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PubMed2003

Migraine treatment patterns and patient satisfaction with prior therapy: a substudy of a multicenter trial of rizatriptan effectiveness.

BACKGROUND: Migraine is a common, chronic, often disabling neurologic condition that is underdiagnosed and undertreated. OBJECTIVE: We undertook this questionnaire-based study as a substudy of a multicenter trial of rizatriptan effectiveness. Our goal was to assess the history of acute migraine medication use and the relationship between different migraine medication regimens and patient satisfaction with prior therapy. METHODS: This study was conducted at 85 neurology clinics throughout Spain from March Lo December 2001. It was planned prospectively as part of the screening visit for a multicenter trial of the effectiveness of rizatriptan therapy for migraine. Male and female patients >/=18 years of age were eligible for the primary trial, and hence for this study, if they had a history of migraine attacks and did not have a contraindication for triptan use. At the screening visit for the primary trial, a questionnaire was used by clinicians to record past and current use, and duration and order of use, of analgesics, nonsteroidal anti-inflammatory drugs (NSAIDs), ergot derivatives, and triptans; satisfaction with treatment was scored on a 5-point scale ranging from "very dissatisfied" to "very satisfied." RESULTS: Of 712 patients completing the questionnaire (mean [SD] age, 34 [10] years; range, 18-69 years), 75% were women and 94% experienced moderate or severe functional disability during migraine attacks. Analgesics were used by the majority of patients (81%) and for the longest mean [SD] duration (8.8 [7.6] years) but were associated with the least satisfaction (10% of patients "very satisfied" or "somewhat satisfied"). Triptans were used by the fewest patients (32%) and for the shortest mean duration (18 [1.6] years) but were associated with the highest rate of satisfaction (66%) compared with NSAIDs (27%) and ergot derivatives (31%). Regardless of duration or order of drug use, or sex or age of the patient, the likelihood of satisfaction with triptans was significantly greater (P < 0.001) than with nontriptan regimens, with an adjusted odds ratio (95% CI) of 16.8 (11.4-24.9) versus analgesics, 5.1 (3.6-7.1) versus NSAIDs, and 4.1 (2.8-6.0) versus ergot derivatives. CONCLUSIONS: Our results showed that analgesics, NSAIDs, and ergot derivatives were used for long durations but provided low satisfaction among patients. Triptans were rarely used as a first treatment choice; however, patients reported the highest treatment satisfaction scores after triptan therapy compared with ergot derivatives, NSAIDs, or analgesics.

Adolescent↗
PubMed2003

Measuring satisfaction with migraine treatment: expectations, importance, outcomes, and global ratings.

BACKGROUND: Patients tend to express high satisfaction with treatment using global rating scales. Previous work in health services, marketing, and operations research suggested that global ratings of satisfaction need to account for multiple influences and differing patient values. Prior qualitative work with patients and clinicians supported a 4-part model that incorporates the gap between expectations and outcomes of treatment and accounts for the relative importance of different treatment attributes. OBJECTIVE: The aim of this work ws to generate a small experimental data set to develop and evaluate the potential usefulness of the conceptual model and scoring algorithm for the application of this new measurement strategy, the Migraine Treatment Satisfaction Measure (MTSM). METHODS: Before treatment, migraine patients who were beginning a new prescription for headache rated their expectations and the importance of 9 attributes of treatment: pain relief, speed of relied, freedom from pain, additional symptoms, confidence in treatment, disruption in life, dosing, freedom from relapse, and ease of use. After treatment, patients rates outcomes on these 9 attributes and provided global satisfaction ratings. Weights reflecting the gap between expectations and outcomes and the importance ratings were applied to these global ratings after treatment to produce the MTSM score. The weighted rating scales were then tested for internal consistency, reliability, and construct validity using the Short-Form 36-item Health Survey (SF-36), 24-hour Migraine Quality of Life Questionnaire (MQoLQ), a measure of symptom bothersomeness, and a measure of migraine intensity. RESULTS: Forty-eight patients were screened and 29 patients completed this pilot study. Internal consistency of coefficients exceeded 0.90 for all 4 components of the MTSM (patients' expectations of treatment, ratings of the importance of individual attributes of treatment, assessments of outcome on each attribute, and global treatment satisfaction ratings). Derived or weighted scores expanded the distribution of unweighted global satisfaction ratings and improved statistical performance by reducing variability (from 20.5 to 14.8) for overall score). Hypothesized associations were confirmed between the MTSM, SF-36, MQoLQ, symptom bothersomeness, and migraine intensity. CONCLUSION: The 4-part conceptual model reflecting multiple attributes of treatment and preliminary scoring system for the MTSM generated satisfaction scores that improved discrimination among patients. Further validation is warranted.

Adult↗
PubMed2003

Use of patient satisfaction data in a continuous quality improvement program for endoscopic sinus surgery.

OBJECTIVE: Continuous quality improvement (CQI) is an effort by health care providers to improve the quality of service by continuously exceeding patients' expectations. Patient satisfaction is one of the measures of the quality of care. The aims of this study were to report the patients' evaluation of endoscopic sinus surgery (ESS) and to explore the feasibility in using patient satisfaction data in the CQI program for ESS. METHODS: Eighty-three patients completed a validated patient satisfaction survey (PSS) 1 month after undergoing ESS. Logistic regression models were applied to determine the confounders of patient satisfaction. RESULTS: In general, 72% of patients were very satisfied with the services. Education level and milder disease correlated with higher overall satisfaction levels (P </= 0.01). Anesthesia, the addition of nasal septal surgery, intranasal packing, and postoperative sinuscopy had significant impacts on patient satisfaction (P < 0.05). CONCLUSION: ESS is a good technique to evaluate for implementing efforts in quality improvement. Confounding factors need to be adjusted before patient satisfaction data can be used in a CQI program.

Adolescent↗
PubMed1993

Job satisfaction of paramedics: the effects of gender and type of agency of employment.

STUDY OBJECTIVES: To document specific factors important in paramedic job satisfaction and job performance. DESIGN AND TYPE OF PARTICIPANTS: A cohort analysis sampled 63 male public-agency paramedics and 131 private-agency paramedics (90 male, 41 female). METHODS: Three scales from the Michigan Organizational Assessment Questionnaire measured total job satisfaction. A four-item scale assessed attitudes toward paramedic job performance. RESULTS: Fire paramedics reported highest levels of overall satisfaction, followed by male and female private-agency paramedics. Fire paramedics reported higher levels of intrinsic job satisfaction (eg, opportunity to learn new things) than private-agency paramedics. Differences in extrinsic job satisfaction (eg, pay, benefits) were even greater between fire paramedics and private-agency paramedics. Fire paramedics reported higher satisfaction than female private-agency paramedics with the social rewards of work (eg, the way they are treated by their coworkers). These findings were not explained by age, race, education level, and years on the job. Analysis of the attitudes toward paramedic job performance scale suggested that male paramedics are more likely to believe that female paramedics are not as capable of performing certain job functions. CONCLUSION: Type of agency and gender affect job satisfaction. Male public-agency paramedics are most satisfied, and female private-agency paramedics are least satisfied with their jobs.

Adult↗
PubMed2002

Factors determining inpatient satisfaction with care.

The objective of the study was to identify factors associated with satisfaction among inpatients receiving medical and surgical care for cardiovascular, respiratory, urinary and locomotor system diseases. Two weeks after discharge, 533 patients completed a Patient Judgments Hospital Quality questionnaire covering seven dimensions of satisfaction (admission, nursing and daily care, medical care, information, hospital environment and ancillary staff, overall quality of care and services, recommendations/intentions). Patient satisfaction and complaints were treated as dependent variables in multivariate ordinal polychotomous and dichotomous logistic stepwise regressions, respectively. Patient sociodemographic, health and stay characteristics as well as organization/ activity of service were used as independent variables. The two strongest predictors of satisfaction for all dimensions were older age and better self-perceived health status at admission. Men tended to be more satisfied than women. Other predictors specific for certain dimensions of satisfaction were: married, Karnofsky index more than 70, critical/serious self-reported condition at admission, emergency admission, choice of hospital by her/himself, stay in a medical service, stay in a private room, length of stay less than one week, stay in a service with a mean length of stay longer than one week. The factors associated with inpatient satisfaction elucidated in this study may be helpful in interpreting patient satisfaction scores when comparing hospitals, services or time periods, in targeting patient groups at risk of worse experiences and in focusing care quality programs.

Adolescent↗
PubMed2002

Automated external defibrillators and first responders: a satisfaction survey.

PRIMARY OBJECTIVE: Automated external defibrillators (AEDs) are used with increasing frequency in the United States by first responders (FR) such as police officers (PO) or firefighters (FF). However, FR satisfaction with use of AEDs has not been investigated. We hypothesized that FR satisfaction is comparable with that of paramedics (PA) and that, among those who have defibrillated with AEDs, those who have restored a pulse before PA arrival have a higher level of satisfaction than those who have not restored a pulse. MATERIALS AND METHODS: A 21-item questionnaire with closed answers was sent to FR and PA in four communities. Each answer was scored 0, 1 or 2. A score between 10 and 16 correlated with the highest satisfaction level. RESULTS: 276 out of 311 questionnaires were returned (89%). Two hundred and eleven respondents (35 PA, 70 FF and 106 PO) had used an AED and 99 FF and PO had restored a pulse before PA arrival. The satisfaction level of PO, FF and PA was high as demonstrated by the scores: 13.26, 13.07 and 13.39, respectively. Use of AED and pulse restoration resulted in higher scores than those of groups who had been trained only and who had not restored a pulse. CONCLUSION: FR demonstrated a high level of satisfaction with using AEDs, and also had a favorable attitude toward implementation of AED use. Restoration of a pulse was clearly a factor responsible for a higher satisfaction. This positive attitude should encourage further implementation of early defibrillation programs in non-medical first responder settings.

Allied Health Personnel↗
PubMed1999

Patient satisfaction and diagnostic accuracy with ultrasound by emergency physicians.

In recent years, there has been considerable interest and controversy concerning the performance of ultrasound by emergency physicians (ED Sono), but patient satisfaction with ED Sono has not been well studied. The primary purpose of this investigation was to assess the level of patient satisfaction with ED Sono and to compare satisfaction with ED Sono with ultrasound by the Medical Imaging Department (MI Sono). A secondary objective was to assess the accuracy of ED Sono at our facility. During a 5-month period, which included the startup phase of a program for ED Sono, emergency physicians prospectively identified patients who were candidates for ultrasound as a part of their workup. Patients were contacted by telephone after their ED visit and asked to rate satisfaction on a 0 to 10 scale for various aspects of their care, including the ultrasound if one was done. The accuracy of ED Sono was determined by comparing ED ultrasound interpretations with surgical pathology, repeat imaging studies, or clinical follow-up. Two hundred forty patients were entered into the study, and 186 (78%) responded to the satisfaction survey. Satisfaction ratings were similarly high for ED Sono (mean, 8.9; 95% Cl, 8.6 to 9.2) and for MI Sono (mean, 8.8; 95% Cl, 8.2 to 9.4). Eighteen percent of ultrasounds performed by emergency physicians were indeterminate. Excluding indeterminate scans and scans for which confirmation was not possible, the accuracy of ED Sono was 99.1% (95% Cl, 95.1% to >99.9%). We conclude that during the startup phase of our ED Sono program, patient satisfaction was high, and the error rate was very low.

Adult↗
PubMed2004

Validation of the EORTC QLQ-SAT32 cancer inpatient satisfaction questionnaire by self- versus interview-assessment comparison.

Doubts are expressed on the validity of patient satisfaction questionnaires. High satisfaction levels are consistently reported. Within the European Organisation for Research and Treatment of Cancer (EORTC) quality of life group, we developed a cancer inpatient satisfaction questionnaire (QLQ-SAT32), adopting several precautions to overcome the ceiling effect commonly reported in satisfaction ratings. Since patients are often more critical when expressing themselves in an interview, in order to study the validity of the QLQ-SAT32, we assessed the agreement between self- and interview-administered QLQ-SAT32 responses. One hundred and twenty three patients were asked to complete the QLQ-SAT32 at home within 2 weeks of hospital discharge and were randomly allocated to participate in a telephone interview-administration of the QLQ-SAT32, either before or after self-completing the QLQ-SAT32. One hundred and four of them completed both modalities of questionnaire administration. Correlation and agreement between self- and interview-administered QLQ-SAT32 ratings were examined, for each subscale and the general satisfaction item of the QLQ-SAT32, using Spearman correlation, intra-class correlation coefficients (ICC) or weighted kappa coefficients. Agreement showed excellent for the doctors' and nurses' subscales and satisfactory for the services' subscale and the general satisfaction single item. The telephone interview-administration modality did not prove an adequate procedure to assess the validity of a patient satisfaction questionnaire.

Adolescent↗
PubMed2001

Impact of reminders and method of questionnaire distribution on patient response to mail-back satisfaction survey.

Nonresponse and methods of data collection could affect satisfaction measurement. The goal of this study was to estimate the impact of (1) nonresponse and (2) distribution method on evaluation of patient satisfaction in a mail-back study measuring patient opinion of medical and nursing care. The study was conducted in an adult hospital. Patients were pseudo-randomized according to the initial mode of questionnaire distribution (given at hospital or sent by mail). Three reminders were made at 1-week intervals to nonrespondents, regardless of the method of initial questionnaire distribution. Groups were distinguished according to the delay of response: initial (before any reminder), middle (after one or two mailed reminders), and late respondents (after mailed reminders plus telephone contact). The study included consecutively discharged patients to obtain 300 patients per arm. 482 patients returned the questionnaire (248 in the group receiving the questionnaire at the hospital and 234 in the other group). Groups were compared for satisfaction scores and delay of response. Early respondents were compared with middle and late respondents for patient characteristics, modality of hospital care, and satisfaction scores. Multivariate analyses were performed. Participation rate before any reminder was higher when the questionnaire was mailed than when it was given at the hospital (45% versus 39.7%, p = 0.03). The initial method of distribution did not influence patient satisfaction level. Satisfaction did not differ between respondents with or without reminders. Distributing questionnaires by mail may be preferred to distribution at discharge to optimize response rate. Reminders do not seem necessary to estimate satisfaction of overall potential respondents.

Adult↗
PubMed2003

The metaphor of patients as customers: implications for measuring satisfaction.

The use of satisfaction surveys in health care reflects the current tendency to think metaphorically of patients as "customers." This article reflects critically on the logic underlying this metaphor because metaphors are integral to the meaning of concepts. We argue that because the metaphor works differently when considering satisfaction with the process of care and satisfaction with treatment outcome, there are theoretical reasons for assessing these concepts from different perspectives. It seems reasonable to ask patients to rate their satisfaction with the processes of care or services received (e.g., hospital food, the physical environment) in much the same way they would rate services received at a repair shop or restaurant. When evaluating satisfaction with treatment outcome, however, the customer metaphor is problematic because the body is made an object when it is conceived of as the repairable possession of a customer. We conclude that measures of satisfaction with treatment outcome should be based on the assumption that rather than having bodies, people are embodied. Hence, the validity of satisfaction with treatment outcome would be enhanced by questions about psychologic, social, and experiental aspects of treatment outcome.

Health Services Research↗
PubMed1998

Maternal satisfaction with labour analgesia.

Satisfaction with childbirth is a multidimensional issue, of which analgesia is but one component. The importance of analgesia as a contribution to overall satisfaction has been recognized increasingly in the last 50 years, but improvement in quality of available analgesia has not always resulted in commensurate improvement in satisfaction. Satisfaction by its very nature has proved to be difficult both to define and to quantify, and no reliable standards of measurement have been accepted. Pain relief in childbirth is subject to many social and cultural modifiers, which continue to change. Control of pain rather than absolute amelioration is seen by many to provide greater satisfaction. Analgesia issues still do not figure prominently in the overall satisfaction of the birthing process for the vast majority of women, despite the availability of and demand for improved methods of relief. The interpersonal relationships established between patient and healthcare providers may ultimately be of more importance in the determination of satisfaction with management.

Analgesia, Obstetrical↗
PubMed1998

Determinants of adolescents' satisfaction with health care providers and intentions to keep follow-up appointments.

OBJECTIVE: To better understand the determinants of adolescents' satisfaction with their health care providers and to examine the relationship among satisfaction, intention to return for follow-up, and appointment-keeping behavior. METHODS: One hundred and twenty-four adolescent patients attending a university-based general adolescent medicine clinic were surveyed prior to the visit about their attitudes regarding provider behavior. After the visit, subjects completed a questionnaire on provider behavior during the visit, satisfaction with the visit, and intention to keep their follow-up appointment. RESULTS: Multivariate regression analysis revealed that pre-visit attitudes about providers' style of behavior predicted satisfaction (beta = 0.252; p < 0.01). After controlling for pre-visit attitudes, perceptions about providers' style of behavior proved to be a strong predictor of visit satisfaction (beta = 0.512; p < 0.01). Visit satisfaction was associated with intention to keep scheduled follow-up appointments (r = 0.327; p < 0.01). However, subjects with greater intention to return were not more likely to keep their follow-up appointments. CONCLUSION: Provider behavior is an important determinant of adolescents' satisfaction with their health care.

Adolescent↗
PubMed2000

Using root cause analysis to address patient satisfaction and other improvement opportunities.

BACKGROUND: Despite the considerable attention that health care organizations are devoting to the measurement of patient satisfaction, there is often confusion about how to systematically use these data to improve an organization's performance. A model to use in applying traditional quality improvement methods and tools to patient satisfaction problems includes five primary steps: (1) identifying opportunities, (2) prioritizing opportunities, (3) conducting root cause analysis, (4) designing and testing potential solutions, and (5) implementing the proposed solution. PATIENT SATISFACTION SURVEYS: A satisfaction survey serves best as a high-level screening device, not as a tool to provide highly detailed information about the root causes of patient dissatisfaction. The primary purpose of the survey in the model is to identify improvement opportunities and areas of significant improvement or deterioration. Secondary tools such as brief patient interviews or focus groups may better serve to probe intensively into the problem areas identified by the survey. These tools allow for a direct dialog with the patient to uncover root causes of dissatisfaction and establish potential solutions. DISCUSSION: Although the primary focus of this model has been patient satisfaction issues, the basic steps could easily be applied to virtually any improvement opportunity. Improvement teams should commit to a schedule of 90-minute weekly meetings for 7 weeks. The model, a simple translation of traditional improvement methods and tools to address the unique issues facing patient satisfaction improvement teams, can save improvement teams considerable time, resources, and frustration as they design and launch initiatives to improve patient satisfaction.

Causality↗
PubMed2002

The problem of bias when nursing facility staff administer customer satisfaction surveys.

BACKGROUND: Customer satisfaction instruments are being used with increasing frequency to assess and monitor residents' assessments of quality of care in nursing facilities. There is no standard protocol, however, for how or by whom the instruments should be administered when anonymous, written responses are not feasible. Researchers often use outside interviewers to assess satisfaction, but cost considerations may limit the extent to which facilities are able to hire outside interviewers on a regular basis. This study was designed to investigate the existence and extent of any bias caused by staff administering customer satisfaction surveys. METHODS: Customer satisfaction data were collected in 1998 from 265 residents in 21 nursing facilities in North Dakota. Half the residents in each facility were interviewed by staff members and the other half by outside consultants; scores were compared by interviewer type. In addition to a tabulation of raw scores, ordinary least-squares analysis with facility fixed effects was used to control for resident characteristics and unmeasured facility-level factors that could influence scores. RESULTS: Significant positive bias was found when staff members interviewed residents. The bias was not limited to questions directly affecting staff responsibilities but applied across all types of issues. The bias was robust under varying constructions of satisfaction and dissatisfaction. DISCUSSION: A uniform method of survey administration appears to be important if satisfaction data are to be used to compare facilities. Bias is an important factor that should be considered and weighed against the costs of obtaining outside interviewers when assessing customer satisfaction among long term care residents.

Activities of Daily Living↗
PubMed2002

Satisfaction with treatment for chronic pain in a specialty service: preliminary prospective results.

Treatment satisfaction is an increasingly popular outcome measure in pain management. While it is a subjective variable, it may nonetheless reflect the quality of care and it may predict other important patient behaviors. The purpose of this study was to prospectively evaluate predictors of satisfaction with treatment for chronic pain. Subjects included 62 adults seeking treatment for pain at a community-based, specialty clinic. Treatment included combinations of analgesic medications (e.g., opioids, tricyclic antidepressants) and procedures performed by anesthesiologists (e.g., epidural steroid injections, facet joint blocks). Subjects completed measures of pain severity, depression, disability, and pain-related anxiety, prior to treatment and at a 6-month follow-up. Follow-up assessment also included measures of treatment satisfaction and characteristics of the patient's clinic experience and a chart review to assess medications, procedures, and number of visits. Comparison of baseline and follow-up data showed statistically significant reductions in pain (25%) and depression. Most patients were satisfied (45.6%) or extremely satisfied (43.9%) with the treatment they received (10.5% was somewhat satisfied, none were dissatisfied). Correlation analyses showed that patient demographic variables did not predict treatment satisfaction. Changes in pain, depression, and pain-related anxiety were associated with treatment satisfaction but change in pain was a relatively weak predictor. Nine of the 16 characteristics of the patient's clinic experience correlated with treatment satisfaction. Regression analyses showed that the strongest unique predictors of treatment satisfaction were the patients feeling their evaluation was complete, believing they received an explanation for clinic procedures, and finding that treatment helped them improve their daily activity.

Activities of Daily Living↗
PubMed2005

Do on-site patient satisfaction surveys bias results?

BACKGROUND: Response rates, patient sample characteristics, and patient satisfaction ratings were compared between two surveying methods: (1) surveys completed at the physician office site (on-site surveying), and (2) surveys mailed to patient homes following the encounter (mail-out/mail-back). METHODS: Surveying was completed at three physician practices within a 214-physician medical practice. Patients with physician appointments during four-hour time blocks were randomly split to receive either on-site or mail-based satisfaction surveys. RESULTS: Participants younger than 45 years of age provided much higher satisfaction ratings on site than they did by mail (p < .0001), and participants older than 45 years of age reported satisfaction levels consistently whether on site or by mail. Both age groups reported higher satisfaction with "people aspects" of care on site than they did by mail (p < .001). DISCUSSION: On-site methods may yield satisfaction results that are biased in a positive direction for younger patients and for all patients in which social desirability pressures are prominent. Therefore, organizations that rely on such information may have an inflated view of the patient's satisfaction with their care delivery experience. Secondly, because the differences in ratings are the greatest for the "people aspects" of care, if improvement efforts are prioritized on the basis of these rapid results, the wrong priorities may be set.

Adolescent↗
PubMed2003

Recollection of dreams after short general anaesthesia: influence on patient anxiety and satisfaction.

BACKGROUND AND OBJECTIVE: We ascertained whether dreams during short general anaesthesia influence subsequent patient satisfaction and anxiety. METHODS: Fifty female patients were randomized into two groups to test for a difference between intravenous and inhalational anaesthesias. In Group Propo, anaesthesia was induced and maintained with propofol; in Group Metho-Iso, anaesthesia was induced with methohexital and maintained with isoflurane. Satisfaction and anxiety with anaesthesia were evaluated using a visual analogue scale from 0 to 100. Dream incidence rate, satisfaction and anxiety were assessed from immediately after waking until 3 months later. RESULTS: Seventeen patients (34%) dreamed during anaesthesia. There were no significant differences in satisfaction or anxiety after anaesthesia between the dreaming and non-dreaming patients (satisfaction, 92.3 +/- 21.6 versus 92.1 +/- 21.6; anxiety, 21.1 +/- 21.1 versus 30.3 +/- 32.1), or between Group Propo and Group Metho-Iso (satisfaction, 94.4 +/- 19.3 versus 90.0 +/- 23.4; anxiety, 26.0 +/- 27.6 versus 28.4 +/- 30.7). There was no significant difference in the incidence rate of dreaming with the type of anaesthesia used (Group Propo, 11 patients; Group Metho-Iso, 6 patients). CONCLUSIONS: Dreaming during general anaesthesia is common but does not influence satisfaction or anxiety after anaesthesia.

Adult↗
PubMedDate not supplied

[The patient and family satisfaction with the department of mental health in Rome].

OBJECTIVE: Satisfaction's measurement with Mental Health Services in patients and their relatives. DESIGN: Satisfaction scale administration to the patients who were treated in community-based psychiatric service from 1.1.1996 to 31.3.1996 and the relatives who were primarily involved in caring for the patient. SETTING: The ASL Rome "C" community-based psychiatric service. MAIN OUTCOME MEASURES: Verona Service Satisfaction Scale-54, a multidimensional instrument which measure satisfaction with community-based psychiatric service. RESULTS: Main results (301 scales for patients, 163 scales for relatives), pointed out for patients a higher satisfaction for the technical and interpersonal skills of psychiatrists and psychologists (score of specific items > 4). Lowest scores of satisfaction were towards the appearance, comfort level and physical layout of the facility (score 2.95) and towards the response of the service to emergencies during the night, weekend and Bank Holidays (score 2.87). Relatives were not particularly keen for the item regarding help to find open employment (score 2.76). Furthermore patients and their relatives gave a negative evaluation of the publicity and information offered by Mental Health Services. Dimension's analysis reaches the same conclusions deduced items's average score. The result of this study emphasizes the patients higher degree of satisfaction than the relatives. CONCLUSIONS: The above results point out three aspects to be improved by the Mental Health Service in order to satisfy the demands of the patients and relatives: 1. appearance, comfort level and physical layout of the facility, 2. publicity and information, 3. social activities and social skills.

Community Mental Health Services↗