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PubMed1983

Satisfaction with medical care: replications and theoretic reevaluation.

Satisfaction with medical care is frequently measured in health services research but for many different reasons. The widening conceptualizations and uses of satisfaction reported make comparisons between studies difficult. Questions regarding the structure and dimensionality of satisfaction remain. The relation of satisfaction with utilization still requires theoretic and empiric clarification. This article reports on several surveys containing measures of satisfaction conducted in a research program in community pediatrics. Using multidimensional scaling techniques, the stability of the structure of satisfaction and patients' preferences for care is examined across several samples. The different structures that emerged seem to reflect unique patient experience. Several multivariate approaches were applied to study the relation between satisfaction and utilization. A regulatory self-equilibrating model was offered. Satisfaction is seen as a multifaceted concept related to short-term and long-term processes. Specific models are required to link satisfaction to the various health and illness behaviors.

Blue Cross Blue Shield Insurance Plans↗
PubMed1989

The quality of outpatient psychiatric care. A survey of patient satisfaction in a sectorised care organisation.

Patient satisfaction with outpatient psychiatric care in a sectorised care organisation was studied by means of a mailed questionnaire to a one-year population of patients. Response rate was 40.7%. The results showed a high general satisfaction with treatment. Satisfaction was highest in areas of treatment planning/treatment design, treatment accomplishment and relationship to staff. A somewhat lower level of satisfaction was noted concerning information and coinfluence of the patient. Level of satisfaction was not related to social and psychiatric background characteristics. Patients with longer time in therapy showed a higher level of satisfaction. Patients' ratings of the quality of information and coinfluence were related to both satisfaction with treatment and treatment outcome, pointing to the importance of these factors for course of treatment and treatment success. A comparison with patient satisfaction with in-hospital care revealed significant differences in favour of the outpatient group. It is concluded that surveys of patient satisfaction with care may be a important and useful tool in the evaluation of changes in care organisations and in the monitoring of quality assurance standards.

Adult↗
PubMed2005

Spouses' satisfaction with caregiver support in stroke rehabilitation.

OBJECTIVE: To examine the satisfaction of spouses of stroke patients with the support given to them during clinical rehabilitation and to explore the relationships between satisfaction and characteristics of the support received. METHODS: Spouses of patients with a first-ever supratentorial stroke were included (n = 194). Satisfaction was measured on a 0-10 scale. Bivariate and multivariate relationships were studied between overall satisfaction score and characteristics of the support provided (number of full days of attendance, participation in caregiver group, discipline providing most support), the spouses (age, gender, family situation, education and employment) and the patients (activity of daily living (ADL) dependency (Functional Independence Measure), length of stay). RESULTS: The median satisfaction score was 7, and 44% of all spouses scored >or=8 (very satisfied) but 23% were dissatisfied. Spouses' and patients' characteristics and satisfaction scores were not associated. Of the support characteristics the number of full days of attendance (p = 0.02), participation in a caregiver group (p = 0.006) and support received from a team member (p = 0.000) were related to satisfaction. No differences in spouses' satisfaction scores were found between the participating rehabilitation centres. Only 39% of the spouses participated in a caregiver group. The most important reason for not participating in such a group was not being aware of the opportunity to take part in a group (49%). Spouses participating in a group showed more depressive symptoms and had a more severely disabled partner. Caregiver support was primarily given by the nurse and the social worker. One in five spouses indicated not to have been supported at all by the rehabilitation team. CONCLUSION: A large proportion of the caregivers were satisfied with the care they had received, although one in four was dissatisfied. Satisfaction was related to support characteristics.

Consumer Behavior↗
PubMed1990

[Factors influencing sexual satisfaction in women who have had a hysterectomy: a comparative group study].

This descriptive study was done to identify factors influencing sexual satisfaction in women who had had a hysterectomy and to compare these women who had not had a hysterectomy. The purpose was to contribute theoretical understanding on which to base nursing care planning. One group of subjects were 156 women who had had a hysterectomy, between one and 18 months post surgery, living with their spouse, having no complications, and menstruating before surgery. The other group of subjects were 282 healthy women who were living with their husbands and menstruating. The study tool consisted of 108 items including item concerning personal characteristics, characteristics related to the hysterectomy, husband's support, body image, emotions, attitude toward the sexual relationship, knowledge of sexuality, sexual behavior, and sexual satisfaction. Sexual satisfaction was measured by a tool based on Derogatis Sexual Function Inventory. The range of the internal level of the study tool was from .5208 to .9462. Data collection was done during the period from June 20 to Aug. 20, 1989. The same questionnaire was used of data collection for both groups, but a mail survey method was used for the women who had had a hysterectomy, and an interview method was used for the women who had not had a hysterectomy. Data analysis was done using frequency, ratio, mean and S.D. for the characteristics of the subjects and level of sexual satisfaction. t-test or ANOVA was used for the differences between the groups with regard to the general and hysterectomy related characteristics. The relationship between the score for sex life related factors and the level of sexual satisfaction was analyzed using the Pearson Correlation, and the influencing factors on sexual satisfaction were analyzed by stepwise multiple regression. The results of this study were as follows; 1. Mean age and income level were the only general characteristics for the two groups that were significantly different. The mean age, and income level of the group who had had a hysterectomy were 45 years, and 1,150,000 won respectively, and for those who had not had a hysterectomy, 41 years and 999,000 won. 2. There was no statistical difference of the sexual satisfaction score between the two groups. 3. There was differences in the factors influencing sexual satisfaction between the two groups. Factors influencing sexual satisfaction for the group who had had a hysterectomy were husband's support (R = .5793, P = .000) and the women's Knowledge of sexuality (R = .6670, P = .000) (total variance: 33.56).(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1992

Sexual satisfaction in survivors of bone marrow transplantation.

Of 157 (80%) adult survivors of bone marrow transplantation, 126 responded to a mailed survey 6-149 months after transplant concerning their ability to attain sexual satisfaction. Sixty-five percent of the subjects indicated some degree of sexual satisfaction (with 29% indicating a high degree of satisfaction). Thirteen percent were neutral and 22% were dissatisfied. Gonadal physiological disturbances were present in most subjects as a result of intensive treatments. Fifty-seven percent of women were receiving estrogen replacement, and only 40% had regular menses. Twenty-four percent of men had difficulty with erections and 13% had ejaculatory dysfunction. For men, difficulties with erection (r = 0.54, p less than 0.001) or ejaculation (r = 0.52, p less than 0.001) were associated with inability to attain sexual satisfaction. For women, loss of menses (r = 0.34, p = 0.008) was associated with inability to attain sexual satisfaction. Although few women had abnormally low serum estradiol (even with hormonal supplementation), and none of the 43 men tested had abnormally low serum testosterone, sexual satisfaction correlated with serum levels of estrogen in women (r = 0.42, p = 0.04) and serum testosterone in men (r = 0.28, p = 0.04). Forty-two subjects rated their level of sexual satisfaction before and after transplant. Post-transplant satisfaction was not associated with pretransplant satisfaction (r = 0.07, p = 0.67).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2006

Essential tips for measuring levels of consumer satisfaction with rural health service quality.

INTRODUCTION: Quality of health services is a matter of increasing importance to health authorities. Monitoring consumer satisfaction of health care is an important input to improving the quality of health services. This article highlights a number of important considerations learned from rural consumer studies relevant to ensuring the valid measurement of consumer satisfaction with rural health services, as a means of contributing to quality improvements. METHODS: This article compares two methods of analysing rural consumers' satisfaction with healthcare services. In one study of three rural communities in western New South Wales (NSW) and eight communities in north-west Victoria, residents were asked to rate their satisfaction with five key aspects of local health services (availability, geographical accessibility, choice, continuity, economic accessibility as measured by affordability) using a 5 point Likert scale from: one = very satisfied to five = very dissatisfied. An alternative method of assessing levels of consumer satisfaction was undertaken in the survey of eight rural communities in north-west Victoria by investigating consumers' experiences with actual and potential complaints in relation to health services. RESULTS: Both the NSW and Victorian respondents reported generally high levels of satisfaction with the five indicators of quality of health care. At the same time, 11% of Victorian study respondents reported having made a complaint about a health service in the previous 12 months, and one-third of the Victorian respondents reported experiences with their health services about which they wanted to complain but did not, over the same period. CONCLUSIONS: Interpretation of apparent consumer satisfaction with their health services must take particular account of the measures and research methods used. In assessing consumer satisfaction with health services in rural areas, specific attention should be given to maximising the engagement of rural consumers in order to ensure representativeness of findings, and to minimise possible biases in satisfaction ratings associated with the use of particular tools.

Consumer Behavior↗
PubMed1988

A follow-up comparison of patient satisfaction among prepaid and fee-for-service patients.

This study reports the results of a follow-up patient satisfaction survey that sampled patients enrolled in a capitation program and compared their satisfaction levels with otherwise similar patients in a fee-for-service program two years after the programs began. On a scale of 1 (very dissatisfied) to 5 (very satisfied), the mean general satisfaction level for 158 prepaid patients was 3.17 +/- 0.70, and 3.42 +/- 0.61 for 87 fee-for-service patients (P less than .05). This finding contrasts with no differences seen in a previous study of the same populations at six months after the programs began (mean general satisfaction levels of 3.26 and 3.36 for the prepaid and fee-for-service patients, respectively). A statistically significant difference also existed in the subdimension "technical aspects of quality of care": 3.38 +/- 0.65 for prepaid patients, and 3.61 +/- 0.53 for fee-for-service service patients (P less than .05). Levels of satisfaction within other individual constructs were similar for both groups and tended to remain the same over two years, although satisfaction with access to care decreased among prepaid patients, and satisfaction with continuity of care increased among fee-for-service patients. These data support the hypothesis that overall satisfaction levels and certain aspects of patient satisfaction may be compromised by a capitation program.

Consumer Behavior↗
PubMed1979

III. Profile, expectation and satisfaction of outpatients (1970-1972).

The present study deals with patients' assessment of the OPD and the experimental changes in terms of "patient satisfaction". The hypothesis tested, stated that the level of satisfaction of clients of the OPD at Machakos hospital would increase after the introduction of changes in the operational and technical procedures. Data on clients' profiles and satisfaction were collected by means of structured interview schedule; 24 background variables and 17 satisfaction indicators were selected for final analysis to compare profiles and satisfaction of 324 baseline and 367 evaluation respondents. Profiles and satisfaction differed significantly at the 5% level. The significant difference in satisfaction could not be explained by the difference in profiles; the hypothesis was confirmed. A detailed analysis showed that total clinic time (the total time patients spent in the clinic) was significantly correlated with some of the 24 background variables and with some of the 17 satisfaction indicators; its duration was one of the key determinants for patient satisfaction, with a highly discriminative value. Another key variable was the answer to the question: "Did you get the treatment you wanted?". OPD patients discriminated various aspects and facets of OPD process and procedures for their assessment.

Consumer Behavior↗
PubMed2002

Patient and staff satisfaction with the quality of in-patient psychiatric care in a Nigerian general hospital.

BACKGROUND: Patient satisfaction has been proposed as a simple measure of the quality of care. The present study aimed to assess how satisfied the patients and staff in an acute admission psychiatric unit were with experiences in the ward, including the physical environment, freedom, comfort, attitudes of staff towards patients, access to staff, and duration of hospitalization. METHOD: A descriptive study of all patients admitted for functional psychiatric disorders in a 5-month period was conducted. Patients and staff completed similar 16-item self-rated Likert-type questionnaires. Satisfaction was graded as follows: dissatisfaction < 50 % positive appreciation), bare satisfaction (50-65 %), moderate (66-74 %), and highest satisfaction (> or = 75 %). RESULTS: The 118 patients were dissatisfied with items that indicated curtailment of their freedom, while the 35 staff were dissatisfied with the physical facilities for care. Highest satisfaction for patients and staff were for items on staff-patient relationship. Barely satisfactory items for patients included the time spent with doctors. Patients had a higher positive appraisal of the adequacy of physical facilities than staff, while staff had a more positive appraisal of their relationship with patients. There were no significant differences in satisfaction among diagnostic groups. CONCLUSION: The logical and discriminating manner in which patients assessed satisfaction supports the impression that they can be relied upon to make objective appraisal of the process of care, and that patient satisfaction is a valid index of the quality of care.

Adult↗
PubMed2003

What effect does increasing inpatient time have on outpatient-oriented internist satisfaction?

OBJECTIVE: Because career satisfaction among general internists is relatively low, we sought to understand the impact on satisfaction of general internists managing patients both in and outside of the hospital. Using data from a national survey, we asked, "Among outpatient-oriented general internists (i.e., internists who spend less than 50% of their clinical time caring for inpatients), what effect does time spent in the hospital have on physician satisfaction, stress, and burnout?" DESIGN/PARTICIPANTS: The Physician Worklife Study, in which 5,704 physicians in primary and specialty nonsurgical care selected from the American Medical Association's Masterfile were surveyed (adjusted response rate = 52%), was used. Our analyses focused on clinically active outpatient-oriented general internists (N = 339). MEASUREMENTS AND MAIN RESULTS: We constructed multivariate linear models to test for statistically significant associations between the amount of time spent seeing inpatients and physician satisfaction as measured by several satisfaction scales. Even after controlling for total hours worked and other possible confounding variables, we found that increased time working in the hospital was significantly associated with decreases in satisfaction with administration, specialty, autonomy, and personal time, and significantly associated with an increase in life stress. There was also a significant association between increased time spent in the hospital and burnout. CONCLUSIONS: Our findings imply that there may be a tension between the practice of inpatient and outpatient medicine by general internists, and suggest that fewer hospital duties may increase career satisfaction for outpatient-oriented internists. Although additional studies are warranted in order to better understand why these relationships exist, our data suggest that the hospitalist model of inpatient care might be one approach to alleviate stress and improve satisfaction for many general internists.

Adult↗
PubMed2001

Levels of career satisfaction amongst dental healthcare professionals: comparison of dental therapists, dental hygienists and dental practitioners.

OBJECTIVE: To compare the levels of career satisfaction expressed by three professional groups working in dental health: dental therapists, dental hygienists and dental practitioners. BASIC RESEARCH DESIGN: Level of career satisfaction was assessed using a ten point scale in three surveys. Postal surveys were conducted of all dental therapists and dental hygienists registered with the General Dental Council. Data for dental practitioners were collected as part of the British Dental Association Omnibus Survey 2000. PARTICIPANTS: Data are reported for 227 dental therapists, 2,251 dental hygienists and 970 dental practitioners. RESULTS: Significant differences were found between groups in the level of career satisfaction expressed. Dental practitioners were less likely to express high levels of satisfaction in comparison with the other two professional groups. Within each group characteristics of the respondents were associated with satisfaction levels. Younger dental therapists and dental hygienists expressed lower levels of career satisfaction. The level of career satisfaction expressed by dental practitioners was associated with gender, place of work (North vs South UK), year of qualification, size of practice and system of remuneration. CONCLUSIONS: Dental practitioners express lower levels of job satisfaction in comparison to other groups of dental health care professionals. Job dissatisfaction among dental practitioners is related to a number of socio-demographic factors.

Adult↗
PubMed2001

Is patients' perception of time spent with the physician a determinant of ambulatory patient satisfaction?

BACKGROUND: Time management in ambulatory patient visits is increasingly critical. Do patients who perceive a longer visit with internists report increased satisfaction? METHODS: Prospective survey of 1486 consecutively encountered ambulatory visits to 16 primary care physicians (PCPs) in an academic primary care clinic. Patients were queried regarding demographics, health status, perception of time spent before and after ambulatory visits, whether the physician appeared rushed, and visit satisfaction. Physicians were queried regarding time spent, estimated patient satisfaction, and whether they felt rushed. RESULTS: In 69% of 1486 consecutive visits, patient previsit expectation of visit duration was 20 minutes or less. Patient and PCP postvisit estimates of time spent significantly exceeded patient previsit time expectation. Patients who estimated that they spent more time than expected with the PCP were significantly more satisfied with the visit. When patient postvisit estimate of time spent was less than the previsit expectation, visit satisfaction was significantly lower independent of time spent. Patient worry about health and lower self-perceived health status were significantly associated with patient expectation for longer visits. Primary care physicians felt rushed in 10% of encounters. Although PCPs estimated patient satisfaction was significantly lower when they felt rushed, patient satisfaction was identical when PCPs did and did not feel rushed. Patients indicated that PCPs appeared rushed in 3% of encounters, but this perception did not affect patient satisfaction. CONCLUSION: Perceived ambulatory visit duration and meeting or exceeding patient expectation of time needed to be spent with the physician are determinants of patient satisfaction in an ambulatory internal medicine practice.

Ambulatory Care↗
PubMed2002

Physician career satisfaction across specialties.

BACKGROUND: The career satisfaction and dissatisfaction physicians experience likely influence the quality of medical care. OBJECTIVE: To compare career satisfaction across specialties among US physicians. METHODS: We analyzed data from the Community Tracking Study of 12 474 physicians (response rate, 65%) for the late 1990s. Data are cross-sectional. Two satisfaction variables were created: very satisfied and dissatisfied. Thirty-three specialty categories were analyzed. RESULTS: After adjusting for control variables, the following specialties are significantly more likely than family medicine to be very satisfying: geriatric internal medicine (odds ratio [OR], 2.04); neonatal-perinatal medicine (OR, 1.89); dermatology (OR, 1.48); and pediatrics (OR, 1.36). The following are significantly more likely than family medicine to be dissatisfying: otolaryngology (OR, 1.78); obstetrics-gynecology (OR, 1.61); ophthalmology (OR, 1.51); orthopedics (OR, 1.36); and internal medicine (OR, 1.22). Among the control variables, we also found nonlinear relations between age and satisfaction; high satisfaction among physicians in the west north Central and New England states and high dissatisfaction in the south Atlantic, west south Central, Mountain, and Pacific states; positive associations between income and satisfaction; and no differences between women and men. CONCLUSIONS: Career satisfaction and dissatisfaction vary across specialty as well as age, income, and region. These variations are likely to be of interest to residency directors, managed care administrators, students selecting a specialty, and physicians in the groups with high satisfaction and dissatisfaction.

Adult↗
PubMed1997

Occupational and nonoccupational factors in job satisfaction and psychological distress among nurses.

To facilitate nurses' job satisfaction and reduce their psychological distress, it is useful for a nursing manager to know whether factors within the workplace provide greater prediction of these affective states than variables outside the domain of work, and whether there are common predictors of satisfaction and distress. The relative importance of occupational and nonoccupational variables in the prediction of job satisfaction and psychological distress was investigated in a survey of hospital nurses (N = 376). Perceived relations with the head nurse, coworkers, physicians, and other units/departments, along with unit tenure and job/nonjob conflict, were predictors of job satisfaction. Personal disposition (anxiety-trait), social integration, unit tenure, professional experience, position level, and job/nonjob conflict, along with the relations with the head nurse and physicians, were predictors of psychological distress. The relations with the head nurse and physicians, as well as unit tenure and job/nonjob conflict, were predictors of both satisfaction and distress. The prediction by unit tenure is noteworthy. Unit tenure had a negative relationship to satisfaction and a positive one to distress, whereas total experience had a negative relationship to psychological distress and none with job satisfaction. The role of unit tenure in nurses' affective experiences warrants more attention in future research, along with the role of job/nonjob conflict and other variables predictive of nurses' satisfaction and distress.

Adult↗
PubMed2005

Predictors of satisfaction among cognitively intact nursing home residents in Hong Kong.

Resident satisfaction is widely recognized as a critical dimension in assessing quality of nursing home care. Although many factors are associated with satisfaction, little is known about the relative importance of these factors in predicting satisfaction. The purpose of this study was to identify the demographic, physiological, psychological, and social predictors of satisfaction in a convenience sample of 175 nursing home residents in Hong Kong. Seventeen resident variables were investigated. Variables that showed significant bivariate associations with satisfaction were entered into the stepwise regression model. Health-related quality of life (mental component), state self-esteem, and social support satisfaction, significantly accounted for 31% of the variance of satisfaction. These findings suggest approaches to tailor care plans to increase resident satisfaction.

Aged↗
PubMedDate not supplied

Patients' satisfaction ratings and their desire for care improvement across oncology settings from France, Italy, Poland and Sweden.

There has been an increasing interest in patient satisfaction assessment across nations recently. This paper reports on a cross-cultural comparison of the comprehensive assessment of satisfaction with care (CASC) response scales. We investigated what proportion of patients wanted care improvement for the same level of satisfaction across samples from oncology settings in France, Italy, Poland and Sweden, and whether age, gender, education level and type of items affected the relationships found. The CASC addresses patient's satisfaction with the care received in oncology hospitals. Patients are invited to rate aspects of care and to mention for each of these aspects, whether they would want improvement.One hundred and forty, 395, 186 and 133 consecutive patients were approached in oncology settings from France, Italy, Poland and Sweden, respectively. Across country settings, an increasing percentage of patients wanted care improvement for decreasing levels of satisfaction. However, in France a higher percentage of patients wanted care improvement for high-satisfaction ratings whereas in Poland a lower percentage of patients wanted care improvement for low-satisfaction ratings. Age and education level had a similar effect across countries. Confronting levels of satisfaction with desire for care improvement appeared useful in comprehending the meaning of response choice labels for the CASC across oncology settings from different linguistic and cultural background. Linguistic or socio-cultural differences were suggested for explaining discrepancies between countries.

Adult↗
PubMed2005

Access to care and satisfaction in colorectal cancer patients.

This study described the various components of access to care for resectable colorectal cancer, and correlated the timeliness of these components with patient satisfaction. With a prospective/retrospective cohort design, all patients undergoing surgical resection for primary colorectal cancer from 2/1/01 to 15/12/01, were identified during their admission for surgery. A comprehensive, standardized method of ascertaining specific time intervals, which included a patient interview, was used. A patient satisfaction questionnaire was developed, tested, and used in consenting patients. Over the study period, 118 patients underwent colorectal cancer resection. Of these, 110 (93%) consented to participate and 101 (86%) completed the satisfaction questionnaire, including test-retest. The median time intervals (interquartile range) for the various components of access to care were as follows: symptoms to first physician visit, 32 days (10-75); first physician visit to diagnosis, 88 days (44-218); diagnosis to surgery, 19 days (10-44); surgery to chemotherapy (where applicable), 54 days (47-72). On multivariate analysis, tumor location in the rectum was associated with longer prediagnosis intervals, whereas increasing tumor stage was associated with shorter intervals from diagnosis to surgery. Variation in the time interval from diagnosis to surgery was associated with patient satisfaction (r = 0.49; P < 0.0001). Substantially less correlation was identified between patient satisfaction and the time from first physician visit to diagnosis (r = 0.25, P = 0.04). No significant correlation was identified between patient satisfaction scores and the time interval from symptoms to first physician visit (r = 0.11; P = 0.7). Despite concerns regarding surgical waitlists, the longest time intervals experienced by colorectal cancer patients precede diagnosis. However, variations in the relatively short time period from diagnosis to surgery appeared to have the most impact on patient satisfaction. Interventions which improve the timeliness of specific components of access to care may not necessarily result in improved patient satisfaction.

Aged↗
PubMed2002

[Patient satisfaction with dental implants].

BACKGROUND: Almost all implant systems available today achieve success rates of over 90%. The subjective satisfaction of patients with dental implants is only rarely considered in the definition of implant success and there are only limited data on the satisfaction of patients with dental implants in the literature. Therefore, a satisfaction analysis was carried out in a retrospective study. DESIGN OF STUDY: In addition to a clinical investigation, 330 patients with 1,273 implants (Astra, Frialit-2, IMZ TwinPlus and ITI) were asked to answer a standardized questionnaire to rate their personal opinion on the implant success. A total of 199 questionnaires (803 implants, 63%) were returned and could be analyzed. RESULTS: Of the patients, 67% participated in regular follow-up after implantation and 15% indicated postoperative discomfort. Patient satisfaction with the implants (rated on a scale of 1-6) was good or excellent (2 and 1, respectively) in 88% of cases. Satisfaction with the prosthetic treatment was 80%. The whole treatment was considered good or very comfortable by 86% of patients. If necessary, 91% of patients who underwent the procedure would do so again, and 94% would recommend the procedure to someone else. The Spearman correlation analysis did not reveal any statistically significant correlations between the clinical parameters and patient satisfaction scores. DISCUSSION: Despite the high number of patients involved ( n=330), the expected influence of objective clinical parameters on patient satisfaction could not be statistically evaluated. Nevertheless, in addition to the clinical parameters, subjective patient satisfaction should be included in the evaluation of implant success.

Dental Implants↗