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Change in job satisfaction, and its association with self-reported stress, cardiovascular risk factors and mortality.

Many studies have suggested that occupational stress may be related to the development of cardiovascular disease (CVD), independently of other known risk factors. Despite the recognition of job satisfaction as a particular form of stress, however, few studies have examined its association with CVD. Those studies that have explored the associations between job satisfaction and CVD risk factors, or job satisfaction and CVD mortality, have been largely cross-sectional in approach and report contradictory findings. This study revisits the associations between job satisfaction, self-reported stress. CVD risk factors and CVD mortality using longitudinal data from a cohort of working Scottish men and women recruited between 1970 and 1973. Approximately half of the cohort was screened for a second time, 4-7yr after the baseline examination. Job satisfaction at baseline was strongly associated with low or moderate perceived stress at 2nd screening. Men and women reporting decreased satisfaction in their jobs between baseline and 2nd screening tended to report moderate or high perceived stress at 2nd screening. Job satisfaction was associated with own occupational class in different directions for men and women. Men in the manual social classes reported more satisfaction with their jobs than their peers, whilst it was women in the non-manual social classes who reported more satisfaction with their jobs than their peers. There was limited evidence of an association between job satisfaction and age-adjusted CVD risk factors (diastolic blood pressure; blood cholesterol; body mass index; forced expiratory volume in 1st amount of recreational exercise undertaken; cigarette smoking and alcohol consumption) for men, after adjustment for occupational class, but there was no evidence of any association for women. There was also no evidence to suggest that men or women reporting job dissatisfaction on one occasion or on two occasions several years apart, had a significantly greater risk of mortality from CVD.

Adult↗

Assessment of satisfaction with treatment for chronic pain.

The purpose of this study was to develop an instrument to assess satisfaction with treatment of chronic pain, evaluate the reliability and validity of this instrument, and then examine predictors and consequences of satisfaction. The Pain Service Satisfaction Test (PSST) is the result of this effort. Fifty adult patients receiving services for chronic pain in a university pain clinic completed the PSST as part of a survey mailed to their homes. Findings supporting the validity of the PSST included significant positive correlations with a general measure of treatment satisfaction, patient ratings of global treatment satisfaction and effects of treatment, and physician ratings of patient satisfaction with treatment. Regression analyses of predictors of satisfaction highlighted significant contributions of confidence and trust in the provider, pain reduction, and waiting in the clinic. These predictors together accounted for 60% of satisfaction with treatment. Treatment satisfaction was negatively correlated with depression, reported number of physicians consulted, and number of physician visits for pain in the past 12 months; and there was a trend toward a negative correlation with disability. Results of the present study support the importance of satisfaction with treatment as a predictor and possible determinant of later health, function, and service utilization.

Chronic Disease↗

Job satisfaction among Canadian orthodontists.

Job satisfaction has been well researched for many professions, including general dentistry. The job satisfaction of orthodontists has not been adequately studied. The aims of this study were to describe job satisfaction among orthodontists and to determine characteristics associated with job satisfaction in the profession. A self-administered, anonymous survey was mailed to Canadian orthodontists. It included a modified version of the Dentist Satisfaction Survey, an overall occupational stress score, and items addressing various characteristics of the respondents. Of 654 mailed surveys, 335 were returned, for a response rate of 51.2%. Most orthodontists (79.3%) were classified as satisfied according to the overall job satisfaction scale of the Dentist Satisfaction Survey; however, some (2.5%) were classified as dissatisfied. The facets of orthodontics with the highest degree of satisfaction were patient relations (93%), delivery of care (86%), respect (84%), professional relations (80%), and staff (76%). The most dissatisfaction was associated with personal time (26%) and practice management (15%). Stepwise multiple regression analysis resulted in a model including overall occupational stress, membership in the Canadian Association of Orthodontists, total number of staff, and age to account for 27.1% of the variation in the overall job satisfaction scale. Based on accountable sources of variance, the overall job satisfaction scale seems to be more affected by other variables than the characteristics evaluated by this survey.

Age Factors↗

Cross-cultural correlates of life satisfaction and self-esteem.

College students in 31 nations (N = 13,118) completed measures of self-esteem, life satisfaction, and satisfaction with specific domains (friends, family, and finances). The authors assessed whether cross-cultural variations in the strength of associations were related to societal dimensions including income and individualism. At the national level, individualism correlated -.24 (ns) with heterogeneity and .71 (p < .001) with wealth. At the individual level, self-esteem and life satisfaction were correlated .47 for the entire sample. This relation, however, was moderated by the individualism of the society. The associations of financial, friend, and family satisfactions with life satisfaction and with self-esteem also varied across nations. Financial satisfaction was a stronger correlate of life satisfaction in poorer countries. It was found that life satisfaction and self-esteem were clearly discriminable constructs. Satisfaction ratings, except for financial satisfaction, varied between slightly positive and fairly positive.

Adolescent↗

Satisfaction with care in peritoneal dialysis patients.

Patient satisfaction is an important aspect of dialysis care, only recently evaluated in clinical studies. We developed a tool to assess peritoneal dialysis (PD) customer satisfaction, and sought to evaluate and validate the Customer Satisfaction Questionnaire (CSQ), quantifying PD patient satisfaction. The CSQ included questions regarding administrative issues, Delivery Service, PD Training, Handling Requests, and transportation. The study was performed using interviews in all Hungarian Fresenius Medical Care dialysis centers offering PD. CSQ results were compared with psychosocial measures to identify if patient satisfaction was associated with perception of social support and illness burden, or depression. We assessed CSQ internal consistency and validity. Factor analysis explored potential underlying dimensions of the CSQ. One hundred and thirty-three patients treated with PD for end-stage renal disease for more than 3 months were interviewed. The CSQ had high internal consistency. There was high patient satisfaction with customer service. PD patient satisfaction scores correlated with quality of life (QOL) and social support measures, but not with medical or demographic factors, or depressive affect. The CSQ is a reliable tool to assess PD customer satisfaction. PD patient satisfaction is associated with perception of QOL. Efforts to improve customer satisfaction may improve PD patients' quantity as well as QOL.

Aged↗

Services for spinal cord injured: availability and satisfaction.

This article discusses service delivery for Spinal Cord Injured (SCI) in the Netherlands. In this wealthy country, almost everyone has access to domestic adaptations and other equipment, regardless of income and with low, or without user contributions. However, satisfaction with this system of its products is rarely examined. Subjects in this research are 318 SCI individuals between 18 and 65 years of age, living in the community at a mean time of 3.6 years after injury. Availability of accessible housing, domestic adaptations, wheelchairs and outdoor transportation is investigated. Satisfaction with available services and satisfaction with service delivery procedures is measured by self-developed questionnaires. Relationships between these satisfaction scores and measures for functional health status (SIP68) and life satisfaction (LSQ) are analyzed. The presence of domestic adaptations is high, and 78.3% said their houses were sufficiently adapted at the time of the interview. Wheelchairs were generally available and most respondents had more than one. However, many users had complaints about their wheelchairs: 35.9% about their manual wheelchairs and 47.5% about their electric wheelchairs. Public transport was rarely used, 51.1% of respondents had an adapted car. Having an adapted car was significantly related to the ability to drive independently. Satisfaction with available services was acceptable, but satisfaction with service delivery procedures was very low. Satisfaction with available services did have a significant relationship with functional health status when the influence of the type of injury was taken into account. Satisfaction with available services also had a significant relationship with life satisfaction, after the influence of functional health status was taken into account. Further research on this topic is recommended.

Activities of Daily Living↗

Patient compliance: a determinant of patient satisfaction?

Recent studies have shown that there is a distinct relationship between patient satisfaction and patient compliance in orthodontic treatment. The aim of this study was to investigate whether patient compliance, as noticed and recorded by the orthodontist during treatment, can be used as a determinant of patient's satisfaction in the long run. Documentation of 100 patients who completed active orthodontic treatment in the year 2000 at the Academic Centre of Dentistry Amsterdam was analyzed, and compliance scores for patients were computed. Three years after completion of active orthodontic treatment, a questionnaire about satisfaction was sent to all subjects. Items were divided over six subscales on the basis of item content. Compliance and satisfaction scores of both sexes were compared, and correlations between compliance and satisfaction were explored. Regression analyses were done to examine the predictive value of sex and compliance on patient satisfaction. No significant correlations between compliance and satisfaction scores were found. Sex, but not compliance, predicted the patient's satisfaction with the doctor-patient relationship and the situational aspects of the treatment. Compliance, as noticed and recorded by the orthodontist during treatment, is not a decisive determinant of patient satisfaction in the long run. Sex, however, is a predictor of patient satisfaction with regard to the doctor-patient relationship and the situational aspects of the orthodontic treatment.

Adolescent↗

'Satisfaction with care': associations with health-related quality of life and psychosocial function among Swedish patients with endocrine gastrointestinal tumours.

The aims of this study were to investigate 'satisfaction with care' and its possible relationships to hope, health-related quality of life, anxiety and depression. Eighty-five patients with endocrine gastrointestinal (GI) tumours responded to questionnaires a few days after a hospital visit. 'Satisfaction with care' was assessed by the Comprehensive Assessment of Satisfaction with Care (CASC), health-related quality of life by the EORTC QLQ C-30 and anxiety and depression by the Hospital Anxiety and Depression Scale (HADS). Patients' highest satisfaction scores were obtained for 'general satisfaction' and 'nurses' and doctors' technical skills'. The lowest satisfaction was expressed for 'doctors' interpersonal skills', 'nurses' communication skills' and 'care organization'. Patients reporting a clinically relevant level of anxiety were less satisfied with several care aspects than those reporting less anxiety. Satisfaction with 'nurses' communication skills' and 'doctors' interpersonal skills' was associated with several aspects of health-related quality of life, whereas satisfaction with 'doctors' information', 'nurses' technical skills' and 'general satisfaction' was not. Satisfaction with psychosocial aspects of care is related to the psychosocial function of patients with endocrine GI tumours.

Adult↗

Predictors of job satisfaction and absenteeism in two samples of Hong Kong nurses.

BACKGROUND: Stress-related outcomes of job satisfaction and absenteeism among nurses should receive more attention in Hong Kong because absenteeism is costly. Many nurses' complaints are due to organizational change in privatization since the establishment of the Hong Kong Hospital Authority in 1991. Organizational climate is found to be an antecedent of job dissatisfaction and absenteeism in many studies in western societies. AIM: To investigate the role of organizational climate and psychological distress on job satisfaction; and the role of climate, distress and job satisfaction on absenteeism in Hong Kong nurses, while controlling for demographic variables. METHODS: A self-administered questionnaire survey method was used to collect data from two samples of nurses within a 8-month period. They are, respectively, 144 (74 general nurses, 70 psychiatric nurses; 47 males, 97 females) and 114 (85 general nurses, 29 psychiatric nurses; 17 males, 97 females) nurses. RESULTS: Multiple regression analyses revealed that occupational type (psychiatric/general), environment (the physical conditions in the work area) and psychological distress were significant predictors of job satisfaction for sample 1; and well-being (social relations, welfare and health issues) was the only significant predictor of job satisfaction for sample 2. However, age, involvement (the degree of commitment displayed towards employees by the organization), psychological distress and job satisfaction were significant predictors of absenteeism for sample 1; and occupational type, organization (the interaction between the worker and the organization), and involvement were significant predictors of absenteeism for sample 2. CONCLUSIONS: The empirical findings provide support for the climate-job satisfaction and climate-absenteeism relationships. Psychological distress could be an antecedent of job satisfaction; and job satisfaction could be an antecedent of absenteeism. Certain climate dimensions should be improved to enhance job satisfaction and reduce distress, which in turn will reduce absenteeism.

Absenteeism↗

A method for quantifying overall satisfaction of complete denture patients.

Reproducible and quantitative evaluation of patient satisfaction with their complete dentures is of great importance for preoperative diagnosis, treatment planning and assessment of complete denture treatment outcome. This study attempted (1) to clarify the degree of contribution of various factors to overall satisfaction, and (2) to develop a method for quantitative assessment of overall satisfaction with complete dentures. Twelve satisfaction factors and a three-grade scale were used to assess 302 complete denture patients. The contribution of each grade of the 12 factors to the overall satisfaction level was determined by multiple regression analysis. Seven factors were highly correlated to the overall satisfaction. Based on the level of contribution by these seven significant factors, a scoring method for satisfaction was established. Category scores for these factors were calculated and the sum of the category scores was converted to an integer between 0 and 100. The resulting quantification score was closely correlated with overall satisfaction. A protocol for scoring overall satisfaction was developed based on the scientifically analysed contribution of each satisfaction factor.

Aged↗

The association between satisfaction with services provided in primary care and outcomes in Type 2 diabetes mellitus.

BACKGROUND: Patient satisfaction is of increasing importance, is taken into account when planning services, and is used by healthcare providers as a measure of healthcare quality. Satisfaction with medical care, including diabetic care, has been associated with various health-related behaviours and outcomes that have a direct bearing on health and illness. The association between satisfaction and health outcomes is poorly understood. AIM: The aim of the study was to determine whether there is an association between satisfaction in patients with Type 2 diabetes and the outcome of their diabetic care, and to determine the contribution of different aspects of satisfaction with the primary care. METHODS: Patients with Type 2 diabetes were identified from two general practices in Leeds. PATIENTS: scores on the General Practice Assessment Survey Questionnaire (GPAS) were correlated with the outcome of care, as measured by HbA1c level collected from patients' medical records. RESULTS: Data from 106 patients were analysed. There was a generally high satisfaction rate for all GPAS domains. The correlation between different GPAS domains and HbA1c level showed significant positive correlations (P < 0.001) for continuity of care, trust and overall satisfaction; and positive correlations (P < 0.01) for access, receptionists, interpersonal care, communication skills, knowledge of patient about the doctor, technical care, and practice nursing. CONCLUSION: The findings from this study demonstrate that there is an association between satisfaction and outcome in diabetes, which goes across all the GPAS domains. This suggests that processes that can act to increase patient satisfaction may be contributing to improved clinical outcomes. More development work is needed in this field to explore and elucidate the complex relationship between satisfaction and clinical outcomes.

Adult↗

Satisfaction and use of prenatal care: their relationship among African-American women in a large managed care organization.

BACKGROUND: Although many more mothers of almost all ethnic groups began prenatal care in the first trimester during the last decade, a significant number of low-income and minority women still fail to obtain adequate care in the United States-a failure that may be related to their dissatisfaction with the prenatal care experience. This study sought to examine the relationship between satisfaction with care and subsequent prenatal care utilization among African-American women using prospective methods. METHODS: A sample of 125 Medicaid and 275 non-Medicaid African-American adult women seeking care through a large Midwest managed care organization were interviewed before or at 28 weeks' gestation at one of two prenatal care sites. Women were interviewed about personal characteristics, prenatal care experience, and ratings of care (satisfaction). Information about subsequent use of prenatal care was obtained through retrospective medical record review after delivery. Univariate and multivariable analyses examining the relationship between women's satisfaction and prenatal care use were conducted using a dichotomous measure of satisfaction and a continuous measure of utilization. RESULTS: Women were highly satisfied with prenatal care, with an overall mean satisfaction score of 80.3. Non-Medicaid women were significantly (p < 0.05) less satisfied with their prenatal care (mean score, 79.1) than Medicaid women (mean score, 82.8), and the latter had significantly fewer visits on average than the former subsequent to the interview. Analyses showed no significant difference in subsequent utilization according to whether a woman had a high versus low level of satisfaction at the prenatal care interview. CONCLUSIONS: This study challenges the assumption that improving a woman's satisfaction with care will lead to an increase in the adequacy of her prenatal care utilization. Since this study was limited to African-American women and is the first prospective study of women's satisfaction with care and prenatal care utilization, the negative findings do not yet settle this area of inquiry. Monitoring women's satisfaction with prenatal care in both managed care and fee-for-service settings and working to improve those aspects of care associated with decreased satisfaction is warranted.

Adolescent↗

A randomised controlled trial of maternal satisfaction with the routine examination of the newborn baby at three months post birth.

OBJECTIVE: to determine whether any differences in maternal satisfaction with the examination of a newborn baby between midwives and junior paediatricians are maintained over a three-month period. DESIGN, SETTING AND PARTICIPANTS: randomised controlled trial. Eight hundred and twenty-six mother and baby pairs in a district general hospital in South East England were randomised to a junior paediatrician or a midwife for the routine examination. Four hundred and eighty-six mothers completed a maternal satisfaction questionnaire on day-one and again three-months later. Maternal satisfaction with the examination was analysed in relation to randomised group, process and background variables. FINDINGS: high satisfaction with the examination was reported by most mothers (day-one: 82%; three-months: 79%). At day-one, mothers whose babies were examined by a midwife were more satisfied with the examination (crude odds ratio (OR) for the lowest tertile of satisfaction 0.49, 95% CI 0.32-0.73). However, after controlling for provision of health education during the examination (e.g. discussing feeding, sleeping and skin care) and continuity of care provided, maternal satisfaction was no longer related to status of examiner (adjusted OR 0.83, 95% CI 0.52-1.33). Three months later, there was no significant difference in maternal satisfaction with midwife and junior paediatrician examinations of the newborn baby (crude OR 0.89, 95% CI 0.58-1.37). Discussion of health-care issues by the examiner during the examination was significantly related to increased satisfaction even at three-months. Three month ratings of low satisfaction with the examination were most strongly predicted by current maternal depressive mood, even when other factors were adjusted for (adjusted OR 2.58, 95% CI 1.19-5.59). KEY CONCLUSIONS: from the mother's perspective, the quality of midwife examination is at least as satisfactory as that of junior paediatricians and this perception is maintained over a three-month period. Satisfaction can be significantly enhanced if the examiner provides information on behavioural and health-care issues. The examination of the newborn baby provides an important window of opportunity for sharing information on newborn behaviour and care issues.

Continuity of Patient Care↗

Validating a model of patient satisfaction with emergency care.

STUDY OBJECTIVE: We sought to validate a previously developed model of emergency department patient satisfaction in a general population using a standard mailed format. The study aims to export the findings of a comprehensive ED quality-of-care study to an easily measured patient population. METHODS: A double-sided, single-page survey was mailed to all patients discharged home from 4 teaching hospital EDs during a 1-month period. Determinants of patient satisfaction were analyzed with a previously developed multivariate, ordinal logistic-regression model. RESULTS: The mail survey response rate was 22.9% (2,373/10,381). The survey validates the importance of previously identified determinants of patient satisfaction, including age, help not received when needed, poor explanation of problem, not told about wait time, not told when to resume normal activity, poor explanation of test results, and not told when to return to the ED (P <.01). Greater age predicted higher patient satisfaction, whereas all other variables correlated with lower patient satisfaction. In contrast with prior findings, black race was not a significant predictor of satisfaction in the mail survey population. Low ratings of overall care are strongly correlated with reduced willingness to return (P <.0001). CONCLUSION: A patient satisfaction model was previously developed from a comprehensive research survey of ED care. We demonstrate the generalizability of this model to a mail survey population and replicate the finding that satisfaction strongly predicts willingness to return. The response rate of this study is typical of commercial patient-satisfaction surveys. The validated model suggests that ED patient satisfaction improvement efforts should focus on a limited number of modifiable and easily measured factors.

Adult↗

Perceived stress and coping resource availability as predictors of life satisfaction in young, middle-aged, and older adults.

Global satisfaction with life across three age groups (18 to 40 years, 41 to 65 years, and 66 years and above) was investigated. Multiple regressions were computed to examine the separate and joint effects of perceived stress and coping resource availability upon life satisfaction across the three age groups (N = 189). Age differences in perceived stress, coping resource availability, and life satisfaction, were also investigated. Results of this cross-sectional investigation indicated that self-appraisal measures of perceived stress and coping resource effectiveness served as moderate predictors of global life satisfaction, and that for the total sample the combined effects of perceived stress and coping resource effectiveness were better predictors of life satisfaction than either variable considered separately. Perceived stress was found to be a better predictor of life satisfaction for younger adults, and coping resource effectiveness was a better predictor of satisfaction with life for middle-aged and older adults. Significant age differences in life satisfaction, perceived stress, and coping resources were also found. The assessment of perceived stress and coping has important implications for life satisfaction among all age groups, and has particular significance to older adults. By identifying age differences in variables associated with satisfaction with life, more effective efforts can be made to promote physical and psychological well-being in late adulthood.

Adaptation, Psychological↗

Influence of length of stay on patient satisfaction with hospital care in Japan.

OBJECTIVE: The objective of this study was to identify specific patient satisfaction items related to overall satisfaction by different length of stay (LOS) for patients in Japanese hospital settings. METHODS: This cross-sectional study involved a participant sample, drawn from 77 voluntarily participating hospitals throughout Japan, of in-patients discharged to the community. Older patients and psychiatric, pediatric, obstetric and gynecologic patients were excluded. The 1050 respondents analyzed (response rate > or = 5l.1%) were divided into three groups based on their LOS: group 1, LOS < or = 1 week; group 2, LOS < or = 1 month; and group 3, LOS > 1 month. Using stepwise multiple regression analysis, we explored for each LOS group the relationship between overall patient satisfaction and satisfaction with 33 individual items, including three regarding perceived reputation of the hospital in question. RESULTS: Some unique satisfaction items for each group (e.g. 'skill of nursing care' in group 1, 'Recovery of physical health', 'skill of nursing care', and 'respect for patients opinions and feelings' in group 2, and 'relief from pain' and 'respect for patients' opinions and feelings' in group 3) were significantly associated with overall satisfaction. In all three groups, common items (e.g. 'recovery from distress and anxiety' and 'doctor's clinical competence') also related significantly to overall satisfaction. Two items pertaining to the hospital reputation dimension (e.g. 'family member's evaluation of the hospital' and 'hospital reputation among other patients') were also significant predictors of overall satisfaction in all three groups. CONCLUSION: The findings show that according to LOS, unique items could determine significantly the achievement of overall satisfaction, while some common predictors across all three LOS groupings also seemed to be indispensable for inpatient's assessment of hospital care. It was also confirmed in this study that a positive perception of hospital reputation might have an important role in patient satisfaction in Japan.

Adolescent↗

Personal, interpersonal, and organizational influences on student satisfaction with clinical education.

BACKGROUND AND PURPOSE: Understanding the factors that contribute to student satisfaction may lead to improved education in physical therapy. This study tested the extent to which variables in the personal, interpersonal, and organizational domains influence satisfaction with clinical experiences. SUBJECTS: Physical therapist students (N = 113) in 2 phases of their clinical experiences at one private school participated. METHODS: A nonexperimental design tested 3 models for predicting overall satisfaction. Students completed 3 surveys and weekly logs during 8-week-long clinical experiences. RESULTS: The survey return rate was 96%. Overall satisfaction with the clinical experience was predicted by life satisfaction, gender, off-site events, on-site events, interaction between negative events and gender, instructor teaching skills, interaction between education phase and gender, variety, and use of selected orientation methods. CONCLUSION AND DISCUSSION: Overall satisfaction is predicted by variables in all 3 domains. Overall satisfaction was best explained by factors in the interpersonal domain and student gender. Causal research is needed to confirm whether satisfaction can be improved and whether the results apply to other students at other schools. The relationships among satisfaction, performance, later job satisfaction, and career commitment need to be explored further.

Adult↗

Longitudinal changes in hearing aid satisfaction and usage in the elderly over a period of one or two years after hearing aid delivery.

OBJECTIVE: The objective of this study was to measure hearing aid satisfaction and usage for extended periods of time, up to 2 yr after hearing aid delivery, to determine whether longitudinal changes occur in the elderly for these outcome measures. DESIGN: A longitudinal study of hearing aid satisfaction and usage was performed in a group comprised of 134 elderly hearing aid wearers with these outcome measures obtained at 1, 6, and 12 mo postfit. A total of 49 of the original 134 elderly returned 2 yr after hearing aid delivery to complete the satisfaction and usage measures again. Multiple self-report measures of hearing aid satisfaction and hearing aid usage were obtained at each follow-up session. RESULTS: Most between-interval comparisons of the various measures of satisfaction and usage failed to reveal significant changes over time. However, some significant changes were observed in both satisfaction and usage. When such changes occurred, they were always in a direction that suggested a decrease in satisfaction or usage over time. Correlations across various postfit interval pairs were found to be positive, statistically significant, and moderate to strong in strength for all measures of satisfaction and usage. CONCLUSIONS: Although there were slight declines in hearing aid usage and satisfaction over time, measures of hearing aid satisfaction obtained at 1 mo postfit and of hearing aid usage obtained at 6 mo postfit are generally stable for up to 2 yr after hearing aid delivery.

Aged↗