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PubMed1998

A Path Model of Whitewater Boating Satisfaction on the Cheat River of West Virginia

/ Recreation satisfaction is a complex psychological construct that is difficult to define and measure. Recent approaches suggest that overall satisfaction may be a function of multiple satisfactions derived from specific elements of a recreation experience such as the situational characteristics of a recreation setting or activity and the recreationist's subjective evaluations of the experience. In this paper, a path model of whitewater boating satisfaction was tested using data from a survey of 1210 commercial and 111 private boaters on the Cheat River of West Virginia. The pathmodel included the direct and mediating effects of situational variables and the subjective evaluations of boaters and explained 52% and 54% of the variation in satisfaction of commercial and private boaters, respectively. Factors related to the satisfaction of both groups included a composite variable representing opportunities for challenge, excitement, and skill testing on the river trip; water flow levels; and crowding perceptions. In combination, water flow level and boater's perceptions of opportunities to experience challenge, excitement, and test boating skills were the most important variables for explaining satisfaction of both groups. Additional factors affecting commercial, but not private, boater satisfaction included the motive of escaping the usual demands of life and a social interaction variable. Among private boaters, perceptions of the environmental conditions also contributed to overall satisfaction. The results support the multiple satisfaction approach of previous research. River management implications are discussed.KEY WORDS: Whitewater; River recreation; Satisfaction

Journal Article↗
PubMed1982

Social psychological determinants of patient satisfaction: a test of five hypothesis.

Five hypothesis regarding the social psychological determinants of patient satisfaction were tested among patients attending the primary care clinics of a university medical center in Manhatten. The social psychological variables operationalized here were expectations, values, entitlement and perceived occurrences; the three dimensions of satisfaction studied were doctor conduct, convenience and general satisfaction. The social psychological variables together were found to explain only a small proportion of the variance in satisfaction, although their contribution varied with the dimension of satisfaction. Expectations consistantly explained most of the variance in satisfaction ratings; particularly noteworthy was the direct effect of prior expectations of the doctor's conduct on subsequent satisfaction with that dimension of the care received. Values had little independent effect on satisfaction, and the combination of values and expectations (their interaction) was unrelated to satisfaction. Feelings of entitlement were also unrelated to satisfaction ratings. There was some support for the discrepancy model, which holds that the greater the discrepancy between perceived occurrences and prior expectations the less the satisfaction. The importance of carrying out further methodological studies aimed at developing reliable measures of these constructs is stressed.

Adolescent↗
PubMed2000

Family satisfaction with end-of-life care in seriously ill hospitalized adults.

OBJECTIVE: To examine factors associated with family satisfaction with end-of-life care in the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT). DESIGN: A prospective cohort study with patients randomized to either usual care or an intervention that included clinical nurse specialists to assist in symptom control and facilitation of communication and decision-making. SETTING: Five teaching hospitals in the United States. PARTICIPANTS: Family members and other surrogate respondents for 767 seriously ill hospitalized adults who died. MEASUREMENTS: Eight questionnaire items regarding satisfaction with the patient's medical care expressed as two scores, one measuring satisfaction with patient comfort and the other measuring satisfaction with communication and decision-making. RESULTS: Sixteen percent of respondents reported dissatisfaction with patient comfort and 30% reported dissatisfaction with communication and decision-making. Factors found to be significantly associated with satisfaction with communication and decision-making were hospital site, whether death occurred during the index hospitalization (adjusted odds ratio (AOR) 2.2, 95% CI, 1.3-3.9), and for patients who died following discharge, whether the patient received the SUPPORT intervention (AOR 2.0, 1.2-3.2). For satisfaction with comfort, male surrogates reported less satisfaction (0.6, 0.4-1.0), surrogates who reported patients' preferences were followed moderately to not at all had less satisfaction (0.2, 0.1-0.4), and surrogates who reported the patient's illness had greater effect on family finances had less satisfaction (0.4, 0.2-0.8). CONCLUSIONS: Satisfaction scores suggest the need for improvement in end-of-life care, especially in communication and decision making. Further research is needed to understand how factors affect satisfaction with end-of-life care. An intervention like that used in SUPPORT may help family members.

Aged↗
PubMed2002

The relationship and its change with aging between ADL and daily life satisfaction characteristics in independent Japanese elderly living at home.

The purposes of this study were to examine the characteristics of the relationship between ADL ability and daily life satisfaction and the pattern change with aging in independent Japanese elderly, and to compare these tendencies between males and females. The characteristics of ADL ability and daily life satisfaction of 482 subjects (213 males, 269 females) were investigated in a self-response survey. Seventy-four ADL items, considered from previous studies, were selected from nine ADL domains of 1) movement, 2) going up and down stairs, 3) changing and holding posture, 4) bathing, 5) toileting, 6) dressing, 7) grooming, 8) eating, and 9) manual activities, and nine items of daily life satisfaction were selected from physical, psychological and sociological factors. Both ADL ability and life satisfaction of independent elderly tended to decline with aging. From correlation analysis, since life satisfaction of the elderly was higher with high ADL ability level, it was considered that ADL ability level is one of the important factors in providing for life satisfaction of independent elderly. The subjective symptoms of inconvenience in the lower extremity and lumbar region increased from the 70s in both genders, and the use of assisting devices for movement remarkably increased in the 80s in both genders. The use of assisting devices closely related to the activity area in daily life and influenced the characteristics of life satisfaction and its age-related change in the relationship between ADL ability and life satisfaction. The relationship between ADL ability and satisfaction with physical function was similar in both genders, while the relationship between ADL ability and satisfaction with sociological and psychological factors was different between males and females. Since the relationship between ADL ability and life satisfaction of independent elderly is influenced by a combination of personal, cultural, and environmental factors, additional study must investigate in detail the influence of these factors.

Activities of Daily Living↗
PubMedDate not supplied

Parental satisfaction with bonded resin composite strip crowns for primary incisors.

PURPOSE: The purpose of this study was to evaluate the parental satisfaction of bonded resin composite strip crowns for the treatment of maxillary anterior primary incisors and compare their satisfaction with the clinical evaluation and success of the crowns. METHODS: This was a retrospective, clinical study of patients who had strip crowns (SC) placed on maxillary primary incisors, returned for at least 1 recall examination, and whose parents gave consent for them to participate in the study. Color photographs were used for evaluation by 2 independent pediatric dentists. Parental satisfaction regarding the esthetics of the crowns was evaluated by a questionnaire. RESULTS: One hundred and twelve restorations placed in 40 children were evaluated. The evaluations were performed after the crowns had been in place for an average of 18 months (range=6-25 months). Overall parental satisfaction with the treatment was excellent; however, satisfaction with regard to color received the lowest rating. No significant differences were found between dentist and parent evaluations of color, size, and overall appearance (Fisher exact test; P=.194,.776,.291, respectively). Parents rated their overall satisfaction as being positive regardless of their poor ratings of color, size, or overall appearance. However, a significant relationship was found between durability and overall satisfaction (P=.046). Parents who gave poor ratings to durability also rated their overall satisfaction as being poor. CONCLUSIONS: Parental satisfaction with bonded resin composite SCs for the treatment of primary incisors with large or multi-surface caries was excellent. Parents' dissatisfaction was most often related to color of the restorations. However, this did not affect their overall satisfaction with the crowns. The durability of restorations negatively affected the rating of overall satisfaction with the crown. Durability seems to be of more concern than excellent color match to this group of parents.

Acrylic Resins↗
PubMed1994

The feasibility and value of using patient satisfaction ratings to evaluate internal medicine residents.

OBJECTIVE: To determine the feasibility and value of using patient satisfaction ratings to evaluate the physician-patient relationship skills of medical residents. DESIGN: A cross-sectional survey was used to collect patient satisfaction information for medical residents from all patients attending the out-patient teaching clinics over a three-month period. The feasibility of patient rating was assessed by evaluating the reliability of resident satisfaction scores and potential sources of bias in rating. The value of using this method was assessed by evaluating the proportion of variance in ratings attributable to residents, the prevalence of residents with ratings substantially below average, and the effect of training on patient satisfaction. SETTING: The medical clinics of two teaching hospitals at McGill University. PARTICIPANTS: 91 medical residents and clinical clerks, 1,003 patients, and 1,219 visit ratings. RESULTS: An average of 12.2 satisfaction ratings were collected per resident, providing a reliability of 0.56 (intraclass correlation) for resident satisfaction score. Adjustment for differences in patient populations would be necessary to obtain comparable scores among residents. Fifteen percent of the residents had a substantially greater proportion of poor and fair satisfaction ratings than the study average. Residents were responsible for a substantial proportion of the variance in clinic waiting time and patient satisfaction rating. Training appeared to have no effect on improving satisfaction scores, except among women residents. CONCLUSIONS: Patient satisfaction ratings provide valuable information about a resident's ability to establish an effective physician-patient relationship. However, the number of ratings required to obtain a reliable estimate of resident skill may limit the feasibility of using patient ratings as part of residency evaluation.

Adolescent↗
PubMedDate not supplied

Analysis of factors affecting satisfaction in the emergency department: a survey of 1019 patients.

The objective of this study was to identify factors that affect overall satisfaction of patients admitted to the emergency department (ED). All consecutive adult patients in the ED during a 14-day period who could communicate well were enrolled into this cross-sectional analytic study. Patients' demographic data, information on care, and level of satisfaction were recorded. Patients were asked to rate specific issues concerning their satisfaction (good and excellent) on a 5-point Likert scale. Response to the survey was obtained from 1019 (91.6%) of 1113 patients for analysis during the study. Satisfaction with physician experience, physician attitude, triage, explanation of health status and treatment, and discharge instructions were found to have significant impact on satisfaction (P < .001 for each). Satisfaction with physician experience level was the most important factor affecting overall satisfaction. Patient perception of the total time spent in the ED as "short" and "very short" was not demonstrated to be significantly related to overall satisfaction (P = .162). Temporal perceptions as "long" and "very long" were shown to be significantly related to overall satisfaction (P < .001). Behavioral characteristics of the healthcare providers and the hospital itself were the factors that had the greatest impact on overall satisfaction of the ED population evaluated.

Adolescent↗
PubMed2000

Comparison of maternal satisfaction between epidural and spinal anesthesia for elective Cesarean section.

PURPOSE: Epidural anesthesia was a commonly used technique for elective Cesarean section. Recently, because of the availability of non-cutting spinal needles, many institutions have changed from epidural to spinal anesthesia. The purpose of this study was to compare maternal satisfaction between epidural and spinal anesthesia for elective Cesarean section with a new satisfaction tool. METHODS: We studied healthy parturients in a randomized, double-blinded pilot study in which patients were assigned to receive either epidural (n = 13) or spinal (n = 14) anesthesia for elective Cesarean section. Two and 24 hr postoperatively, patients completed a validated 22-point maternal satisfaction questionnaire and a 10-cm visual analog score (VAS) for satisfaction. Maternal satisfaction scores were compared between groups. RESULTS: There was no difference in demographics, complications or technical failures between groups. Mean satisfaction scores on the questionnaire (0-154) at two and 24 hr were 130.23 +/- 11.36 and 129.54 +/- 16.70 for the epidural group and 116.92 +/- 18.47 and 115.92 +/- 15.71 for the spinal group (P = 0.04 and P = 0.03 respectively). No difference in VAS scores was noted. The presence of minor side effects including pruritus contributed to the lower satisfaction in the spinal group at 24 hr. CONCLUSION: This pilot study demonstrated higher maternal satisfaction with epidural than with spinal anesthesia for elective Cesarean section. This may be related to the increased side effects caused by neuraxial morphine. The satisfaction questionnaire was able to elucidate differences not detected with a global VAS for satisfaction. Further study with a larger patient population is required to confirm these data.

Adult↗
PubMed2005

A survey of satisfaction in anophthalmic patients wearing ocular prosthesis.

PURPOSE: The purpose of this study was to evaluate patient satisfaction with ocular prosthesis after evisceration or enucleation and to determine which variables were correlated to their satisfaction in order to find out how to increase patient satisfaction. METHODS: A satisfaction questionnaire was given to consecutive anophthalmic patients who visited Korea University Hospital from March 2002 through August 2002. Many kinds of variables such as age, gender, type of implant, pegging, and postoperative ocular symptoms that might influence patient satisfaction were evaluated by correlation analysis and multivariate analysis to find the determinants of patient satisfaction. RESULTS: The overall rate of satisfaction with ocular prosthesis was 71.8%. The variables significantly correlated to patient satisfaction were economic status, other people's response, and insertion of motility coupling post or motility peg. CONCLUSION: Patient satisfaction with ocular prosthesis was relatively high. Successful peg insertion to improve the prosthesis movement may be one way for surgeons to increase patient satisfaction.

Adolescent↗
PubMed2005

Marital and sexual satisfaction in testicular cancer survivors and their spouses.

GOAL: To compare marital and sexual satisfaction of men who survived testicular cancer (TC) and their spouses to a reference group, and to compare marital and sexual satisfaction of couples who had a relationship at time of diagnosis (couples during TC) to couples who developed a relationship after completion of treatment (couples after TC). PATIENTS AND METHODS: Two hundred and nineteen couples during TC and 40 couples after TC completed the Maudsley Marital Questionnaire, a validated instrument to measure marital and sexual satisfaction. RESULTS: Survivors and spouses of both couple groups reported similar marital satisfaction as men and women of the reference group. Survivors (t=2.9, p<0.01) and spouses (t=2.9, p<0.01) of couples during TC and survivors of couples after TC (t=1.9, p=0.05) reported less sexual satisfaction than the reference groups. Survivors of couples after TC reported less sexual satisfaction than survivors of couples during TC (F=4.0, p<0.05). Correlations between sexual satisfaction of survivors and spouses in couples during TC (r=0.76, p<0.001) and couples after TC (r=0.77, p<0.001) were high. CONCLUSION: Testicular cancer did not appear to have a negative effect on marital satisfaction in couples during TC, although TC survivors and their spouses reported less sexual satisfaction than men and women of the reference group. Survivors who developed a relationship after completion of treatment seemed to form a vulnerable group: their sexual satisfaction was lower than that of men in the reference group and of TC survivors with a longer relationship. Besides that, they more often reported marital problems than their spouses did.

Adult↗
PubMedDate not supplied

Mental health and psychiatry training in primary care residency programs. Part II. What skills and diagnoses are taught, how adequate, and what affects training directors' satisfaction?

OBJECTIVE: The purpose of this study is to describe the psychiatric skills and diagnostic categories taught in primary care training programs, their adequacy, the perceived needs and desires for curriculum enhancement and the factors affecting training directors' satisfaction. METHOD: All 1365 directors of accredited residency training programs in Internal Medicine (IM), Family Practice (FP), Obstetrics and Gynecology (Ob/Gyn), Pediatrics (Peds) and psychiatry received a 16-item anonymous questionnaire about psychiatry training in their program. Responses to the questionnaire to items concerning the skills and diagnostic categories taught, assessment of adequacy of teaching and desires for curriculum enhancement for specific skills and diagnostic categories were analyzed. The factors affecting training directors' satisfaction were explored. RESULTS: Interviewing skills were taught by a majority of all training programs and were considered adequate by 81% of FP and 54% of IM programs, in contrast to less than a majority of Ob/Gyn and Peds programs (P<.001). A majority provided diagnostic interviewing and counseling training, but only FP considered it adequate. A majority taught psychopharmacology and various psychiatric diagnoses, but only in FP did a majority consider them adequate. Both Peds and FP programs teach child psychiatry; significantly, more Peds compared to FP consider their training to be adequate. A vast majority of IM, Ob/Gyn and Peds programs, and 50% of FP programs desired more training in interviewing techniques and diagnostic interview. A majority of all programs desired more counseling and psychopharmacology training and more training in disorders of childhood and adolescence. The overall satisfaction rate for psychiatric training across specialties was 46% (n=657). Sixty-four percent of FP programs were satisfied compared to 31% of non-FP programs. Satisfaction was associated with increased amount of psychiatric training, diversity of training formats, venues, faculty and settings, the amount of contribution to teaching by psychiatry departments and the presence of current teaching in interviewing skills. There were specialty-specific differences in factors associated with satisfaction. In general, a smaller size of residency program was associated with satisfaction except in IM, where larger size was associated with satisfaction. Satisfaction was associated with the opinion that primary care physician should be ready and willing to treat more psychiatric conditions. CONCLUSION: Most primary care training programs currently offer training in most psychiatric skills and disorders, but a majority of training directors are dissatisfied with their psychiatry training. There is a difference in the estimation of adequacy concerning training between FP, which consistently rates their teaching to be adequate, and all other primary care programs, which consider their teaching inadequate. This difference may be partly due to actual differences in amount and diversity of training as well as differences in the threshold for satisfaction. A vast majority of primary care training programs desire more training in almost all aspects of psychiatry, and there may be specialty-specific needs and areas of curriculum enhancement. To enhance satisfaction, we should improve the quality as well as the quantity of training, as well as the diversity in training formats, venues and faculty.

Administrative Personnel↗
PubMed2006

Job satisfaction in a Norwegian population of nurses: a questionnaire survey.

BACKGROUND: Although job satisfaction is a factor that influences retention, turnover and quality of nursing care globally, there are few studies exploring these factors in European countries. OBJECTIVES: To describe job satisfaction among hospital nurses in Norway, to explore the relationship between nurses' job satisfaction and participation in a clinical ladder program and to explore relationships between several variables and intent to stay. A secondary purpose was to investigate the use of a job satisfaction instrument in a different culture than its origin. DESIGN: In a survey, 2095 nurses in four different hospitals answered a questionnaire that included demographic data, intent to stay and a job satisfaction instrument covering the importance of and actual satisfaction with different job factors. RESULTS: Interaction, followed by pay and autonomy were the most important job factors for Norwegian nurses. Actual job satisfaction was similar to nurses in other countries. There was no significant difference in job satisfaction between participants and non-participants in a clinical ladder. Nurses intending to stay more than a year were significantly more satisfied in their job. Further education and 1 day or more scheduled for professional development were factors that were positively related to intent to stay in the hospital. CONCLUSIONS: Norwegian nurses' views on the importance of different job factors mirrored views of the importance ascribed to working milieu in the Norwegian society. As such, the instrument used seemed sensitive to cultural differences. Nurses' actual satisfaction with their job was similar to respondents in many other countries and may imply that structures and content defining nurses' working situation are similar in many parts of the world. Participation in a clinical ladder did not increase nurses' overall job satisfaction. However, further education and the opportunity for professional development increased nurses' intention to stay in the organization.

Adult↗
PubMed2004

Patient satisfaction and ethnic identity among American Indian older adults.

Work in the field of culturally competent medical care draws on studies showing that minority Americans often report lower satisfaction with care than White Americans and recommends that providers should adapt care to patients' cultural needs. However, empirical evidence in support of cultural competence models is limited by reliance upon measurements of racial rather than ethnic identity and also by a near-total neglect of American Indians. This project explored the relationship between ethnic identity and satisfaction using survey data collected from 115 chronically ill American Indian patients >or=50 years at a Cherokee Nation clinic. Satisfaction scores were high overall and comparable to those found in the general population. Nevertheless, analysis using hierarchical linear modeling showed that patients' self-rated American Indian ethnic identity was significantly associated with satisfaction. Specifically, patients who rated themselves high on the measure of American Indian ethnic identity reported reduced scores on satisfaction with health care providers' social skill and attentiveness, as compared to those who rated themselves lower. Significant associations remained after controlling for patients' sex, age, education, marital status, self-reported health, wait time, and number of previous visits. There were no significant associations between patients' American Indian ethnic identity and satisfaction with provider's technical skill and shared decision-making. Likewise, there were no significant associations between satisfaction and a separate measure of White American ethnic identity, although a suggestive trend was observed for satisfaction with provider's social skill. Our findings demonstrate the importance of including measures of ethnic identity in studies of medical satisfaction in racial minority populations. They support the importance of adapting care to patient's cultural needs, and they highlight the particular significance of interpersonal communication for patient satisfaction among American Indians. Results will be of special interest to health researchers, clinicians, and policy makers working in fields related to minority health.

Aged↗
PubMed1998

Patient satisfaction and rehabilitation services.

OBJECTIVE: Despite the widespread use of patient satisfaction measures, there has been only a small amount of research and writing on the topic in rehabilitation. This article reviews selectively the large amount of literature on satisfaction in health care, examines work in rehabilitation settings, and highlights issues in patient satisfaction, given the unique circumstances of rehabilitation services. DATA SOURCES: A Medline search was made of the past 10 years using descriptors related to patient satisfaction, rehabilitation, and selected diagnostic categories. Additional sources came from references on satisfaction accumulated by the author over the past 20 years. STUDY SELECTION: Because of the voluminous literature, findings from existing reviews were emphasized, particularly those using meta-analytic methods. All articles that involved satisfaction in rehabilitation settings were included. DATA SYNTHESIS: Research in health care generally shows high levels of satisfaction. Personal aspects of care, including full communication, are the most important predictors, whereas age, education, and social status show weak relationships with rating levels. Dissatisfied patients tend to seek other providers. Higher satisfaction is associated with patient compliance and better outcomes. Levels of satisfaction are especially high in rehabilitation. CONCLUSIONS: Measures of patient satisfaction with rehabilitation should include items regarding progress and degree of return to independent living. Responses of proxies answering in place of patients should not be regarded as equivalent to patients' opinions. The field is in need of standard, validated measures appropriate for various settings.

Health Services Research↗
PubMed2002

Treatment satisfaction in type 2 diabetes: a comparison between an inhaled insulin regimen and a subcutaneous insulin regimen.

BACKGROUND: In patients with type 2 diabetes, published data suggest that glycemic control can be achieved as effectively with an inhaled insulin regimen (preprandial inhaled intrapulmonary insulin plus a single bedtime Ultralente injection) as with a conventional subcutaneous insulin regimen involving 2 to 3 injections per day. It is unknown whether inhalation delivery of insulin improves patient satisfaction. OBJECTIVE: Our objective was to compare patient satisfaction between an inhaled insulin regimen and a subcutaneous insulin regimen. METHODS: This was a 12-week randomized, open-label, parallel-group, controlled trial in patients with type 2 diabetes. They were randomized to receive either a subcutaneous insulin regimen (split/mixed insulin with 2 to 3 injections daily) or an inhaled insulin regimen (inhaled insulin before meals and a single Ultralente insulin injection at bedtime). Change in glycosylated hemoglobin (HbA1c) from baseline to week 12 was the study's primary end point. At baseline and week 12, patients completed a questionnaire (Patient Satisfaction with Insulin Therapy Questionnaire) covering attributes of patient satisfaction. Treatment regimens were compared on each item with the Wilcoxon rank sum test and on the overall score with a t test. RESULTS: Fifty-one patients (age range, 35-65 years) participated in the study, 26 receiving inhaled insulin and 25 receiving subcutaneous insulin. Forty-seven patients (22 inhaled insulin, 25 subcutaneous insulin) completed the satisfaction questionnaire. The mean percent improvement in overall satisfaction with an inhaled insulin regimen (31%; 95% CI, 14-50) was significantly greater (P < 0.05) than that with a subcutaneous insulin regimen (13%; 95% CI, 7-19). Increases in overall satisfaction correlated with improvements in glycemic control (r = 0.30; P < 0.05). Both treatment regimens experienced a mean HbA1c reduction of approximately 0.7%. Although patient satisfaction was the chief focus of this article, these results should be considered exploratory, as the trial was powered prospectively for HbA1c values (the primary end point) and not for patient satisfaction. CONCLUSIONS: Administration of an inhaled insulin regimen may offer the first practical, noninvasive alternative to insulin injections. In the patients with type 2 diabetes studied, an inhaled insulin regimen with the need for only 1 subcutaneous injection at bedtime appeared to offer more ease of use, comfort, and convenience, as well as greater overall satisfaction, than a subcutaneous insulin regimen of 2 to 3 injections daily.

Administration, Inhalation↗
PubMed1999

The relation of patient satisfaction with treatment of otitis externa to clinical outcomes: development of an instrument.

This survey was undertaken to develop a short, comprehensive measure of patient satisfaction with pharmacologic treatment for otitis externa and to assess the relationships between satisfaction, disease symptoms, and medication side effects. Otitis externa was diagnosed in 41 patients recruited from 6 sites; 34 patients completed and returned the study instruments and were included in the study. Patients or their caregivers administered polymyxin/neomycin/hydrocortisone ear drops prescribed by a physician and completed a daily diary for 10 days and a satisfaction questionnaire at the end of the treatment period. The main outcome measures were the subscale scores for patient satisfaction and their relation to medication side effects, symptoms of ear infection, activity limitations, pain, and adherence to prescription regimens. The questionnaire and its subscales demonstrated good psychometric properties (ie, reliability coefficients >0.75, except for 1 subscale). Overall satisfaction was found to be significantly correlated with relief of symptoms, ability to return to normal activities, ease of administration, and medication side effects. Satisfaction subscale scores were correlated with patient-reported severity of medication side effects and disease symptoms. More than half the patients took drops for more than the prescribed number of days, and one third took more than the prescribed number of drops per administration (ie, overadherence). The relation between satisfaction and adherence was weak, perhaps due to the high rates of overadherence. Our results demonstrate that patient satisfaction with otic medication can be assessed across various aspects of satisfaction and that it is correlated with reported disease symptoms and medication side effects. This type of multifaceted assessment may help physicians select between medications with different side-effect profiles and administration schedules. Larger studies are needed to evaluate the relationship between satisfaction with an otic medication and adherence to a medication regimen.

Adolescent↗
PubMed2003

[Job satisfaction and burnout in general practitioners].

OBJECTIVE: To describe job satisfaction in general practitioners (GP) in the province of Barcelona, and to analyse its relationship with their job burnout, and social and professional characteristics. DESIGN: Transversal observational study.Setting. Province of Barcelona, Spain. PARTICIPANTS: 603 General Practitioners had participated in ninety three primary care centers. MEASUREMENT: Through a direct interview (individual or in group) a validated questionnaire was administered in three parts: general data (social, demographic and professional), job satisfaction (Font Roja-9 dimensions) and job burnout (Maslach Burnout Inventory-3 scales). RESULTS: The job satisfaction questionnaire (score ranging from 1-5) showed a global satisfaction level of 3.02 (95%CI, 2.98%-3.05%) and we obtained a 18% non response rate. There was a positive association between overall satisfaction and the following variables: less years working in primary health, working in centres providing instruction, and willingness to receive information from the survey. Low levels of satisfaction were associated to high scores in emotional exhaustion and depersonalisation scales, and low scores in personal accomplishment scale. CONCLUSIONS: Overall satisfaction has a medium score in the Font-Roja questionnaire. Age seems to lead to a significant tendency to decrease satisfaction as practitioners grow older. Job satisfaction and job burnout present a closely linked behaviour, inversely, as satisfaction increases when job burnout presents low scores.

Adult↗
PubMed2001

Predictors of patient satisfaction.

Correlates of patient satisfaction at varying points in time were assessed using a survey with 2-week and 3-month follow-up in a general medicine walk-in clinic, in USA. Five hundred adults presenting with a physical symptom, seen by one of 38 participating clinicians were surveyed and the following measurements were taken into account: patient symptom characteristics, symptom-related expectations, functional status (Medical Outcomes Study Short-Form Health Survey [SF-6]), mental disorders (PRIME-MD), symptom resolution, unmet expectations, satisfaction (RAND 9-item survey), visit costs and health utilization. Physician perception of difficulty (Difficult Doctor Patient Relationship Questionnaire), and Physician Belief Scale. Immediately after the visit, 260 (52%) patients were fully satisfied with their care, increasing to 59% at 2 weeks and 63% by 3 months. Patients older than 65 and those with better functional status were more likely to be satisfied. At all time points, the presence of unmet expectations markedly decreased satisfaction: immediately post-visit (OR: 0.14, 95% CI: 0.07-0.30), 2-week (OR: 0.07, 95% CI: 0.04-0.13) and 3-month (OR: 0.05, 95% CI: 0.03-0.09). Other independent variables predicting immediate after visit satisfaction included receiving an explanation of the likely cause as well as expected duration of the presenting symptom. At 2 weeks and 3 months, experiencing symptomatic improvement increased satisfaction while additional visits (actual or anticipated) for the same symptom decreased satisfaction. A lack of unmet expectations was a powerful predictor of satisfaction at all time-points. Immediately post-visit, other predictors of satisfaction reflected aspects of patient doctor communication (receiving an explanation of the symptom cause, likely duration, lack of unmet expectations), while 2-week and 3-month satisfaction reflected aspects of symptom outcome (symptom resolution, need for repeat visits, functional status). Patient satisfaction surveys need to carefully consider the sampling time frame as well as adjust for pertinent patient characteristics.

Adult↗