental, and social health over a 12-week period. In total, 97 adolescents, aged 10 to 18 years (M?=?14.7 years, 82% female), waiting for evaluation at an interdisciplinary pediatric pain clinic completed assessments at enrollment and at 4-, 8-, and 12-week follow-up. We performed a review of the medical record of attendance patterns 12 months later. Twelve adolescents and their parents also completed qualitative interviews, describing their experience of waiting for evaluation. Wait times averaged 197.5 days (range?=?69–758 days) from the time of referral to the first-attended appointment, and 86.6% of youths completed appointments. Longitudinal repeated measures analyses demonstrated little improvement in pain or other domains of functioning over the 12-week period. In qualitative interviews, families described anxious anticipation for the upcoming appointment, combined with frustration in waiting. Findings highlight the need to consider approaches to reduce wait times and provide early intervention for youths awaiting pain clinic evaluation.Perspective: This study extends the literature on the characteristics and symptom trajectories of adolescents during the wait period for interdisciplinary pain clinic evaluation, described previously only in adults with chronic pain. Findings demonstrated an average wait time of 6.5 months, during which youths’ pain and physical and social health remained impaired.