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PubMed2001

The ups and downs of dating: fluctuations in satisfaction in newly formed romantic relationships.

This research examined the association between relationship satisfaction and later breakup status, focusing on the temporal changes in satisfaction ratings of individuals in newly formed dating relationships. Growth curve analytic techniques were used in 2 longitudinal studies to create 4 predictors: each participant's initial level of satisfaction, linear trend in satisfaction over time, degree of fluctuation in satisfaction over time, and mean level of satisfaction. Consistent with hypotheses, individuals who exhibited greater fluctuation in their repeated satisfaction ratings were more likely to be in relationships that eventually ended, even after controlling for overall level of satisfaction. Individuals with fluctuating levels of satisfaction also reported relatively lower commitment. The results are discussed in terms of conditions that promote versus undermine relationship stability.

Adolescent↗
PubMed2005

An assessment of career satisfaction among a group of general dental practitioners in Staffordshire.

OBJECTIVES: To assess the level of job satisfaction among general dental practitioners from one area of England, and to assess the association of various personal and work related factors with job satisfaction. DESIGN: Postal questionnaire survey. SETTING: General dental practices in South Staffordshire, Wolverhampton and Dudley, England. METHOD: An anonymous questionnaire posted to all 396 registered dentists in the above areas. RESULTS: A 75% response rate was achieved. Data were analysed using non-parametric statistics for any significant differences in the scores for stress, respect, overall professional satisfaction, quality of life and overall job satisfaction according to the different demographic groupings of the dentists (alpha =0.05). Dentists with an area of special interest had higher scores in all categories except quality of life. Overall job satisfaction was higher among private dentists, and those in group practices and in non-rural locations. The highest bi-variate correlation occurred between overall job satisfaction and overall professional satisfaction, delivery of care, income, respect and professional time. CONCLUSIONS: Job satisfaction was judged to be good among this group. Stress was the factor associated with the greatest dissatisfaction. This survey produced similar results to preceding US studies, and suggests ways of improving job satisfaction.

Attitude of Health Personnel↗
PubMed2001

Factors associated with patient satisfaction with care among dermatological outpatients.

BACKGROUND: It has been shown that poor patient satisfaction can lead to poor adherence to treatment with consequently poor health outcomes. In order to improve the quality of care perceived by the patient and thus the health outcome, it is important to understand which are the main factors influencing patient satisfaction. OBJECTIVES: To examine factors associated with patient satisfaction with care among dermatological out-patients. METHODS: This longitudinal study is based on a sample of dermatology out-patients. The independent effects on patient's satisfaction of patient characteristics (sociodemographic characteristics, disease severity, quality of life) and of specific aspects of provided health care (the time the physician spent with patients, physician's interpersonal skills, etc.) were examined by multiple logistic regression. RESULTS: A total of 1389 out-patients were selected at random and invited to participate. Of the 722 patients who agreed to participate, 424 fulfilled the inclusion criteria and 396 of these patients (93.4%) completed the study. Overall satisfaction was reported by 60.0% of patients. The likelihood of overall satisfaction was found to be significantly and independently increased by the physician's ability to give explanations and to show empathy for the patient's condition, and by the older age of patients. The likelihood of satisfaction also increased with increasing disease severity, but decreased with symptom-related poor quality of life. The lowest level of satisfaction was found among patients whose symptom-related quality of life was worse than the clinical severity rated by the dermatologist. CONCLUSIONS: Improving the physician's interpersonal skills can increase patient satisfaction, which is likely to have a positive effect on treatment adherence and health outcomes. Dermatologists succeeded better in establishing a good relationship with clinically more severely affected patients than with patients who were clinically mildly affected despite their quality of life being impaired. Thus, the inclusion of a patient-rated quality of life can be a useful measure in dermatology, as it enables clinicians to perceive the patients' perception of their health status.

Adolescent↗
PubMed2003

Using satisfaction to measure the quality of palliative care: a review of the literature.

BACKGROUND: The advent of clinical governance in British health policy has placed increased demands on health care providers and practitioners to ascertain the quality of their services. Traditional indicators of quality of health care, such as death or recovery rates, are not appropriate in palliative care. Thus, it is important to establish alternative approaches to measuring the quality of palliative care services and interventions. AIMS: Satisfaction levels have been used widely in palliative care to assess quality. A literature review was conducted which aimed to explore the strengths and weaknesses of using satisfaction as an indicator of the quality of palliative care services. It also aimed to provide a solid basis upon which further work could be built. METHODS: Five electronic databases were searched using key words and phrases and key authors. Hand searches were conducted of four journals that contributed significantly to the concept of satisfaction, and reference lists of reviewed papers were scrutinized. Relevant papers were reviewed, data were extracted and these data were thematically analysed. FINDINGS: There are a number of important unresolved issues in the literature with regard to using satisfaction as an indicator of the quality of palliative care services. First, few alternatives to satisfaction are available. Secondly, satisfaction is under-theorized and no widely accepted definition exists. Thirdly, there are methodological inconsistencies across studies. It is important to take into account these findings when planning and implementing change following service evaluation using satisfaction as a measure. CONCLUSIONS: Relying on findings of satisfaction surveys to determine clinical and policy amendments in palliative care may not result in improvements in overall quality of care. Using satisfaction as a method of assessing the quality of health care services is particularly problematic and requires further investigation in both practical and conceptual terms.

Humans↗
PubMed2001

Maternal satisfaction with active management of labor: a randomized controlled trial.

BACKGROUND: Active management of labor reduces the length of labor and rate of prolonged labor, but its effect on satisfaction with care, within a randomized controlled trial, has not previously been reported. The study objectives were to establish if a policy of active management of labor affected any aspect of maternal satisfaction, and to determine the independent explanatory variables for satisfaction with labor care in a low-risk nulliparous obstetric population. METHODS: Nulliparous women at National Women's Hospital in Auckland, New Zealand, in spontaneous labor at term with singleton pregnancy, cephalic presentation, and without fetal distress were randomized after the onset of labor to active management (n = 320) or routine care (n = 331). Active management included early amniotomy, two-hourly vaginal assessments, and early use of high dose oxytocin for slow progress in labor. Routine care was not prespecified. Maternal satisfaction with labor care was assessed by postal questionnaire at 6 weeks postpartum. Sensitivity analyses were performed, and logistic regression models were developed to determine independent explanatory variables for satisfaction. RESULTS: Of the 651 women randomized in the trial, 482 (74%) returned the questionnaires. Satisfaction with labor care was high (77%) and did not significantly differ by treatment group. This finding was stable when sensitivity analysis was performed. The first logistic regression model found independent associations between satisfaction and adequate pain relief, one-to-one midwifery care, adequate information and explanations by staff, accurate expectation of length of labor, not having a postpartum hemorrhage, and fewer than three vaginal examinations during labor. The second model found fewer than three vaginal examinations and one-to-one midwifery care as significant explanatory variables for satisfaction with labor care. CONCLUSIONS: Active management did not adversely affect women's satisfaction with labor and delivery care in this trial. Future studies should concentrate on measurement of potential predictors before and during labor.

Adult↗
PubMed2001

Doctor discontent. A comparison of physician satisfaction in different delivery system settings, 1986 and 1997.

OBJECTIVE: To examine the differences in physician satisfaction associated with open- versus closed-model practice settings and to evaluate changes in physician satisfaction between 1986 and 1997. Open-model practices refer to those in which physicians accept patients from multiple health plans and insurers (i.e., do not have an exclusive arrangement with any single health plan). Closed-model practices refer to those wherein physicians have an exclusive relationship with a single health plan (i.e., staff- or group-model HMO). DESIGN: Two cross-sectional surveys of physicians; one conducted in 1986 (Medical Outcomes Study) and one conducted in 1997 (Study of Primary Care Performance in Massachusetts). SETTING: Primary care practices in Massachusetts. PARTICIPANTS: General internists and family practitioners in Massachusetts. MEASUREMENTS: Seven measures of physician satisfaction, including satisfaction with quality of care, the potential to achieve professional goals, time spent with individual patients, total earnings from practice, degree of personal autonomy, leisure time, and incentives for high quality. RESULTS: Physicians in open- versus closed-model practices differed significantly in several aspects of their professional satisfaction. In 1997, open-model physicians were less satisfied than closed-model physicians with their total earnings, leisure time, and incentives for high quality. Open-model physicians reported significantly more difficulty with authorization procedures and reported more denials for care. Overall, physicians in 1997 were less satisfied in every aspect of their professional life than 1986 physicians. Differences were significant in three areas: time spent with individual patients, autonomy, and leisure time (P < or =.05). Among open-model physicians, satisfaction with autonomy and time with individual patients were significantly lower in 1997 than 1986 (P < or =.01). Among closed-model physicians, satisfaction with total earnings and with potential to achieve professional goals were significantly lower in 1997 than in 1986 (P < or =.01). CONCLUSIONS: This study finds that the state of physician satisfaction in Massachusetts is extremely low, with the majority of physicians dissatisfied with the amount of time they have with individual patients, their leisure time, and their incentives for high quality. Satisfaction with most areas of practice declined significantly between 1986 and 1997. Open-model physicians were less satisfied than closed-model physicians in most aspects of practices.

Adult↗
PubMed2002

Evaluation of satisfaction with midwifery care.

OBJECTIVE: to determine if there were differences in women's satisfaction with maternity care given by doctors and midwives. In addition a simple, six-question, satisfaction questionnaire was to be tested. DESIGN: a randomised controlled trial comparing two models of maternity care. SETTING: a tertiary referral centre in Alberta, Canada. PARTICIPANTS: one hundred and ninety four women with a low-risk pregnancy were randomly assigned to either the midwife care, experimental group (n = 101), or the doctor care, control group (n = 93). INTERVENTIONS: a pilot midwifery programme was introduced into a maternity services delivery system that did not have established midwifery. MEASUREMENTS: women's satisfaction was measured, at two weeks postpartum, with the Labour and Delivery Satisfaction Index (LADSI), general attitudes toward the birth experience, also at two weeks postpartum; with the Attitudes about Labour and Delivery Experience (ADLE) questionnaire. Fluctuations in satisfaction were measured with a Six Simple Questions (SSQ) questionnaire at 36 weeks gestation and 48 hours, two and six weeks postpartum. FINDINGS: women in the midwife group reported significantly greater satisfaction and a more positive attitude toward their childbirth experience than women in the doctor group (p < 0.001). The SSQ demonstrated scores similar to the LADSI. Satisfaction in both groups was lowest at 36 weeks gestation and highest immediately postpartum. KEY CONCLUSIONS: women experiencing low-risk pregnancies were more satisfied with care by midwives than with care provided by doctors. Satisfaction scores were high for both groups and may have been lower for women in the doctor group as a result of disappointment with caregiver assignment as all women had sought midwifery care. The SSQ measures similar dimensions to the LADSI but the agreement is not strong enough to recommend its use as a substitute at this time. IMPLICATIONS FOR PRACTICE: the significantly higher satisfaction of the women with the care provided by the midwives together with better clinical outcomes reported elsewhere suggest that the option of midwifery care should be accessible as an option for all women in Canada. Further research is suggested to determine the usefulness of the SSQ.

Female↗
PubMed2005

[Patient and therapist satisfaction in outpatient psychotherapy].

Increasing attention is devoted to the patient perspective in mental health services research. Consequently, patient satisfaction has taken a prominent role and is frequently applied as an indicator of treatment quality and even outcome. However, the suitability of patient satisfaction for assessing quality of mental health services is doubtful, and there is a lack of longitudinal data especially for outpatient psychotherapy. By using data of the TRANS-OP study, we examine the course of patient satisfaction in outpatient psychotherapy over time and its predictors such as symptom change and duration of treatment. Furthermore, the relation between treatment satisfaction ratings of patients and therapists will be scrutinized. This study was conducted by the Center for Psychotherapy Research in Stuttgart (now Heidelberg) in cooperation with the Deutsche Krankenversicherung. N = 714 participants who applied for reimbursement of outpatient psychotherapy were consecutively recruited and asked to provide data at five (therapists two) measurement points during a two-year period. In line with previous evidence, high rates of patient satisfaction have been found, and also therapists appraised favorably the quality of their treatments. Course of patient satisfaction was found to be markedly stable over time. While some variables related to initial patient satisfaction, its course could hardly be predicted. Treatment outcome and session number moderately affected satisfaction at treatment termination. Concordance between patients' and therapists' satisfaction ratings was poor. Implications of these findings for research and practice are discussed.

Adult↗
PubMed1999

[Patient satisfaction with psychiatric care. Historical perspective, methods and results from the international literature].

Whereas evaluations of patients' satisfaction have been made in the U.S. beginning in the early 50's, there has been an increasing interest in German-language countries only in recent years. The present article summarizes the aims, methods and results of patient satisfaction surveys. A selection of questionnaires comprising the Client Satisfaction Questionnaire (CSQ, 43), the General Satisfaction Questionnaire (GSQ, 37) and the Verona Service Satisfaction Scale (VSSS, 72) is described in detail. The vast majority of the published studies suggest a high rate of general satisfaction with psychiatric inpatient services, whereas most of the more specific findings remain less well demonstrated. The main problem involved with this type of survey seems to be the term "patient satisfaction", which is defined as the relation between the patient's expectations in regard to psychiatric services and the perception of the service the patient has received. This means that the level of patient satisfaction itself does not allow a conclusion to be drawn on the objective quality of a psychiatric treatment. Nevertheless the authors are convinced of the importance of patient satisfaction questionnaires when these questionnaires are part of a quality assurance program.

Data Collection↗
PubMed2000

Paediatric otolaryngology--a parental satisfaction study in outpatient surgery.

A parental satisfaction survey was administered to obtain information as to exactly how patients and their parents experience essential aspects of their treatment. The parents of 178 children who underwent ear, nose and throat (ENT) surgery completed a questionnaire on various aspects of treatment satisfaction during a 6-week period. Most of the respondents expressed overall satisfaction with the treatment. The factor analysis revealed three parental satisfaction factors. Accordingly, we interpreted the subscales as i) surgical staff and general treatment satisfaction, ii) nursing staff and general information satisfaction and iii) anaesthetic staff satisfaction. The internal consistency values of the subscales, as measured by Cronbach's alpha coefficient, were 0.86, 0.84 and 0.71, respectively. The three scores were mutually correlated; this correlation was significant (0.46-0.67). The duration of general anaesthesia and demographic factors had a small, but significant impact on the satisfaction subscores. In conclusion, the satisfaction study encourages improvement in the evaluation and administration of treatment.

Ambulatory Surgical Procedures↗
PubMed1999

Achievement and social relations values as conditions of the importance of work aspects and job satisfaction.

One hundred and sixty-nine bank employees were investigated with the Orientation to Work Values Inventory by Seifert and Bergmann (values; Seifert & Bergmann, 1983), and the Work Description Inventory by Neuberger and Allerbeck (importance and satisfaction with work aspects, overall job satisfaction; Neuberger & Allerbeck, 1978). The data show complex connections between values and the perceived importance of work aspects and job satisfaction. The results indicate that (a) the importance of achievement and social relations values influences the importance of aspects of work, (b) overall job satisfaction depends on social relations value and satisfaction with some aspects depends on this value or on interactions of both of the values, (c) predicting overall job satisfaction from satisfaction with aspects of work is modified by the interaction of the values. However, the hypothesis that overall job satisfaction can be predicted from satisfaction with most important aspects of work is not confirmed by the data.

Adult↗
PubMedDate not supplied

Predicting life satisfaction among adolescents from immigrant families in Norway.

OBJECTIVE: To find out the degree of life satisfaction among adolescents with immigrant background, and the factors that may predict the level of life satisfaction among them. METHOD: Five hundred and six adolescents (mean age = 15.34, SD = 1.67) with immigrant background from Vietnam, Pakistan, Chile and Turkey were recruited from five major Norwegian cities, and were asked to fill in a questionnaire with several measures, including demographic information, life satisfaction, acculturation strategies, ethnic identity and mastery. A control group involving 209 Norwegian youth were also included in the study. RESULTS: On the whole the adolescents with immigrant background were found to be fairly satisfied with their life (M = 3.55, SD = 0.81). Using Socio-Economic Status as covariance, adolescents with immigrant background did not differ from their Norwegian counterparts on life satisfaction level (F = 0.58, p > 0.05). Chileans were found to be the most satisfied group, and Vietnamese the least satisfied. The higher life satisfaction among Chileans compared with the other ethnic groups is viewed as a possible selection bias. While demographic factors accounted for just 4% of the explained variance, personal factors accounted for over 20% of the explained variance. Mastery (beta = 0.39) and ethnic identity (beta = 0.17) were the two most important predictors of life satisfaction. Living in an ethnically homogenous neighbourhood was also found to be related to life satisfaction. Perceived discrimination and integration as an acculturation strategy were not related to life satisfaction. CONCLUSION: The study concludes that helping adolescents with immigrant background to develop a good sense of mastery and a positive ethnic identity will go a long way to boost their life satisfaction.

Adolescent↗
PubMed2003

Predictors of work satisfaction among physicians.

BACKGROUND: Work satisfaction among physicians is an important concern because it is associated with several important aspects of care, such as the continuity of care and health care costs. In this study, a brief work satisfaction questionnaire was developed, its validity was assessed, and it was used to examine the determinants of work-related satisfaction among a sample of Swiss physicians. METHODS: Based on the literature, a 17-item work satisfaction questionnaire was developed that addressed five dimensions of satisfaction: patient care, work-related burden, income-prestige, personal rewards and professional relations with colleagues. This questionnaire was administered by mail to 1904 doctors practising in Geneva, Switzerland; 1184 (59%) responded. Additional data were collected on physicians' personal and work situation. RESULTS: In general, physicians were more satisfied with the following aspects of their current work situation: patient care, professional relations and personal rewards (intellectual stimulation, opportunities for continuing medical education, enjoyment at work). The lowest satisfaction scores were found for work-related burden (workload, time available for family, friends or leisure, work-related stress, administrative burden) and work-related income and prestige. In multivariate models, variables associated with most dimensions of satisfaction included type of practice (physician in training were less satisfied), specialty (internal medicine specialists and pediatricians were more satisfied), time spent on administrative tasks (globally negative effect), time spent on continuing medical education (globally positive effect). Age and sex had only a minor influence on satisfaction scores. CONCLUSION: Physician work satisfaction is multidimensional and can easily be measured using a short self-administered questionnaire. This instrument could be useful to monitor changes in the near future.

Adult↗
PubMed2000

GP job satisfaction in 1987, 1990 and 1998: lessons for the future?

BACKGROUND: Job satisfaction is an important determinant of physician retention and turnover, and may also affect performance. Objective. Our aim was to investigate changes in GP job satisfaction from 1987 to 1998, covering a period of major change in the organization of British general practice. METHODS: Postal surveys of random national samples of GPs were carried out by separate groups of investigators in 1987, 1990 and 1998. In each survey, the questionnaire contained a standardized job satisfaction scale and a list of 14 job stressors. The final samples consisted of 1817 GPs in 1987 (response rate 45%), 917 GPs in 1990 (response rate 61%) and 1828 GPs in 1998 (response rate 49%). RESULTS: For both men and women, overall job satisfaction declined from 1987 to 1990 and then improved from 1990 to 1998, although satisfaction in 1998 remained below that in 1987. Women tended to report higher levels of satisfaction than men in all 3 years. Satisfaction with nine specific aspects of work showed dissimilar patterns of change over time. From 1987 to 1990, reported levels of stress increased for eight of 14 job stressors. Of these, three subsequently declined in 1998, two remained unchanged and three continued to increase. Of the six job stressors which showed no change from 1987 to 1990, five subsequently increased as sources of stress. Men and women differed in their sources of stress, but the differences were not consistent over time. CONCLUSIONS: The results suggest that GP job satisfaction has improved significantly from the low point reached following the introduction of the 1990/1991 NHS reforms, although reported levels of stress in relation to many aspects of work have continued to increase. The changes are discussed within the context of wider research into the determinants of GP job satisfaction in order to anticipate the likely effects on GPs of future organizational reforms.

Adult↗
PubMed2000

Effects of patient demands on satisfaction with Japanese hospital care.

OBJECTIVE: The objective of this study was to detect whether there was any difference among the characteristics of patient satisfaction between two patient emphasis groups: patients demanding technical elements of hospital care and patients demanding interpersonal elements. DESIGN AND SETTING: The sample for this study was drawn from in-patients discharged from 77 voluntarily participating hospitals throughout Japan. The relationship between overall satisfaction with hospital care and patient satisfaction, and the evaluation of a hospital's reputation, was explored by stepwise multiple regression analysis of 33 variables relevant to aspects of hospital care for each patient group. RESULTS: In the interpersonal emphasis (IE) group, 'nurse's kindness and warmth' was associated significantly with overall satisfaction, while 'skill of nursing care' and 'nurse's explanation' were significant predictors of overall satisfaction in the technical emphasis (TE) group. On the other hand, 'doctor's clinical competence', 'recovery from distress and anxiety', and items pertaining to the hospital's reputation were significantly related to overall satisfaction in both emphasis groups. CONCLUSION: For overall patient satisfaction, it is essential to satisfy specific items related to the aspect of hospital care emphasized by the patient. Specific significant predictors of overall satisfaction (e.g. 'doctor's clinical competence') were indispensable measures of professional performance in hospital care, irrespective of the patients' emphasis. A positive perception of hospital reputation items might increase overall patient satisfaction with Japanese hospitals.

Chi-Square Distribution↗
PubMed2001

Evaluation of the consumer model: relationship between patients' expectations, perceptions and satisfaction with care.

OBJECTIVE: To evaluate the consumer model in a health care system, by studying the relationship between four variables: expectations, perceived degree of fulfillment, satisfaction and changing of physicians. DESIGN: Cross-sectional study; telephone interview of patients who had visited a primary care physician 1-2 months previously. SETTING: The Maccabi health plan, Israel. STUDY PARTICIPANTS: A random sample of 759 patients, aged 18 and over residing in two towns in Israel. Response rate to telephone interview was 50.7% (n=385). MAIN OUTCOME MEASURES: Expectation, perceived expectations fulfilled by the physician, satisfaction with the visit to the primary care physician and intention to change physician. RESULTS: The gap between the expectations and their fulfillment showed a low correlation with satisfaction. For attributes where a large difference was found, no correlation was found with patient satisfaction. Attributes such as 'diagnosis', 'preventive health care' and 'answering questions' presented correlation coefficients of 0.3. The correlation between the perceived fulfillment of these attributes and satisfaction presented higher correlation coefficients (between 0.4-0.5). This limits the consumer model as a way to predict satisfaction. Satisfaction correlated highly with intention to change physician. The mean score for the satisfaction of those intending to change doctors was 3.8 compared to 5.5 in the group of consumers not intending to change doctors. CONCLUSION: The consumer model is able to explain only to a modest extent the variation in satisfaction, but dissatisfaction is a good predictor of the intention to change doctors.

Adolescent↗
PubMed1991

Results of a comparative study of in-patient satisfaction in eight hospitals in the Paris region.

Using the method of self-administered questionnaires, patient satisfaction was measured in eight hospitals for both in-patient stays and out-patient visits, excluding emergency departments for which this method is not appropriate. According to the size of the ward, the in-patient satisfaction was assessed for a period of time, ranging from one to three months in order to obtain 110 questionnaires; for outpatients, the satisfaction was assessed for one week. On the whole, the study showed high satisfaction with the care provided by physicians and nurses (81% and 74% of patients were "very satisfied"), satisfaction with cleanliness and comfort (respectively 64% and 61%), and low satisfaction for quietness and for the time schedule and the quality of meals (respectively 48%, 52% and 40%). As far as comparisons between hospitals and between wards within a given specialty were made, a major result of the study was to point out the very great range of dispersion of satisfaction scores. For example, if the mean value of the satisfaction about comfort is 61% of patients "very satisfied", the extreme values for the set of eight hospitals are 35% and 70%. Another example may be given in general surgery specialty: if the mean value of the satisfaction for medical care is 78%, the extreme values for the set of seven wards are 68% and 86%. These results make clear that however encouraging the scores may be, the evidence of the variability is a powerful incentive to organize corrective actions.

Hospitals↗
PubMed1997

Patients' satisfaction with surgical care impaired by cuts in expenditure and after interventions to improve nursing care at a surgical clinic.

Between 1991 and 1994 the number of beds in the surgical clinic at a central hospital in Southern Sweden was cut back by almost 50%. To develop the nursing care and to control the effects of the budgetary cuts, an intervention, including nursing care development, of an organization that would secure continuity in the nurse-patient relationship, individually planned care and quality assurance for aspects believed to be crucial to the quality of nursing care was implemented. The aim of this study was to analyse patients' satisfaction with surgical nursing care between, under and after the last cut in expenditure and the concluded intervention. A patient satisfaction questionnaire covering such areas as: patient satisfaction with information and decision-making; patient satisfaction with contact and the staff-patient relationship; patient satisfaction with ward facilities and the physical treatment or examination and patient satisfaction with various other aspects of care, was administered (1993 n = 131; 1994 n = 128). Subsample analysis showed lower scores for patient satisfaction if the respondents were women, young, or acutely ill when admitted. While surveys carried out between 1991 and 1993 showed an overall improvement in the quality of care, as measured by patient satisfaction, it remained at the same level in 1994 as in 1993, or decreased, regarding patient contacts with staff and physicians, involvement in decision-making, anxiety before examination/treatment, anxiety regarding professional secrecy, opportunity to influence the solution to their physical problems, chance to get sleep without being disturbed, physical nursing care and preparations before discharge. Thus a deterioration in quality seemed to take place in 1994 indicating that the cuts in expenditure may have been too hard and had been made at the expense of patient satisfaction.

Adult↗