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Vocational rehabilitation in northern Sweden. III. Aspects of life satisfaction.

Levels of global (1 item) and domain-specific (8 items) life satisfaction were explored at the commencement of vocational rehabilitation and two years later in a consecutive series of subjects who were partly or completely vocationally disabled with a diagnosis of bodily impairment. At the onset of vocational rehabilitation, global life satisfaction (satisfaction with life as a whole) and satisfaction derived from performance- and provider-related (instrumental) domains of life were significantly lower than satisfaction derived from socio-emotional (expressive) facets of life. The eight domain-specific items of life satisfaction described a characteristic three-factor pattern (76% of variance) which resembled quite closely that of non-impaired subjects, one factor being expressive. The other two factors were instrumental and separated recreative from vocational domains of satisfaction. Successful vocational rehabilitation resulted in increases in vocational satisfaction. For those subjects who were successfully rehabilitated, satisfaction with other instrumental aspects of life and with life as a whole also increased. The results indicate that successful vocational rehabilitation leads to increased social well-being.

Persons with Disabilities↗

The relationship between primary health care practitioners' job satisfaction and characteristics of their practice settings.

Today, individuals spend much of their time at the workplace, and theorists argue that an individual's employment experience is an integral part of his or her social identity. Current research emphasizes the importance of job satisfaction to a person's entire life adjustment. Yet little data exists about the job satisfaction of nurses working in the advanced practice role of primary care. The purposes of this article's study were to describe those individual and situational factors that contribute to job satisfaction and dissatisfaction among nurse practitioners, and to explore the relationship between levels of job satisfaction and characteristics of primary health care practitioners' work/practice settings. The study results suggest that, overall, NPs demonstrate a high level of job satisfaction; only 9 percent reported overall dissatisfaction with their jobs. Autonomy, sense of accomplishment and time spent in patient care ranked as the top three factors contributing to job satisfaction. The highest ranked dissatisfier was salary. Differences in satisfaction existed according to several practice-setting characteristics. Fewer factors than initially expected were associated with overall job satisfaction. The correlates that were noted, however, identified number of years of experience and self-perceived skill levels as important variables contributing to overall job satisfaction. Implications of these findings for the early guidance of practitioners assuming the advanced-practice role and for the NP educational curriculum are discussed.

Adult↗

The effect of education on foodservice manager job satisfaction.

We conducted a study to determine whether educational background (field of study and level of education) was related to the job satisfaction of foodservice managers. The Index of Organizational Reactions Questionnaire was used to measure specific components of job satisfaction based on a five-point Likert-style scale (1 = low satisfaction, 3 = moderate satisfaction, and 5 = high satisfaction). Questionnaires were mailed to the entire population of 256 foodservice managers employed in college and university dining facilities of a regional division of a major foodservice company in the northeastern United States. Names, titles, positions, and addresses of the managers were obtained from the company's human resources department. Analysis of data was done through computation of the point-biserial correlation coefficient and the rank order correlation coefficient. Managers who responded to the questionnaire (74.6%) indicated moderate overall job satisfaction (mean = 3.42 on a 5-point scale). Of the respondents, 44% had an educational background in foodservice; these respondents had lower overall job satisfaction than did those having no education/training in foodservice. Both groups were most satisfied with the job components of supervision, type of work, and relationship with coworkers. Both groups were least satisfied with pay and benefits, company identification, and amount of work. A significant (p less than .01) positive relationship was found between educational field of study and job satisfaction, and a significant (p less than .001) negative relationship was found between educational level (i.e., degree[s] earned) and job satisfaction.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[User satisfaction in primary care: the results of a home survey].

OBJECTIVE: To discover the general and specific levels of satisfaction of our Primary Care centre (PCC) users, such as their satisfaction with the new Primary Care structures; to determine the relationship between satisfaction and sociodemographic factors; and to study the possible influence of certain user attitudes on satisfaction. DESIGN: Descriptive crossover study by means of a door-to-door survey. SETTING: A basic care unit of the Primary Care team of Number 3 health zone of area 19, Alcoy. PATIENTS AND OTHER PARTICIPANTS: The survey had a sample of 312 users, obtained by means of systematic sampling on the basis of our PCC's records. MEASUREMENTS AND MAIN RESULTS: Satisfaction was scored on a scale from 1 (very satisfied) to 5 (not at all satisfied). Average general satisfaction was 2.08 +/- 0.8 (quite satisfied), which in general depended on the length of time waiting to be seen. Average waiting time was 30 minutes (+/- 25 min 55 s) and the number of calls to obtain an appointment was 5.4 (+/- 4.6). Specific satisfaction with different professionals was around 2 (quite satisfied), a score which became more favorable in the case of doctors, but without statistically significant differences from the rest of the professionals. Socio-demographic factors did not show any influence on satisfaction. CONCLUSIONS: The user is in general "quite satisfied" with the attendance received at the PCC, despite the average waiting times and numbers of prior calls needed to make an appointment, which are among the highest published. This should make us aware of users' health access difficulties and should therefore forestall any over-optimism in the evaluation of a result which was generally positive as to user satisfaction. All in all, abundant information was obtained, which will assist in correcting the more negative features of the running of our PCC.

Adult↗

Levels of satisfaction among hospital pharmacists.

Hospital pharmacists in a Midwestern, metropolitan area were surveyed to determine levels of job satisfaction. Of the 195 pharmacists who received the 120-item questionnaire, 132 (68%) responded. The questionnaire included facet-free questions which reflect the overall satisfaction of an individual with his job. Results to these questions were compared to those for professional, managerial and nonprofessional workers in two University of Michigan Surveys of Working Conditions. Also included in the survey were facet-specific job satisfaction measures from the Minnesota Job Satisfaction Questionnaire. The study found an overall pattern of less satisfaction among hospital pharmacists than among workers included in the Michigan surveys. The data indicate that hospital pharmacists might be less committed to their jobs and more likely to change jobs than other employees. Compared to other employees, hospital pharmacists showed a greater commitment to the work ethic and were more dissatisfied with their general life situation. The average general job satisfaction score of the respondents was 2.53, on a five-point scale, indicating something less than "satisfied". Pharmacists were least satisfied with the lack of opportunity for advancement, staffing practices, employer's policies and practices, and compensation practices. Compensation relative to others and amount of compensation were the sources of greatest satisfaction. Staff pharmacists had the lowest level of satisfaction; clinical pharmacists the highest--other personnel categories compared were directors, associate and assistant directors, and supervisors. The profession of pharmacy should decide whether or not to be concerned with the general low level of satisfaction among hospital pharmacists.

Attitude↗

[Patient satisfaction in the ambulatory setting: validation of a scale and identification of associated factors].

BACKGROUND: Patient satisfaction is increasingly used to evaluate the performance of health services. Validated French-language instruments to measure satisfaction are currently lacking. This study was designed to validate a questionnaire of this kind and to identify factors associated with patient satisfaction. METHODS: Mail survey of 1027 patients who consulted at 4 different ambulatory health care settings in Geneva, Switzerland. The participation rate was 81%. The questionnaire measured 7 dimensions of satisfaction using 16 items adapted from other sources. RESULTS: The questionnaire was easy to respond to (scores were available for 95 to 99% of respondents, depending on the scale). The internal consistency of the scales was satisfactory (Cronbach alpha between 0.65 and 0.82) for 5 of 6 multi-item scales; it was lower for the scale which measures satisfaction with access to care. Factor analysis identified two principal components corresponding roughly to the "process" and to the "organization" of care. Open comments also confirmed the validity of the multi-item scales. Several patient or visit characteristics were independently associated with the level of satisfaction: older patients, those who were born in Switzerland, who had a visit appointment, who consulted a specialist, and those who saw the same physician as at their previous visit were more satisfied than other patients. CONCLUSIONS: The brief satisfaction questionnaire described in this paper is easy to use, and its reliability and validity are good. Its use can be recommended in ambulatory health care settings. Several variables associated with the level of satisfaction were identified; they should be measured in satisfaction surveys to allow correct appraisal of the results.

Adolescent↗

[Global life satisfaction and its related factors in community elderly residents].

This study was aimed at identifying the distribution of global life satisfaction as measured by Visual Analogue Scale (VAS) and factors related to it in 531 community elderly residents aged 75-80 years. Subjects were divided into two groups according to the extent of their daily activities, which has been emphasized as an important health index for the elderly: the outdoor-activity group (defined as people whose daily activities extended into their community) and the indoor-activity group (defined as people whose daily activities was limited to inside their home). The distribution of global life satisfaction and related factors were compared between the two groups. For independent variables, daily behaviors were classified into five categories and examined for how they related to global life satisfaction. The results obtained were as follows: Global life satisfaction showed a bimodal distribution in both groups tending to be lower in the indoor-activity group than in the outdoor-activity group. Most of the indoor-activity group indicated low or moderate life satisfaction. The extent of their daily activities was thus related to global life satisfaction. The strongest direct factor relating to global life satisfaction was self-rated health for the outdoor-activity group. Some of their daily behaviors also related to it and these significant daily behaviors differed by sex. Only self-rated health was related to global life satisfaction in the indoor-activity group. The results indicate that, when compared to other factors, daily activity in community elderly residents is crucial to increasing their global life satisfaction, and therefore efforts to enlarge subjects' daily activities are also required.

Activities of Daily Living↗

Preventive medicine physician satisfaction and its relation to practice characteristics.

BACKGROUND: Physicians specializing in general preventive medicine and public health manage programs, conduct research, and care for patients. This study examines their satisfaction overall and in five dimensions: contribution to people's lives, respect from physicians in clinical practice, research opportunities, income, and time to pursue outside interests. METHODS: A survey of 1979-1989 graduates of preventive medicine residencies rated satisfaction on a five-point scale. Linear models were used to regress physician satisfaction against employer, hours worked, practice content, and other covariates. RESULTS: Respondents' (n = 778) overall job satisfaction was high, with 44% very satisfied, 44% satisfied, 7% neutral, and 6% dissatisfied. Federal government physicians had the highest satisfaction overall and for research opportunities and time for outside interests. Independent, statistically significant (p < .001) associations were found between higher satisfaction with research opportunities among academic and federal government employers, among Caucasians, and those with substantial epidemiologic practice; and lower satisfaction with time to pursue outside interests, more hours worked, and among women. CONCLUSIONS: Physician satisfaction could be understood in relation to a number of practice characteristics including its content, hours worked, income, and employer. The results suggest ways to improve physician satisfaction, including balancing competing demands of practice and focusing the physicians' responsibilities.

Female↗

Job satisfaction and self-esteem of South African nurses.

The overall aim of this study was to investigate job satisfaction and self-esteem among South African nurses. The objectives of the study were to: (1) ascertain South African nurses' satisfaction with their work, pay, promotion, supervision and co-workers; (2) compare job satisfaction of South African nurses with that of North American nurses; (3) determine levels of self-esteem; and (4) test the direct and indirect effects of self-esteem on job satisfaction. A postal survey was conducted on a random sample of 2,000 nurses registered with the South African Nursing Council; 396 persons returned the questionnaires (Group 1). A subsample of 93 nonrespondents was traced and agreed to complete the questionnaire (Group 2). Minimal differences justified combining the groups and conducting subsequent analyses on total sample scores. Nurses were most satisfied with supervision and co-workers and least satisfied with promotion and pay. Reliability coefficients for the five job satisfaction subscales and overall scale ranged between 0.79 (work) and 0.93 (overall scale). South African nurses were significantly less satisfied with all aspects of their jobs than their American counterparts. Coefficient alpha for the self-esteem scale was 0.72, 0.87 for the work-related needs scale and 0.80 for the social approval scale. High self-esteem nurses were more likely to attend to work-related needs in judging their job satisfaction than low self-esteem nurses. The best model for predicting job satisfaction was the linear incorporation of self-esteem and work-related needs. It was concluded that: (1) the Job Descriptive Index (JDI) was a useful measure of job satisfaction; (2) the quality of life in the South African nursing profession was lower than their American counterparts; (3) nurses had high levels of self-esteem; and (4) self-esteem directly and indirectly affected job satisfaction.

Career Mobility↗

Assessment of medical care by elderly people: general satisfaction and physician quality.

OBJECTIVE: To identify personal characteristics and factors related to health and patterns of healthcare utilization associated with the elderly people's satisfaction with medical care. DATA SOURCES/STUDY SETTING: Data from the 1991 Medicare Current Beneficiary Survey (MCBS) on 8,859 persons age 65 and over living in the community. STUDY DESIGN: Items reflecting general satisfaction with care and views of physician quality are examined and, based on factor analysis, grouped in dimensions of two (global quality, access) and three (technical skills, interpersonal manner, information-giving), respectively. The relationship of high levels of satisfaction in each dimension to personal characteristics of elderly people, and to measures of access and utilization, is assessed using logistic regression. PRINCIPAL FINDINGS: While satisfaction is high, with over 90 percent surveyed expressing some satisfaction, there is substantial variation with less likelihood of high satisfaction among those 80 or older, with less education and income and in poorer health. Longer waiting time at visits and less frequent visits are factors in lower satisfaction as well. A favorable perception of physician quality, especially regarding technical skills, appears to play a significant role in satisfaction with global quality of care. CONCLUSIONS: Studies of patient satisfaction in elderly people are rare. Some factors expected to be related to positive assessment based on earlier studies, were, e.g., better health and shorter waiting time, while others were not, e.g., increasing age. Elderly people appear to place greater importance on physician technical skills, as opposed to interpersonal dimensions, in assessing global quality. These findings suggest the need for a better understanding of how elderly people evaluate care and what they value in interactions with the healthcare system.

Age Factors↗

[Patient satisfaction in rehabilitation of musculoskeletal diseases--effect of patient characteristics, treatment, evaluation schedule and correlation with treatment outcome].

Within quality assurance in medical rehabilitation, patient satisfaction is viewed as one of the essential features. Patient satisfaction is expected to comprehensively cover structure, process and outcome quality. The aim of our study was to evaluate factors on which patient satisfaction with the rehabilitation measure depends. Sociodemographic factors, diagnosis at admission, characteristics of treatment, and the time of evaluation were considered. Furthermore, we examined whether four orthopedic-rheumatologic rehabilitation hospitals differ in respect of patient satisfaction and how patient satisfaction is associated with the result of treatment. Data collection was conducted in four German rehabilitation hospitals. Patient satisfaction was assessed in 1832 patients with an orthopedicrheumatologic disease as first diagnosis three months after discharge, using a postal questionnaire (Raspe et al. 1996). Additionally, 153 patients were assessed at the end of the rehabilitation measure. Besides the satisfaction with the treatment, its result was documented for 100 patients. For all sections of the questionnaire no or small differences could be demonstrated with respect to gender, age, education, and diagnosis. The questionnaire can differentiate between treating physicians and hospitals. The time of questioning had no influence. No relevant correlation existed between patient satisfaction and result of the treatment. The questionnaire assessing patient satisfaction can be applied with little expenditure. The acceptance is high. The questionnaire can assess the current status of many areas of rehabilitation practice, so that quality assurance measures could be introduced immediately. A comparison between hospitals is possible and reveals strengths and weaknesses. Thus, the questionnaire may be used as a quality assurance measure for hospitals and for health care providers. This tool may be used routinely for monitoring and for longitudinal evaluations.

Adult↗

Surgeon satisfaction agreement after total knee arthroplasty using a visual analogue scale: a single surgeon series.

INTRODUCTION: The outcome of total knee arthroplasty (TKA) is traditionally rated by objective criteria such as the knee society clinical rating system (KSCRS). Subjective criteria, such as satisfaction, will be of more importance, because health-care is shifting towards a market model. The aim of this study was to investigate the agreement on satisfaction after TKA between two orthopaedics surgeons, when one of the surgeons reviews his own results. PATIENTS AND METHODS: We investigated a group of 57 patients (63 TKAs) using a visual analogue scale (VAS) for satisfaction. There were 53 TKAs available and were separately seen by the two orthopaedic surgeons for clinical follow-up. RESULTS: After we split the satisfaction rate as excellent-good and fair-poor (VAS smaller or equal to 20 was excellent-good), we found a substantial agreement (kappa = 0.77) between the orthopaedic surgeons. However, we found that the surgeon who viewed his own results (B) scored a significantly lower satisfaction than surgeon A when analysing the complete group. CONCLUSIONS: The interobserver agreement of satisfaction, using a VAS, was high between the two orthopaedic surgeons. The satisfaction VAS is a simple tool to quantify satisfaction of surgeons and patients after TKA and could be used to evaluate quality. Comparison between studies could be more efficient and reliable using the satisfaction VAS method.

Aged↗

Artifact in client satisfaction assessment: experience in community mental health settings.

Artifact in client satisfaction assessment is discussed and the results of a study of three factors thought to mediate client satisfaction ratings; (a) general life satisfaction, (b) mode of administration, and (c) psychological symptomatology, are reported. A standard client satisfaction questionnaire (CSQ) was modified to yield parallel forms and was administered orally and in writing to 92 clients in two mental health day treatment programs. Satisfaction ratings obtained from these clients were quite similar to out-patient ratings obtained in previous studies conducted in this setting and using the same measures. Oral administration of the CSQ produced 10% higher satisfaction ratings than written administration (p less than .05) and less missing data (p less than .01). Satisfaction ratings were also obtained using a simple graphic instrument. Graphic ratings were comparable to CSQ ratings. Satisfaction with life in general and level of psychiatric symptoms together accounted for 25% of CSQ variance. The implication of these findings for future client satisfaction research is discussed.

California↗

Determinants of informal caregivers' satisfaction with services for dying cancer patients.

The association between bereaved informal caregivers' satisfaction with services delivered by district nurses, general practitioners and hospital doctors, and various service and non-service variables was examined to assess whether satisfaction is a reflection of service characteristics, non-service related factors, or attributable to both. Secondary analysis was undertaken on a sub-sample from the "Regional Study of Care for the Dying" (RSCD) in which bereaved relatives or friends of a random sample of deaths in 1990 in 20 health districts across England were interviewed some ten months after the death. 1858 relatives or close friends/neighbours of people who died from cancer were included in this analysis. Using multiple logistic regression, larger odds ratio were found in association with service than non-service variables. For example, high satisfaction with district nurses was strongly associated with visiting the patient very frequently (OR = 10.8, 95% CI = 4.5 - 25.9), while the GP visiting 20 times or more (OR = 5.5, 95% CI = 3.6 - 8.5), and informing the informal caregiver of the diagnosis (OR = 3.3, 95% CI = 2.3 - 4.7) were associated with high satisfaction with GPs. However, some non-service variables were significantly associated with satisfaction. For instance, having no bereavement-related psychological problems was positively associated with high satisfaction with district nurses (OR = 2.3, 95% CI = 1.6 - 3.4) and GPs (OR = 2.0, 95% CI = 1.4 - 2.8), while the informal caregiver perceiving caring as rewarding as opposed to a burden was positively associated with high satisfaction with district nurses (OR = 3.7, 95% CI = 1.8 - 7.5) and negatively associated with high satisfaction with hospital doctors (OR = 0.46, 95% CI = 0.24 - 0.86). The findings indicate that, in post-bereavement surveys evaluating services delivered to dying cancer patients, informal caregivers' satisfaction is mainly determined by service characteristics. However, attributes of both patients and informal caregivers also play an important role.

Adult↗

What 'really' affects health professions students' satisfaction with their educational experience? Implications for practice and research.

Student satisfaction has been widely recognised as an indicator of the quality of the students' learning and teaching experience. The aim of the study was to explore the extent to which student satisfaction is influenced by 13 demographic- and educational-related variables. A cross-sectional survey was undertaken (18-item questionnaire, 1660 questionnaires). Principal component analysis categorised the 18 items into four learning and teaching dimensions. Each of the 13 variables was analysed for its influence on student satisfaction generally and on the four dimensions individually, before and after controlling for all the other variables. After controlling for all the variables, none of the demographic characteristics was associated with satisfaction. Most of the educational variables exercised their own independent and significant effects on general satisfaction and on satisfaction with the four individual dimensions. Collectively, decreased satisfaction was associated with being a pre registration, full-time student, usually with A level entry qualifications, attending term two modules whose assessment/s comprised combined strategies. Decreased satisfaction was also significantly associated with larger class sizes as regards the student numbers and with attaining lower grades in the assessments. The demographic variables were not as influential as the educational ones as regards the affects on students' satisfaction. The implications of the findings for research and practice are discussed.

Consumer Behavior↗

Validating a satisfaction questionnaire using multiple approaches: a case study.

We examined the validity of a questionnaire designed to measure the satisfaction of users of health services, using multiple tests of construct validity. Members of 2 health insurance plans in Geneva (Switzerland) answered a mailed questionnaire in 1992 (n = 1007) and 1993 (n = 1424). Response rates were 82% participants were 18-44 years old in 1992. The questionnaire included 22 questions on satisfaction with medical care received during the past 12 months. Most items were adapted from the Patient Satisfaction Questionnaire. Four dimensions of satisfaction were measured: satisfaction with physician services (8 items), communication (8 items), access (4 items) and insurance services (2 items). Reliability (Cronbach's alpha) was satisfactory for the 2 former dimensions (alpha = 0.81 and 0.82 respectively), but lower than desired for the 2 latter (alpha = 0.63 and 0.49 respectively). Participants who gave positive open-ended comments had satisfaction scores 0.7-1.2 standard deviation units higher than participants who gave negative comments. Satisfaction scores were weakly correlated with satisfaction with private life, which indicates that the instrument did not simply measure a general tendency to be satisfied. Participants who said that care received in 1993 was worse than care received in 1992 (retrospective assessment) experienced a decrease in satisfaction scores between 1992 and 1993 (prospective assessment). Most validation procedures provided independent but partial evidence for the validity of the instrument. Triangulation of several validation methods, as illustrated in this paper, may greatly improve the understanding of an instrument's properties.

Consumer Behavior↗

Parental satisfaction and outcome: a 4-year study in a child and adolescent mental health service.

OBJECTIVE: The aim of this paper is to examine the facets of parental satisfaction and its relationship with clinician-rated outcome in a child and adolescent mental health service. METHOD: Patients (n = 1278) consecutively assessed between 1992 and 1996 were included in the study. When treatment ended, clinicians rated the outcome of the intervention and parents were asked to complete a satisfaction questionnaire. RESULTS: Sixty-nine per cent of cases were rated by clinicians as having a positive outcome. Outpatients were more likely to be given a positive rating than inpatients. Satisfaction questionnaires were returned by 40% of parents; 76% of these were mostly or very satisfied. Satisfaction scores increased with the number of outpatient sessions attended but did not differ between inpatients and outpatients. There was a significant but small agreement (27% better than chance) between clinicians' rating of outcome and parental satisfaction. Level of agreement varied according to service provided and the number of sessions attended. While rates of positive outcome increased over the study period, ratings of satisfaction were stable. CONCLUSIONS: Overall, ratings of satisfaction were comparable with those reported in other studies. Variations in concordance between parents and clinicians show that outcome and satisfaction, although related, are different constructs influenced by different factors depending on the services provided. Focusing on specific aspects of satisfaction, as opposed to global measures, may be more useful for services, although such undertakings must be supported with efforts to improve clinical outcomes.

Adolescent↗

Trust, benefit, satisfaction, and burden: a randomized controlled trial to reduce cancer risk through African-American churches.

BACKGROUND: Community-based participatory research (CBPR) approaches that actively engage communities in a study are assumed to lead to relevant findings, trusting relationships, and greater satisfaction with the research process. OBJECTIVE: To examine community members' perceptions of trust, benefit, satisfaction, and burden associated with their participation. DESIGN, SETTING, AND PARTICIPANTS: A randomized controlled trial tested a cancer prevention intervention in members of African-American churches. Data were collected at baseline and 1-year follow-up. MEASUREMENTS: Subscales measured perception of trust in the research project and the project team, benefit from involvement with the project, satisfaction with the project and the team, and perception of burden associated with participation. MAIN RESULTS: Overall, we found high levels of trust, perceived benefit, and satisfaction, and low perceived burden among community members in Partnership to Reach African Americans to Increase Smart Eating. In bivariate analyses, participants in the intervention group reported more perceived benefit and trust (P <.05). Participants in smaller churches reported more benefit, satisfaction and trust, while participants from churches without recent health activities perceived greater benefit, greater satisfaction, and lower burden with the project and the team (P <.05). Participants whose pastors had less educational attainment noted higher benefit and satisfaction; those whose pastors were making personal lifestyle changes noted higher benefit and satisfaction, but also reported higher burden (P <.05). CONCLUSIONS: A randomized clinical trial designed with a CBPR approach was associated with high levels of trust and a perceived benefit of satisfaction with the research process. Understanding variations in responses to a research partnership will be helpful in guiding the design and implementation of future CBPR efforts.

Black or African American↗