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PubMed1997

Rating satisfaction research: is it poor, fair, good, very good, or excellent?

Satisfaction is one of the core outcome measures for health care. It is intuitively more appealing than measures of health care effectiveness or efficiency that are more difficult to understand. Satisfaction with health care is a measure with a long history in the social sciences. Most current research is less interested in correlations between patient characteristics and satisfaction and more focused on improving the quality of care and service delivered to patients and health plan members. While this article provides a brief overview of historical satisfaction literature, the primary focus is on current trends in measuring satisfaction, including efforts by the National Committee for Quality Assurance and the Foundation for Accountability. Limitations of current satisfaction measures are discussed; alternatives to using satisfaction to understand the experience of the health care system are suggested.

Health Services Research↗

PubMedDate not supplied

Job characteristics related to job satisfaction in rehabilitation nursing.

While much research is available on the job satisfaction of nurses in general, little is known about the job satisfaction of rehabilitation nurses. The purpose of this quantitative descriptive study was to identify job characteristics that are related to job satisfaction in rehabilitation nursing. The target population was rehabilitation nurses throughout the United States. The McCloskey-Muller Satisfaction Scale was used to measure three dimensions of job satisfaction: safety rewards (potential against dangerous threats), social rewards (the need to belong), and psychological rewards (autonomy, responsibility, recognition, and appreciation). Respondents rated their satisfaction with aspects of their current job by selecting a response from a 5-point Likert scale for 31 items in these three dimensions. The results suggest that rehabilitation nurses are satisfied with scheduling, extrinsic rewards, coworkers, social interactions, professional opportunities, delivery of care, praise, recognition, and responsibility. They are, however, less satisfied with child care facilities, balance between family and work, opportunities to participate in organizational decision making, control in the work setting, and career advancement. Opportunities to participate in nursing research or to write and publish neither satisfied nor dissatisfied the majority of respondents. Nursing administrators need to examine the factors that provide job satisfaction to rehabilitation nurses so as to retain capable nurses in the practice environment.

Adult↗

PubMed2002

An analysis of the relationship between job satisfaction and job stress in correctional nurses.

Stamps and Piedmonte's Index of Work Satisfaction and Harris's Nurse Stress Index were completed by 287 registered nurses employed in state prison health care facilities in order to assess job satisfaction and job stress among correctional nurses. Correctional nurses' expectations about job satisfaction were influenced by pay and autonomy. This finding was consistent with studies of hospital nurses. Important sources of job satisfaction were professional status and interaction with employees. Analysis of differences between expectations and sources of job satisfaction may provide understanding of career benefits and sources of dissatisfaction. Time pressures and organizational support and involvement were sources of stress. Multivariate analyses showed an inverse relationship between stress and job satisfaction. Information about job satisfaction and work stress and their correlates may be used to develop strategies to improve the recruitment and retention of correctional nurses.

Adult↗

PubMedDate not supplied

Patient care in multidisciplinary cancer clinics: does attention to psychosocial needs predict patient satisfaction?

Satisfaction with treatment is an important early indicator of medical outcome for cancer patients. This study examined patient satisfaction with treatment-planning and follow-up appointments among 58 recently diagnosed ENT and GI cancer patients seen at a multidisciplinary cancer clinic. Patients reported which medical specialties they saw, whether adjuvant treatment was planned, and whether they had a chance to discuss their feelings about the diagnosis. Patients also rated the attention paid by staff to several psychosocial issues considered relevant to cancer. These included how the patient was coping, support services available, and the issue of common emotional reactions to cancer. Patients then rated their overall satisfaction with their clinic visits. Overall satisfaction was predicted by younger age, female gender, and greater attention to how patients were coping with their illness. Having a chance to discuss one's feelings about the diagnosis, and staff attention to other psychosocial issues, also predicted patient satisfaction. The relationship of these psychosocial issues to patient satisfaction did not vary by gender. Results suggest that patient satisfaction may be enhanced when hospital staff attend to and provide for the psychosocial needs engendered by a diagnosis of cancer.

Adaptation, Psychological↗

PubMed1996

Parent satisfaction with children's mental health services in a children's mental health managed care demonstration.

This article presents findings from a quasi-experiment that included the use of satisfaction scales to compare parent's satisfaction with the services their children received through two different mental health care delivery systems. Satisfaction with the following three types of service were compared: (1) intake assessment during the admission process to any service setting, (2) outpatient services, and (3) residential treatment including inpatient hospitalization and residential treatment centers (RTCs). Additionally, satisfaction with several areas of care (e.g., access, treatment process, therapist relationship, parent and family services, discharge and transition planning), as well as global satisfaction, was assessed. In general, parents whose children received services through an innovative continuum of care system reported significantly higher satisfaction with intake assessment and outpatient services than did parents whose children received care in a traditional fee-for-service system. Fewer differences were found in satisfaction with residential services.

Adolescent↗

PubMed1998

Perceived importance and satisfaction with physical function in patients with knee osteoarthritis.

This investigation examined the determinants of satisfaction with physical function for participants in an Observational Arthritis Study in Seniors (OASIS). The sample consisted of 480 men (51%) and women (49%) over the age of 65 years who had difficulty performing activities of daily living due to knee pain. As part of baseline testing for OASIS, participants completed a measure that assessed satisfaction with function for six physical activities. After controlling for relevant covariates, scores on the satisfaction index were regressed on seven conceptually relevant predictor variables. The results revealed that satisfaction with physical function is a distinct construct from level of function, irrespective of whether the latter variable is measured objectively or subjectively. When entered into a hierarchical regression model, 6-minute walk test data accounted for 11% of the variance in satisfaction scores, whereas perceived difficulty accounted for an additional 22%. Moreover, a significant interaction term between importance and perceived difficulty revealed that patients who rated the activities as important and who had high levels of perceived difficulty had the lowest satisfaction scores. Discussion focuses on the determinants of satisfaction with physical function with emphasis on the interaction between perceived difficulty and importance.

Activities of Daily Living↗

PubMed2005

Functional status and satisfaction with community participation in persons with stroke following medical rehabilitation.

BACKGROUND AND AIMS: Researchers and policy-makers have recognized that quality of life assessments are essential to better understand the benefits of rehabilitation intervention. The purpose of the study was to examine associations between functional status and satisfaction with community participation for persons with stroke at 80-180 days after discharge from medical rehabilitation. METHODS: The study was retrospective, using data from the Information Technology (IT) Health-Track database for patients discharged from medical rehabilitation facilities in 2001/2002. The study population included 1870 persons with stroke aged 40 or older who had complete information at admission and follow-up (mean age at admission 68.3 yr, SD 14.5). The sample was 49.3% female and 72.6% were non-Hispanic white. RESULTS: Results showed a significant positive association between change in functional status (admission to follow-up) and satisfaction with community participation. Positive change ratings in functional status were associated with increased satisfaction with community participation (b = 0.02, SE = 0.001, p = 0.0001), after adjustment for age, gender, marital status, race/ethnicity, insurance source and functional status score at admission. Similarly, positive associations were observed for changes in motor and cognitive subscale ratings and satisfaction with community participation. The strongest association among six functional status domains and satisfaction with community participation was for communication (beta = 0.60) and social cognition (beta = 0.58). CONCLUSIONS: This study showed a statistically significant association between a modifiable factor (functional status) and a quality of life indicator (satisfaction with community participation). Results add to emerging literature on patient-centered outcomes and extend measures of recovery beyond functional status to include consumer satisfaction with a community outcome.

Activities of Daily Living↗

PubMed2006

[Transsexuals' life satisfaction after gender transformation operations].

BACKGROUND: More and more frequently, the registration of life satisfaction is being used to evaluate different medical treatments. So far, there have been only few such surveys on transsexuals (TS). Therefore, the aim of this study was to evaluate the general and the health-related life satisfaction of transsexuals after gender transformation operations. PATIENTS AND METHODS: Forty patients took part in this German cross-sectional study. The Questions on Life Satisfaction Module (FLZ) and free questions on different aspects of the new gender identity were used as measuring instruments. RESULTS: Of the TS studied, 85-95% were "very satisfied" or "satisfied" with the results of their gender transformation operation in respect to gender identity. The TS were significantly less satisfied (P>0.001) in overall "general life satisfaction" than the general population. In overall FLZ scores for "health-related life satisfaction", no differences were seen. CONCLUSION: These data indicate a discrepancy between subjective satisfaction with new gender identity and current life situation, and they identify problems with life satisfaction.

Adult↗

PubMed1996

[Patient satisfaction--artefact or social reality?].

The concept of patient satisfaction has become an independent evaluation criterion in the context of quality assurance. A review of patient satisfaction surveys referring to consumer satisfaction as a relevant health care concept, mostly being conducted in the USA, identifies numerous theoretical and methodological deficiencies. A consistently high level of patient satisfaction is reported, which is difficult to interpret. This requires critical analysis of what is meant by the term "satisfaction", considering theoretical concepts of satisfaction taken from various research areas. The paper concludes by pointing out that the concept "patient satisfaction" as it is used at present should not be seen as a valid indicator for the quality of care.

Humans↗

PubMed2006

In-patient management and treatment satisfaction after intravitreous plasminogen activator injection.

AIMS: To assess patient satisfaction after intravitreous plasminogen activator injections for subretinal hemorrhages secondary to age-related macular degeneration (AMD) and to analyse how it relates to the patients' postoperative visual and functional abilities. Further, to suggest ways to improve in-patient management and thereby treatment satisfaction. METHODS: A consecutive series of 101 patients with a subretinal hemorrhage of at least one disk diameter were enrolled in this longitudinal prospective study conducted during 2001-2004. After complete preoperative eye examination all patients were treated with intravitreal injection of 25 microg recombinant tissue plasminogen activator (rTPA) and 0.5 ml sulphur hexafluoride gas (SF6), followed by face-down positioning for 1 week. Patient satisfaction was assessed using standardised questionnaires administered postoperatively at 4 and 12 months. Outcome measures were: (1) responses to the patient satisfaction survey, (2) degree of satisfaction with in-patient management, (3) subjective change in the patients' functional status, and (4) visual acuity results. RESULTS: Whereas the patients' actual functional status deteriorated from a median value of 2.4 at 4 months to 3.4 at 12 months, their recall of their preoperative functional status shifted from a median value of 4.2 to to 2.3, consecutively. Twelve months after treatment, 75% of patients reported an improved visual acuity, however, only 12% reported satisfaction with treatment. 67.4-87% of patients were dissatisfied with various areas of in-patient management. CONCLUSIONS: Satisfaction with plasminogen activator injection treatment is low even though patients experience an improved visual and functional status at 12 months. This suggests that the current system requires improvement in certain areas such as in-patient management.

Drug Therapy, Combination↗

PubMed2001

Patient satisfaction after implantation of diffractive designed multifocal intraocular lenses in dependence on objective parameters.

BACKGROUND: For optimal patient satisfaction and greatest independence from spectacles after implantation of a diffractive designed multifocal intraocular lens (IOL), emmetropia with a low postoperative astigmatism must be achieved. The aim of this study was to prospectively determine patient satisfaction after implantation of diffractive designed multifocal IOLs in relation to objective parameters. PATIENTS AND METHODS: A total of 69 eyes of 50 patients without additional ocular pathology (mean age 64.8 years) received a diffractive designed multifocal IOL and were examined 12 months postoperatively. Overall patient satisfaction, visual phenomena (halos, glare), and frequency of use of reading spectacles and distance correction were assessed as subjective parameters. As objective parameters, uncorrected and best-corrected distance visual acuity (UCVA, BCVA, respectively), uncorrected, distance corrected and best-corrected near visual acuity, contrast sensitivity (Pelli-Robson charts), pre- and postoperative astigmatism, postoperative spherical equivalent and depth of focus (defocusing curve from +5.0 to -5.0 D) were measured. RESULTS: The mean overall satisfaction on a scale from 5 (excellent) to 1 (poor) was 4.49. Mean postoperative UCVA was 0.85 and BCVA was 1.03. Mean uncorrected near visual acuity was J1.04, distance corrected near visual acuity J1.0 and best corrected near visual acuity J1.0. Postoperative mean spherical equivalent was -0.17 +/- 0.43 D and absolute mean astigmatism was 0.64 D. The use of spectacles was highly correlated with postoperative spherical equivalent and absolute postoperative astigmatism. On a subjective scale from 0 (none) to 4 (very disturbing), a mean halo score of 0.45 and a mean glare score of 0.44 was recorded. Overall satisfaction was significantly correlated with UCVA, age, use of spectacles for distance purposes, contrast sensitivity, postoperative astigmatism, and postoperative spherical equivalent (P<0.05). Linear stepwise regression analysis identified UCVA as the most influential factor for overall patient satisfaction. CONCLUSIONS: For diffractive designed multifocal IOLs, emmetropia and a low astigmatism postoperatively are the most important factors for high patient satisfaction.

Adult↗

PubMed2005

Psychosocial rehabilitation and satisfaction with life in adults with childhood-onset of end-stage renal disease.

Little information is available on vocational rehabilitation and satisfaction with the quality of life in adult patients with early onset of end-stage renal disease (ESRD). A sample of 39 patients (mean age =26.7+/-6, range, 18 to 43 years, n =13 on dialysis, n =26 transplanted successfully) were required to report data on their vocational qualification and employment, and their degree of general and health-related satisfaction with life was surveyed. Data on psychosocial rehabilitation were collected by a structured questionnaire, whereas satisfaction with the quality of life was assessed with the standardized "Questionnaire on Satisfaction in Life (FLZ)." Fifty-eight percent of the patients had left school with certificates equivalent to high school graduation, 87% had completed vocational training and 67% were in paid employment. Forty-nine percent lived on their own or with a partner and 72% fully or partly earned their own living. The mean general and health-related satisfaction with life is significantly reduced compared to the general population. The patients were least satisfied in the areas 'partnership/sexuality' and 'family life/offspring' in general, as well as 'physical condition' and 'ability to relax' within health-orientated satisfaction. Final mean body height was 167.6+/-11.9 (SDS -1.54+/-1.59) for male and 153.77+/-8.29 for female patients (SDS -1.58+/-1.54). Thirty-six percent reported to be dissatisfied with their present body height compared to 4% of age-matched healthy controls. Positive perception of quality of life was significantly correlated to satisfaction with adult height ( r =0.41, P =0.008). Vocational rehabilitation of adult patients with early onset of ESRD achieves lower values than among the general population, however, more favorable percentages than among young adult patients or patients with adult onset of ESRD. The patients' self-evaluation of both their general and health-related quality of life proves to be clearly muted, which is a clear indication of the physical and psychological strain of living with a chronic disease.

Activities of Daily Living↗

PubMed2004

[Does patient satisfaction correlate with pain level during patient-monitored epidural analgesia. Evaluation of data from postoperative pain service].

INTRODUCTION: The evaluation of patients' satisfaction and outcome after surgery is of increasing importance. An optimized postoperative pain management may contribute substantially to this important goal. METHODS: After approval of the local ethics committee and written informed consent, 150 adult patients receiving epidural catheters for postoperative pain management were evaluated over 1 week postoperatively with respect to their satisfaction with the pain therapy and incidence of side effects. All patients received a continuous epidural infusion with ropivacaine 0.2% plus sufentanil 0.5 microg/ml via a PCEA pump (basal rate 6-8 ml/h, bolus 2 ml, lockout time 5 min). For assessment of pain the VAS scale (0-100 mm) was used, and patients' satisfaction was evaluated using a numeric rating scale (1-6, 1=very good, 6=very dissatisfied). RESULTS: Of the patients, 95 were operated in general surgery, 32 in orthopedics, and 23 in gynecology. Time of treatment with epidural catheters (71% thoracic, 29% lumbar catheters) was 5.1 +/- 2.9 days. Of the patients, 87.8% evaluated the postoperative pain service as very good or good, and 89% of the patients would choose the same pain therapy again. Side effects mainly consisted in bladder dysfunction (19%) and intermittent motor blockade (18%) especially with lumbar catheters. Correlation between patient satisfaction and the remembered maximum pain levels was low ( r=0.266). CONCLUSION: Evaluation of patients' satisfaction with postoperative epidural pain therapy resulted in a high degree of satisfaction without correlation between patients' satisfaction and recalled maximum pain levels. These results, including side effects and special problems during pain therapy, provide motivation to further improve postoperative pain management.

Anesthesia, Epidural↗

PubMed2005

Validation of the treatment satisfaction questionnaire for Crohn's disease (TSQ-C).

Treatment satisfaction is used to capture the full impact of disease on patients' lives. Currently, no instruments exist to evaluate satisfaction with pharmacologic therapy in patients with Crohn's disease (CD). The purpose of this study was to evaluate the psychometric properties of a treatment satisfaction questionnaire for CD (TSQ-C). The 36-item questionnaire was completed by CD patients who reported taking 5-aminosalicylic acid derivatives to treat their CD. Measures used in the validation study were the Inflammatory Bowel Disease Questionnaire (IBDQ), Crohn's Work Activity Impairment Index (CWAII), and patient reports of clinical indicators (e.g., number of active flares and medications taken). Exploratory factor analysis was used to evaluate the items and subscale structure. Internal consistency reliability and concurrent and discriminant validity were assessed using Cronbach's alpha, Pearson correlation coefficients, and analysis of variance. A total of 813 CD patients participated, with the majority being Caucasian (95.9%), female (67.0%), and >34 years old (86.1%). Patient-rated severity of CD was mild (49.3%), moderate (41.7%), and severe (7.5%). The final TSQ-C consisted of 32 items, with six subscales (Symptoms, Satisfaction, Expectations, Physician Relationships, Bother, and Cost), with each subscale score ranging from 1 to 6. Cronbach's alpha values ranged from 0.63 (Cost) to 0.94 (Symptoms). Strong correlations were observed among the IBDQ, CWAII, and the Satisfaction and Symptoms subscales of the TSQ-C. TSQ-C subscales, particularly Symptoms and Satisfaction, significantly discriminated among levels of number of flares per year, patient-rated disease severity, and number of medication classes. The TSQ-C demonstrated excellent validity and reliability and appears to be a useful tool for evaluating satisfaction with pharmacologic therapy among patients with CD.

Adult↗

PubMed2006

Training and motivational factors as predictors of job satisfaction and anticipated job retention among implementers of a school-based prevention program.

Despite increasing dissemination of prevention programs, little is known about program implementers, including factors that promote satisfying job roles. Using Self-Determination Theory as a conceptual framework, we surveyed 128 implementers of the widely disseminated Primary Mental Health Project. Implementers reported 7.1 years average experience on the job (range 1-25 years), and 55% had two or more years of college. In a multivariate regression model, predictors of higher job satisfaction were: lower education level; positive perceptions of supervision and continuing education opportunities; and satisfaction at work of needs for autonomy and competence. For implementers with </=3 years experience, satisfaction of competence needs predicted job satisfaction; for implementers with >3 years experience, satisfaction of needs for autonomy and for relatedness predicted job satisfaction. Contrary to expectations, job satisfaction was unrelated to anticipated job retention.

Adult↗

PubMed1986

Life satisfaction of the elderly American Indian.

This study examined the life satisfaction of 58 elderly American Indians and its relationship to selected external and internal environmental factors. Elderly Indians were 51-85 years of age and resided on two midwestern reservations. Data were collected through use of the Life Satisfaction Index Z-scale (LSI-Z), the Oars Multi-dimensional Functional Assessment Questionnaire (OARS) and a semi-structured interview schedule. Findings indicated that life satisfaction tended to be high. Six internal environmental variables explained 40% of the variance in life satisfaction scores. A higher correlation was found between self-perception of life satisfaction and mental health than objective ratings on these two variables. This study suggests that variables associated with the internal environment may be useful as indicators of life satisfaction in elderly reservation American Indians and that subjective measures of life satisfaction may be more predictive of mental health than objective measures.

Aged↗

PubMed1995

Satisfaction and continuity of care: staff views of care in a midwife-managed delivery unit.

OBJECTIVE: to examine whether there are differences in the midwife's role in, and satisfaction with, intrapartum care and delivery of women at low obstetric risk in a midwife-managed delivery unit compared to a consultant-led labour ward. DESIGN: a pragmatic randomised controlled trial. Subjects were randomised in a 2:1 ratio between the midwives' unit and the labour ward. SETTING: Aberdeen Maternity Hospital, Grampian, UK. SUBJECTS: midwives within the delivery suite who cared for the 2844 women at low obstetric risk receiving care in a pragmatic randomised controlled trial of the two delivery areas. PRIMARY OUTCOME MEASURES: continuity of carer and midwife satisfaction. FINDINGS: midwives looking after women in the midwives' unit group were significantly more likely to be of a higher grade, more qualified and have a longer length of experience than those in the labour ward group. There was greater continuity of carer both during labour and after delivery in the midwives' unit group. Despite a small but statistically significant difference in overall satisfaction between the groups, area of 'booking' or area of delivery were not important in predicting midwife satisfaction. Autonomy and continuity of carer were the best predictors of midwife satisfaction. CONCLUSIONS: midwife-managed intrapartum care increases continuity of carer and, therefore, midwife satisfaction. Extending this outside the delivery suite requires a system of care that is acceptable to midwives as well as women. Such systems will depend to a large extent on geography, consumer demand and availability of resources. However, midwife satisfaction should also be considered. In order to do this further research is required to fully evaluate the effect these systems have on the midwives working in them.

Attitude of Health Personnel↗

PubMed1991

Occupational stress and job satisfaction among physicians: sex differences.

The present study provides empirical findings from a national survey of physicians and addresses issues of sex differences in the nature of occupational stress experienced by physicians, and the sources of satisfaction in medical practice. Data were collected using questionnaires from 2584 physicians. The sample was randomly selected to represent physicians in all Canadian provinces. About 10% of the respondents were female. Measures included self-reports of stress and satisfaction, demographic variables, practice characteristics, and attitudes about health care. Major sources of stress indicated by female and male physicians were time pressures on the job, and major sources of satisfaction were relationships with patients and colleagues. Sex differences were found in terms of the specific variables that predicted job stress and satisfaction. However, for both women and men, various work setting variables positively predicted occupational stress and negatively predicted job satisfaction. Significant sex differences were present in both demographic and situational variables as well as measures of occupational stress and attitudes about health care. Correlations indicate that for both female and male physicians, high levels of occupational stress was associated with less satisfaction with medical practice and more negative attitudes about the medicare system and health care in general, and high job satisfaction was related to fewer specific work stressors and more positive attitudes about health care. Several methodological limitations necessitates caution in interpreting the findings. Nevertheless, the results may have some implications for future health care policies and procedures.

Burnout, Professional↗