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PubMed1997

Assessment of postoperative pain management: patient satisfaction and perceived helpfulness.

OBJECTIVE: Increasing attention has been given to the assessment of patient satisfaction as a way to monitor quality of care in hospital settings. Postoperative patient satisfaction has been thought to be related to level of pain intensity, expectations of outcome, perceived concern by the staff, and helpfulness of treatments. The aim of this study is to develop a simple, reliable measure to assess pain and satisfaction in postsurgical patients and to examine factors related to patient satisfaction. DESIGN: A satisfaction questionnaire was developed for this study and administered to 119 patients who had undergone a major orthopedic surgical procedure. The majority of the patients were diagnosed with osteoarthritis and reported moderate to severe preoperative pain. The 13-item measure was found to be reliable (test-retest r = .86; interexaminer r = .98), valid (exploratory factor analyses; intercorrelations), and easy to administer. RESULTS: Results showed that the majority of the patients were satisfied with their care (91%), postoperative pain intensity (94%), and the way they were treated by the physicians and nurses (98%). Patients with low postoperative pain ratings who perceived that the physicians and nurses showed concern with how much pain they were feeling reported greatest satisfaction with their care (p < .001). In general, lower postoperative pain ratings were the best predictors of satisfaction and helpfulness of treatment. Preoperative pain status, expected level of postoperative pain, and time waiting for pain medication after a request was made were not significantly correlated with ratings of postoperative pain or satisfaction. CONCLUSIONS: These results highlight the important influence of adequate treatment of postoperative pain and perceived concern by the hospital staff on patient satisfaction.

Arthroplasty, Replacement, Hip↗
PubMed2000

Predictors of elder and family caregiver satisfaction with discharge planning.

Client satisfaction is considered an important outcome measure in a managed care environment faced with escalating health care costs, shortened lengths of hospital stay, and competition among acute care hospitals. With shortened lengths of stay in acute care hospitals, discharge planning has assumed increased importance, particularly for elders who have chronic conditions, such as heart failure, that require follow-up care. Consequently, understanding the predictors of client satisfaction with discharge planning can help hospitals and their nursing staff to tailor services to meet client needs. Previous studies have focused on patient satisfaction with hospital care, with little attention given specifically to satisfaction with discharge planning and to family caregiver satisfaction with discharge planning. The purpose of this study was to determine whether there is a difference between elder and family member satisfaction with discharge planning 2 weeks after hospitalization and what factors predict satisfaction with discharge planning 2 weeks after hospitalization for elders hospitalized with heart failure and their family caregivers. Telephone interviews were conducted with 134 elder/family caregiver dyads 2 weeks after hospitalization. The results indicated that there were no statistically significant differences in discharge planning satisfaction of elders and their family caregivers. Continuity of care and extent to which they felt prepared to manage care following hospitalization were the best predictors of elder's and family caregiver's satisfaction with discharge planning.

Adult↗
PubMed1998

The relationship of job satisfaction with organizational variables in public health nursing.

OBJECTIVE: This study examined the relationship of the organizational variables of structure, technology, and environment with job satisfaction among public health nurses in a southeastern state. BACKGROUND: There is little research on the characteristics of the work environment that influence nurses to remain in the public health work setting. Prior research in this setting has focused on the negative aspects of the nursing positions. These aspects of least desirability for the public health nurse provide only a partial view of job satisfaction. To decide and plan specific strategies, the nurse administrator must have valid and useful information about the positive aspects of job satisfaction of public health nurses. METHODS: The researchers distributed a questionnaire to all licensed nursing personnel employed by a state public health department. Data collection consisted of four tools: 1) structure instrument; 2) technology instrument; 3) environmental uncertainty instrument; and 4) McCloskey-Mueller Job Satisfaction Scale (MMSS). The sample of 838 public health nurses (response rate of 50.6%) included representation from all 13 districts and the central office of the public health department. RESULTS: Significant relationships were found between job satisfaction and the demographic variables of nurse category (registered nurse and licensed practical nurse) and years of experience with the public health department. The critical variable for predicting job satisfaction in this group of public health nurses was organizational structure (vertical participation, horizontal participation, and formalization). Dimensions of structure accounted for 41% of the variance in job satisfaction. Structure remained the critical predictor of job satisfaction, although the findings do not suggest a conclusive model. The three dimensions of technology (instability, variability, and uncertainty) and environmental uncertainty assumed significance only in concert with each other or with the dimensions of structure. CONCLUSIONS: This study contributes to nursing management theory by examining the relationship of organizational structure, technology, and environmental uncertainty with job satisfaction in public health nurses. This research also has implications for nurse administrators in public health for creating more flexible work environments and facilitating staff involvement in decision making.

Education, Nursing↗
PubMed2001

Factors influencing satisfaction and anticipated turnover for nurses in an academic medical center.

OBJECTIVES: The purpose of this study was to examine the relationships between work satisfaction, stress, age, cohesion, work schedule, and anticipated turnover in an academic medical center. BACKGROUND DATA: Nurse turnover is a costly problem that will continue as healthcare faces the impending nursing shortage, a new generation of nurses enter the workforce, and incentives provided to nurses to work for institutions increase. A variety of factors influence the retention of nurses in adult care settings, including work satisfaction, group cohesion, job stress, and work schedule. In general, previous research has documented positive relationships between work satisfaction, group cohesion, strong leadership, and retention rates and a negative relationship between stress, work schedule, and retention. In addition, age and experience in nursing are related to job satisfaction. METHODS: This study used a cross-sectional survey design in which nurses from 12 units in a 908-bed university hospital in the Southeast completed questionnaires on one occasion. The following factors were measured using self-report questionnaires: nurse perception of job stress, work satisfaction, group cohesion, and anticipated turnover. RESULTS: The more job stress, the lower group cohesion, the lower work satisfaction, and the higher the anticipated turnover. The higher the work satisfaction, the higher group cohesion and the lower anticipated turnover. The more stable the work schedule, the less work-related stress, the lower anticipated turnover, the higher group cohesion, and the higher work satisfaction. Job Stress, work satisfaction, group cohesion, and weekend overtime were all predictors of anticipated turnover. There are differences in the factors predicting anticipated turnover for different age groups. CONCLUSIONS: As healthcare institutions face a nursing shortage and a new generation of nurses enter the workforce, consideration of the factors that influence turnover is essential to creating a working environment that retains the nurse.

Academic Medical Centers↗
PubMed2002

Job satisfaction among nurses: a predictor of burnout levels.

OBJECTIVE: This study assessed the impact of differential levels of job satisfaction on burnout among nurses, hypothesizing that higher levels of job satisfaction predict lower levels of burnout. BACKGROUND: Social environmental factors of the workplace arising from organizational restructuring cost containment strategies, diminishing resources, and increasing responsibilities, cause highly stressed, burned out nurses to leave the profession. METHODS: This study used the Maslach Burnout Inventory (MBI) to measure emotional exhaustion, depersonalization, and personal accomplishment. The job satisfaction scale of Katzell et al was used to measure overall job satisfaction. Statistical tests for significance used were Confirmatory Factor Analysis, Structural Equation Modeling, the chi statistic, Root Mean Square Error of Approximation, Goodness of Fit Index, and Comparative Fit Index. RESULTS: The findings show that job satisfaction has a significant direct negative effect on emotional exhaustion, whereas emotional exhaustion has a direct positive effect on depersonalization. A significant indirect effect was seen of job satisfaction on depersonalization via exhaustion. The path coefficient shows that job satisfaction has both direct and indirect effects on burnout, confirming job satisfaction as a significant predictor of burnout. IMPLICATIONS: Collaborative efforts between nurses, administrators, and educators to research and test practical models to improve job satisfaction may work as an antidote to burnout.

Adult↗
PubMed1993

The importance of patient preferences in the measurement of health care satisfaction.

The idea that patients will be more satisfied with health care services that are delivered to meet their preferences is central to the concept of health care marketing. Health care providers increasingly use market segmentation and target marketing to optimize the fit between their services and the consumers who receive them. This study evaluates one model for incorporation of patient preferences into the measurement of satisfaction. Using multiple regression analysis, evaluations of three dimensions of health care satisfaction, interpersonal care, technical quality, access to care accounted for 63% of the variance in overall satisfaction. Inclusion of preferences, defined as importance ranks of each dimension, did not improve ability to predict satisfaction. Four preference segments were identified: interpersonal care seekers, access/quality seekers, access seekers and quality seekers. These four subgroups differed significantly on a number of sociodemographic, health status and health service use characteristics but no significant differences were found in satisfaction between preference segments. Patient satisfaction can best be measured as quality evaluations of dimensions without regard to preferences. In considering the merits of market segmentation and target marketing, alternative satisfaction models that link preferences to health care satisfaction or the possibility that preference targeting does not lead to greater satisfaction should be evaluated.

Consumer Behavior↗
PubMed2003

Correlation of patient satisfaction with symptom severity and walking ability after surgical treatment for degenerative lumbar spinal stenosis.

STUDY DESIGN: Prospective follow-up of 83 patients who had decompressive laminotomy with or without fusion for degenerative lumbar spinal stenosis between September 1992 and September 1998. OBJECTIVE: To evaluate the significance of the correlation between patient satisfaction and both the severity of postoperative symptoms and walking ability. SUMMARY OF BACKGROUND DATA: In clinical studies of surgery for degenerative lumbar spinal stenosis, patient satisfaction often is an item in the outcome questionnaire. However, little is known about the relationship of patient satisfaction to postoperative symptoms or functioning. METHODS: Patients completed standardized preoperative and follow-up questionnaires about symptom severity, walking ability, and their satisfaction with the results of surgical treatment. The significance of the correlation of patient satisfaction with the severity of postoperative symptoms and walking ability was evaluated. RESULTS: The mean length of follow-up was 39 months (range 12-84 months). The final questionnaire of a series was answered by 77 patients (93% of the cohort). By univariate analysis, the correlations of patient satisfaction with postoperative back pain, leg pain, numbness, subjective difficulty in walking, and walking ability were statistically significant (Spearman rank-order correlation coefficient: 0.58, 0.57, 0.53, 0.64, and 0.43, respectively). Postoperative walking ability was a weaker correlate of patient satisfaction than the severity of postoperative symptoms. By multivariate regression analysis, the only independent correlate was subjective difficulty in walking. CONCLUSIONS: In the evaluation of patient satisfaction as an outcome in patients operated on for degenerative lumbar spinal stenosis, we should keep in mind that postoperative functioning is a weak correlate of satisfaction.

Aged↗
PubMed2003

Serial assessment of efficacy and satisfaction profiles following penile prosthesis surgery.

PURPOSE: Penile implants are associated with a high level of patient satisfaction. Studies to date have failed to use instruments that accurately record patient satisfaction data. We used 2 validated instruments to assess the chronology of efficacy and satisfaction profiles in men undergoing penile prosthetic surgery. MATERIALS AND METHODS: Men who elected penile implant surgery were administered the International Index of Erectile Function (IIEF) questionnaire preoperatively, and 3, 6 and 12 months postoperatively as well as the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire 3, 6 and 12 months postoperatively. Comparison was done of preoperative and postoperative values for the overall IIEF, IIEF erectile function domain, IIEF satisfaction domain and EDITS. All surgeries were primary and in all patients an inflatable implant device was placed. RESULTS: A total of 96 men with a mean age of 56 years were enrolled in the study. All 12-month scores were statistically significantly higher than baseline scores. The 12-month values were statistically higher than 6-month values for the IIEF satisfaction domain and for EDITS. CONCLUSIONS: This study indicates that implant surgery causes a dramatic improvement in erectile function. It also indicates that satisfaction increases in year 1 after implant surgery with significant improvements in the second half of year 1. Current efforts are aimed at following this cohort of patients in an even more long-term fashion as well as evaluating partner satisfaction profiles. These findings should permit clinicians to provide penile prosthesis candidates with optimistic and realistic expectations for implant device function and postoperative satisfaction.

Adult↗
PubMed2005

The role of psychiatric diagnosis in satisfaction with primary care: data from the department of veterans affairs.

BACKGROUND: Although patient satisfaction is widely used as a quality indicator, most such measures do not account for patient subgroups such as those with psychiatric illness. There is also very little data on satisfaction of psychiatric patients with their medical care. OBJECTIVE: The objective of this study was to assess the role of psychiatric illness in satisfaction with outpatient primary care services in the Department of Veterans Affairs (VA). METHOD: Data from the VA Customer Feedback Survey (n = 50,532) were merged with administrative data to determine diagnoses and other characteristics. Satisfaction ratings were compared across psychiatric diagnoses and across various aspects of satisfaction with care. RESULTS: After controlling for patient characteristics (eg, gender, age, disability, acute vs. routine visit) and subjective health, patients with schizophrenia, posttraumatic stress disorder, drug abuse, depression, and other psychiatric disorders reported significantly lower satisfaction with their outpatient primary care. Dissatisfaction was particularly reported for access to care and overall coordination of care. CONCLUSIONS: Despite VA characteristics that might be thought to improve satisfaction (eg, easier access to specialty mental health services as a result of the integrated VA system), patients with psychiatric disorders are significantly less satisfied than patients without such disorders. Possible explanations include both lower technical quality of care and poorer interpersonal communication between providers and patients with mental illness, including the negative effects of stigma. These findings highlight the need for satisfaction ratings to be case-mix-adjusted, including the incorporation of health and mental health diagnoses, and the need for further research that elucidates the reasons behind lower satisfaction ratings.

Adolescent↗
PubMed2005

Parent satisfaction in pediatric intensive care: a critical appraisal of the literature.

OBJECTIVE: To assess the content and characteristics of satisfaction surveys for the development of a parent satisfaction questionnaire to improve clinical practice in pediatric intensive care. DESIGN: A structured literature review process. The databases PubMed and CINAHL were searched, via identified search terms, for relevant articles published between May 1994 and May 2004. Assessment and analysis of the material was related to development, content, reliability and validity, scales for scoring, and distribution of the satisfaction questionnaires. MAIN RESULTS: Twelve original studies were identified using ten different satisfaction surveys in pediatric, neonatal, or adult intensive care units or in general pediatric wards. All surveys counted a total of 248 questions or statements. Six satisfaction questionnaires categorized the questions or statements in 21 different formulated domains. Most questionnaires showed sufficient results on reliability and validity. Except for one satisfaction instrument, Likert-type scales were used for rating. One study described the distribution of the questionnaire after discharge from the hospital, whereas other questionnaires were distributed during hospital admission. CONCLUSION: The use of parent satisfaction surveys in pediatric intensive care is not well documented. Family-centered care has become widely accepted as an important issue in quality of care, and satisfaction surveys are a valuable resource for measuring and improving clinical practice. Parent satisfaction surveys need to be developed based on the needs and experiences of parents, and emphasis should be put on methodologic issues to have the results accepted as valid and effective for possible changes in clinical practice.

Adult↗
PubMed2004

Satisfaction with breast reconstruction in women with bilateral prophylactic mastectomy: a descriptive study.

Prophylactic bilateral mastectomy is an option for women who are at an increased risk of developing breast cancer. Prophylactic mastectomy is often performed with immediate reconstruction (i.e., at the same time and under the same anesthetic as the mastectomy). Satisfaction with reconstruction has been described previously for women with mastectomy for breast cancer. However, the authors know of no previous research that has reported on satisfaction with reconstruction in patients who have electively sought mastectomy for the prevention of breast cancer. Women in the province of Ontario who had undergone prophylactic bilateral mastectomy plus breast reconstruction between 1991 and 2000 were asked to rate their level of satisfaction with the cosmetic results of their mastectomy and reconstruction and their overall satisfaction with their decision to have prophylactic mastectomy. Women were also asked whether they experienced complications associated with their surgery and what types of complications they experienced. Thirty-seven women completed questionnaires for this study, and all of them had immediate breast reconstruction after prophylactic mastectomy. The majority of women (70.3 percent) reported being satisfied or extremely satisfied with the cosmetic results of their breast reconstruction. Women with self-reported postsurgical complications (16.2 percent) were significantly less satisfied with reconstruction than those who did not report complications (p = 0.009). Personal subjective risk of breast cancer before prophylactic mastectomy was negatively correlated with satisfaction with reconstruction (r = -0.38, p = 0.024) and with subjective risk estimation after prophylactic surgery (r = -0.54, p = 0.001). Women who did not worry about developing breast cancer after prophylactic mastectomy had significantly higher levels of satisfaction with breast reconstruction than those who continued to worry (p < 0.001). Women who reported an improved body image after reconstruction were significantly more likely to report higher levels of satisfaction than those who reported a diminished body image (p = 0.007). The majority of women were satisfied with the cosmetic results of breast reconstruction after prophylactic mastectomy. Women who overestimated their breast cancer risk had lower satisfaction levels. Correcting overestimation of breast cancer risk in women who have prophylactic mastectomy may improve satisfaction with reconstruction following prophylactic mastectomy.

Adult↗
PubMed2005

Patient satisfaction after electroconvulsive therapy.

OBJECTIVE: We sought to determine the degree of satisfaction with bifrontal and right unilateral electroconvulsive therapy (ECT) and to investigate the relation with treatment-related variables, such as memory complaints, and patient-related variables, such as self-rated depression severity and negative affectivity. METHODS: Subjects included all patients who started a course of ECT between May 2001 and December 2003, or still were receiving continuation or maintenance ECT (C/M-ECT) at the time of the study. A psychiatric nurse that was not a member of the treatment team conducted semi-structured interviews based on a battery of questionnaires (Patient Satisfaction Survey [PSS], Mini-Mental State Examination [MMSE], Squire Subjective Memory Questionnaire [SSMQ], Beck Depression Inventory [BDI], and Positive and Negative Affect Schedule [PANAS]). RESULTS: Of 50 eligible subjects, 36 (72%) completed the survey. Fourteen patients refused to participate. At the time of the interview, 19 patients (52.8%) were hospitalized, and 14 (38.9%) were receiving C/M-ECT. The mean time between last treatment session and interview was 282 days. Diagnostic categories were depressive disorder (50%) and psychotic disorder (47.2%). Bifrontal electrode position was used in 25 (69.4%) of the study patients and unilateral in 4 (11.1%). Patients had a considerable degree of satisfaction (mean PSS 153.41; SD 16.29), although they had prominent cognitive complaints (mean score SSMQ -11.86; SD 21.30). In a multiple regression model, in which satisfaction was predicted on the basis of age, sex, and scores on BDI, SSMQ, PANAS, and GAF, only the GAF-score at the time of the interview was significantly related to satisfaction. All other predictors were not significant. CONCLUSION: Patients receiving bifrontal or right unilateral ECT do have considerable memory complaints, even a long time after their treatment. However, the degree of these complaints does not seem to predict satisfaction with the treatment. Only 38% of the variance of satisfaction could be predicted on the basis of age, sex, BDI, SSMQ, Negative Affectivity subscale of the PANAS, and GAF-scores, which proves that satisfaction with ECT is based on other factors than just the relief of symptoms or the occurrence of side-effects. The factors that contribute to patients' satisfaction remain largely unknown.

Adult↗
PubMed2006

A patient satisfaction survey for haemophilia treatment centres.

The importance of patient satisfaction has continued to grow such that patient satisfaction is now viewed as a vital component of health-care delivery. This is evidenced by the expanding body of research in the area and the use of measures of patient satisfaction as indicators of health-care quality. The value of patient satisfaction is particularly apparent in the setting of chronic disease where medical care utilization is high, compliance with therapy is critical and the patient-provider relationship is often long-term. Although several validated tools exist to quantify general measures of patient satisfaction, there is a recognized need for disease-specific instruments. Not only are there issues that are unique to haemophilia, but many patients receive care via a specialized comprehensive clinic model. The authors were unaware of an instrument that could adequately address patient satisfaction issues specific to haemophilia; thus, they undertook to develop one. The patient satisfaction survey presented here contains fixed-choice, Likert-scale and open-ended questions adapted from previously validated questionnaires. Assessment of face validity and internal consistency indicate that the survey is measuring one underlying construct - patient satisfaction. Information acquired through this survey will provide a quantitative assessment of patient satisfaction within a clinic population of persons with bleeding disorders and could be used to guide decisions regarding provision of health-care services.

Adolescent↗
PubMed2004

Patient satisfaction is rated higher by radiation oncology outpatients receiving nutrition intervention compared with usual care.

BACKGROUND: Satisfaction with services has been considered vital for the provision of quality health care, however, there are few published papers utilizing patient satisfaction with nutrition services as a measurable outcome. METHOD: A randomized, controlled trial investigating the impact of nutrition intervention (NI) vs. usual care (UC) in 54 ambulatory oncology patients receiving radiotherapy to the gastrointestinal or head and neck area demonstrated beneficial impacts in terms of body weight, nutritional status, quality of life and bowel health. This study reports the changes in patient satisfaction that were associated with these improved outcomes for patients receiving NI compared with UC. The patient satisfaction with clinical nutrition services questionnaire was used to measure overall satisfaction and satisfaction with four components of nutrition services 12 weeks after patients commenced radiotherapy. RESULTS: Patients receiving NI rated satisfaction higher for staff interpersonal skills (P < 0.001), perceived health benefits (P = 0.008), staff presentation skills (P = 0.044) and for overall patient satisfaction with nutrition services (P = 0.002). There were no significant differences between those patients receiving NI or UC for the nutrition supplements factor (P = 0.191). CONCLUSIONS: These data suggest that patients receiving NI perceive nutrition as being beneficial and of higher importance to their health than those receiving UC. This may lead to increased compliance with the nutrition prescription and help explain the better outcomes observed in the NI group compared with the UC group. Patient satisfaction with nutrition services should be conducted regularly to act as a quality-control measure and target areas for improvement.

Adult↗
PubMed2004

The impact of visit frequency on the relationship between service quality and outpatient satisfaction: a South Korean study.

OBJECTIVE: To examine the relative impact of four service quality dimensions on outpatient satisfaction and to test the invariance of the structural relationships between the service quality dimensions and satisfaction across three patient groups of varying numbers of prior visits to the same hospital as outpatients. DATA SOURCES/STUDY SETTING: Survey of 557 outpatients using a self-administered questionnaire over a 10-day period at a general hospital in Sungnam, South Korea. DATA COLLECTION: Patients answered questions related to two main constructs, patient satisfaction and health care service quality. The health care service quality measures (30 items) were developed based on the results of three focus group interviews and the SERVQUAL scale, while satisfaction (3 items) was measured using a previously validated scale. STUDY DESIGN: Confirmatory factor analysis was used to assess the construct validity of the service quality scale by testing convergent and divergent validity. A structural equation model specifying the four service quality dimensions as exogenous variables and patient satisfaction as an endogenous variable was estimated to assess the relative impact of each of the service quality dimensions on satisfaction. This was followed by a multigroup LISREL analysis that tested the invariance of structural coefficients across three groups with different frequencies of outpatient visits to the hospital. PRINCIPAL FINDINGS: Findings support the causal relationship between service quality and satisfaction in the context of the South Korean health care environment. The four service quality dimensions showed varying patterns of impact on patient satisfaction across the three different outpatient groups. CONCLUSION: The hospital management needs to be aware of the relative importance of each of the service quality dimensions in satisfaction formation of outpatients, which varies across different hospital utilization groups, and use this in strategic considerations.

Adult↗
PubMed2003

Customer satisfaction measurement in emergency medical services.

OBJECTIVES: The annual patient volume in emergency medical services (EMS) systems is high worldwide. However, there are no comprehensive studies on customer satisfaction for EMS. The authors report how a customer satisfaction survey on EMS patients was conducted, the results, and the possible causes for dissatisfaction. METHODS: Two prospective customer satisfactions surveys were conducted in an urban EMS system. Consecutive patients treated by EMS received a postal questionnaire approximately two weeks after service. Satisfaction was measured in a scale from 1 (very poor) to 5 (excellent). Neither EMS personnel nor patients were made aware prospectively that patient satisfaction would be measured. RESULTS: Response rates to the surveys were 36.8% (432/1,175) in 2000 and 40.0% (464/1,150) in 2002. The mean general grades for the service were 4.6 and 4.5, respectively. Patients reported the highest degree of dissatisfaction when they were not taken to their hospital of choice, when they perceived that the paramedics were not able to meet their needs, and when paramedics did not introduce themselves or communicate directly with the patient's relatives. In high-volume calls (i.e., frequent chief complaints), the general satisfaction was highest in patients with arrhythmias, breathing difficulties, and hypoglycemia. Patients with drug overdose included the highest proportion of unsatisfied patients. None of the background variables (e.g., gender, transport decision, working shift) was statistically related to general patient satisfaction. CONCLUSIONS: This study shows that customer satisfaction surveys can be successfully conducted for EMS. EMS systems should consider routinely using customer satisfaction surveys as a tool for quality measurement and improvement.

Adult↗
PubMed1998

Measuring patient satisfaction with mandibular prostheses.

OBJECTIVES: Previous research has shown that patients' evaluations of their prostheses correlate poorly with the clinicians' assessments, as well as with intraoral anatomic factors. It has been recommended that researchers conduct more studies that use patient satisfaction as the primary outcome measure in treatment evaluation and that more attention be paid to understanding exactly what measures of patient satisfaction represent. In this study, the relationship between patients' ratings of general satisfaction and their perceptions of different aspects of mandibular prostheses is investigated. METHODS: One hundred and twenty subjects applied to participate in a randomized controlled clinical trial comparing two types of mandibular prostheses: conventional dentures and implant prostheses. At baseline, they were asked to rate on 100 mm visual analog scales (VAS) factors that edentulous patients indicated were important to them. These included comfort, ability to chew, stability, esthetics, ability to speak and ease of cleaning of their conventional dentures. Subjects were also asked to rate their general satisfaction with their dentures. In addition, they selected the one quality of their denture that they considered to be most important. RESULTS: Multiple regression methods revealed that gender, as well as patients' ratings of comfort, stability, esthetics, ability to chew and ability to speak with their prostheses contributed significantly to general satisfaction (F<0.0001). Furthermore, 89% of the variation in ratings of general satisfaction was explained by these factors. In addition, patients who considered ability to chew as the most important factor associated with their dentures rated their general satisfaction significantly higher than the other subjects (P=0.0003). CONCLUSION: Patient satisfaction with conventional dental prostheses is highly dependent on gender, and the appearance and functionality of the appliance. The combined effect of these factors explained most of the variation in the satisfaction ratings.

Adult↗
PubMed2005

Exposure to 'ideal' facial images reduces facial satisfaction: an experimental study.

OBJECTIVE: Psychological research has suggested that exposure to media images of 'ideal' female models has a negative impact on women's perception of their body image. The present study examined the effects of exposure to images of faces rated as high in attractiveness upon facial satisfaction, compared with exposure to 'neutral' stimuli. METHODS: Participants comprised three groups of women: 24 women undergoing orthodontic treatment, 22 patients undergoing orthognathic treatment, and 20 women receiving no current dental treatment. All completed measures of facial and body image satisfaction after viewing images of houses or faces as follows: The Body Satisfaction Scale, The Revised Body Image Scale of Secord and Jourard and a Visual Analogue Scale measuring satisfaction with Facial Appearance. A repeated-measures design was adopted with a 4-6-week period between experimental conditions. All participants were randomly assigned to one of the two orders (Houses-Faces or Faces-Houses). The findings were analysed using general linear modelling analysis of variance. RESULTS: Exposure to idealized images of faces resulted in a significant decrease in facial satisfaction when compared with the control condition (mean facial satisfaction for all participants in Faces condition, Body Satisfaction Scale-Head Scale = 22.2, SD = 7.81; Revised Body Image Scale-Facial Subscale = 25.5, SD = 4.57; VAS = 7.8, SD = 2.47; Mean facial satisfaction for all participants in Houses condition, Body Satisfaction Scale-Head scale = 19.5, SD = 6.81; Revised Body Image Scale-Facial Subscale = 26.8, SD = 4.87; VAS = 6.2, SD = 2.72). CONCLUSIONS: Media may exert a negative influence on self-perception, particularly amongst individuals who, for one reason or another, are sensitive to the appearance of their face. The findings of the present study have implications for the demand for orthodontic treatment for aesthetic enhancement at a time when resources are limited. Interventions are discussed to help individuals question their acceptance of such media messages.

Adolescent↗