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PubMed2004

Determining factors of patient satisfaction for frequent users of emergency services in a medical center.

BACKGROUND: The present era of a competitive healthcare environment indicates that providers have been convinced that attentiveness to patient satisfaction is integral to care quality and market share. Patient satisfaction is especially critical for frequent users of the emergency department (ED). The aim of this study was to compare satisfaction of overall ED care between frequent and infrequent ED users, and to find out the factors determining satisfaction among the frequent ED users. METHODS: Frequent ED users (> or = 4 visits/per year) and infrequent ED users (< 4 visits/per year) were selected randomly from patients visiting the adult ED of a public tertiary medical center from October 1, 2000 to September 30, 2001. Retrospective telephone interviews were completed for 200 frequent users and 200 infrequent users. Ordinal logistic regression analysis was performed. RESULTS: Infrequent ED users tended to give a higher satisfaction rating than frequent ED users to emergency care (OR = 2.14; 95% CI = 1.40-3.25). The 2 significant determinants associated with satisfaction with emergency care among frequent ED users were discharge instructions (OR = 2.78; 95% CI = 1.27-6.12) and subjective waiting time (OR = 12.6; 95% CI = 4.22-37.8). CONCLUSIONS: The frequent ED users were unique, and their satisfaction with overall emergency care was significantly lower than that of infrequent ED users. Managing waiting time perceptions and providing discharge instructions may be an effective strategy to achieve improved patient satisfaction among frequent ED users.

Adolescent↗
PubMed2004

Development and validation of the BSP-BPH (Bononian Satisfaction Profile--Benign Prostatic Hyperplasia) a "disease-specific" questionnaire for the evaluation of health related quality of life in patients with benign prostatic hyperplasia.

OBJECTIVES: Lower Urinary Tract Symptoms (LUTS) associated to Benign Prostatic Hyperplasia (BPH) are very common in middle aged and older men. Since BPH, and the related therapies have a significant impact on a patient's Quality of Life (QoL), the health related quality of life (HQoL) evaluation is becoming an important aspect to be considered. The present study deals with the development and validation of a BPH disease specific questionnaire (Bononian Satisfaction Profile - BSP-BPH), considering HQoL in patients seeking medical help for BPH. The innovation of this questionnaire is that the patients' scores achieved are related to their subjective satisfaction. MATERIALS AND METHODS: Questionnaire development: On the base of our previous experience with BSP-PC (a disease specific questionnaire assessing HQoL in prostate Cancer patients), of a careful review of other available instruments (SAT-P, SF-36, ICS-QoL, BPH-HqoL) and of three subsequent meetings with experts (10) and patients (20), we defined the ten life aspects mostly impaired by BPH. We created a first 72-item version of the BSP-BPH. Ten patients cross matched for age end education to our study population were asked to fill in the questionnaire. A 31 item questionnaire version, together with EuroQoL, an already generic validated instrument, was administered to 121 patients as well. Further meetings and statistical analysis defined the 18 items of the BSP- BPH. Questionnaire validation: the BSP-BPH was filled in by 435 patients enrolled in a campaign for detection of prostatic diseases held among the male population of Bologna. RESULTS: Questionnaire development: the participants' mean age was 63 years (N = 121); 47.1% had BPH. The 18 items were selected on the basis of the following criteria: a) r > 0.50, p < 0.05 (correlation test re-test); b) p < 0.05 (ANOVA presence vs absence of BPH); c) r > 0.50, p < 0.05 (correlation with EuroQol). Questionnaire validation: the participants' mean age was 63 years (N = 436). 16 patients with a history of neoplasia were excluded from our study. 21 were missing data. 45% of the sample had BPH. Principal component analysis identified 5 components: 1) satisfaction about sexual functionality (Cronbach alpha = 0.94); 2) satisfaction about social functionality (alpha = 0.80); 3) satisfaction about cognitive/emotional functionality (alpha = 0.82); 4) satisfaction about urinary functionality (alpha = 0.87); 5) satisfaction about physical functionality (alpha = 0.66); total Cronbach alpha was 0.88. CONCLUSIONS: The 18 items version of BSP-BPH questionnaire can be used as an instrument for HQoL evaluation in patients with BPH focusing on patients' subjective satisfaction. At the moment only the Italian version is available.

Humans↗
PubMed2004

Patients' satisfaction with psychiatric inpatient care.

BACKGROUND: Patient satisfaction with medical treatment is important, and although in mental health the literature on the topic is scant, awareness of the issue is rapidly growing. AIM: Evaluation of patient satisfaction among hospitalized psychiatric patients. METHODS: 100 consenting patients (47 men and 53 women) were surveyed and completed a questionnaire regarding satisfaction with psychiatric care. SETTING: Fifty-nine percent of the patients were in a new modern building, 41% were in an older hospital building; 21% were in a psycho-geriatric ward. The various settings allowed comparison across different environments. RESULTS: Most participants expressed mild general satisfaction. The overall rating was 3.40 +/- 0.43 (range 1-5). The ratings were similar regarding the various components of treatment: satisfaction with the nursing staff, physical conditions on the ward and treatment per se. Positive correlation was found between satisfaction with nursing and overall ratings. CONCLUSION: Inpatients were mildly satisfied with treatment. However, no correlation was found between satisfaction and either the type of case manager or the physical conditions in the ward. Further research is needed to characterize specific variables that may influence patient satisfaction with psychiatric care. In addition, the question of whether self-report evaluation questionnaires are appropriate for the inpatient psychiatric population should be addressed.

Adult↗
PubMed2005

[Study on patient satisfaction with two type of Twin-block].

OBJECTIVE: To compare patient satisfaction with two type of Twin-block by clinic complain questionnaire, treatment effect satisfaction questionnaire and total satisfaction questionnaire, and to analyse their related factors with patient satisfaction. METHODS: 56 patients were randomly classified into fixed-Twin-block (TB1) and unfixed-Twin-block (TB2). The complaint and satisfaction of patients was evaluated by clinic complain questionnaire, treatment effect satisfaction questionnaire and total satisfaction questionnaire after 10 days and 6 months of treatment. RESULTS: (1) There was significant difference between the complaint of two groups in the sixth month, but there was no difference in the tenth day. (2) There was significant difference between the total satisfactory degree of two groups. (3) There was significant difference between the tooth-jaw effective index and the mandible effective index of the two groups. CONCLUSION: The satisfactory degree of fixed-Twin-block is superior to that of unfixed-Twin-block. The adorn fashion, treatment stage and functional position has influence on patient satisfaction.

Female↗
PubMed1984

Alterable correlates of extrinsic and intrinsic job satisfaction at a state residential facility.

A cross-section of employees at a state residential facility for mentally retarded persons was administered a composite questionnaire to assess factors associated with job satisfaction. Using a multivariate statistical approach, we examined two measures of job satisfaction (extrinsic and intrinsic) in relation to employee perceptions of organizational climate and selected job characteristics. Unique multiple regression analyses indicated that constraining conformity, decision frequency, and clarity of supervisor instructions were related to both measures of job satisfaction; organizational clarity, reward, and satisfaction with materials were related only to extrinsic satisfaction; and organizational standards and degree of resident contact were related only to intrinsic job satisfaction. Differences in variable contributions "ignoring" and controlling for other variables were emphasized. Variables were ranked according to their importance in predicting job satisfaction. Investigators are encouraged to consider the distinction between extrinsic and intrinsic job satisfaction in future research.

Humans↗
PubMedDate not supplied

Head nurse leadership style with staff nurse burnout and job satisfaction in neonatal intensive care units.

Leadership style has been defined as a two-factor construct composed of "consideration" and "initiating structure." Research has suggested that these factors affect the behavior and attitude of subordinates. This study's purpose was to quantify the relationships of head nurse leadership style with self-reported staff nurse burnout and job satisfaction in Neonatal Intensive Care Units (NICUs). Three instruments--the Minnesota Satisfaction Questionnaire, the Tedium Scale, and the Leadership Opinion Questionnaire--were voluntarily completed by 283 registered nurses employed by 14 level-III NICUs in the United States. The leadership dimensions of consideration and structure were distinct (r = -.10). Staff nurse satisfaction and burnout were related (r = -.41). Head nurse consideration was clearly related to staff nurse satisfaction (r = -.55) and to a lesser extent to burnout (r = -.29). Initiating structure alone was not related to satisfaction or burnout. Aggregate perceptions of head nurse leadership were ranked across NICUs in order to classify the head nurses on consideration and structure. The 14 head nurses were separated into four groups: high consideration-high structure, high consideration-low structure, low consideration-high structure, and low consideration-low structure. Satisfaction and burnout of staff nurses in each of the leadership-style groups were then compared. Analysis of variance for satisfaction (F(3,279) = 3.10, p = .03) and burnout (F(3,279) = 3.90, p = .01) were both significant. For both satisfaction and burnout, the head nurse leadership classification of low consideration-high structure was most deviant.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1983

Job satisfaction among U.S. pharmacists.

A review of the literature on job satisfaction that is relevant to pharmacists is presented. Studies conducted in the United States between 1951 and 1982 were evaluated to answer two questions: (1) What is known about the level of job satisfaction among pharmacists? and (2) What factors are related to pharmacists' job satisfaction? Some study populations were selected on the basis of work setting, others on position in the job hierarchy, and others on different criteria. Job satisfaction measures were of two general types, facet-free measures, which assess overall satisfaction, and facet-specific measures, which gauge satisfaction with respect to a specific aspect of the job. Pharmacists in the studies represented a wide variety of work settings and geographic locations. Most of the studies were not comparable because they used instruments unique to a particular study. In some cases, response rates were low and sample sizes were small. Frequently, results were not analyzed statistically for significance. A few studies compared pharmacists with other job populations; the differences were not striking, although pharmacists may be slightly less satisfied with their specific jobs than the general public. Repeatedly, job position and ability utilization appeared related to pharmacists' job satisfaction. Further study of the extent, causes, and consequences of pharmacists' job satisfaction is needed. Research methods should be designed so that results can be analyzed and compared statistically.

Environment↗
PubMedDate not supplied

[Correlates of life satisfaction in middle age].

A sample of 104 men and 114 women aged 42;8 to 56;6 years was interviewed about their life satisfaction, responded to a life satisfaction questionnaire and gave informations about biographical experiences in the areas "experiences of loss", "indicators of aging", "experiences of bodily vulnerability" and "death-related experiences". A negative relationship was found between satisfaction with one's past and experiences of loss as well as between satisfaction with one's presence and indicators of aging. Life satisfaction which is directed to the presence is stronger in men between 43 and 46 years than in men between 53 and 56 years. Life satisfaction which is directed to the past is stronger in men between 53 and 56 years. Subjects with a small number of negative life experiences (the "psychologically young") had a higher life satisfaction than subjects with a great deal of negative life experiences (the "psychologically old"). Results were discussed in respect to age-dependent changes in life satisfaction and in respect to a more relative view of the age variable.

Adult↗
PubMedDate not supplied

Job satisfaction and turnover among nurses: integrating research findings across studies.

A meta-analytic study investigated the causal relationships among job satisfaction, behavioral intentions, and nurse turnover behavior. A theoretical model was proposed in which behavioral intentions were viewed as a direct antecedent to turnover behavior. Job satisfaction was expected to be indirectly related to turnover by virtue of the mediating role of behavioral intentions. Consistent with these expectations, a strong positive relationship was indicated between behavioral intentions and turnover; a strong negative relationship between job satisfaction and behavioral intentions; and a small negative relationship between job satisfaction and turnover. The results of the modifier analysis suggested that effect sizes are fairly robust to differences in study designs, response rates, and methods of measuring job satisfaction, but the manner in which behavioral intentions were operationalized appeared to moderate the relationship between behavioral intentions and turnover and job satisfaction. Of variables related to nursing job satisfaction, work content and work environment had a stronger relationship with job satisfaction than economic or individual difference variables.

Canada↗
PubMedDate not supplied

Listening to the customer: implementing a patient satisfaction measurement system.

Patient satisfaction is an important issue in positioning ambulatory medical services. An effective patient satisfaction measurement program not only helps hospital managers improve the quality of clinical and administrative activities, but also helps the hospital remain viable in increasingly competitive markets. A method for the design and measurement of patient satisfaction with outpatient Endoscopy Lab services is described in this article. The survey focuses on the sequence of events experienced by the patient. Outcome measures of primary interest include global patient satisfaction and the likelihood of using the service again if given a choice. Analysis of patient responses shows that global satisfaction with the outpatient experience is positively associated with service return intention. Additional analysis shows that facility cleanliness, privacy and nurse attention are most strongly associated with global patient satisfaction. Results underscore the importance of various service attributes on patient satisfaction and return intention and of the need to further expand the uses of patient satisfaction measurement in the outpatient Endoscopy Lab.

Adult↗
PubMed1994

[Assessment of job satisfaction of the nursing staff].

OBJECTIVE: To find the overall and specific levels of job satisfaction of nursing staff in an Area's Health Institutions. DESIGN: Descriptive study of a crossover type of a population base. SETTING: Primary (PC) and Specialist (SC) Care within INSALUD in Madrid's Area 10. PARTICIPANTS: Nursing staff with at least six months in their post. All 147 working in PC were included and a random sample of 130 from SC. INSTRUMENT: The Font-Roja questionnaire, which measures overall job satisfaction and a series of specifics, was used. MEASUREMENTS AND MAIN RESULTS: 68.2% replied. By means of a factorial analysis of the main components, 9 dimensions explaining 59.2% of the variance were obtained. There was average general job satisfaction (3.05 +/- 0.35). The most valued dimension was that which referred to work content (4.01 +/- 0.59) and the least valued was tension associated with the job (2.47 +/- 0.70). CONCLUSIONS: Nursing staff at both levels of Health Care are less satisfied in the areas of "tension associated with work," "promotion prospects" and "over-work". The greatest satisfaction was found in "work content" and "relationships with colleagues". PC nursing staff showed greater satisfaction in "communication with superiors", "satisfaction with the post", "tension associated with the job" and "professional autonomy." Temporary scored higher than permanent staff in "satisfaction with the post" and "tension associated with the post." In general the afternoon shift provides most satisfaction.

Cross-Sectional Studies↗
PubMed1995

[User satisfaction with primary care teams: related to doctor's training in the field of physician-patient relations].

OBJECTIVE: To find the satisfaction level of health users attended by Bizkaia primary care teams (PCT) with 5 or more permanent doctors and to determine whether there is any relationship between satisfaction and doctors being trained in doctor-patient relationships (DPR). SETTING: Primary Care. Towns in the 2 health areas out of the 6 in which Bizkaia is divided. PARTICIPANTS TARGET POPULATION: the users of PCTs with 5 or more doctors in the 2 health areas. The randomly selected sample had 323 patients, to which we had earlier added 30% (n = 420) due to the probable non-repliers. INTERVENTION AND RESULTS: Satisfaction was measured using the questionnaire composed by J.M. Moreno et al; and training in DPR, using a questionnaire composed by the authors. Satisfaction scored on average 73 points out of 80 (range 34 to 80). 36.7% of the doctors had low or nil training in DPR (< 10 hours); 16.7% had average training (10 to 40 hours); and 46.7% stated they had a high level of training (> 40 hours). Data analysis showed that satisfaction increased in line with the user's age and the length of the user's relationship with the doctor. CONCLUSIONS: 1) The satisfaction found is high, which corroborates other authors' results. 2) The most determinant variable of user satisfaction is age. 3) We found no statistically significant association between patient satisfaction and doctor training in the field of DPR.

Adolescent↗
PubMed1996

Objective life circumstances and life satisfaction: results from the course of homelessness study.

Relations between objective life circumstances and life satisfaction were examined using structural equation modeling of two waves of data obtained from homeless and mentally ill homeless participants (N = 298) in the Course of Homelessness Study (COH). Cross-sectional analyses revealed that objective indexes of life quality were primarily associated with domain-specific, rather than general, life satisfaction. Results could not be attributed to the covariation of life satisfaction with other indexes of subjective well-being (i.e., psychological symptoms and perceived self-mastery). In addition, significant direct ("causal") cross-lagged effects were found linking initial objective housing status with subsequent income and subsequent satisfaction with housing. By contrast, neither life satisfaction nor any other index of subjective well-being exerted a direct impact on subsequent life quality as assessed by objective indexes. Finally, we found no support for previous claims that perceived self-mastery mediates the impact of objective life circumstances on subsequent life satisfaction. Findings are discussed with reference to the utility of a hierarchical model of life satisfaction that incorporates domain-specific, as well as global, satisfaction.

Adult↗
PubMed1997

Measuring patient satisfaction with pharmaceutical services.

Common conceptualizations of satisfaction are discussed, and different ways of measuring patient satisfaction with pharmaceutical services are suggested. Patient satisfaction is becoming increasingly popular as an indicator of the quality of health care services, including pharmaceutical services. Satisfaction can be conceptualized as a performance evaluation, disconfirmation of expectations, an affect-based assessment, or an equity-based assessment. A satisfaction measure should have a theoretical base on which the measure's validity can be assessed. The measure chosen must fit the context of an overall research process, and the researcher must have a clear idea of what is to be measured. A large pool of items, or questions, for potential inclusion in a patient-satisfaction questionnaire can then be generated. The researcher should develop a format for each item (e.g., Likert scale). The items should be reviewed by experts for relevance and completeness. Questions that will help validate other questions should be included. To assess reliability and validity, the questionnaire should be given to a representative sample of respondents before being refined into its final format. Finally, the researcher must ensure that the patient-satisfaction questionnaire is practical (e.g., in terms of length and complexity). No single standard measure of patient satisfaction is applicable to all pharmacy situations. Researchers should either use an existing measure with demonstrated reliability and validity or develop a new measure by using a systematic process.

Humans↗
PubMed1998

Perceived control mediates the relationship between pain severity and patient satisfaction.

The factors that account for patient satisfaction with acute pain management remain a mystery. Consistently, there has been an inverse, but very small association between pain severity and patient satisfaction; most patients are in severe pain, yet report they are satisfied with pain management. The hypothesis that perceived control mediates the relationship between pain severity and patient satisfaction was examined in 137 patients who underwent elective inpatient orthopedic surgery. Postoperatively, patients rated their pain severity (the highest level of pain experienced), their perceptions of control over the pain and taking pain medication, and their satisfaction with the relief they obtained from analgesics. Path analysis using LISREL was used to test for mediation. Pain severity was associated inversely with perceptions of control over pain and with satisfaction. There was a significant association between perceived control and satisfaction and perceived control partially mediated the relationship between pain severity and satisfaction. Although individuals who report experiencing severe pain are less satisfied with pain relief than individuals with less pain, it is the interpretation or perception of having control over the pain that most relates to satisfaction with pain relief. Clinically, it is important to examine ways in which individuals control their pain, teach them methods to exert control, and educate them that it is preferable to not allow pain to become severe--it is easier to "control" pain if you intervene at an early point.

Adolescent↗
PubMed1998

Satisfaction of active duty U.S. service members with military dental care.

This study explores the satisfaction of active duty service members with military dental care. The data were collected from April 1994 to January 1995. A prestratified, random sample of 15,915 service members was drawn. Of 12,050 respondents (81% response rate), 11,200 had an annual dental visit and answered 22 questions on satisfaction with military dental care. We calculated simple descriptive statistics and derived a composite overall satisfaction score using factor analysis. We then converted composite scores into a satisfaction index, a continuous variable with a mean of 100 and a standard deviation of 10. The satisfaction index was regressed on respondent demographics to determine which factors influence service members' overall satisfaction with military dental care. Results show that satisfaction with military dental care is high and consistent across respondent demographics. However, because this study was conducted before the recent, sizable drawdown of military dental personnel, these findings may not describe the current state of satisfaction with military dental care.

Dental Care↗
PubMed1983

Research assessing consumer satisfaction with mental health treatment: a review of findings.

This article reviews the findings of studies examining consumer satisfaction with mental health treatment. Typically, published studies find the vast majority of patients satisfied with treatment. Despite the numerous methodological problems in this research, it remains highly probable that the majority of consumers are satisfied with the services received. More specific findings in this literature remain less well demonstrated; there generally are few studies relevant to each specific question and the methodology of these studies often has been weak. However, trends point to weak relationships between patient demographic variables and satisfaction; significant relationships between patient diagnosis, treatment history, and psychological status and satisfaction; strong relationships between length of treatment and manner of termination and satisfaction; a strong relationship between satisfaction and patient global report of outcome; and a weak relationship between satisfaction and therapist rating of outcome. Satisfaction also appears to be multidimensional, although a large general factor is evident in most studies. A number of additional findings are catalogued; and research lying outside the formal domain of satisfaction research, but relevant to this body of research, is reviewed.

Consumer Behavior↗
PubMed1983

Patient satisfaction with mental health services: a meta-analysis to establish norms.

Patients typically express high rates of satisfaction with their mental health care. This finding and the lack of well controlled studies on patient satisfaction in the literature underscore the need for meaningful guidelines for clinicians and program evaluators in interpreting patient satisfaction data. To address this problem a meta-analysis was undertaken to establish norms on patient satisfaction for various types of mental health programs. Programs were categorized according to three dimensions: inpatient vs. outpatient vs. residential care; chronic vs. non-chronic; and conventional vs. innovative. Meta-analysis procedures were modified to accommodate the single-group study designs that dominate the literature. The analysis revealed that chronic patients express less satisfaction with their treatment compared to non-chronic patients. Innovative programs are viewed more positively than conventional ones. No differences were found in rates of patient satisfaction between inpatient and outpatient programs. Acceptably reliable norms and confidence intervals of patient satisfaction were established for conventional inpatient programs serving either chronic or non-chronic patients; conventional outpatient programs for non-chronic patients; and for all programs combined according to chronic vs. non-chronic, inpatient vs. outpatient, and conventional vs. innovative. However, data were insufficient to compute norms for other program types. The norms thus established can be used for comparative purposes by program evaluators. A cumulative, national data base on patient satisfaction is recommended to further refine these norms.

Consumer Behavior↗