https://www.um.edu.mt/library/oar/handle/123456789/86309 2026-04-05T10:29:35Z 2026-04-05T10:29:35Z https://www.um.edu.mt/library/oar/handle/123456789/99157 2022-07-13T05:07:41Z 2021-01-01T00:00:00Z

Title: Real-time tracking of patients’ experience in an acute rehabilitative hospital setting in the delivery of person-centred care Abstract: Purpose: This study explored how real-time tracking of patients’ experiences in a rehabilitation hospital can be used by healthcare professionals to improve the delivery of Person-Centred Care to patients. Design: A qualitative research methodology was adopted, whereby the phenomenological qualitative tradition was applied with an interpretivist epistemological approach, to conduct a case study of how Real-Time Experience Tracking can be used to improve the delivery of Person-Centred Care in the chosen hospital. Real-time data on patients’ experiences was collected and subsequently used to stimulate discussions during several interviews that were held with various healthcare non-managerial and managerial professionals at the rehabilitation hospital. Findings: Several themes emerged on each of the three pillars of Person-Centred Care and on the use and acceptance of Real-Time Experience Tracking by patients and healthcare professionals. The relatively innovative method of collecting data on patients’ experiences in real-time was generally accepted by both patients and healthcare professionals. Additionally, Real-Time Experience Tracking can be used to improve the delivery of Person-centred Care by promptly highlighting weaknesses on each of the three pillars of Person-centred Care, for the consideration of healthcare professionals. Conclusion: Collecting real-time data on patients’ experiences can improve healthcare professionals’ understanding of patients’ experiences and thus enable them to adjust their treatment plans and delivery in time to improve patients’ experiences. Questions on which real-time data are collected need to be carefully aligned with the three pillars of Person-centred Care. Real-time data can also enable the hospital to measure the quality of Person-centred Care and continuously improve the care provided to the current needs of its patients, rather than sticking with standard procedures. Practical limitations to improving Person-centred Care with Real-Time Experience Tracking include preserving patient anonymity and lack of time and resources. Healthcare institutions should evaluate how the recommendations being made in this study can enable them to track their patients’ experiences in real-time to improve the delivery of Person-Centred Care for the same patients. Value: Several recommendations on how Real-Time Experience Tracking can be implemented to improve the delivery of Person-Centred Care were proposed. These recommendations were based on findings from interviews held with various healthcare professionals working at the rehabilitation hospital. Healthcare institutions should consider developing an application to collect data in real-time on patients’ experiences and analyse it to assist healthcare professionals to improve the delivery of Person-Centred Care. Description: M.Sc.(Melit.)

2021-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/99156 2022-07-13T05:05:45Z 2021-01-01T00:00:00Z

Title: An investigation of foot morbidity in patients with end stage renal disease on dialysis Abstract: Aim: To determine the prevalence of foot morbidity amongst patients with End Stage Renal Disease on dialysis treatment. Methods: A prospective single centre, non-experimental, non-randomized quantitative time series design was employed. The sample was recruited using convenience sampling. The study was carried out at the Renal Unit, Mater Dei Hospital, Malta. Forty seven patients were recruited (a total of 94 limbs). Baseline data was gathered via an initial consultation with the participant whereby medical reports were also reviewed followed by various noninvasive foot assessments which included: Neurological, Arterial, Biomechanical, and Dermatological Assessments. Participants were assessed twice during the study. At the time of recruitment (Time 0) and after six months (Time 1), the Toe Brachial Pressure Index (TBPI), Spectral Doppler Waveform Analysis, and the Quantitative Sensory Testing (QST) were measured at each visit. Results: The prevalence of foot morbidity was found to be high amongst participants with ESRD on dialysis. 95.74% of participants presented with foot deformities, whilst 76.60% presented with skin and nail conditions. 22% of participants had a history of ulceration, 19% had a history of amputation, 9% had active ulceration, and 7% had history of revascularisation. Findings demonstrated an overall poor foot health and footcare behaviour within this population with 40.43% of participants presenting with inappropriate footwear, 70% did not check feet regularly, 87% did not attend to podiatry appointments, whilst 68% were unable to reach their feet for self-care. The mean TBPI decreased during the study period (6months). Albeit not statistically significant, one should not dismiss the reduction in TBPI which indicates that TBPI decreases with time in this specific cohort. The relationship between the TBPI and duration of dialysis was found to be significant and also compliments the reduction of TBPI with time. Both Diabetes Mellitus and dialysis duration were identified as significant predictors for the reduction in TBPI. Results indicated that for every one month increase in dialysis duration, the TBPI was expected to decrease by 0.013 and that the mean TBPI for patients with DM and ESRD was expected to be 0.1565 less than the mean TBPI of patients with ESRD. Conclusion: This study has shed light on the high prevalence of foot morbidity amongst the cohort of patients with ESRD on dialysis within the renal unit in Malta. This study highlighted the importance of expanding practice by introducing a new podiatry service within the renal unit to provide prompt foot screening, foot care, and foot care education, with the aim to reduce severe foot complications. Indeed, the study recommended that End Stage Renal Disease patients on dialysis should embark on a podiatry screening algorithm as soon as they are diagnosed with this condition and continue to be reviewed and monitored closely within the renal unit to delay and/or prevent severe outcomes. Description: M.Sc.(Melit.)

2021-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/99151 2022-07-13T05:04:34Z 2021-01-01T00:00:00Z

Title: Management of mild to moderate osteoarthritis : an insight into the perspectives of physiotherapists and general practitioners Abstract: Research question: How do General Practitioners and Physiotherapists manage mild to moderate osteoarthritis in the local primary health care? Design: A complementarity mixed method design using surveys, an interview and a focus group. Methods: A vignette-based survey was sent to all general practitioners and physiotherapists working in Malta. The quantitative data was analysed via descriptive statistics and the open-ended questions were analysed through a thematic analysis. A semi-structured interview was conducted with a key-person who bridges primary and secondary care. The data collected was analysed using thematic analysis. Data convergence labels were also used to merge the two data sets, from which topics were developed as discussion points for a focus group, in which three general practitioners and three physiotherapists participated. A thematic analysis was then carried out for the data collected from the focus group. Results: In this study it was observed that although general practitioners and physiotherapists take a detailed history and a thorough clinical examination, there is nonetheless a significant reliance on the use of medical imaging for diagnosing osteoarthritis. Although pharmacological treatment is prescribed according to guidelines, such treatment is generally being offered before non-pharmacological treatment, at odds with recommended guidance. A sub-optimal level of communication between professionals was also perceived. Conclusion: The findings from this research study suggest a need for further professional education for general practitioners and physiotherapists on diagnosing and conservative treatment approaches in osteoarthritis. Although many professionals are aware of the recommended guidelines, there is lack of congruency in clinical practice, in the information that is being imparted to the patients together with a sub-optimal level of communication between professionals. With an increasing aging population, it is crucial to target osteoarthritis at its earliest stages as this will have an impact on the long-term quality of life of the patient. Description: M.Sc.(Melit.)

2021-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/99149 2022-07-13T05:01:10Z 2021-01-01T00:00:00Z

Title: Development of novel gelling systems using milk analogues Abstract: Recent dynamic on food trends, climate change and food sustainability have pushed people, researchers and industries to find sustainable alternatives in different food sectors. One of them is milk and dairy products since they are among the most consumed food products globally. Milk analogues are already present on the market but there is more to discover about their application on a daily life basis like in the preparation of dessert gels. The characteristics and the application of a milk analogue on a dessert gel with alternative hydrocolloids ingredients, such as konjac and gellan gum have been investigated and compared to a commercial recipe. The physicochemical characteristics of the dessert gel have been tested in relation to different type of environmental conditions and in relation to time, in order to assess the stability of the product at extreme storage conditions. The stability study was conducted at conditions representing an accelerated shelf life environment. The results of this study have brought more knowledge for the use of uncommon hydrocolloids on the production of milk analogues and their application as dessert gels. Their use as replacers of animal protein in milk analogues is investigated and their impact for the production of dessert gels during adverse or extreme storage conditions is assessed. The developed dessert gel recipes have potential applications for different type of food formulation. In the case of the konjac dessert, the results show that its suitability in food application where there is a high possibility of water release or if an elastic behaviour is needed. The results on gellan dessert indicate a more suitable application where there is a requirement for a strong gel with a plastic behaviour. Description: M.Sc.(Melit.)

2021-01-01T00:00:00Z