Saturday, 28 May 2016

Handling patient complaints

Roger Watson, Editor

'Patient complaints are considered a valuable source for quality improvement in health care. Moreover, patient satisfaction is an important issue for healthcare providers to fulfil their caring duties, to ensure patient safety and also for compassionate clinical nursing. In Sweden, the number of healthcare complaints is growing despite an increased patient focus in health care. In 2015 a new law was enrolled in Sweden – The Patient Act (2014:821) – that aims to reinforce and clarify the patients’ position and facilitate patients’ integrity, self-determination and participation.'

The aim of this Swedish study by Skålén et al. (2016) published in Nursing Open was: 'To describe patient complaints and to examine possible associations between healthcare providers’ statements and reports of satisfaction/dissatisfaction.'  Over 600 complaints were examined.

As the authors say: 'The study included 618 complaints at different clinics from either a patient (67%) or a relative (33%). Most complained by phone (71 5%) and the remaining by letter or e-mail. Most complaints concerned patients aged 20-79 (80%). Patients under the age of 20 or over the age
of 80 were represented in roughly equal proportions. A greater proportion of complaints concerned female patients (57%) than male patients and more women than men lodged complaints regarding themselves (60% vs. 40%). The most frequent category of relatives who lodged complaints were mothers (30%) followed by daughters and wives. The share of complaints at different clinics agrees well with the share of patient visits at each hospital clinic while primary care had a smaller proportion. In some cases, there were lodged complaints about more than one clinic, for example, both primary care and a hospital clinic.'

The authors conclude: 'The results of this study provide novel insights about patients’ complaints that can contribute to a scientific knowledge base and can be applied to facilitate quality improvements in clinical practice. The present results can be used in, for example, nursing education when teaching nursing ethics or for reflection and discussion among nurses in clinical practice. Procedure neglect, untrue explanations, lack of communication, blaming other clinics etcetera indicate that healthcare providers at times neither take their caring responsibility nor their obligation to learn from mistakes/incidents. Mistakes are inevitable, but healthcare providers need to learn a lesson from them, they need to listen and they need to respond in a helpful manner. To improve patient safety and contribute to quality improvement healthcare organizations should insure a leadership providing an ethical culture for receiving complaints and strive for transparency regarding complaints.'


Skålén C, Nordgren L, Annerbäck E-M (2016) Patient complaints about health care in a Swedish County –characteristics and satisfaction after handling Nursing Open doi: 10.1002/nop2.54

Wednesday, 11 May 2016

What is it like to live to over 100?

Roger Watson, Editor

Ever wondered what it is like to live to 100 and what the factors are that enable a person to do this?  Clearly, some luck is involved supported by a blend of genetic and environmental factors; but what is it like to outlive all your friends, your spouse and even some of your children?  This is precisely what was investigated by Hutnik et al. (2016) and reported in an article titled: 'Using a cognitive behavioural lens to understand psychological processes underlying resilience in the stories of 16 UK centenarians' and published in Nursing Open. 

Of the study, the authors say: 'In 2010, we interviewed 16 UK centenarians about their lives and later published a paper on the socio-emotional aspects of positive ageing. We were struck by their ability to ‘move on’ from difficult situations which we recognized conceptually as ‘resilience’. In the effort to understand aspects of resilience as portrayed in their stories, we re-examined their data.'

Some of the quotes are very revealing, for example: '. . quite a lot of things have happened. . .different things, what with my father being killed and then my husband going to the war and my brother being killed and things like that. But then again, you’re left and you’ve got to get on and that’s it. . .You just have to cope with it, don’t you? I’m afraid I’m one of those resilient people, I don’t just sit down and cry when it comes, I’ve just got to get on with it.'  and 'Never give up. I don’t think of death. I think of living and what I am going to do and what I am going to enjoy.'

In conclusion, the authors say: 'We have shown that 16 centenarians demonstrated resilience in their ability to positively frame very difficult life events by considering themselves ‘lucky’ or ‘fortunate’ thereby creating for themselves positive emotion. Their resilience was also evident in their ability to accept things they could not change (such as physical decline) with resignation and at the same time, a determination to move on. They knew how to manage anxiety and worry. Additionally, resilience was seen in their psychological flexibility, their positive attitude to and adaptation to change. We also found resilience in their quest to flourish, to be engaged in their passions, hobbies and interests and thus to find continuing meaning in their very long lives.'


Hutnik M, Smith P, Koch T (2016) Using a cognitive behavioural lens to understand psychological processes underlying resilience in the stories of 16 UK centenarians Nursing Open doi: 10.1002/nop2.44