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PubMed1980

Job to career satisfaction spillover among physician's assistants.

From the empirical studies that generalize the individual's job satisfaction to his life satisfaction, a meta-level hypothesis was developed to suggest a positive association between the physician's assistant's satisfaction with his current job and his satisfaction with his broader occupational or career choice. A questionnaire was mailed to 280 graduates of two Physician's Assistant Programs. Data analysis is based on 170 returns. Job satisfaction is measured with an amended version of the Job Description Inventory that includes a patient satisfaction component. Job satisfaction is found to relate positively to a global measure of career satisfaction, with the work satisfaction component explaining most of the variance in career satisfaction.

Career Choice↗
PubMed1985

Professional satisfaction and client outcomes. A comparative organizational analysis.

In studies of the effectiveness of health care organizations, the job satisfaction level of professional staff is often viewed as an "outcome," since providing a climate that satisfies participants' needs is one aspect of organizational effectiveness. Staff satisfaction, however, has not been linked with outcomes associated with clients. In this article, the authors examine the relationship between the aggregate job satisfaction level of nursing staff in 77 family planning clinics and two client outcomes: the aggregate satisfaction level of teenage clients with contraceptive services obtained in the clinic, and the subsequent rate of client compliance with contraceptive prescriptions. Among the variables studied in testing an organizational-level model, it is found that the job satisfaction level of nursing staff is the strongest determinant of the aggregate satisfaction level of clients; client satisfaction level, in turn, predicts the rate of clients' subsequent contraceptive compliance. Staff satisfaction has a noteworthy indirect effect on compliance through client satisfaction. Compliance, however, appears to be more susceptible to variations in clinic structure than to variations in staff satisfaction levels. Implications of these findings for studies of effectiveness of health services and for management of health care organizations are discussed.

Adolescent↗
PubMed2006

Patient satisfaction as an outcome measure after surgical treatment for lumbar spinal stenosis: testing the validity and discriminative ability in terms of symptoms and functional status.

STUDY DESIGN: A prospective observational study of 204 patients treated surgically for lumbar spinal stenosis. OBJECTIVES: To validate a measure of patient satisfaction with outcome in terms of symptoms and functional status, investigate the association of satisfaction with treatment effect, and estimate the discriminative ability. SUMMARY OF BACKGROUND DATA: The properties of global measures of patient satisfaction with outcome are unknown. METHODS: Patients completed preoperative and follow-up questionnaires about symptom severity, walking ability, functional status, and their overall satisfaction with the surgical results. The patients were asked a single-item question rating their satisfaction. Correlations between satisfaction and symptom severity, walking ability, and function measured by back-specific questionnaires were calculated. The associations of satisfaction with the postoperative score and the score change for each outcome measure were determined, and the discriminative ability was evaluated by the receiver-operating characteristic method. RESULTS: The correlations with the postoperative scores were significant. Satisfaction was much more strongly associated with postoperative scores than with score changes. However, patient satisfaction did not correctly discriminate between improved and nonimproved patients. CONCLUSION: The single-item global measure of satisfaction with outcome was valid, but it did not reflect the treatment effect and did not correctly distinguish between clinically important changes.

Activities of Daily Living↗
PubMed2002

Life-satisfaction is a momentary judgment and a stable personality characteristic: the use of chronically accessible and stable sources.

Social cognition research indicates that life-satisfaction judgments are based on a selected set of relevant information that is accessible at the time of the life-satisfaction judgment. Personality research indicates that life-satisfaction judgments are quite stable over extended periods of time and predicted by personality traits. The present article integrates these two research traditions. We propose that people rely on the same sources to form repeated life-satisfaction judgments over time. Some of these sources (e.g., memories of emotional experiences, academic performance) provide stable information that explains the stability in life-satisfaction judgments. Second, we propose that the influence of personality traits on life satisfaction is mediated by the use of chronically accessible sources because traits produce stability of these sources. Most important, the influence of extraversion and neuroticism is mediated by use of memories of past emotional experiences. To test this model, participants repeatedly judged life-satisfaction over the course of a semester. After each assessment, participants reported sources that they used for these judgments. Changes in reported sources were related to changes in life-satisfaction judgments. A path model demonstrated that chronically accessible and stable sources are related to stable individual differences in life-satisfaction. Furthermore, the model supported the hypothesis that personality effects were mediated by chronically accessible and stable sources. In sum, the results are consistent with our theory that life-satisfaction judgments are based on chronically accessible sources.

Cognition↗
PubMed2002

A demonstration of the impact of response bias on the results of patient satisfaction surveys.

OBJECTIVES: The purposes of the present study were to examine patient satisfaction survey data for evidence of response bias, and to demonstrate, using simulated data, how response bias may impact interpretation of results. DATA SOURCES: Patient satisfaction ratings of primary care providers (family practitioners and general internists) practicing in the context of a group-model health maintenance organization and simulated data generated to be comparable to the actual data. STUDY DESIGN: Correlational analysis of actual patient satisfaction data, followed by a simulation study where response bias was modeled, with comparison of results from biased and unbiased samples. PRINCIPAL FINDINGS: A positive correlation was found between mean patient satisfaction rating and response rate in the actual patient satisfaction data. Simulation results suggest response bias could lead to overestimation of patient satisfaction overall, with this effect greatest for physicians with the lowest satisfaction scores. CONCLUSIONS: Findings suggest that response bias may significantly impact the results of patient satisfaction surveys, leading to overestimation of the level of satisfaction in the patient population overall. Estimates of satisfaction may be most inflated for providers with the least satisfied patients, thereby threatening the validity of provider-level comparisons.

Bias↗
PubMed2004

Patient satisfaction: a descriptive study of a breast care clinic in Iran.

A descriptive study was carried out to examine patient satisfaction among women attending the Iranian Centre for Breast Cancer. A specially designed patient satisfaction questionnaire was distributed to all attendees and they were asked to complete the questionnaire. The questionnaire contained items on satisfaction with care organization, physical environment, personnel communication skills, clinical care, and overall satisfaction. In all, 425 women participated in the study. The mean age of women was 40.4 years (SD = 11.6), most were married (81%) and housewives (69%). A vast majority of women were very satisfied or satisfied with physical environment, personnel communication skills, and clinical care received. Eighty-two per cent of respondents were very satisfied or satisfied with the clinic's overall performance. There was a significant agreement between patients' overall satisfaction and satisfaction with physical environment, personnel communication skills, and clinical care. There was greatest agreement between patients' overall satisfaction and satisfaction with examination room (Kappa = 0.21, P < 0.0001) and with physicians' consultation (Kappa = 0.20, P < 0.0001). None of the demographic variables showed any significant association with patients' overall satisfaction. The findings suggest that the physical environment and physicians' style of consultation contribute most to the patients' overall satisfaction.

Adult↗
PubMed2005

Unpacking the concept of patient satisfaction: a feminist analysis.

AIM: The aim of this paper is to present a feminist critique of the concept of patient satisfaction. BACKGROUND: Fiscal restraint, health care restructuring, shifting demographics, biomedical technological advances, and a significant shortage of health care professionals are stretching health care systems across North America to the breaking point. A simultaneous focus on consumerism and health service accountability is placing additional pressure on the system. The concept of patient satisfaction, with roots in the consumer movement of the 1960s, has both practical and political relevance in the current health care system and is commonly used to guide research related to consumer experiences of health care. Because the quality of health care encounters may lead to treatment-seeking delays, patient satisfaction research may be an effective vehicle for addressing this public health issue. However, there is wide agreement that patient satisfaction is an under-theorized concept. Using current conceptualizations of patient satisfaction, we end up all too often producing a checklist approach to 'achieving' patient satisfaction, rather than developing an understanding of the larger issues underlying individual experiences of health care. We focus on the symptoms rather than the problems. DISCUSSION: Without further theoretical refinement, the results of research into patient satisfaction are of limited use. To push forward theoretical development we might apply a variety of theoretical lenses to the analysis of both the concept and the results of patient satisfaction research. Feminism, in particular, offers a perspective that may provoke further refinement of patient satisfaction as a concept. CONCLUSIONS: Without a deeper understanding of the values and beliefs (or the worldview) that informs our approaches to researching patient satisfaction, researchers will be reacting to the most obvious indicators and failing to address the underlying issues related to individual experiences of health care.

Appointments and Schedules↗
PubMed2006

Life satisfaction among older people (65+) with reduced self-care capacity: the relationship to social, health and financial aspects.

AIMS AND OBJECTIVES: This study aimed at investigating life satisfaction and its relation to living conditions, overall health, self-care capacity, feeling lonely, physical activities and financial resources among people (65+) with reduced self-care capacity. BACKGROUND: Knowledge about factors related to low life satisfaction among older people with reduced self-care capacity is sparse, although this is important in health care and nursing so that the care is adapted to their needs and perspective. Previous research has mainly focused on isolated aspects such as pain in relation to life satisfaction among older people in general and less among so those with reduced self-care capacity in general. DESIGN AND METHOD: A subsample of 522 persons was selected from a randomly selected cross-sectional survey using a modified form of the Older Americans' Resources Schedule and Life Satisfaction Index Z. RESULTS: The mean age in the total sample was 77.9; women (79.5) were significantly older than men (77.0). Low life satisfaction was found among women, as well as those living in special accommodations. Life Satisfaction Index Z was 15.3 (SD 5.6) in the total sample. Gender and living conditions did not explain life satisfaction whilst poor overall self-reported health and poor financial resources in relation to needs had the strongest explanatory value. Also of significant importance were loneliness, the degree of reduced self-care capacity and feeling worried. CONCLUSION: Life satisfaction in older people with reduced self-care capacity is determined by several factors, with social, physical, mental and financial aspects probably interacting with each other; especially feeling lonely, degree of self-care capacity, poor overall health, feeling worried and poor financial resources in relation to needs. These factors need to be considered in the care of these people to preserve or improve their life satisfaction. RELEVANCE TO CLINICAL PRACTICE: Nursing interventions in terms of preventive home visits, rehabilitation, health education directed towards physical, psychological, social and economic aspects of importance may help to preserve or improve life satisfaction for those with reduced self-care capacity.

Activities of Daily Living↗
PubMed2004

Patient satisfaction profiling of individual physicians: impact of panel status.

RATIONALE, AIMS AND OBJECTIVES: Evaluation of physician performance is increasingly based on patient satisfaction. However, few data are available regarding the extent to which individual physician profiles might be influenced by factors such as whether a physician's practice is open or closed. We evaluated whether panel status (whether or not a physician is accepting new patients) is associated with patient satisfaction with their primary care physician (PCP). METHODS: Cross-sectional analysis of patient satisfaction surveys. Surveys were available for 1,750 patients cared for by 69 PCPs. Patient satisfaction with their PCP was determined based on a composite of six questions derived from the Medical Outcomes Study. We used Generalized Estimating Equations to adjust for physician level variation. RESULTS: Patients of closed-panel physicians were more likely to rate their satisfaction with the provider as 'Excellent' or 'Very Good' compared to patients of open-panel physicians (78% vs. 69%, P <0.0001). After adjusting for satisfaction with the practice site, provider years in practice, managed care coverage, provider productivity, and patient race, the association between a closed panel and satisfaction remained significant (odds ratio 1.60, 95% confidence interval 1.10-2.31). CONCLUSIONS: Individual physicians' patient satisfaction data are confounded by factors not likely to be adjusted for in available profiles. After adjusting for other variables, physicians with closed panels still had better patient satisfaction compared to physicians with open panels. Further research is necessary to determine if panel status might also confound patient satisfaction.

Boston↗
PubMed2004

The combined effects of participatory styles of elderly patients and their physicians on satisfaction.

OBJECTIVES: To test whether concordance or discordance of patient participation between patients and physicians is associated with higher satisfaction, and to examine the effects of patients' and physicians' participatory styles on patients' satisfaction with their physicians. DATA: Data collected in the Texas Tech 5000 Survey of elderly patients in West Texas were used. Patient satisfaction with their physicians was measured by a single item from the Consumer Assessment of Health Plans (CAHPS), representing patients' ratings of their physicians. Patient participation was measured by an index derived from a three-item instrument and physicians' participatory decision-making (PDM) style was measured by a three-item instrument developed by the Medical Outcomes Study. METHODS: An ordered logit multivariate regression was used to investigate the effects of patients' and physicians' participatory styles on satisfaction with physicians. The interaction between patients' participation and physicians' participatory styles was also included to examine the dependency of the two variables. RESULTS: Controlling for confounding factors, a higher PDM score was associated with a higher rating of patient satisfaction with physicians. A higher patient participation score was related to a lower physician satisfaction rating. The combined effect of patients' and physicians' participation styles indicated that for a low patient participation score, a high PDM score was not needed to produce high satisfaction. The greater the discordance in this direction, the higher the satisfaction. However, with a high patient participation score, only an extremely high PDM score would produce relatively high satisfaction. CONCLUSIONS: The current study supports the discordance hypothesis. Participatory physicians and patient-physician communications concerning patient participation can promote higher satisfaction.

Aged↗
PubMed2006

Patient satisfaction of female and male users of Veterans Health Administration services.

OBJECTIVE: To compare patient satisfaction of male and female users of Veterans Health Administration (VHA) services. DESIGN: Cross-sectional study based on secondary analysis of data from VHA's Survey of Healthcare Experiences of Patients (SHEP). PATIENTS: National random sample of 107,995 outpatients and 112,817 inpatients in FY2004. MEASURES: Patient's ratings of overall quality (OQ) and unique dimensions of satisfaction. Sociodemographic and health-related patient attributes. ANALYSIS: Bivariate unadjusted analyses of the association between gender and other patient attributes and the outcomes of OQ and dimensions of satisfaction were conducted followed by multivariate analyses for each outcome, adjusting for demographic and health variables. RESULTS: Significant differences between female and male reporting of satisfaction were found in the unadjusted analyses with males showing greater levels of satisfaction than females (P<.05). These differences disappeared or became smaller for both outpatient and inpatient services, after adjusting for covariates. For 6 of the inpatient dimensions (Transitions, Physical Comfort, Involvement Family and Friends, Courtesy, Coordination, and Access) males had higher satisfaction than females after statistical adjustment. CONCLUSIONS: After adjustment for patient attributes, female VHA outpatients report similar OQ with VHA services as male patients. The fact that some inpatient dimensions of satisfaction continued to show effects favoring males even after adjustment suggests areas for continued focus in improving health care quality. Covariate adjustment is essential for evaluating satisfaction with health care services. Breaking down overall satisfaction into independent aspects of services is useful. The SHEP survey has provided a useful tool for evaluating and improving satisfaction among its VHA veteran users.

Adult↗
PubMed2005

Postoperative pain management in elderly patients: correlation between adherence to treatment guidelines and patient satisfaction.

OBJECTIVES: To evaluate pain management satisfaction in elderly postoperative patients; to define pain management strategies documented in the medical record (MR) that predict patient satisfaction. DESIGN: Prospective cohort. SETTING: Eight urban hospitals. PARTICIPANTS: Three hundred twenty-two postsurgical patients aged 65 and older. MEASUREMENTS: Patients were surveyed regarding satisfaction with pain management in the first 24 hours postsurgery and the survey results summarized in a score. Pain management variables (patient education, pharmacological and nonpharmacological interventions, demographic variables, and surgery and anesthesia information) were abstracted from their MR. The correlation between the satisfaction score and MR variables was assessed using linear regression. RESULTS: Sixty-two percent of patients experienced severe postoperative pain, yet 87% reported being satisfied with the treatment. The mean satisfaction score+/-standard deviation was 59.3+/-10.8 (range 10.6-84.3; potential range 0-100, higher score=higher satisfaction). MR variables explained 14% of the satisfaction score variation. The worst pain intensity in the first 24 hours postsurgery as documented in the MR was the most powerful predictor of satisfaction. Other predictors associated with satisfaction were younger age, male sex, preoperative education, surgery type (laparotomy/thoracotomy patients were more satisfied than orthopedic patients), shorter recovery room stay, analgesic given through oral route, and morphine (compared with other opioids). CONCLUSION: Pain in elderly surgical patients remains undermanaged. Simple strategies such as emphasizing preoperative education may have a large effect in pain management. This study developed a validated patient satisfaction score and a MR instrument to assist in monitoring pain management quality.

Aged↗
PubMed1998

Mammographic technologist job satisfaction: what radiologists need to know--results of a large national survey.

PURPOSE: To determine mammographic technologists' overall level of job satisfaction, the variables that correlate with job satisfaction, and whether job satisfaction has changed since 1987. MATERIALS AND METHODS: A 29-item, scannable survey was mailed randomly to 5,000 mammographic technologists. Survey items were related to work setting, job description, rate of pay and other benefits, experience, education, age, and overall job satisfaction. The results were compared with those of a 1987 survey of general radiologic technologists. RESULTS: A total of 1,503 technologists responded to the survey. On a five-point scale, in which 5 represents very satisfied, the mean rating of job satisfaction +/- the standard deviation was 3.4 +/- 0.9; 83.1% of technologists rated overall satisfaction as 3 or higher compared with 86% of general technologists who reported being satisfied with their jobs in 1987. Regression analysis revealed that enjoyment from working with fellow mammographic technologists and enjoyment from working with radiologists (combined adjusted R2, 26.5%) correlated significantly with increased job satisfaction. CONCLUSION: Mammographic technologist job satisfaction is high and similar to that of general radiologic technologists, as reported in 1987. Survey results indicate that the most important variable related to mammographic technologist job satisfaction is the technologist-radiologist relationship; a negative relationship results in lower job satisfaction, which can affect job performance and patient care.

Adult↗
PubMed2001

A brief scale for assessing patients' satisfaction with care in outpatient psychiatric services.

OBJECTIVE: The authors evaluated the reliability and preliminary validity of the Charleston Psychiatric Outpatient Satisfaction Scale, a 15-item measure of patients' satisfaction designed for use in outpatient settings. The instrument uses a 5-point Likert-type response format that minimizes positive response bias and optimizes variability and predictive validity. METHODS: The Charleston Psychiatric Outpatient Satisfaction Scale was administered to 282 patients seen in psychiatric outpatient clinics affiliated with a public-academic psychiatric institution over a one-week period in 1995. RESULTS: The internal reliability of the instrument was high (alpha=.87), and its convergent validity was supported by the significant correlation of all items with anchor items that measured overall satisfaction with care and likelihood of recommending the clinic to others. The best predictors of overall ratings of care were the items measuring patients' satisfaction with helpfulness of the services and with the respect shown for patients' opinions about treatment. The best predictors of recommendation of the program to others were the items measuring satisfaction with matching of the treatment plan to patients' individual needs and with the respect shown for patients' opinions about treatment. Mean scores for all items ranged from 3.6 (satisfaction with parking) to 4.5 (satisfaction with helpfulness of the secretary and with the overall quality of care), indicating that overall satisfaction in this sample was high. CONCLUSIONS: The results provide preliminary support for the reliability and validity of the Charleston Psychiatric Outpatient Satisfaction Scale:

Adult↗
PubMed2005

Construct validity of a measure of subjective satisfaction with life of adults with serious mental illness.

OBJECTIVE: In a multisite study, the authors examined the construct validity and utility of a brief self-report Satisfaction With Life scale, an expanded 21-item version of one of the earliest measures of subjective satisfaction with life used with individuals with serious and persistent mental illness. The Satisfaction With Life scale measures satisfaction in four domains: living situation, social relationships, work, and self and present life. METHODS: Satisfaction With Life scale data were gathered from consumers receiving community treatment at two sites in Los Angeles (N=166 and N=172, respectively) and one in Wisconsin (N=146). A confirmatory factor analysis of a hypothesized four-factor structure using data from the pooled Los Angeles samples revealed that several items were less than optimal indicators of the underlying domain. On the basis of an analysis of each item, the Satisfaction With Life scale was reduced to 18 items, and the factor structure and factor loadings of the revised scale were cross-validated with data from the Wisconsin sample. The 18-item scale was further validated by testing hypotheses regarding the relationship between the instrument's four domains, or subscales, and clinically important life conditions of clients in the areas of symptoms, living and employment situations, and social relationships. RESULTS: The findings provided excellent support for the construct validity of the 18-item Satisfaction With Life scale, which assesses an individual's subjective satisfaction with his or her current life in the four domains: living situation, social relationships, work, and self and present life. CONCLUSIONS: The brief, easily completed 18-item Satisfaction With Life scale is a useful tool in evaluation research for assessing the subjective satisfaction with life of adults with serious mental illness.

Adult↗
PubMed2006

Cornerstones of career satisfaction in medicine.

OBJECTIVES: To establish a reliable and concise measure of career satisfaction that covers all 4 of its dimensions and to document higher dimensions of satisfaction among the major medical specialties and across varying patterns of clinical practice. METHODS: In 2004, we conducted a stratified, cross-sectional survey of physicians in Canada. Of the eligible population, 2810 physicians (56.7%) responded. We checked response bias and found it was negligible. Responding physicians completed a 17-item measure of career satisfaction along with a detailed breakdown of clinical, academic, and administrative duties. We used confirmatory factor analysis to verify the existence of the hypothesized dimensions of higher-order satisfaction. We then used Scheffe's tests to document differences in the levels of all satisfaction dimensions, both among specializations and by clinical practice profile. RESULTS: Factor analysis revealed 4 reliable dimensions of satisfaction: personal (alpha = 0.85), professional (alpha = 0.78), inherent (alpha = 0.70), and performance (alpha = 0.75). Inherent satisfaction with medicine as a career was the most important dimension for all specializations and for all patterns of practice. The addition of administrative duties without a reduction of clinical duties compromised personal, professional, and performance dimensions of career satisfaction. Academic duties contributed significantly to most physicians' overall, inherent, and performance satisfaction. CONCLUSION: Distinguishing higher-order dimensions of satisfaction from basic ones is a groundbreaking finding because addressing higher-order dimensions supports self-actualization and superior performance of duties.

Canada↗
PubMed2003

The association between three different measures of health status and satisfaction among patients with diabetes.

Studies suggest that health status influences patient satisfaction, but little work has examined the influence of different measures of health status on satisfaction. The authors examined whether the association between health status and satisfaction varied for different measures of health status among 2000 diabetic patients receiving care across 25 Veterans Affairs facilities. Health status was measured using (1) the diabetes-related components of the Total Illness Burden Index (DM TIBI), a measure of diabetes severity and comorbidities; (2) the Short Form 36 (SF-36) Physical Function Index (PFI10); and (3) the SF-36 general health perceptions question (SF-1). Satisfaction was measured both by a 5-item scale on satisfaction with patient-provider communication and by a single item on overall diabetes care satisfaction. In adjusted models, worse health on all three health status measures correlated with lower satisfaction, but the DM TIBI explained more of the variation in satisfaction than either the PFI10 or SF-1. Moreover, when the DM TIBI was added to the model containing PFI10, PFI10 was no longer significantly associated with satisfaction. In this diabetes population, health status appears to have a substantial impact on patient satisfaction, and this effect is considerably greater for diabetes severity than for physical functioning.

Aged↗
PubMed2002

Life satisfaction among kidney transplant recipients: demographic and biological factors.

PURPOSE: The Transplant Learning Center is a program providing education and support for solid-organ transplant recipients taking cyclosporine (Neoral or Sandimmune). One goal of the program is to improve patients' quality of life, which may be influenced by demographic and biological factors, and in turn influences adherence to prescribed medication regimens. We analyzed the results from the initial survey of enrollees to better understand life satisfaction and to test the validity and reliability of the satisfaction scale used in the program. METHOD: Patients enter the program through self-selection: all enrollees who received a kidney transplant were included in this analysis. Satisfaction was measured using the Life Satisfaction Index, which includes 8 questions about aspects of satisfaction with the patient's life. Associations between the Life Satisfaction Index and demographic factors, comorbid medical conditions, adverse effects of immunosuppressants, and medication compliance were examined. RESULTS: All 3676 kidney transplant recipients who completed the initial survey were included. Mean satisfaction scores were highest in persons who were older than 64 years, men, and those who were married. Satisfaction scores were positively correlated with education and income. Mean satisfaction score was significantly lower among persons with medical comorbidities, persons who reported that adverse effects of medications were more frequent, and persons who reported noncompliance with their medication regimen. CONCLUSION: The Life Satisfaction Index is a transplant-specific measure of health-related quality of life that can be used to help detect areas of potential concern in the clinical management of kidney transplant recipients.

Adolescent↗