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[Validation of the French version of the Princess Margaret Hospital Patient Satisfaction with their Doctor Questionnaire].

BACKGROUND: The evaluation of patient satisfaction receives increasing attention partly due to pressure from state agencies involved in the administration of health care. Outpatients' satisfaction with their doctor is a major component of total patient satisfaction. However, a validated instrument for assessing this has not previously been available in French. PATIENTS AND METHODS: The Princess Margaret Hospital Patient Satisfaction with Doctor Questionnaire (PMH/PSQ-MD) is a recently validated tool available in English for this purpose. A three-step procedure was conducted to obtain a validated French translation of the PMH/PSQ-MD. Subsequently, outpatients receiving chemotherapy, symptomatic treatment or attending a follow-up clinic were approached to participate in the study and complete the questionnaire. Acceptability and reliability (Cronbach's alpha score), as well as internal and external (Pearson correlation coefficient with the Patient Satisfaction Questionnaire IV) validities were studied. RESULTS: 137 patients were approached and 116 fully completed the study. The PMH/PSQ-MD's acceptability was high (<10% of non-responders). Internal validity was also high (Cronbach's alpha score > 0.7 for each dimension). External validity in comparison with the PSQ IV was high as well. Women demonstrated higher satisfaction scores, while age had no influence on patient satisfaction. CONCLUSIONS: The F-PMH/PSQ-MD is a questionnaire which addresses outpatients' satisfaction with their doctor, and is now available for research purpose as well as for daily practice.

Aged↗

Client satisfaction with abortion care in three Russian cities.

This paper explores client satisfaction with abortion care, looking at overall satisfaction and satisfaction with hygiene, comfort and courtesy. The analysis aimed to determine whether client satisfaction was related to the characteristics of the client, in order to guide quality improvement efforts. The analysis is a secondary analysis of data collected in a survey of 489 abortion clients who attended a limited number of hospitals in three cities in Russia. The data were analysed using logistic regression. Client characteristics, in general, did not affect overall satisfaction though there were significant differences in overall satisfaction for unmarried versus married women (OR=0.29, CI=0.13, 0.63). Similarly, most characteristics of the abortion visit were not related to client satisfaction, although women who were awake for the procedure were less likely to be satisfied (OR=0.37, CI=0.16, 0.89). Information provided to abortion clients about self-care was the most important predictor of overall satisfaction for abortion clients (OR=3.55, CI=1.64, 7.69). This suggests that improving the information provided to clients, through training providers and other staff, is important in these settings.

Abortion, Legal↗

[Pattern of intervention and patients' satisfaction with community mental health services in Bologna].

OBJECTIVE: To measure satisfaction with Community Mental Health Service (CSM) in patients and to check if it will be associated with some selected demographic and service variables. DESIGN: This study compares data from satisfaction scale administration in patients who attended CSM at least once every two months during 1998 and services that them have benefited from. SETTING: The Community Mental Health Service of Saragozza-Porto District in Bologna. Main outcome measures--Demographical, clinical and service variables taken from CSM informative system and Verona Service Satisfaction Scale (VSSS-32), a multidimensional instrument which measures satisfaction with community-based psychiatric service. RESULTS: Main results (145 subjects) pointed out higher satisfaction for technical and interpersonal skills of staff, information, drugs, help to get economical benefits and domiciliary care. Four issues stood out by comparing patients' satisfaction and their demographic, clinical and services' benefit features: 1) aged patients complained about high drugs costs and of contacts with other seriously ill patients into the waiting room; 2) relative's involvement was judged as insufficiently effective; 3) in young patients with serious mental disease high frequency of visits seemed to correlate with low satisfaction; 4) patients with complex pattern of intervention (including economical benefits) were the less satisfied ones with service's economical support. CONCLUSIONS: Patients' satisfaction differs according to their demographic and clinical features, but the pattern of intervention seems to influence their judgements too, sometimes in a incoherent way.

Adult↗

Correlates of adolescents' satisfaction with mental health services.

While there has been increased attention to consumers' satisfaction with mental health services as an indicator of quality of care, little is known about the construct of consumer satisfaction, especially for youth. The goal of this study was to examine potential correlates of adolescents' satisfaction with mental health services. One hundred eighty adolescents who had received out-patient mental health services completed a multidimensional satisfaction scale and measures of behavior problems, attitudes and expectations about treatment, perceived choice/motivation in seeking treatment, and service use history. Results indicate that the strongest unique correlates of satisfaction are severity of behavior problems, positive expectations about services, and perceived choice in seeking services. Satisfaction with services was also associated with service site, length of time in treatment, and reason for entering treatment. Demographic variables were not related to satisfaction. A discussion of the appropriateness of using satisfaction as an indicator of quality of care is included.

Adolescent↗

Framing the construct of life satisfaction in terms of older adults' personal goals.

Older adults' life satisfaction can be better understood in light of their personal goals. This study of 179 elders examined (a) how goals correlate with satisfaction, (b) whether elders maintain satisfaction by accommodating goals to past losses, and (c) how correlations between satisfaction and key predictors differ among groups with different goals. Satisfaction was related positively to social maintenance and energetic life-style goals and negatively to concerns for improvement, disengagement, stability, and reduced activity. Past losses were correlated with current goals but not with satisfaction, consistent with the notion of accommodation. A cluster analysis identified 5 patterns of goals: high demand, age prescribed, self-focused, socially engaged, and low demand. Correlations between satisfaction and other predictors differed by cluster, suggesting that the determinants of elders' satisfaction depend on personal goals.

Achievement↗

Association between obesity and patient satisfaction.

OBJECTIVE: To examine the relationship between BMI and patient satisfaction with health care providers using a nationally representative survey. RESEARCH METHODS AND PROCEDURES: This analysis examined the 9914 adult patients who completed the 2000 Medical Expenditure Panel Survey and had visited a health care provider within 12 months of the survey. Linear regression models were employed with patient satisfaction as the dependent variable. The patient satisfaction scale was based on ratings from five questions assessing the quality of provider interactions. The independent variable was BMI, with adjustments for the domains of demographics, social-economic status, health attitudes and behavior, health status, and health care use. BMI (weight in kilograms/square of height in meters) was classified as normal weight (18.5 to 24.9), overweight (25.0 to 29.9), or obese (>or=30.0). Hierarchical models were used to evaluate how each domain modified the BMI-satisfaction association. RESULTS: Obese patients reported significantly greater satisfaction with their health care providers than their normal-weight counterparts did (p < 0.05). There were no significant differences in satisfaction between normal-weight and overweight patients or between overweight and obese patients. The health status domain produced the largest modification in the BMI-satisfaction relationship. Examination of interaction effects revealed that the association between BMI and satisfaction was confined to older persons. DISCUSSION: In this nationally representative sample of individuals, obese persons were more satisfied than their normal-weight counterparts. This finding counters those of previous studies. Incomplete adjustments for health care use and insurance status may have led to those conclusions.

Adult↗

The job satisfaction of health visitors, district nurses and practice nurses working in areas served by four trusts: year 1.

This paper reports the results of the first of three annual surveys of the job satisfaction of health visitors, district nurses and practice nurses working in communities served by four trusts. Analysis of variance illustrates differences in the level of Personal Satisfaction, Satisfaction with Workload, Satisfaction with Professional Support, Satisfaction with Training and Satisfaction with Pay and Prospects. Practice nurses appear to be the most satisfied group; the level of satisfaction for health visitors is significantly lower. Qualitative analysis of the additional comments made by approximately one-third of respondents illustrates the gulf in perceived values between staff and management and the feelings of uncertainty experienced by community nurses in the wake of major legislative change. Possible reasons for differences in level of staff satisfaction between the four trusts are discussed.

Adult↗

Nurses' personalities, nursing-related qualities and work satisfaction: a 10-year perspective.

The personalities and qualities of nursing personnel are considered to be of great importance for their interactions and nursing relationships with patients and may also influence work satisfaction. The aim of the study was to explore the extent to which different personal qualities and personality factors, with a possible effect on motivation, professional conduct and coping with stress and anxiety, are represented in a group of assistant nurses (second level nurses), and how these qualities are related to nursing competence and long-range work satisfaction. A group of 51 female nursing students (mean age 31.8 years) participated in the study. The nursing-related qualities were empathy, sensitivity to non-verbal communication, feelings of discomfort in different nursing situations and work satisfaction. The personality factors were psychogenic needs and defence mechanisms. At a follow-up 2 years later, 43 nurses were interviewed, work satisfaction was assessed and nursing competence was appraised. At a follow-up 10 years after completion of nursing school, 33 of the nurses took part in a telephone interview. Work satisfaction was assessed in 23 of those who were still working as nurses. Cluster analysis performed on baseline data resulted in four groups: empathic, discomfort prone, service-minded and dominant. At the first follow-up, the service-minded had the greatest work satisfaction, with many considered to be 'real jewels'. At the second follow-up 8 years later, there appeared to be an overrepresentation of injuries and long-term sick leave in this group, whose members had apparent difficulties in being dominant and asserting own interests. Work satisfaction diminished in all the groups over time. Long-term work satisfaction was found, however, to be related to degree of empathy and a low degree of sensitivity to aggressiveness.

Attitude of Health Personnel↗

In-patient management of diabetes mellitus and patient satisfaction.

AIMS: To devise a system for assessing in-patient glycaemic control and care satisfaction in diabetic patients admitted to hospital for reasons other than their diabetes. METHODS: Consecutive January to March 2001 case-notes were reviewed. Admissions with acute metabolic complications, acute myocardial infarction and pregestational or gestational diabetes were excluded. Glycaemic control, frequency of blood monitoring and management of hyperglycaemia were recorded. The diabetes treatment satisfaction questionnaire was used to assess preadmission satisfaction with care. Post-admission a 12-stem questionnaire was used to assess satisfaction with in-patient diabetes management. RESULTS: Hypoglycaemia was common. Although none developed a hyperglycaemic emergency, high blood glucose was prevalent and, frequently, persistent hyperglycaemia or recurrent hypoglycaemia was not acted on appropriately. The overall score for in-patient satisfaction with treatment was fair (4.1 +/- 1.8 on a six-point scale; 6 = very satisfied and 1 = very dissatisfied). Scores were higher among patients on surgical wards than on medical wards (P = 0.008), but satisfaction did not vary when patients were stratified according to sex, age and mode of treatment. CONCLUSION: Current systems are not achieving satisfactory in-patient glycaemic control and there is poor satisfaction with medical in-patient diabetes care. Following changes intended to produce improvements, this assessment system can be used recurrently to monitor in-patient care and satisfaction.

Adolescent↗

Impact of upper endoscopy on satisfaction in patients with previously uninvestigated dyspepsia.

BACKGROUND: In patients with uninvestigated dyspepsia who undergo endoscopy, the presence of abnormal findings guides subsequent management. However, upper endoscopy is "negative" in the majority of these patients, and the value of endoscopy in these individuals has been questioned. This study evaluated the impact of endoscopy on patient satisfaction in patients with previously uninvestigated dyspepsia. METHODS: The study was a secondary analysis of data obtained from a double-blind, randomized placebo-controlled trial, evaluating a 6-week course of omeprazole versus placebo in 140 patients with uninvestigated dyspepsia who were followed for up to 1 year. The setting was the primary care outpatient clinics at the Houston Veterans Affairs Hospital. Participants had to be 18 years of age or older with at least a 1-week history of dyspepsia (epigastric discomfort) without alarm features. Satisfaction was measured at each visit with the Severity of Dyspepsia Assessment, a validated, reliable dyspepsia-related health measure that has a satisfaction scale (scores 2-23; higher scores indicate greater satisfaction). Patients unresponsive to empiric therapy with placebo or omeprazole based on predefined criteria underwent endoscopy. Severity of Dyspepsia Assessment satisfaction scores were analyzed for 5 visits: 2 closest in time to, but before, the day of endoscopy (Times 1 and 2); immediately before endoscopy (Time 3); and the 2 visits closest in time after endoscopy (Times 4 and 5). After determining there was no difference in treatment failure rates between patients who received placebo or omeprazole, data from these groups were combined. The mean Severity of Dyspepsia Assessment satisfaction scores for Times 1 through 5 in all patients who underwent endoscopy were compared as well as for subgroups with positive and negative endoscopic findings with a repeated-measures analysis of variance. RESULTS: Data on all 5 visits were available in 62 patients, 36 of whom had a negative endoscopy. For all patients the mean scores for Time 2 (8.5; 95% CI [7.4, 9.6]), and Time 3 (7.6; 95% CI [6.6, 8.6]) were significantly lower than those for Time 4 (13.7; 95% CI [12.2, 15.3]) and Time 5 (14.4; 95% CI [12.9, 15.9]). The mean score for Time 1 (11.1; 95% CI [9.5, 12.6]) was significantly lower than the mean score for Time 5. Similar significant improvements in satisfaction scores were observed in subgroups with negative and positive findings. CONCLUSIONS: In patients with previously uninvestigated dyspepsia, endoscopy leads to improved patient satisfaction regardless of the endoscopic findings.

Anti-Ulcer Agents↗

Can patient satisfaction with decisions predict compliance with surgery?

BACKGROUND: Patient satisfaction with treatment decisions is a discrete and measurable component of the satisfaction paradigm, distinct from satisfaction with health care services. OBJECTIVE: The study goal was to determine if the Satisfaction With Decision (SWD) scale, a valid and reliable 6-item survey, can predict patient compliance with surgery proposed by their otolaryngologist. DESIGN: Prospective study using the SWD scale plus measures of office visit satisfaction, provider satisfaction, and disease-specific quality of life. SETTING: Metropolitan, private nonprofit hospital. PATIENTS: The study population consisted of 151 patients scheduled for surgery, with a median age of 5.8 years and an age range of 0.6 to 65.3 years. INTERVENTIONS: At the time surgery was scheduled, the decision-maker completed a 12-item questionnaire about satisfaction and quality of life that included the SWD scale. Noncompliant patients were contacted, and the specific reason for cancellation was ascertained. RESULTS: The strongest predictor of surgical cancellation was the SWD survey score, with a median value of 4.8 for patients completing surgery compared with 3.8 for those who cancelled (P < 0.001). Patients with scores <4.0 had a 57% cancellation rate, whereas those with scores > or =4.0 had a 98% completion rate. Patients were also more likely to cancel if it was their first visit with the surgeon (P = 0.004) or if they were responsible for their own decisions (P = 0.007). Cancellations were not associated with office visit satisfaction, patient quality of life, or demographic characteristics of the decision-maker. CONCLUSIONS: Patients who are satisfied with their initial decision to undergo surgery are most likely to comply with planned therapy. Conversely, patients who score <4.0 on the SWD scale may benefit from additional preoperative counseling to increase the likelihood of compliance.

Adult↗

Perceived overqualification and dimensions of job satisfaction: a longitudinal analysis.

The present study is an investigation of the effects of perceived overqualification on dimensions of job satisfaction. The data for this study came from a two-wave panel study of members of a midwestern American Postal Workers Union local. Job satisfaction was operationalized with 4 subscales from the Job Descriptive Index (P. Smith, L. Kendall, & C. Hulin, 1969). The following three hypotheses were tested: (a) Perceived overqualification will be negatively related to facets of job satisfaction; (b) there is stability in the test-retest correlations of facets of job satisfaction; and (c) the effects of perceived overqualification on facets of job satisfaction will not change from Time 1 to Time 2 because of adaptation. The cross-sectional results supported the hypotheses and suggested that perceived overqualification has a negative effect on job satisfaction. However, the relationships varied by dimension of perceived overqualification and dimension of job satisfaction. Future researchers of overqualification and dimensions of job satisfaction should consider relative deprivation as a source of work-related deprivations.

Adult↗

Marital and parenting satisfaction and infant care self-efficacy during the transition to parenthood: the effect of infant sex.

The purpose of this follow-up study was to examine the effect of infant sex on changes in and differences between parents' reports of infant care self-efficacy and parenting and marital satisfaction from 4 months to 12 months after the birth of their first child. A convenience sample of 32 couples was selected from 44 couples who participated in a longitudinal study of the development of parenting satisfaction and infant care self-efficacy during the first 4 months after the birth of a first child (Brage Hudson, Elek, Fleck, 2001). Couples completed a demographic questionnaire, the Infant Care Survey (ICS, Froman Owen, 1989), the What Being the Parent of a New Baby is Like--Revised Questionnaire (WPBL-R, Pridham Chang, 1989), and the Dyadic Adjustment Scale (DAS, Spanier, 1976, 1989) 4 and 12 months postpartum. Infant care self-efficacy, but not parenting satisfaction, increased from 4 to 12 months; mothers reported higher infant care self-efficacy and parenting satisfaction than fathers at both times. Fathers of boys reported greater parenting satisfaction and infant care self-efficacy at 12 months than fathers of girls. Marital satisfaction decreased from 4 to 12 months for both mothers and fathers. Significant relationships existed among infant care self-efficacy, parenting satisfaction, and marital satisfaction at both 4 and 12 months postpartum. Implications for families and for nursing interventions are discussed.

Adult↗

Sexual satisfaction in male infertility.

Infertility is proposed to be a continuing stressor for couples suffering from involuntary childlessness. A long duration of the desire for a child and, correspondingly, a longer period of diagnostic and treatment procedures could have a negative impact on sexual satisfaction, thus leading to an unfavorable psychological circuit. The present evaluation should clarify the state of sexual satisfaction and relationships, with relevant parameters in 68 men with fertility problems, of couples with involuntary childlessness. Subjects reported relatively high average levels of present sexual satisfaction with only nonsignificant lower scores (p = .08) compared to recalled sexual satisfaction prior to diagnosis of infertility. Multiple regression analyses revealed that a positive age difference between men and their spouses (p = .042) and a higher weekly coitus frequency (p = .002) were the only significant parameters associated independently with higher sexual satisfaction. Neither the age of partners, attitudes toward sexuality, treatment duration, duration of the partnership and the duration of the desire for a child, nor andrological findings had an influence on present sexual satisfaction. The results propose that treatment duration and duration of the desire for a child may not necessarily be connected to lowered sexual satisfaction in infertile males and that coitus frequency seems to be an indicator of sexual satisfaction in this patient group.

Adult↗

Life satisfaction related to work re-entry after brain injury: a longitudinal study.

PURPOSE: The aim of this study was to assess the subjective life satisfaction after brain injury and its relation to work re-entry. METHOD: The research design was a longitudinal study. Thirty-six individuals answered a questionnaire at 3 and 6 years after admittance to a rehabilitation programme. The questionnaire addressed work status, job satisfaction, subjective symptoms of illness and life satisfaction. RESULTS: The reported life satisfaction both for life as a whole and for different domains of life was low. No significant difference between follow-ups was found for satisfaction with life as a whole. For the domain IADL activities, the subjects reported a statistically significant lower satisfaction at the second follow-up than at the first. No correlation between work status and subjective satisfaction with life as a whole was found in this population. At the second follow-up, significantly more people were satisfied with IADL in the group that had returned to work. CONCLUSIONS: The results from this study indicate that brain injury has a lasting effect on a person's life also many years after onset. The decreasing satisfaction with the ability to perform IADL-activities in along-term perspective should give implications for clinical practice. More research in this area is needed.

Activities of Daily Living↗

Job satisfaction among Norwegian general practitioners.

OBJECTIVE: To explore the level of job satisfaction among general practitioners (GPs) and to compare it with that of hospital doctors. DESIGN: Postal questionnaire among Norwegian doctors in 2002 and similar data from 1994 and 2000 for most of the respondents. MATERIAL: A total of 295 GPs out of 1174 doctors completed the questionnaire (73% response rate). Main outcome measures. Self-reported levels of job satisfaction according to the Job Satisfaction Scale (JSS). RESULTS: Norwegian GPs reported a high level of job satisfaction with a mean score on the JSS of 52.6 (10 is minimum and 70 maximum). The reported level of satisfaction was highest for their opportunities to use their abilities, cooperation with colleagues and fellow workers, variation in work, and freedom to choose own method of working. The GPs' level of job satisfaction remained stable in 1994, 2000, and 2004 in spite of major health reforms. GPs report a higher level of job satisfaction than hospital doctors. CONCLUSIONS: In spite of international discussions on unhappy doctors and doctors' discontent, Norwegian GPs do report a high and stable level of job satisfaction.

Adult↗

Patient satisfaction and treatment environment: a 20-year follow-up study from an acute psychiatric ward.

The aim of this study was to examine to what extent the different subscales of the Ward Atmosphere Scale (WAS) are related to patient satisfaction on wards for psychotic patients. We wanted to examine if it was possible to replicate previous findings from cross-sectional studies and improve the understanding of which of the WAS subscales that should be considered the most important for patient satisfaction. From 1981 through 2000, the ward atmosphere, in an acute psychiatric ward, was evaluated 11 times with the Ward Atmosphere Scale (WAS). A total of 129 patients completed the WAS as well as a General Satisfaction Index (GSI) comprising three items. Z-scores were calculated to describe the fluctuations in the GSI and the WAS subscales. Four of the WAS subscales, Involvement, Practical orientation, Angry and aggressive behavior and Staff control, strongly co-varied with patient satisfaction. Unexpectedly, the Support and Order and organization subscales correlated only moderately with patient satisfaction. The remaining five WAS subscales (Spontaneous behavior, Autonomy, Personal problem orientation, Program clarity and Staff attitude to expressed feelings) were only weakly correlated with patient satisfaction. This study confirms that four of the six assumedly most important WAS subscales are strongly related to patient satisfaction on wards for psychotic patients. Changes in these WAS subscales seems to be paralleled by changes in patient satisfaction in the expected direction.

Acute Disease↗

Humor coping, health status, and life satisfaction among older adults residing in assisted living facilities.

The present study examined the relationships between humor coping, health status, and life satisfaction among older residents of assisted living facilities. A structural equation model with latent variables was specified for the three variables. Health status was expected to directly affect humor coping and life satisfaction. Humor coping was hypothesized to have a direct association with life satisfaction and indirectly affect the relationship between health status and life satisfaction. Participants completed the Multidimensional Functional Assessment Questionnaire, Coping Humor Scale, and Life Satisfaction Index A. The relationships between health status and humor coping and health status and life satisfaction were statistically significant. Both the direct association of humor coping on life satisfaction and the intervening role between health status and life satisfaction were not supported. Humor as a coping strategy seems to be available to older adults who are in better health.

Adaptation, Psychological↗