5 research outputs found
The Safety and Efficacy of Vascular-Targeted Photodynamic Therapy in Low-Risk Prostate Cancer
No full textBackground: Prostate cancer (PCa) is one of the most prevalent cancers in
the world. Standard methods of screening and diagnosis for prostate cancer have been
effective but can result in overtreatment of indolent prostate cancer, leading to increased
morbidity. Multiparametric magnetic resonance imaging (MRI) and fusion biopsy are
effective tools to achieve better diagnostic accuracy. A combination of multiparametric
MRI and photodynamic therapy can be used as an alternative to active surveillance in
low-risk prostate cancer to better detect disease progression while avoiding overtreatment.
Methods: We conducted a retrospective multicenter study on 13 patients with low-risk
prostate cancer who underwent vascular-targeted photodynamic therapy. The patients
were evaluated for up to 15 months after the procedure using biochemical parameters
like serum Prostate Specific Antigen (PSA), digital rectal examination, multiparametric
MRI, and functional parameters like the International Prostate Symptom Score (IPSS), the
15-question International Index of Erectile Function questionnaire (IIEF-5), quality of life
score (QoL), the International Consultation on Incontinence Questionnaire-Short Form
(ICIQ-SF), and a uroflowmetry examination. Results: The patients did not experience any
significant complications during or after the treatment. A decrease in serum PSA and
prostate volume was observed from 7.38 ng/mL to 3.8 ng/ml with functional improvement
evidenced by a decrease in the IPSS (from 15.4 to 11), QoL (from 3.15 to 2), and the IIEF-
Un modello di indagine della partecipazione del paziente. Il miglioramento del servizio sanitario tra empowerment, co-creazione e soddisfazione
No full text2015 - 2016Alla luce delle diverse problematiche che stanno interessando il settore sanitario negli ultimi anni,
l’obiettivo di questa tesi è quello di indagare il coinvolgimento del paziente nella gestione sanitaria
evidenziando l’importanza della sua partecipazione per il miglioramento del servizio. A tal fine, si
analizzano tre dimensioni principali appartenenti alla sfera del paziente, segnatamente, la
partecipazione al processo di co-creazione del valore “salute”, il patient empowerment e la
soddisfazione del paziente e si propone un modello di indagine volto ad individuare le relazioni tra
le stesse.
La co-creazione di valore è un paradigma che si è diffuso nel marketing durante l’ultima decade e
può essere definito come un processo grazie al quale le imprese co-creano valore durante le
interazioni con i propri clienti attraverso l’integrazione di risorse e l’applicazione di competenze. I
clienti, quindi, diventano parte attiva del processo di generazione dell’offerta. Le risorse e le
competenze che il paziente può applicare in questi processi sono positivamente influenzate dal suo
livello di empowerment, ovvero quell’insieme di conoscenze e capacità che il paziente possiede
nella gestione della propria condizione di salute. Dall’analisi svolta in questo lavoro emerge che
entrambe queste variabili sono positivamente correlate alla soddisfazione del paziente che, in
ambito sanitario, viene spesso considerata come indicatore della qualità percepita del servizio. I
risultati mostrano che il paziente non ha l’unico ruolo di valutare la qualità in termini di
soddisfazione ma è anche parte attiva nella sua creazione. Di conseguenza gli strumenti per la
verifica della qualità non dovrebbero indagare solo la capacità dell’organizzazione sanitaria di
garantire servizi di qualità ma, anche, il ruolo del paziente nel raggiungimento della stessa. Inoltre,
essendo la soddisfazione una variabile soggettiva, nella sua valutazione è essenziale considerare le
risorse e le competenze che il paziente possiede in relazione alla propria salute e che possono
influire sulle sue percezioni della qualità.
In termini di management, i risultati dovrebbero stimolare i policy makers ad adottare politiche
dirette ad incentivare la partecipazione attiva dei cittadini nella sanità. Ciò implica uno sforzo
economico e culturale in quanto realizzare e promuovere l’integrazione effettiva significa investire
tempo e capitale (incluso umano) nella rieducazione, sia degli operatori sanitari che dei pazienti, a
una logica di beneficio mutuo e sostenibile. [a cura dell'Autore]Considering the various problems that are affecting the healthcare sector in recent years, the aim of this thesis is to investigate patient involvement in healthcare management by highlighting the importance of his participation for the service improvement. To this end, we analyze three main dimensions belonging to the patient's sphere, particularly, participation in the co-creation process of "health value", patient empowerment and patient satisfaction, proposing a model of investigation aimed at identifying the relations between the variables considered.
Value co-creation is a paradigm developed in marketing discipline over the last decade and that can be defined as a process by which businesses co-create value during interactions with their customers through the integration of resources and the application of competences. Customers thus become an active part of the offer generation process.
The resources and competences that patient can applied in these processes are positively influenced by his level of empowerment, ie the set of knowledge and skills that patient possesses in managing his health condition. The analysis in this work shows that both variables are positively related to patient satisfaction which is often seen as a perceived service quality measure. The results show that patient does not have the only role to assess the quality in terms of satisfaction, but he is also an active part in its creation.
Thus, the tools for the quality evaluation should not only investigate the health organization's ability to provide quality of services, but also the patient's role in achieving the same. Moreover, being the satisfaction a subjective variable, in its assessment it is essential to consider the resources and competences that patient possesses in relation to his own health and that can affect his quality perceptions.
In terms of management, the results should encourage policy makers to adopt policies aimed at encouraging the active participation of citizens in healthcare. This implies an economic and cultural effort as build and promote the effective integration means investing time and capital (including human) in the re-education of both health professionals and patients in a logic of mutual and sustainable benefit. [edited by Author]XV n.s.(XXIX ciclo
Patients' perceptions of quality of care delivery by urology residents: A nationwide study
No full textOBJECTIVE: To present the results of a nationwide survey among urological patients to evaluate their perception of the quality of care provided by residents. METHODS: An anonymous survey was distributed to patients who were referred to 22 Italian academic institutions. The survey aimed to investigate the professional figure of the urology resident as perceived by the patient. RESULTS: A total of 2587 patients were enrolled in this study. In all, 51.6% of patients were able to correctly identify a urology resident; however, almost 40% of respondents discriminated residents from fully trained urologists based exclusively on their young age. Overall, 98.2% patients rated the service provided by the resident as at least sufficient. Urology trainees were considered by more than 50% of the patients interviewed to have good communication skills, expertise and willingness. Overall, patients showed an excellent willingness to be managed by urology residents. The percentage of patients not available for this purpose showed an increasing trend that directly correlated with the difficulty of the procedure. Approximately 5–10% of patients were not willing to be managed by residents for simple procedures such as clinical visits, cystoscopy or sonography, and up to a third of patients were not prepared to undergo any surgical procedure performed by residents during steps in major surgery, even if the residents were adequately tutored. CONCLUSIONS: Our data showed that patients have a good willingness to be managed by residents during their training, especially for medium‐ to low‐difficulty procedures. Furthermore, the majority of patients interviewed rated the residents' care delivery as sufficient. Urology trainees were considered to have good communication skills, expertise and willingness
Patients' perceptions of quality of care delivery by urology residents: A nationwide study
No full textIncidencia de los atributos de los hoteles en el EWOM y su capacidad de generar rendimiento financiero en el sector
No full textLa satisfacción del cliente es un elemento preponderante que define el desempeño de las empresas en el mercado global actual (Albayrak & Caber, 2015; Anderson, Fornell & Lehmann, 1994; Anderson & Mittal, 2000). Por su parte, la industria de los servicios hoteleros ha encontrado en los procesos de innovación una estrategia para dar respuesta a las nuevas demandas, tanto de los clientes, como de la sociedad en general (Silvestre & Tirca, 2019; Ahmad, Youjin, & Hdia, 2022). Adicionalmente, los procesos de innovación, entendidos como avances tecnológicos y en la gestión de las empresas, propician su desarrollo (Ahmad, Youjin, & Hdia, 2022), llegando algunos estudios a considerar que el éxito de los negocios depende en gran medida de la innovación (McKinsey & Company, 2021). Dentro de las tendencias de digitalización e innovación de la industria hotelera, el eWOM (electronic word-of-mouth) constituye una de las fuentes de conocimiento más relevantes para el crecimiento de la industria, relacionada con el uso o las características de determinados bienes y servicios generados por la experiencia del entorno hotelero. Los distintos estudios indican que los atributos de los hoteles afectan al eWOM (electronic word-of-mouth) y que este a la vez genera rendimiento financiero en el sector. Razón por la cual, esta tesis doctoral propone examinar la relación entre los componentes del eWOM, como son la calificación global, el volumen de reseñas y la valencia de estas en el entorno hotelero en relación con las variables del rendimiento financiero de los hoteles: ADR, RevPAR, y Porcentaje de ocupación, que son las medidas de rendimiento más comúnmente aceptadas en el negocio hotelero. Adicional a ello, la literatura científica sobre la industria hotelera indica que estos atributos influyen en la elección de los clientes, desde la ubicación y el precio de la habitación, hasta las instalaciones y el servicio, la seguridad, la limpieza, confort y la relación precio-calidad. Los resultados de la presente investigación se han dividido en ocho capítulos correspondientes: En primer lugar, se relaciona todos los aspectos introductorios, donde se explicó el problema, las preguntas de investigación, justificación, objetivos y la estructura de la tesis, seguidamente; se abordó una revisión de la literatura resultante del marco teórico de la investigación. En tercer lugar, se dio a conocer las características del contexto donde se ejecutó esta tesis; continuando en el capítulo 4, con la metodología que se utilizó y fue una guía para el desarrollo de los diferentes estudios. Como quinto lugar, una revisión de la literatura científica a través de un meta-analisis para identificar la correlación significativa entre los componentes del eWOM y el rendimiento financiero de los hoteles. Para ello, se propone aportes al estudio de la literatura científica sobre eWOM en el contexto hotelero haciendo un repaso del estado del arte de la investigación y proponiendo futuras direcciones de investigación. En sexto lugar, en relación al capítulo seis, se realiza la identificación de los atributos y los efectos que inciden sobre el eWOM. En el capítulo 7, se evaluó la capacidad de predecir el volumen y la calificación general del eWom en función de los atributos de los hoteles. En octavo lugar, se analiza la relación existente entre los componentes (calificación global, valencia y volumen) del eWOM en el sector hotelero y un octavo capítulo, un análisis del impacto del eWOM positivos y negativos en el rendimiento financiero de los hoteles.Customer satisfaction is a predominant factor that defines business performance in today's global market (Albayrak & Caber, 2015; Anderson, Fornell & Lehmann, 1994; Anderson & Mittal, 2000). The hospitality industry, in particular, has adopted innovation processes as a strategy to meet new demands from both clients and society at large (Silvestre & Tirca, 2019; Ahmad, Youjin, & Hdia, 2022). Furthermore, innovation processes, understood as advancements in technology and business management, foster industry development (Ahmad, Youjin, & Hdia, 2022), with some studies suggesting that business success largely depends on innovation (McKinsey & Company, 2021). Within the trends of digitization and innovation in the hotel industry, electronic word-of-mouth (eWOM) stands out as one of the most significant knowledge sources for industry growth, linked to the usage or characteristics of goods and services generated by the hotel environment experience. Various studies indicate that hotel attributes impact eWOM, which in turn generates financial performance in the sector. Therefore, this doctoral thesis aims to examine the relationship between eWOM components—such as overall rating, volume of reviews, and sentiment of these reviews—in relation to financial performance variables in hotels: Average Daily Rate (ADR), Revenue Per Available Room (RevPAR), and Occupancy Rate, which are the most commonly accepted performance metrics in the hotel business. Additionally, the scientific literature on the hotel industry suggests that these attributes influence customer choice, from the location and room price to facilities and service, security, cleanliness, comfort, and price-quality ratio. The results of this investigation are divided into eight corresponding chapters: Firstly, it addresses all introductory aspects, where the problem, research questions, justification, objectives, and the structure of the thesis were explained. Secondly, it includes a literature review derived from the research's theoretical framework. Thirdly, the characteristics of the context in which this thesis was conducted are detailed. The fourth chapter discusses the methodology used, serving as a guide for the development of various studies. Fifthly, a review of the scientific literature through a meta-analysis identifies significant correlations between eWOM components and the financial performance of hotels. This review contributes to the study of eWOM in the hotel context by reviewing the state of the art and proposing future research directions. In the sixth chapter, the attributes and their effects on eWOM are identified. The seventh chapter evaluates the ability to predict the volume and overall rating of eWOM based on hotel attributes. Finally, the eighth chapter analyzes the relationship between eWOM components (overall rating, sentiment, and volume) in the hotel sector and assesses the impact of positive and negative eWOM on the financial performance of hotels.Lista de Tablas y Figuras 11 -- Capítulo 1. Aspectos introductorios 14 -- Introducción 14 -- Planteamiento del problema 18 -- Pregunta de investigación 22 -- Preguntas secundarias 22 -- Justificación 23 -- Objetivos de la tesis doctoral 28 -- Objetivo General 28 -- Objetivos Específicos 28 -- Estructura de la tesis doctoral 29 -- Capítulo 2. Revisión de la literatura 35 -- Del eWOM tradicional al eWOM en el contexto hotelero 35 -- Atributos en los hoteles 38 -- Componentes del rendimiento financiero en los hoteles 42 -- Antecedentes 44 -- Hipótesis 52 -- Capítulo 3. Características del contexto de análisis 59 -- Oferta de Alojamiento y Variedad de Experiencias 59 -- Enfoque en el Turismo Sostenible y Natural 60 -- Hospitalidad y Servicio al Cliente 60 -- Capítulo 4. Aspectos claves de la investigación y descripción general del estudio 61 -- Modelo de análisis 63 -- Diseño de la investigación 68 -- Fuentes de información 68 -- Muestra 70 -- Tratamiento de los datos 71 -- Variables dependientes e independientes del estudio. 73 -- Chapter 5. Analysis of the attributes and components of ewom and their impact on the financial performance of hotels: a meta-analysis of the significant correlation in the scientific literature 76 -- Scientific literature review 78 -- Relationship between hotel attributes and eWOM 78 -- Relationship between eWOM and the financial performance of hotels 81-- Methodology 96 -- Coding and definition of variables in the framework of the meta-analysis 99 -- Results 100 -- Discussion 110 -- Chapter 6. The hotel attributes effect on ewom generation in the hotel context 114 -- Review of the background of the scientific literature 116 -- Methodology and sample 124 -- Results 127 -- Discussion 135 -- Conclusions 137 -- Chapter 7. Evaluation of the ability to predict the volume and overall rating of ewom based on the attributes of hotels 141 -- Theoretical framework 142 -- Methodology 149 -- Results 152 -- Discussion 166 -- Conclusions 168 -- Chapter 8. Multidimensional analysis of the impact of positive and negative ewom on the financial performance of hotels 172 -- Background review of the scientific literatura 176 -- Results 191 -- Discussion 205 -- Conclusions 208 -- Referencias 219Doctor(a) en InnovaciónDoctorad
