title: Assessment of care problems in Romania: feasibility and exploration.
abstract: OBJECTIVE
  The objective of this study was to study the feasibility of a recently developed instrument, LPZ-International, which assesses care problems in health care, and to describe the prevalence of care problems in Romanian health care institutions. Large differences exist in care services in Europe. Data on quality of care are absent or incomplete in Central-Eastern European countries. These countries, including Romania, have faced dramatic socioeconomic changes, which led to negative changes in quality of care.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Hospital wards, mental care institutions, and nursing homes.
  
  
  METHODS
  Nine health care institutions and admitted 394 patients.
  
  
  METHODS
  LPZ-International was introduced in 9 health care institutions in Romania. Assessed care problems included pressure ulcers, urinary and fecal incontinence, malnutrition, falls, and physical restraints. The data were collected between November 2013 and March 2014. Two health care professionals completed the questionnaire by hand at the patient's site.
  
  
  RESULTS
  Six of the 9 health care institutions and 90% of the patients participated, which indicates the feasibility of LPZ-International, as did the completeness of the questionnaire. The data showed a high consistency and only a few were missing. The most frequent care problem was urinary and fecal incontinence, especially in the nursing home. Pressure ulcers and malnutrition were less frequent care problems in Romanian patients. Physical restraints were frequently applied in the nursing home and geriatrics and oncology wards.
  
  
  CONCLUSIONS
  LPZ-International is a feasible instrument to assess care problems. The differences between wards and countries in the prevalence of care problems indicate differences in quality of care and the need for high-quality, comparative research.
authors.affiliation: Department of Family Medicine, University Titu Maiorescu, Bucharest, Romania.
authors.forename: Minerva
authors.initials: M
authors.lastname: Ghinescu
authors.affiliation: Research and Advice on Elderly, Spaubeek, The Netherlands.
authors.forename: Marinela
authors.initials: M
authors.lastname: Olaroiu
authors.affiliation: Department of Family Medicine, University Titu Maiorescu, Bucharest, Romania.
authors.forename: Sorina
authors.initials: S
authors.lastname: Aurelian
authors.affiliation: Research Institute CAPHRI, University Maastricht, Maastricht, The Netherlands.
authors.forename: Ruud J G
authors.initials: RJ
authors.lastname: Halfens
authors.affiliation: Audit Department, County Hospital, Slatina, Romania.
authors.forename: Luminita
authors.initials: L
authors.lastname: Dumitrescu
authors.affiliation: Department of Family Medicine, University Maastricht, Maastricht, The Netherlands.
authors.forename: Jos M G A
authors.initials: JM
authors.lastname: Schols
authors.affiliation: Department of Oncology and Palliative Care, Hospital "St. Luke," Bucharest, Romania.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Rahnea-Nita
authors.affiliation: Faculty of Sociology, University of Bucharest, Bucharest, Romania.
authors.forename: Aurelia
authors.initials: A
authors.lastname: Curaj
authors.affiliation: Geriatrics Department, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania.
authors.forename: Ionna
authors.initials: I
authors.lastname: Alexa
authors.affiliation: Research Institute CAPHRI, University Maastricht, Maastricht, The Netherlands. Electronic address: heuvelwim@hotmail.com.
authors.forename: Wim J A
authors.initials: WJ
authors.lastname: van den Heuvel
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005240:Feasibility Studies; D005242:Fecal Incontinence / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006301:Health Services Needs and Demand; D006761:Hospitals; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D009735:Nursing Homes; D003668:Pressure Ulcer / Q000453:epidemiology* / Q000517:prevention & control; D015995:Prevalence; D011787:Quality of Health Care; D012383:Romania / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000517:prevention & control
keywords: Quality of care; care problems; continence; falls; pressure ulcers