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An opportunity for HMOs to use marketing to increase enrollee satisfaction.

PURPOSE: To identify the combination of marketing components (i.e., service, price, access, and promotion) of commercial health maintenance organizations (HMOs) that are related to overall enrollee satisfaction. The researchers focus on factors that commercial HMOs control directly--specifically, health care organization and financing. DESIGN: Descriptive (mail order). METHODOLOGY: This study uses national data provided by a major health benefits consulting firm, which collected data from a 1997 calendar year mail survey of HMO administrators. The administrators responded to an extensive survey, which tapped selected HMO marketing-mix components and the percentage of surveyed members who indicated satisfaction with their HMOs. To test hypotheses, researchers treated marketing-mix components as independent variables and enrollee satisfaction as the dependent variable. PRINCIPAL FINDINGS: This study found statistically significant relationships between overall satisfaction and HMO providers' quality; access, particularly to specialists and out-of-network providers; waiting times for physician services; customer service; and disease prevention/health promotion programs. The researchers did not find significant relationships between overall satisfaction and accreditation by the National Committee for Quality Assurance (NCQA), the presence of physician gatekeepers, numbers of providers, or financial indicators. The relationship between overall satisfaction and utilization was mixed. This study's findings are largely consistent with the literature, consumer- and professional-group position papers, and the President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry. CONCLUSIONS: HMOs can use marketing as a way to address problems and pursue opportunities identified by enrollees. As these findings demonstrate, certain features of HMO design are more appealing to patients. By focusing on these preferences, HMOs can adopt a responsive market orientation that gives rise to more effective marketing mixes and hence improves enrollee satisfaction. With improved satisfaction, enrollees generate less need for government intervention through regulation or legislation.

Data Collection↗

The effect of discussions about advance directives on patients' satisfaction with primary care.

BACKGROUND: Discussions of end-of-life care should be held prior to acute, disabling events. Many barriers to having such discussions during primary care exist. These barriers include time constraints, communication difficulties, and perhaps physicians' anxiety that patients might react negatively to such discussions. OBJECTIVE: To assess the impact of discussions of advance directives on patients' satisfaction with their primary care physicians and outpatient visits. DESIGN: Prospective cohort study of patients enrolled in a randomized, controlled trial of the use of computers to remind primary care physicians to discuss advance directives with their elderly, chronically ill patients. SETTING: Academic primary care general internal medicine practice affiliated with an urban teaching hospital. PARTICIPANTS: Six hundred eighty-six patients who were at least 75 years old, or at least 50 years old with serious underlying disease, and their 87 primary care physicians (57 residents, 30 faculty general internists) participated in the study. MEASUREMENTS AND MAIN RESULTS: We assessed patients' satisfaction with their primary care physicians and visits via interviews held in the waiting room after completed visits. Controlling for satisfaction at enrollment and physician, patient, and visit factors, discussing advance directives was associated with greater satisfaction with the physician (P =.052). At follow-up, the strongest predictor of satisfaction with the primary care visit was having previously discussed advance directives with that physician (P =.004), with a trend towards greater visit satisfaction when discussions were held during that visit (P =.069). The percentage of patients scoring a visit as "excellent" increased from 34% for visits without prior advance directive discussions to 51% for visits with such discussions (P =.003). CONCLUSIONS: Elderly patients with chronic illnesses were more satisfied with their primary care physicians and outpatient visits when advanced directives were discussed. The improvement in visit satisfaction was substantial and persistent. This should encourage physicians to initiate such discussions to overcome communication barriers might result in reduced patient satisfaction levels.

Advance Directives↗

Psychosocial predictors of satisfaction among orthognathic surgery patients.

This study assessed the usefulness of selected psychosocial tests and demographic measures in identifying satisfied versus dissatisfied patients who received orthognathic surgery. Data were collected prior to placement of orthodontic appliances, 1 to 2 weeks presurgery, and at 1 week, 8 weeks, 6 months, 12 months and and 2 years postsurgery. The Revised Symptom Checklist-90 (SCL-90-R) scales, the Eysenck Personality Inventory (EPI), the Sickness Impact Profile (SIP), and the Oral Health Status Questionnaire (OHSQ) were used as independent variables. Indicators from the Post-Surgical Patient Satisfaction Questionnaire (PSPSQ), which assesses patient satisfaction regarding psychosocial issues, oral functioning, and esthetics, served as a postsurgical dependent measure of patient satisfaction. Thirty-one male and 86 female subjects participated in the multisite randomized trial comparing rigid and wire fixation. Patient age was significantly correlated with patient satisfaction from 8 weeks postsurgery through 2 years postsurgery. Older patients appear to report greater postsurgical satisfaction in comparison to younger patients. The postsurgical OHSQ (esthetics subscale) and postsurgical PSPSQ (satisfaction) were significantly related at 8 weeks, 6 months, 12 months, and 2 years postsurgery. Additionally, PSPSQ (satisfaction) and postsurgical OHSQ (general oral health scale) were correlated at 12 months. The EPI, SIP, and SCL-90-R were not significantly associated with postsurgical satisfaction when assessing the entire study sample. Postsurgical qualitative data from the PSPSQ indicated that 50% of the patients reported positive outcomes in oral functioning. Sixty-five percent reported esthetic improvements, and 37% reported neurosensory loss.

Adult↗

[Factors related to satisfaction level in daily life for older people].

The purpose of this study was to examine relations between satisfaction levels and life-style in daily life for older people. A questionnaire, based on 7 factors of life satisfaction level and 13 factors of life-style chosen after considering theoretical validity, was administered to 1,320 healthy people aged 60 or more in the community (665 males and 655 females). Remarkable gender and grade differences were confirmed in the "physical health" satisfaction level. Satisfaction level for "personal relations" related to the number of friends for both sexes and to volunteer activities for males. The influence of the life-style factor on satisfaction level was highest in physical health. The influence of the number of friends was high for each satisfaction level. It was inferred that there are many aspects of life-style backgrounds contributing to the satisfaction level of older people in the community, and individual satisfaction with daily life is affected by different life-style factors.

Activities of Daily Living↗

Impact of reducing antibiotic prescribing for acute bronchitis on patient satisfaction.

CONTEXT: Using a patient and clinician educational intervention, we successfully reduced antibiotic use for uncomplicated acute bronchitis. The impact of this intervention on patient satisfaction is not known. OBJECTIVE: To evaluate whether a strategy for reducing antibiotic use in acute bronchitis affects satisfaction among adult patients. DESIGN: Telephone survey administered 1 to 4 weeks after an office visit for acute bronchitis. SETTING: Two outpatient clinics belonging to a group-model HMO in the Denver, Colorado, metropolitan area. The intervention clinic had received a patient and office-based educational intervention that successfully reduced antibiotic prescribing for acute bronchitis during the previous winter. The control clinic received only the office-based materials, an intervention that did not reduce antibiotic prescribing. OUTCOME: Overall satisfaction with the episode of care. RESULTS: Antibiotics were prescribed to 64% and 85% of survey respondents at the intervention (n = 102) and control clinics (n = 164), respectively (P < 0.001). Patient satisfaction with the visit did not differ between intervention and control clinics (69% of intervention and 63% of control clinic patients reported very good or excellent satisfaction, P > 0.2). After adjustment for patient age, sex, duration of illness before the visit, reason for visit, and clinician specialty, there was no difference between intervention and control clinics in the proportion of patients reporting very good or excellent satisfaction (adjusted relative risk for high satisfaction at the intervention clinic, 1.1 [95% CI, 0.81 to 1.3]). CONCLUSION: A patient- and clinician-oriented educational intervention that reduces antibiotic treatment of adults with uncomplicated acute bronchitis does not appear to reduce satisfaction with care.

Acute Disease↗

Patient satisfaction with general practice in Ireland.

Patient satisfaction in healthcare is gaining widespread recognition as a measure of ascertaining how well health services are being delivered. An analysis of the non-clinical elements of general practice in Ireland using a patient satisfaction questionnaire (PSQ) presents data collected from 2,167 patients to examine patient satisfaction. The level of satisfaction reported in the PSQ was 74.5% (n=1614) with dissatisfaction at 14.5% (n=314). The areas of general practice with the highest level of reported satisfaction are communication 83.7% (n=1814), general satisfaction 81.2% (n=1760), access 74.4% (n=1612) and premises 75% (n=1625), whereas, appointments and availability shows a considerably lower level of satisfaction at 58.6% (n=1270). Further analysis was undertaken to examine how patients' characteristics influenced their responses. The age, educational level, gender and public/private status of the patient all influenced satisfaction levels. It was concluded that if PSQ's are to contribute to developing service delivery and good practice they must take into account the differing characteristics of patients.

Adult↗

Patient expectation and satisfaction in different hospitals in Irbid, Jordan.

OBJECTIVE: This study attempts to identify factors contributing to patients' satisfaction and to examine the relationship between patient satisfaction and patient expectations. METHODS: The study sample consisted of 360 patients randomly drawn from the outpatients' practice of 2 health centers in Irbid, North Jordan; a university and governmental one. Patients' satisfaction was assessed using a self-administered patient satisfaction questionnaire. Patients' expectations were assessed by exposing patients to a series of video clips showing pre-tested patient provider encounters. RESULTS: On average, users of the Community Health Center had lower expectation levels and higher satisfaction means when compared to users of the University Health Center. The study results showed that patient satisfaction was mainly influenced by patient expectation of received care even after adjustment for socio-demographic variables. CONCLUSION: This study therefore, argues that while assessment of patient satisfaction is useful as a monitoring indicator for overall health care delivery performance, still interventions are required to improve the delivered care. There is a need to examine client expectations and tailor services accordingly since satisfaction measures can only diagnose a problem while expectation assessment can identify clients needs and thus program managers can better design health services delivery.

Attitude to Health↗

Factors influencing job satisfaction among Swedish occupational therapists in psychiatric care.

This study examined job satisfaction among occupational therapists in Swedish psychiatric care, and investigated how clinical supervision, organizational aspects and demographic characteristics contributed to job satisfaction. We received 332 returned questionnaires, corresponding to a response rate of 66.9%. Job satisfaction factors that emerged were: general satisfaction with work, communication and co-operation among team members, managerial feedback, the patients' influence on care and the relatives' influence on care. The respondents rated their general satisfaction, co-operation and communication as high. They were least satisfied with the relatives' influence on care. We found few relationships between other factors and job satisfaction, but, for example, satisfaction with the patients' influence on care was higher among occupational therapists working in outpatient care than among those working in hospital wards. Furthermore, having supervision was positively associated with co-operation and communication. This study revealed a fairly satisfactory situation, possibly thanks to social support, advantageous care-planning strategies and supervision. However, managerial staff must be aware that measures need to be taken continuously to counteract detrimental forces. The study pointed to a need for further research that relates occupational therapists' job satisfaction with issues such as support, control and individual need for growth.

Humans↗

Patient satisfaction with outpatient physical therapy: instrument validation.

BACKGROUND AND PURPOSE: Patient satisfaction with physical therapy is used as an outcome variable. The purpose of this study was to develop and test an instrument used to determine which variables are associated with the satisfaction of patients receiving outpatient physical therapy. SUBJECTS: During the pilot study, 191 patients participated, and 1,868 patients then participated in the main phase of this work. METHODS: Using a survey instrument developed by the authors, subjects responded to global questions concerning overall satisfaction with physical therapy. Content validation of the instrument was investigated using item correlation, principal components analysis, and factor analysis. Reliability was measured using the standard error of measurement. Concurrent validity was investigated by correlating summary scores of the final survey instrument with global measures of satisfaction. RESULTS: Reliability was best for a 10-item questionnaire. Patient satisfaction was most associated with items that reflected a high-quality interaction with the therapist (eg, time, adequate explanations and instructions to patients). Environmental factors such as clinic location, parking, time spent waiting for the therapist, and type of equipment used were not strongly correlated with overall satisfaction with care. DISCUSSION AND CONCLUSION: Because the time the therapist spent with patients and the behavior of the therapists are important for patient satisfaction, emphasis on cost-cutting, high patient volume, and the use of "care extenders" may jeopardize satisfaction.

Female↗

[The influence of socio-demographic and psychological variables on the level of satisfaction of geriatric patients from dental care].

UNLABELLED: The increasing geriatric population poses unique treatment challenges for the dental practice. Satisfaction from dental treatment is considered to be an important issue that influences the attitude and cooperation of the geriatric patient. It is associated with the quality of treatment and with different variables, such as physical, emotional, social and financial. The objectives of the present study were to perform a preliminary characterization of a group of geriatric patients and to identify possible factors that might be associated with their level of satisfaction from dental treatment. MATERIAL AND METHODS: Fifty-one geriatric patients (20 males and 31 females) participated in the study. They were given a questionnaire which included 41 items regarding: socio-demographic variables, social activity, self image, level of apprehension, locus of control and level of satisfaction from dental care. RESULTS: Twenty-two patients reported a high level of satisfaction from dental treatment and twenty-nine reported a low level of satisfaction. No significant association was found between the degree of satisfaction from dental treatment and the examined variables of social activity, self-image and level of apprehension. Good doctor-patient relationships--"the art of care", is considered to have an important impact on the level of satisfaction, especially among the geriatric patients. CONCLUSION: Therefore, it is suggested that these relationships might determine the level of satisfaction of the geriatric patient from dental treatment.

Aged↗

Relationship between quality of diabetes care and patient satisfaction.

OBJECTIVE: Patient satisfaction is regarded as a component of the quality of medical care. We examined the association between quality of care and patient satisfaction. DESIGN: Cross-sectional study. SETTING: Population-based random sample in North Carolina, United States, 1997. PARTICIPANTS: 591 African-Americans aged > or = 18 years with self-reported diabetes were interviewed for providers' delivery of 10 preventive measures and patients' performance of four preventive measures for diabetes care. MAIN OUTCOME MEASURES: Satisfaction with health care providers with respect to 11 items, on a 4-point scale (excellent, good, fair, and poor). Average satisfaction scores were compared according to levels of quality of care. RESULTS: Patient satisfaction was positively associated with income, employment, diabetes education, ease of getting care during the last year, having health care coverage and having one physician for diabetes care (P < 0.05 for each). Adjusted for age, sex, education, employment, and income, 8 of 10 preventive care practices by providers during the previous year--monitoring of concentrations of glycosylated hemoglobin (HbA1c) and cholesterol; performing eye, foot, and gum examinations; and physician counseling on self-monitoring of blood glucose concentrations, exercise, and weight reduction--were associated with higher satisfaction scores (P < 0.05). Patients' performance of three of four preventive practices--taking medications for diabetes as prescribed, performing daily self-examination of the feet, and going for an eye examination with dilation of the pupils--were also associated with higher satisfaction scores (P < 0.05). CONCLUSION: Quality of diabetes care was positively associated with patient satisfaction with provider of care. Prospective studies are needed to confirm this association and its direction.

Adult↗

[Expectations and satisfaction in mental health center users].

INTRODUCTION: The user's satisfaction with the health services is an area of increasing interest. Usually the relation between satisfaction and expectations is not taken into account. The objective [corrected] of this paper is to describe the user's expectations, before treatment, in an out patient Mental Health Center and to investigate their satisfaction with the service adjusted by these expectations. METHODS: During six months all patients attending an outpatient mental health center of the Basque Public Health Service, are interviewed (n=315). The survey included the basic sociodemographic variables, one questionnaire of expectations and another one of clinical symptomatology (SCL-90-R). The patients were reviewed six months later by a new SCL-90-R and a questionnaire on satisfaction (CSQ-8). In order to select the factors which gathered the most important expectations, an analysis of principal components was made. A model, incluiding the best variables to explain satisfaction with the service, was adjusted by means of multiple linear regression, taking the expectations into account. RESULTS: Expectations on psychological explorations and interventions were greater than those on biological characteristics. Three factors called < >, < > and < > explained 10 % of the variance. For each increasing point in the initial SCL-90-R, the index of satisfaction decreased 0.02. For each point added to symptomatic recovery, the same index rose in 0.03. CONCLUSIONS: Satisfaction with the service was associated with less severity in initial psychopathology, symptomatic recovery and biological expectations. The psychological expectations were associated with less satisfaction.

Adolescent↗

Job satisfaction among critical care nurses.

OBJECTIVE: To develop a conceptual path model to explain the effects of a set of personal and work-related independent variables and the dependent variables of situational stress, job stress and job motivation on job satisfaction among critical care nurses. DESIGN: A prospective descriptive study using a conceptual path model. SETTING: Nine hospitals licensed for at least 250 beds in the northeastern, northwestern, northcentral, and southern regions of Florida. SAMPLE: Three hundred female critical care nurses employed in the nine hospitals who had worked full-time for at least 3 months. MEASUREMENTS: Subjects were administered a demographic and work survey questionnaire, Daily Hassles Instrument, Psychological Hardiness Test and the Job Diagnostic Inventory. MAIN OUTCOME MEASURES: A conceptual path model was constructed to illustrate the effects of a set of personal and work-related independent variables and the dependent variables of situational stress, job stress and job motivation on job satisfaction. MAIN RESULTS: Path analysis of a job satisfaction model resulted in a causal progression of situational stress leading to either job stress or job motivation, both affecting job satisfaction. The results showed that job stress, job motivation, job expectations, meaningful work, knowledge of work results, commitment to career, health difficulties, task identity, supervision, dealing with others at work, opportunity for advancement, pay and job security had a significant effect on job satisfaction. CONCLUSION: Thirteen variables had a significant effect on job satisfaction and explained 63% of the variance. The four most significant effects on job satisfaction were opportunities for advancement, meaningfulness of work, pay and supervision. Commitment to the career, task identity and job security had a modest effect on job satisfaction.

Adult↗

[French validation of the Verona Service Satisfaction Scale-VSSS-54F].

INTRODUCTION: The Verona Service Satisfaction Scale-French version (13) was translated and adapted from the Italian version of Verona Service Satisfaction Scale (27). The VSSS makes it possible to evaluate the satisfaction of people with serious mental illness with respect to the services. The original VSSS-54 contained 7 dimensions: 1) Overall satisfaction, 2) Professionals' skills and behaviour, 3) Information, 4) Access to services, 5) Services efficacy, 6) Relatives' involvement and 7) Types of interventions. According to factorial analyses carried out by Ruggeri et al., the dimensions Information and Access to services were aggregated. However, no factorial analysis was carried out in order to verify the six dimension-structure of the VSSS. From an international perspective, the study entitled "The European Psychiatric Services: Inputs linked to Outcome Domains and Needs (EPSILON)" achieved the standardisation of different questionnaires in several languages (2). A new version of the VSSS entitled "Verona Service Satisfaction Scale-European version" (VSSS-EU) was developed and is now available in the following languages: Italian, Danish, German, English and Spanish. In order to compare in different countries the satisfaction of people with serious mental illness with respect to services, we undertook from 1998 to ascertain the psychometrical properties of the French version of the VSSS. (13). Confirmatory Factorial Analysis (CFA) was carried out on the six dimension-structure of the VSSS-54F: 1) Overall satisfaction, 2) Professionals' skills and behaviour, 3) Information and Access to services, 4) Services efficacy, 5) Relatives involvement and 6) Types of interventions. For each dimension, consistency analysis (Cronbach's alpha) was computed in order to bring forth additional psychometrical properties of the VSSS-54F. METHOD PARTICIPANTS: 150 clients involved in an intensive case management program and supported by 30 mental health workers, filled out the VSSS-54F questionnaire. These clients were comprised of 110 women and 40 men, their ages ranging from 22 to 90 years (M = 51.7, SD = 14.7). Among them, 65 (43.3%) had a diagnosis of schizophrenia or another form of psychosis, 56 (37.3%) had an affective disorder, 17 (11.3%) had anxious disorders and 7 (7.7%) other. DATA ANALYSES: Using the EQS Software (3), Confirmatory Factor Analyses (CFA) were carried out in this study. Thus, 'the evaluation of the models' fit with the empirical data was carried out by taking into account various statistical indices. In addition to the Chi square/df ratio, the indices of adjustment such as the "NonNormed Fit Index" (NNFI), the Comparative Fit Index (CFI), robust CFI (calculated starting from the Satorra-Bentler Chi Square) as well as the RMSEA (Root Mean Standard Error of Approximation) were used to measure the fit of the models. Moreover, the estimation method "Maximum Likelihood-Robust" was carried out in order to evaluate the models. RESULTS: The original model with 6 dimensions (M1) does not present satisfactory fit indices. Indeed, the Chi Square/df ratio is above 2, the NNFI, CFI and CFI robust indices are lower than. 90 and the RMSEA is higher than. 08. Most items from Types of intervention dimension presented saturation lower than.30, and consequently indicate that these items are not correlated significantly with their dimension. We notice also some correlations between error terms of the three items of Overall Satisfaction scale and other items of the VSSS questionnaire. Considering these last results and the direction taken in VSSS-EU by breaking down by profession items of Professionals' skills and behaviour scale, we obtained a new model (M2). The five dimensions of this model are as follow: 1) Psychiatrists/Psychologists' skills and behaviour (7 items), 2) Nursing staff/social workers' skills and behaviour (7 items), 3) Information and access to services (3 items), 4) Services efficacy (5 items), 5) Relatives' involvement (3 items). When we test this model, the fit indices are satisfactory: the Chi Square/df is 1.36, the NNFI, CFI and robust CFI indices are near or higher than 0.90, respectively 0.88, 0.89 and 0.94. Finally, the RMSEA index is 0.08. In addition, the correlations between five dimensions are significant and vary from 0.58 to 0.87 (p < 0.05). The internal consistency coefficients for each new scale are all satisfactory, and vary from .83 to .91, except for the Information and access to services scales. But this latter finding shall be evaluated knowing that acceptable alpha can be close to .60 when scales count less than four items (16). CONCLUSION: This study confirms with some adjustments the factorial structure of the VSSS. The results indicate five dimensions (25 items): Psychiatrists/Psychologists' skills and behaviour, Nursing staff/social workers' skills and behaviour, Information and access to services, Services efficacy, Relatives' involvement. Even if the Type of interventions dimension was not retained in the model, we suggest preserving it for eventual clinical evaluation based on each item. We also suggest, for future studies, the adaptation of the VSSS-54F to the European version, VSSS-EU. Indeed, the results of our study sustain the European version because the VSSS-EU is more focused since it separates the skills and behaviour of psychiatrists, psychologists, nurses and social workers (e.g. items 3a and 3b or items 22a and 22b). The next step in the validation process would be to measure Inter-rater and test-retest reliability as well as concurrent, convergent and discriminant validity of the VSSS-EU. Furthermore, a multicultural comparison of the VSSS-EU would be required if the instrument is used for interesting comparisons of survey.

Adult↗

Living arrangements and lifestyle satisfaction among the elderly in Chinese immigrant families: a preliminary study.

BACKGROUND: The aims of this preliminary study were to understand the relationship between the living arrangements and lifestyle satisfaction through investigating how choices of living arrangements impacted upon lifestyle satisfaction of elderly Chinese immigrants in London. METHODS: A qualitative research methodology with semi-structured, face-to-face and in-depth interviews was utilized with eight elderly couples of Chinese immigrant families from Vietnam and Hong Kong. RESULTS: The results indicated that the desirability of current lifestyle was associated with lifestyle satisfaction. Among 12 participants who desired their current lifestyles, nine reported this having a "positive effect" on their lifestyle satisfaction, and no negative effects were reported. In comparison, the negative effects on lifestyle satisfaction were found among four participants who did not desire their current independent residence from their adult children. The reasons the participants desired or not their current lifestyles and the effects on their lifestyle satisfaction were explored qualitatively. The participants might consider family situations (finance, health, age, and kin network) to some extent. but not see them as key determinants in making decisions about living arrangements. However, the Chinese cultural beliefs in living arrangement choices were highly visible in their reports. CONCLUSION: The findings suggested that the elderly participants' desirability of their current lifestyles was positively associated with the level of lifestyle satisfaction. The issue of the living arrangements and lifestyle satisfaction of the elderly acquires new significance at a time when the population in Taiwan is aging, and the socio-economic and cultural changes are more radical than ever.

Aged↗

Development of a patient satisfaction survey for outpatient care: a brief report.

Patient satisfaction has become a significant component of health care outcomes and an increasingly important component of quality assessment. Selecting the appropriate methods to measure patient satisfaction is a critical challenge for health care managers, yet, there is limited knowledge of the methods used to develop patient satisfaction instruments. In this brief report, we provide insights into the development of a patient satisfaction instrument for outpatient care at the Duke Private Diagnostic Clinic (PDC). We surveyed the 12 medical directors and asked them to rate 15 concept areas for inclusion in an outpatient satisfaction survey. We then constructed a patient satisfaction survey by drawing selected subscales from the publicly available PSQ-18 (Patient Satisfaction Questionnaire) and CAHPS (Consumer Assessment of Health Plans) surveys to address the seven highest rated concept areas: 1) general/overall satisfaction; 2) courteousness of office staff; 3) courteousness of physicians; 4) doctor/patient communication; 5) professionalism; 6) ease and time to get appointment; and 7) technical quality of care.

Ambulatory Care↗

The mentoring experiences and career satisfaction of dental hygiene program directors.

PURPOSE: The purpose of this study was to describe the relationship between career satisfaction and length of the mentoring experiences of dental hygiene directors. METHODS: Directors were asked a series of questions (74 items) that described their career satisfaction and mentoring experiences during three stages of their lives professional student, faculty member, and director. The extent of career satisfaction was measured on a five point Likert-type scale. The target population consisted of a convenience sample of 235 directors with an active Internet mail address (n = 142). An Internet mail questionnaire was sent to these directors. The data sample consisted of 72 usable responses (51%). The field test was conducted to test for both content and face validity. Cronbach's Alpha was used as a measure of internal consistency and an acceptable alpha was determined to be 0.60. Data were downloaded from the WEB and manually entered into SPSS 9. RESULTS: Results indicated that career satisfaction was positively associated with length of the mentor relationship. The relationship between the total length of mentoring received as a student, faculty member, and director and the perceived level of career satisfaction had a moderate positive association (r = 0.459). The grand means for career satisfaction and length of mentoring in years, were 3.78 (sd = 0.5615, n = 47) and 20.46 (sd = 21.48, n = 45), respectively. CONCLUSION: As the length of the mentor experience increased, so did the level of career satisfaction, albeit a moderate increase. To enhance career satisfaction, mentoring should be initiated in dental hygiene graduate programs, particularly for students who aspire to become directors.

Administrative Personnel↗

Patient satisfaction in dental outpatient clinics in Turkey.

AIM: To measure the level of patient satisfaction in the dental outpatient clinics from a group of state hospitals in Turkey and explore the factors that may influence satisfaction. METHODS: In a cross-sectional study, patients attending the outpatient clinics state hospitals from 9 provinces were interviewed. Data regarding socio-demographic characteristics of the respondents were collected and a patient satisfaction questionnaire, which consisted of 29 statements regarding various aspects of satisfaction, were completed during face-to-face interviews (n=641, response rate 89%). RESULTS: There was no difference between the mean satisfaction scores of the study group with regard to socio-demographic characteristics except for the type of health insurance held by the patient. Patients covered by state pension funds had significantly higher satisfaction scores than the self-employed group with public insurance. Patients were most satisfied with privacy (82.1% of the respondents). Waiting time was the least satisfactory issue, with only 41.8% of patients reporting satisfaction with waiting time. CONCLUSION: The type of health insurance of the patients seems to be a significant predictor of dental patient satisfaction in Turkish state hospitals. Privacy was the most satisfactory service attribute whereas the waiting time had the lowest satisfactory rating.

Adult↗