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Patient satisfaction with preoperative assessment in a preoperative assessment testing clinic.

UNLABELLED: Preoperative Assessment Testing Clinics (PATCs) coordinate preoperative surgical, anesthesia, nursing, and laboratory care. Although such clinics have been noted to lead to efficiencies in perioperative care, patient experience and satisfaction with PATCs has not been evaluated. We distributed a one-page questionnaire consisting of satisfaction with clinical and nonclinical providers to patients presenting to our PATC over three different time periods. Eighteen different questions had five Likert scale options that ranged from excellent (5) to poor (1). We achieved a 71.4% collection rate. The average for the subscale that indicated overall satisfaction was 4.48 +/- 0.67 and the average for the total instrument was 4.46 +/- 0.55. Although the highest scores were given for subscales describing the anesthesia, nurse, and lab, only the anesthesia subscale improved with time (P = 0.007). The subscale that involved information and communication had the highest correlation with the overall satisfaction subscale (r = 0.76; P < 0.0001). The satisfaction with the total duration of the clinic visit (3.71 +/- 1.26) was significantly less (P < 0.0001) than the satisfaction to the other items. The authors conclude that the practitioner and functional aspects of the preoperative visit have a significant impact on patient satisfaction, with information and communication versus the total amount of time spent being the most positive and negative components, respectively. IMPLICATIONS: Patient satisfaction can serve as an important indicator of the quality of preoperative care delivered in Preoperative Assessment Testing Clinics (PATC). Information and communication, both from clinical and nonclinical service providers, remain the most important positive components, and the total duration of the clinic visit represents the most negative component, of patient satisfaction in a PATC.

Anesthesia↗

[Life satisfaction and its related factors among institutionalized patients at a Hansen's disease sanatorium].

We conducted a questionnaire survey on life styles and health status for 293 patients with Hansen's disease. They were admitted to the wards for disabled and physically able patients of Ohshima Seishoen, in Kagawa prefecture, in 1991. This institution is one of Japan's national leprosy sanitarians. We measured patients' life satisfaction with the Delighted-Terrible Scale. In this report, the distribution of life satisfaction and its associated factors were examined for 210(71.7%) respondents. Factors examined were length of treatment, physical health, and social aspects of life at the sanatorium. The major findings were as follows; 1. The patients aged under 60 had lower proportions of being satisfied with life than those aged 60 or older. The proportions of life satisfaction of the 40-59 age group were 17% for men and 22% for women, while for the 60 or older age groups were 33-44% for men and 41-45% for women. The proportions of life satisfaction in the 60 or older age groups were lower than those of community dwelling elderly persons. 2. We examined factors associated with life satisfaction for the respondents aged 60 or older. Dependence on activities of daily living (ADL) was associated with life satisfaction in some ADL items. Care and aid provided by the staff of the sanatorium may modify the relationship between ADL impairment and life satisfaction. For social aspects of life at the sanatorium, both having networks with family members and having resources other than family were associated with life satisfaction. Going out and positively spending their daily lives were associated with life satisfaction, too. These associations were significant for men. Similar patterns of association were observed for women, but were insignificant. This finding suggests that it is important for the health and medical care staff to pay attention to the social aspects of the life of elderly patients with Hansen's disease.

Activities of Daily Living↗

Differences between out-patients with physical disease and those with medically unexplained symptoms with respect to patient satisfaction, emotional distress and illness perception.

OBJECTIVES: This study aimed to assess whether patients with medically unexplained symptoms (MUS) attending cardiology and neurology out-patient clinics were less satisfied with their consultation than patients whose presenting symptoms were explained by an organic diagnosis. The multidimensional nature of satisfaction and its relationships with emotional distress and illness perception were also assessed within the two groups. DESIGN AND SETTING: A prospective cohort study was carried out at a large inner city teaching hospital. PARTICIPANTS: New attenders at cardiology and neurology out-patient clinics participated in the study. MEASURES: The Satisfaction Questionnaire, the Hospital Anxiety and Depression Scale (HADS), the Health Anxiety Questionnaire (HAQ) and the Illness Perception Questionnaire (IPQ) were used in the study. RESULTS: There were no overall significant differences in satisfaction between organic and MUS patients. Factor analysis yielded four factors: satisfaction with information, satisfaction with style of doctor-patient interaction, satisfaction with clinic environment, and satisfaction with patient's health. Levels of internal consistency were good, with Cronbach's alphas between .74 and .95 for the four subscales. CONCLUSION: When considering patients with MUS, these findings emphasize the need to examine healthcare satisfaction from a detailed and multidimensional perspective. Relationships between satisfaction dimensions, clinic specialties and measures of psychological well-being and of illness perception show interesting patterns. These findings raise both theoretical and service delivery questions concerning communication strategies.

Adult↗

A laboratory study of satisfaction effects on mood state, withdrawal intentions, and organizational citizenship behavior.

154 undergraduates role-played a restaurant server experiencing positive, neutral, or negative Job or Life Satisfaction. Positive Satisfaction resulted in ratings of more positive reported mood state, lower expected absenteeism and turnover intentions, and greater expected Organizational Citizenship Behavior than did Neutral Satisfaction and Negative Satisfaction. Life Satisfaction was associated with reported mood states and intentions similarly to Job Satisfaction, except Negative Job Satisfaction was more negatively influential on expectations of quitting than Negative Life Satisfaction. Both Job and Life Satisfaction may be antecedents to affect and its consequences in work settings.

Adult↗

[Factors affecting subjective satisfaction with verbal communication among the disabled elderly and their family caregivers].

The aims of the present study were to investigate satisfaction with verbal communication among the disabled elderly and their family caregivers; and to find the significantly influential factors of satisfaction with verbal communication. The subjects were 85 disabled elderly and 85 family caregivers. For the disabled elderly, satisfaction with verbal communication, demographic, and physical factors were examined using an interview survey. For the caregivers, satisfaction with verbal communication, demographic factors, and some factors related caregiving were examined using a self-administered questionnaire. In the disabled elderly, 82.4% were satisfied with their verbal communication while 55.3% of family caregivers were satisfied. Satisfaction with verbal communication between the disabled elderly and their caregivers showed low agreement (kappa = 0.17). Bivariate analysis revealed that satisfaction with verbal communication of the disabled elderly was significantly related to ADL (p < 0.01), dysphagia risk (p < 0.05), and ability of comprehension (p < 0.05) while satisfaction with verbal communication of caregivers was significantly related to the gender of the disabled elderly and caregivers' burden. Furthermore, multiple regression analysis showed that the factor most related to satisfaction with verbal communication for the disabled elderly was ability of comprehension (p value = 0.032, odds ratio = 2.960), and the most related factor for their caregivers was the burden evaluated by J-ZBI_8 (p value = 0.004, odds ratio = 0.842). These results suggest that satisfaction with verbal communication of the disabled elderly disagrees with that of the family caregivers, and that some related factors for the disabled elderly are different from those in their family caregivers.

Aged↗

[Satisfaction with life and it's predictors of Korean adolescents].

PURPOSE: This study was done to investigate the satisfaction with life in adolescents, and to identify factors affecting satisfaction with life for them. METHOD: The participants were 1,057 adolescents. Data was collected through self-report questionnaires which were constructed to include satisfaction with life, self-esteem, hostility and hopelessness. The data was analyzed using the SPSS program. RESULT: Satisfaction with life for adolescents was significantly different according to school type, grade, scholastic achievement, religion, monthly income of family, conversation with parents and conversation with friends. Satisfaction with life in adolescents correlated with self-esteem, hostility and hopelessness. Significant predictors influencing satisfaction with life in adolescents were self-esteem, hopelessness, school type, conversation with parents, monthly income of family and religion, and these predictors accounted for 37.8% of the variance in satisfaction with life. CONCLUSION: The above findings indicate that satisfaction with life in adolescents is influenced by self-esteem, hostility and hopelessness. Therefore when nursing interventions are developed to improve satisfaction with life in adolescents, these factors need to be considered.

Adolescent↗

Development and testing of a 25-item patient satisfaction scale for black South African diabetic outpatients.

Although there is general agreement that patient satisfaction is an integral component of service quality, there is a paucity of South African research on reliable and valid satisfaction measures and the effects of health status on satisfaction. A 25-item patient satisfaction scale was developed and tested for evaluating the quality of health care for black diabetic outpatients. It was hypothesised that: (1) the underlying dimensions of patient satisfaction were interpersonal and organisational; and (2) patients in poor health would be less satisfied with the quality of their care than patients in good health. The questionnaire was administered to 263 black outpatients from Pretoria Academic Hospital and Kalafong Hospital. Factor analysis was conducted on the patient satisfaction scale and three factors, accounting for 71% of the variance, were extracted. The major items on Factor I were helpfulness, communication, support and consideration, representing the interpersonal dimension. Factors II and III were mainly concerned with service logistics and technical expertise, with the emphasis on waiting time, follow-up and thoroughness of examination. The three factors had excellent reliability coefficients, ranging between 0.82 (technical), 0.85 (logistics) and 0.98 (interpersonal). Multiple analyses of co-variance showed that patients in poor general health were significantly less satisfied with the logistical (p = 0.004) and technical (p = 0.007) quality of their care than patients in good health; patients in poor mental health were significantly less satisfied with the interpersonal quality of their care (p = 0.05) than patients in good mental health. These findings provided support for both hypotheses and suggested that patients in poor health attend to different aspects of their care than patients in good health. Of more importance to clinical practice, the results endorsed the need for a multidisciplinary health team comprising nurse/social worker (Factor I: support, communication), health service managers (Factor II: service logistics) and physician (Factor III: technical expertise) to enhance treatment outcome for diabetic patients. It is recommended that: (1) further research is conducted on this patient satisfaction scale with diverse populations in different settings to complement and validate the scale for generalised use in South Africa; (2) the scale is used to collect information on patient satisfaction before and after implementing an intervention to improve the quality of health care, and (3) measurement of health status is an essential adjunct to assessment of patient satisfaction.

Adolescent↗

Health status and satisfaction with pharmacy services.

OBJECTIVE: To evaluate the relationship between self-reported health status and satisfaction with pharmacy services. STUDY DESIGN: Secondary analysis of data previously collected via a computer-assisted telephone interview system. PATIENTS AND METHODS: Survey respondents were enrollees in a large managed care organization who were recent patrons of either traditional or mail pharmacy services. Satisfaction data were gathered using an existing satisfaction with pharmacy services survey. Health status was measured using the Medical Outcome Study's Short-Form 12-Item Health Survey. The relationships between satisfaction with pharmacy services and health status were analyzed using structural equation modeling. RESULTS: A significant positive relationship between mental health status and satisfaction with pharmacy services was hypothesized and confirmed. The correlations between mental health status and satisfaction, however, were not strong (r = .10 to .18). No relationship between physical health status and satisfaction with pharmacy services was observed. Similar results were observed in patrons of both traditional and mail pharmacy services. CONCLUSION: This investigation offers evidence that satisfaction with healthcare services is more closely related to mental health status than to physical health status. This has important implications for case-mix adjustments in the measurement of satisfaction with care.

Computer Communication Networks↗

The impact of TennCare on patient satisfaction with care.

OBJECTIVE: To measure the level of satisfaction with care by Medicaid-eligible patients before and after implementation of a mandatory managed care plan known as TennCare. STUDY DESIGN: We used multivariate logit analysis of survey data to calculate the effects of TennCare on patient satisfaction for TennCare patients compared to those on traditional Medicaid, using North Carolina as a control state. PATIENTS AND METHODS: Patients were respondents to a survey conducted in late 1996 and early 1997 who had been admitted to hospitals in 1993 and 1995 for labor/delivery (n = 986), acute myocardial infarction (n = 457), and head trauma (n = 248). Dependent variables were yes/no responses to satisfaction questions for labor/delivery and 5-category ordered responses for adults. RESULTS: We found no statistically significant differences in satisfaction between TennCare and traditional Medicaid for either pediatric or adult hospital patients. Generally, TennCare recipients had satisfaction levels as good or better than traditional Medicaid recipients. For pediatric care, TennCare odds ratios ranged from 1.00 to 2.17, the latter for satisfaction with care received (P = 0.107). For adult care, odds ratios ranged from 0.77 to 1.23, the latter for satisfaction with cost of care (P = 0.547). For many dimensions of care, lower rates of satisfaction were reported for respondents who were uninsured, less educated, and in poor health. For adult care, blacks or Hispanics tended to be less satisfied with some aspects of care. CONCLUSION: TennCare did not reduce patient satisfaction with care among those who were hospitalized.

Adult↗

The influence of patient sociodemographic characteristics on patient satisfaction.

The patient satisfaction responses of active duty Army patients in military facilities were analyzed to determine (1) if patients differ along sociodemographic characteristics, (2) the predictors of satisfaction, and (3) the sociodemographic characteristics that moderate patients' satisfaction. Regression results suggest that access, communication, outcomes, and quality predict 42% of the variation in patients' satisfaction scores. Additionally, an analysis of variance suggests that patient satisfaction evaluations are significantly different along sociodemographic characteristics excepting marital status and duty location. Finally, patients' sociodemographic characteristics, with the exceptions of gender and marital status, moderate patients' satisfaction. These findings suggest that patients' satisfaction differs significantly along age, rank, gender, education, race, health status, and utilization individually, but this difference predicts only 5% of patients' satisfaction ratings. This study provides areas of consideration for improving active Army patients' satisfaction in military facilities and suggests theoretically and empirically supported ways to prioritize scarce resources and optimize efforts when faced with constraints.

Adult↗

Determinants of patient satisfaction and willingness to return with emergency care.

STUDY OBJECTIVE: To identify emergency department process of care measures that are significantly associated with satisfaction and willingness to return. METHODS: Patient satisfaction and willingness to return at 5 urban, teaching hospital EDs were assessed. Baseline questionnaire, chart review, and 10-day follow-up telephone interviews were performed, and 38 process of care measures and 30 patient characteristic were collected for each respondent. Overall satisfaction was modeled with ordinal logistic regression. Willingness to return was modeled with logistic regression. RESULTS: During a 1-month study period, 2,899 (84% of eligible) on-site questionnaires were completed. Telephone interviews were completed by 2,333 patients (80% of patients who completed a questionnaire). Patient-reported problems that were highly correlated with satisfaction included help not received when needed (odds ratio [OR] 0.345; 95% confidence interval [CI] 0.261 to 0.456), poor explanation of causes of problem (OR 0.434; 95% CI 0.345 to 0.546), not told about potential wait time (OR 0.479; 95% CI 0.399 to 0.577), not told when to resume normal activities (OR 0.691; 95% CI 0.531 to 0.901), poor explanation of test results (OR 0.647; 95% CI 0.495 to 0.845), and not told when to return to the ED (OR 0.656; 95% CI 0. 494 to 0.871). Other process of care measures correlated with satisfaction include nonacute triage status (OR 0.701, 95% CI 0.578 to 0.851) and number of treatments in the ED (OR 1.164 per treatment; 95% CI 1.073 to 1.263). Patient characteristics that significantly predicted less satisfaction included younger age and black race. Determinants of willingness to return include poor explanation of causes of problem (OR 0.328; 95% CI 0.217 to 0.495), unable to leave a message for family (OR 0.391; 95% CI 0.226 to 0. 677), not told about potential wait time (OR 0.561; 95% CI 0.381 to 0.825), poor explanation of test results (OR 0.541; 95% CI 0.347 to 0.846), and help not received when needed (OR 0.537; 95% CI 0.340 to 0.846). Patients with a chief complaint of hand laceration were less willing to return compared with a reference population of patients with abdominal pain. Willingness to return is strongly predicted by overall satisfaction (OR 2.601; 95% CI 2.292 to 2.951). CONCLUSION: These data identify specific process of care measures that are determinants of patient satisfaction and willingness to return. Efforts to increase patient satisfaction and willingness to return should focus on improving ED performance on these identified process measures.

Adolescent↗

Job satisfaction of doctors in Negeri Sembilan.

A cross sectional study was carried out in Negeri Sembilan to identify factors associated with job satisfaction of doctors serving in Ministry of Health and their intentions to resign. All Ministry of Health doctors currently working in Negeri Sembilan were included in the study and data collection was done via a self-administered postal questionnaire. The response rate was 69.4%. Out of those who responded, only 31.3% had global job satisfaction, with the majority dissatisfied. Intention to resign was high among 32.7% of the respondents. Factors found to be significantly associated with job satisfaction were age, job designation, income, duration of service and intention to resign. Intention to resign was found to be significantly associated with ethnicity and income. From logistic regression, predictors of job satisfaction identified were age, place of first graduation, and satisfaction with status and autonomy, satisfaction with career development, satisfaction with workload and satisfaction with transfers. Predictors of intention to resign were race, income and global job satisfaction.

Adult↗

Development of a Russian satisfaction with Prenatal Care Scale.

Patient satisfaction with health services is used as a measure of the quality of patient care received. The emphasis on accountability and patient as consumer has contributed to the growing interest in studying patient satisfaction. Patient satisfaction with prenatal care services has not been extensively studied including instrumentation to develop a satisfaction scale. The purpose of this study was to develop a reliable and valid scale to measure satisfaction with prenatal care services in St. Petersburg, Russia, using the 6 satisfaction dimensions in Aday and Andersen's Theoretical Framework (1974). It was conducted under the auspices of the World Health Organization, Healthy Cities Project. Although the study was conducted internationally, it provides a basis for further testing of reliability and validity in the United States. A convenience sample of 397 women with uncomplicated pregnancies and normal deliveries was studied (86% response rate). Content, construct, and predictive validity, and reliability testing using Cronbach's alpha was conducted. The scale was found to be an adequate and theoretically sound measure of satisfaction with prenatal care services in Russia. However, rather than the 6 hypothesized satisfaction dimensions, Russian women identified 2 satisfaction subscales or measures for quality of prenatal care received. One was, as hypothesized, convenience, and the other was the doctor's behavior.

Adolescent↗

Metacarpophalangeal arthroplasty in rheumatoid arthritis: what determines satisfaction with surgery?

OBJECTIVE: In patients with rheumatoid arthritis (RA), it is unclear what determines satisfaction with metacarpophalangeal (MCP) joint replacement surgery. Previous studies have focused primarily on objective outcomes, such as range of motion (ROM) or strength, although some subjective measures have been examined. We investigate which outcomes most strongly correlate with patient satisfaction. METHODS: We assembled a retrospective cohort of 26 RA patients who received a total of 160 MCP silastic spacer implants. Patients answered a telephone survey, and 18/26 patients were examined. The strength of association between specific outcome variables and patient satisfaction with surgery was measured using Spearman correlations. RESULTS: Patients had a mean age of 64.8 years and 77% were female. The mean time since surgery was 5.5 years. The strongest determinant of patient satisfaction was postoperative hand appearance (Spearman r > or = 0.60). Pain was also highly correlated with satisfaction with surgery (Spearman r > or = 0.46). Ability to perform activities of daily living and portions of the Jebsen Hand Function Test were moderately correlated with patient satisfaction. Most other measures of hand strength and ROM showed only minimal correlation with patients' overall satisfaction with surgery. CONCLUSION: Overall satisfaction with silastic spacer surgery in this cohort of RA patients was most influenced by postoperative hand appearance and by pain. While objective measures of surgical outcomes are valuable reflections of technical success, they are not important determinants of patient satisfaction. The criteria used to assess MCP arthroplasty results should be revised to better capture the outcomes that appear to matter most to patients.

Activities of Daily Living↗

Factors related to patient satisfaction regarding spinal anesthesia.

PURPOSE: Regional anesthesia has been shown to improve the clinically oriented outcome and many studies investigating the use of regional anesthesia have incorporated patient satisfaction measurements. This study was undertaken to find the factors related to patient satisfaction after spinal anesthesia which is the most frequent regional anesthesia conducted. METHOD: A prospective descriptive study of spinal anesthesia and post-operative survey of patients on the day after surgery was conducted by collecting pre-operative and intra-operative data on a constructed questionaire. Post-operative data including average pain score, satisfaction score of receiving spinal anesthesia, adverse effects and willingness to accept or refuse spinal anesthesia for a similar surgery again were asked by the performer of spinal anesthesia or trained anesthesia personnel. RESULTS: The average satisfaction score of receiving spinal anesthesia of 522 patients was 8.30 +/- 1.80 which was divided into 502 (96.2%) of satisfied patients (satisfaction score > or = 5) and 20 (3.8%) of dissatisfied patients (satisfaction score < 5). Factors associated with dissatisfaction were the increasing number of attempts of spinal block, p = 0.028, OR = 0.67 (0.48-0.96); pain during spinal block, p = 0.035, OR = 0.77 (0.60-0.98), inadequate analgesia, p = 0.005, OR = 0.07 (0.01-0.45) and post-operative urinary retention, p < 0.001, OR = 0.07 (0.02-0.28). Factors associated with refusal to have spinal anesthesia for similar surgery again were: female gender, p = 0.008, OR = 6.00 (1.61-22.37), low body weight, p = 0.009, OR = 0.95 (0.92-0.98), intra-operative vomiting, p = 0.01, OR = 5.02 (1.47-17.08) and low satisfaction score of spinal anesthesia, p < 0.001, OR = 0.04 (0.01-0.12). CONCLUSION: The patients receiving spinal anesthesia gave a high rate of patient satisfaction score of receiving spinal anesthesia. Ensuring quality of spinal anesthesia, improving clinical skill of anesthesiologists and prevention of side effects especially urinary retention would improve patient satisfaction.

Adult↗

[Patient satisfaction with general practice services before and after the list patient reform].

BACKGROUND: The aim of this study was to investigate how satisfied people are with general practitioners' (GPs') services before and after the introduction of a list patient system in Norway. MATERIAL AND METHODS: Data were collected from two national questionnaire surveys carried out in 2000 and 2003. Satisfaction was measured on two dimensions: satisfaction with access and satisfaction with the physician and the actual treatment. RESULTS: The level of satisfaction with GPs' services was high before the reform. This was particularly the case with regard to the second dimension: satisfaction with the GP and the actual treatment (for example, evaluation of the GP's competence). There were only small changes in these indicators from 2000 to 2003, but the changes were for the better. The changes in the indicators for the first dimension (those with the lowest scores before the reform): satisfaction with access (e.g. physicians-to-population ratio in the district and waiting time for an appointment)--were greater and also positive. Respondents in large and medium-sized municipalities reported the highest increase in satisfaction with access. There were no changes with regard to emergency services. The proportion of people who had used more than one physician during the last year was down from 38% to 29%. INTERPRETATION: Higher satisfaction with GPs' services has occurred after the introduction of a list patient system and the associated improvement in the GPs-to-population ratio. That fewer people changed their GP may be the result of more stability in physician posts. It may also be associated with greater satisfaction with people's access to their own GP after the reform.

Clinical Competence↗

Patient and provider satisfaction with the use of telemedicine: overview and rationale for cautious enthusiasm.

Telemedicine research addressing user satisfaction abounds in academic literature. Results from patient satisfaction studies indicate exceptionally high levels of perceived satisfaction, often above the rates of expected satisfaction for traditional forms of health delivery. Results from provider satisfaction studies are also generally quite positive; however, data from providers point to higher concerns with delivery barriers and challenges. Even though data from patient and provider satisfaction research suggests overwhelming optimism for this delivery modality, this paper urges cautious embracement of these results for several reasons. First, many of the studies exhibit serious methodological weaknesses related to design and data collection instruments. In addition, the construct of satisfaction is largely undefined and is not clear. Even recognizing these caveats, the results of the study do offer some evidence that patient satisfaction will not impede the deployment of telemedicine, but provider satisfaction merits additional study.

Attitude of Health Personnel↗

[Patients' satisfaction with their hospital stay at the Department of Psychiatry, Amager Hospital, in 2000 and 2003].

INTRODUCTION: Our goal was to compare patients' satisfaction with their hospital stay at the Department of Psychiatry, Copenhagen University Hospital, Amager, before and after the department was moved to newly built facilities. MATERIALS AND METHODS: In 2000 and again in 2003, patients who were about to be discharged from the department were asked to anonymously fill in a 24-item questionnaire related to their satisfaction with their recent hospital stay. RESULTS: The percentage of participants was 39% of discharged patients in 2000 and 33% in 2003. A high percentage rated their general satisfaction with the hospital stay as either "good" or "very good" (94% in 2000 and 88% in 2003). From 2000 to 2003, we noted a significant (23%) increase in the percentage who rated their satisfaction with the buildings as either "good" or "very good". In other areas, there was reduced patient satisfaction. We noted a reduction with respect to the respondents' satisfaction with the hospital staff on specific matters; for instance, a significant (23%) reduction in the respondents' perception of the hospital staff having spent sufficient time with them. CONCLUSION: After the department was moved to newly built facilities, patients' satisfaction with the buildings appears to have increased. In other areas, such as satisfaction with the hospital staff on specific matters, patient satisfaction appears to have decreased. The results should be interpreted with caution due to the low participation rate.

Denmark↗