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PubMed2001

Validation of the HIV treatment satisfaction questionnaire (HIVTSQ).

Human immunodeficiency virus (HIV) therapies need to be both effective and acceptable. The 10-item HIV Treatment Satisfaction Questionnaire (HIVTSQ) was validated amongst 150 HIV-1 sero-positive individuals, receiving one of two protease inhibitors as part of combined therapy in an open-label randomised trial. Scale and subscale scoring was determined psychometrically. It was hypothesised that satisfaction with control would be greater amongst those with lower viral loads, satisfaction with side-effects would be inversely related to severity of adverse events and satisfaction with the new treatment would be greater than with the control treatment. Principal components analyses suggested that patient ratings of nine items can be summed to compute the total satisfaction scale (Cronbach's alpha 0.82), and/or divided into subscales: general satisfaction/clinical (alpha 0.80) and lifestyle/ease (alpha 0.74). One item (asking how demanding the treatment was) needs modification before inclusion. The HIVTSQ showed construct validity: viral load correlated negatively (Spearman's r - 0.33 p < 0.01) with satisfaction with HIV control; those with <400 copies HIV-1 RNA/ml were more satisfied with HIV control than those with higher viral loads (Mann-Whitney p < 0.01); adverse event grade correlated r - 0.18 (p < 0.05) with satisfaction with side-effects. The HIVTSQ was sensitive to differences between groups: compared with patients in the control group, those receiving the new treatment had significantly higher perceived flexibility and lifestyle/ease scores at week 8 (Mann-Whitney p < 0.01). Patient perceptions did not simply mirror clinical measures, highlighting the importance of measuring patient views.

Adult↗
PubMed2002

Patients' satisfaction with psychiatric treatment: comparison between an open and a closed ward.

The study compared patients' satisfaction with psychiatric inpatient treatment between an open and a closed ward. During a six-month period, all voluntarily participating patients on two wards of a psychiatric University hospital were investigated anonymously at admission and/or before discharge. A self-rating questionnaire (SATQ-98) was used to assess satisfaction with several domains of psychiatric inpatient treatment. In total, 135 questionnaires were received (retrieval rate 49%). The general level of satisfaction with treatment was high. General satisfaction, satisfaction with medication, ward equipment, visiting opportunities, and regulations for going out were significantly lower at discharge on the closed ward. Dissatisfaction with medication was related to low actual mood, and to low satisfaction with the frequency of psychotherapeutic interventions, visiting opportunities, and with the treating doctor. The results thus far strongly support the need for patients' satisfaction with treatment to be taken into account in order to improve psychiatric inpatient services, particularly on closed wards.

Adult↗
PubMed2001

The role of the psychiatrist: job satisfaction of medical directors and staff psychiatrists.

In a previous survey of Columbia University Public Psychiatry Fellowship alumni, medical directors reported experiencing higher job satisfaction compared to staff psychiatrists. To further this inquiry, the authors conducted an expanded survey among the membership of the American Association of Community Psychiatrists (AACP). We mailed a questionnaire to all AACP members. Respondents categorized their positions as staff psychiatrist, program medical director or agency medical director, and rated their overall job satisfaction. The form also included a number of demographic and job characteristic items. Of 479 questionnaires mailed, a total of 286 individuals returned questionnaires (61%-12 forms were undeliverable). As in our previous survey, medical directors experience significantly higher job satisfaction compared to staff psychiatrists. Program and agency medical directors do not differ significantly. In addition, job satisfaction is strongly and negatively correlated with age for staff psychiatrists but not for medical directors. This survey strengthens the previously reported advantage medical directors have over staff psychiatrists regarding job satisfaction. The finding that job satisfaction decreases with increasing age of staff psychiatrists but not medical directors is particularly interesting, suggesting that staff psychiatrist positions may come to be regarded as "dead-end" over time. Psychiatrists are advised to seek promotions to program medical director positions early in their careers, since these positions are far more available, and provide equal job satisfaction, compared to agency medical director positions.

Adult↗
PubMed1997

Correlates of increased sexual satisfaction.

Comparisons of nationally representative survey data of the population ages 18-54 years in 1971 (N = 2252) and 1992 (N = 1718) from Finland show that sexual satisfaction has greatly increased particularly among women. Some predictors of sexual satisfaction of men and women are examined on the basis of the 1992 survey data on people ages 18-74 years (N = 2250). Correlations between social background factors, sexual ideas and assertiveness, optional relationships, sexual practices, organism, and satisfaction with sexual intercourse were calculated. To control the simultaneous effect of the variables explaining satisfaction, path analyses were conducted. Results show that young age, a sexually unreserved and a nonreligious childhood home, early start of sexual life, high education, sexual assertiveness, considering sexuality important in life, reciprocal feeling of love, use of sex materials, frequent intercourse, many-sided (versatile) sexual techniques, and frequent orgasm correlate with finding sexual intercourse pleasurable. There were some gender differences in the connections between the independent factors and satisfaction with coitus. The importance of sexuality in life, love, and the use of sexual materials were connected directly to physical sexual satisfaction among men but only indirectly among women. For women, but not for men, young age and early start of sexual life correlated with enjoyment of intercourse. The greater sexual dissatisfaction of women compared to men, which still prevails, may be due to their late start of sexual life, conservative sexual attitudes, unimportance of sexuality in life, lack of sexual assertiveness, and use of restricted sexual techniques. The emancipation of women may change these ideas and practices of women. This might lessen the gender gap in physical sexual satisfaction.

Adolescent↗
PubMed2003

Validating the accuracy of the resident satisfaction measure.

Amidst its growing popularity as an outcome measure of the service quality of residential aged care, self-reported resident satisfaction is criticized as non-discriminating since most residents tend to give very high satisfaction scores. Three explanations are identified from the literature to account for the apparent positivity bias of the satisfaction measure: namely consumer factors, the service nature of residential aged care and methodological pitfalls. Drawing on a cross-sectional survey of 405 Chinese residents across 11 randomly selected publicly funded care homes in Hong Kong, this paper highlights what could be done to deal with some of the methodological artefacts. This includes the construction and use of the four-item "Residential Care Satisfaction Scale" instead of a single satisfaction item, the adoption of a vigorous sampling method such as stratified random sampling in the selection of facilities, the inclusion of residents suffering from cognitive and/or physical impairment, and the empowerment of participants. Five cultural factors are then suggested to account for the participants' high satisfaction ratings of their facilities. The paper ends with further suggestions for enhancing the validity and usefulness of the self-reported satisfaction measure.

Aged↗
PubMed2004

The role of person versus situation in life satisfaction: a critical examination.

Two main theoretical approaches have been put forward to explain individual differences in life satisfaction: top-down (i.e., personological) and bottom-up (i.e., situational). The authors examine the relative merit of these 2 approaches and the psychological processes underlying top-down models. Consistent with a top-down approach, meta-analytic findings indicate that Neuroticism, Extraversion, Agreeableness, and Conscientiousness are related to both various domain satisfactions and life satisfaction; however, consistent with a bottom-up approach, domain satisfactions are strongly linked to life satisfaction but only weakly linked to each other. Path analyses based on meta-analytic estimates did not support a simple "direct-effects" top-down model but supported both (a) a temperament-based top-down model and (b) an integrative model that incorporates the direct influence of domain satisfactions on life satisfaction.

Humans↗
PubMed2005

Perceptions of and satisfaction with retirement: a comparison of six European union countries.

The main aim of this study was to assess perceptions of and satisfaction with retirement among 1,686 recently retired people from 6 European Union countries. The authors compared their responses to a set of questions taken from the Retirement Satisfaction Inventory (F. J. Floyd et al., 1992). The first significant result was that Belgian, British, Finnish, French, and Spanish retirees all expressed very similar assessments of life satisfaction, whereas Portuguese retirees expressed a lower level of satisfaction. The 2nd result was that the major determinants of overall satisfaction in the 6 countries were (a) health and resources and (b) anticipated satisfaction. Finally, the data revealed that cultural background only accounted for a limited amount of variance in overall satisfaction with retirement.

Aged↗
PubMed2006

The clinical validity of the treatment satisfaction survey for intraocular pressure in ocular hypertensive and glaucoma patients.

PURPOSE: To provide initial validation of the Treatment Satisfaction Survey-Intraocular Pressure (TSS-IOP) quality-of-life survey that analyses specific issues related to side effects, patient satisfaction, and compliance. METHODS: A prospective, observational cohort of 250 consecutive patients with primary open-angle glaucoma or ocular hypertension was administered the TSS-IOP survey. RESULTS: Factors that correlated with patient satisfaction included perceived effectiveness of the medicine (F=7.47, P<0.001), ocular irritation (F=6.06, P<0.001), conjunctival hyperaemia (F=4.40, P<0.001), ease of use (F=8.52, P<0.001), and convenience of use (F=6.90, P<0.001). Patient compliance, acceptance of their illness, and knowledge of glaucoma were also related to perceived effectiveness of the medicine (P<0.001), ease of use (P<0.05) and convenience (P<0.001). Physician ratings of patient pressure control, side effects, and instillation problems also were significantly correlated to patient satisfaction (R=0.13-0.26, P=0.05-0.001). The physician ratings of patient compliance, however, were not significantly related to any dimension of patient satisfaction (P>0.05). Among monotherapy prostaglandin treatments, latanoprost demonstrated statistically greater satisfaction than bimatoprost or travoprost regarding conjunctival hyperaemia (P<0.05) and eye irritation (P<0.01). CONCLUSIONS: This study provides initial evidence that patient satisfaction may be related to compliance, perceived effectiveness of treatment, adverse side effects, ease and convenience of use, acceptance of illness, and knowledge of glaucoma.

Aged↗
PubMed1993

The effects of comprehensive guidelines for the care of sickle-cell patients in crisis on the nurses' knowledge base and job satisfaction for care given.

The primary purpose of this study was to determine the effects of comprehensive nursing guidelines for sickle-cell patients in crisis on the nurses' knowledge base and job satisfaction for nursing care given. This study was carried out through the use of a single-group pretest-posttest design. A total of 18 subjects participated in the study. At the pretesting, each subject completed an Individual Information Questionnaire for the collection of background data, a Knowledge Base tool and a Job Satisfaction tool. Afterwards, all subjects attended 10.5 hours of educational programmes on sickle-cell disease, treatment, interventions and relaxation training. Following this, the comprehensive guidelines for the care of sickle-cell patients were instituted. At 3 months and 6 months after the guidelines had been in effect, subjects were again asked to complete the Knowledge Base and Job Satisfaction tools. The results of the tools were then measured comparing the three time intervals for any differences in knowledge and job satisfaction using independent measure t-tests. t-Tests were also performed for each question on the Job Satisfaction tool comparing the three time intervals. The results of the analyses demonstrated that there was a statistically significant increase in knowledge between the pretest and 6 month time interval. The findings also showed that there was no statistically significant increase in overall job satisfaction. However, the t-test results from the individual questions demonstrated a statistically significant increase in job satisfaction in the areas of nurse/physician collaboration and having a broad knowledge base of sickle-cell disease.

Acute Disease↗
PubMed2001

Factors associated with expressed satisfaction among people with intellectual disability receiving residential supports.

The aim of the present study was to identify factors associated with variations in the levels of expressed satisfaction among adults with intellectual disability (ID) receiving residential supports. Semi-structured interviews were conducted with 96 people with ID. Forty-five subjects lived in village communities and 51 received community-based residential supports. Ratings were made of the participants' expressed levels of satisfaction in seven domains: (1) their home; (2) daytime activities; (3) social and recreational activities; (4) support from services; (5) friendships and relationships; (6) choices available to them; and (7) risks. The data indicated that: (1) interviewees living in village communities expressed greater satisfaction with friendships and relationships than interviewees living in community-based residential supports; (2) in the other six domains of life satisfaction which were investigated, there were no statistically significant differences between groups; (3) interviewees expressed greater satisfaction with their accommodation and day activities than with friendships, risks and support received; and (4) a wide range of variables relating to the personal characteristics of the interviewees and support received were associated with variations in levels of expressed satisfaction. Variation in the levels of expressed satisfaction was reliably associated with variables relating to the personal characteristics of the interviewees and the nature of the support received.

Adult↗
PubMed2000

Patient satisfaction and research-related problems (Part 2). Is triangulation the answer?

AIM: The article consists of two parts, the first of which examined the description of patient satisfaction by means of a questionnaire and the problems related to it. The aim of this second part is to complement the topic by explicating patient satisfaction research using a triangulative approach. BACKGROUND: Patient satisfaction has been the object of interest in health care for some time, and is now increasingly used as the basis for quality management and improvement. At the same time, the methods used have been criticised. As it was shown in the first part of this article, traditional questionnaires contain many problems which are difficult to solve in a satisfactory way, for example, by using different methods of analysis. METHODS: The data were collected from the patients of three different hospital wards using an interview (n = 30). The interview themes corresponded to the classification of a questionnaire employed at the same time. The interview material was analysed using content analysis, whereas satisfaction is investigated using a triangulative approach. FINDINGS: The findings confirm that the interview supplements the questionnaire as a data collection method, but that is also produces overlapping information. The interviews gave deeper information on the patients' experiences and feelings. Triangulative examination made it possible to show factors influencing the reliability of the study. CONCLUSIONS: The advantage of a triangulative approach seems to be that it provides a fairly accurate description of patient satisfaction. However, the problem of this method is that it doubles the amount of work needed and is slow to use which is worth considering as patient satisfaction should be followed on a regular basis and the results reported without delay. In spite of these problems, patient satisfaction surveys are important, since information provided by them is needed as basis for quality management, quality improvement and clinical supervision.

Adult↗
PubMed1999

Patient satisfaction with nursing care: a measurement conundrum.

Patient satisfaction is a major indicator of quality care. There are several theories on the types of concepts that should be measured concerning patient satisfaction with nursing care. Given the different theories of patient satisfaction, the issue of accurate measurement of this concept presents nurse researchers, clinicians and leaders with a challenge. This paper will discuss the findings of a patient satisfaction survey that was conducted in two acute care surgical wards, using the revised 28-item La Monica-Oberst patient satisfaction scale and telephone interviews. Data were analysed using descriptive statistics. Textual data were managed using NUD*IST and analysed for common emerging themes and categories. The findings of the quantitative and qualitative data were compared in order to determine similarities and differences. The survey results revealed very high levels of patient satisfaction; however, the qualitative data revealed some anomalies. Specifically, due to the numbers of nurses involved in the care, some patients had difficulties answering the questionnaire. Moreover, they were unable to discriminate nursing care from the rest of their overall patient experience. Within this study, it seemed that patients' perceptions of nurses influenced the way patients rated quality nursing care. Based on this information, the authors question the accuracy of the measurement of patient satisfaction and raise issues that need to be considered in order to further clarify the measurement of this concept.

Adult↗
PubMed2000

Determinants of patient satisfaction in a large, municipal ED: the role of demographic variables, visit characteristics, and patient perceptions.

We investigated predictors of patient satisfaction in a large, municipal emergency department (ED). Patients were telephoned 10 days postvisit, and satisfaction was assessed using a structured survey with 22 items measuring several domains, as well as the estimated length of stay. The dependent variables consisted of ratings of overall satisfaction and likelihood of recommending the ED to others. Data were obtained from 437 (38.7%) patients. Univariate statistics revealed strong relations between indicators of perceived care and both dependent variables, with weaker and mixed findings pertaining to demographics and visit characteristics. The final logistic regression predicting overall satisfaction included the following items (P < .05): degree to which staff cared for the patient as a person, perceptions of safety, understandability of discharge instructions, nurse's technical skills, and satisfaction with wait for physician. Likelihood to recommend was associated with (P < .05): degree to which staff cared for the patient as a person, understandability of discharge instructions, perceptions of safety, age, and insurance status. Patients' perceptions of care, rather than demographics and visit characteristics, most consistently predicted satisfaction. However, differences were observed between the specific predictors for overall satisfaction and likelihood to recommend, providing a possible explanation for inconsistencies observed in the literature.

Adult↗
PubMed2002

The effects of a physician-nurse patient care team on patient satisfaction in an academic ED.

The objectives were to investigate the effects of a RN/MD patient care team operational change on ED patient satisfaction. In period 1, RNs had standard room assignments and MDs evaluated patients based upon physician availability and perceived patient load. In period 2, RNs and MDs were organized into 2 patient care "teams" and patients were assigned to teams on an alternating basis. Patient satisfaction was rated using the standard ED Press, Ganey survey instrument. A total of 508 surveys were returned in period 1 and 454 in period 2. From period 1 to 2, overall ED patient satisfaction improved from 78.2 +/- 20.4% to 82.2 +/- 17.2% (improvement from 23rd to 59th percentile, P <or=.01). Patient satisfaction with waiting time to treatment area improved from the 33rd to 52nd percentile (73.6 +/- 30.0% v 77.4 +/- 27.0%, P <or=.05). Satisfaction with waiting time to see the physician also improved from the 25th to the 62nd percentile (67.6 +/- 32.2% v 73.4 +/- 28.5%, P <or=.01). Patients feelings that staff cared about them as a person improved from the 20th to the 65th percentile (77.3 +/- 28.3% v 83.0 +/- 22.4%, P <or=.01) Patients were more likely to recommend the ED following the operational change, improving from the 26th to 69th percentile (75.8 +/- 32.7% v 82.83 +/- 25.3%, P <or=.01). ED patient care using a RN/MD patient care team improved patients' overall waiting time and length of stay satisfaction and improved the patients' satisfaction with staff and their likelihood of recommending the ED to others.

Academic Medical Centers↗
PubMed2002

Patient satisfaction with care and behavioral compliance in end-stage renal disease patients treated with hemodialysis.

Compliance with the hemodialysis (HD) prescription is an important predictor of patient outcome. Although there is interest in the concept of patient satisfaction with medical care and caregivers, relatively few such data exist regarding HD patients. We examined whether associations exist between patient satisfaction with medical personnel and depressive affect and social support levels and behavioral compliance with prescribed HD treatment. Seventy-nine HD patients were interviewed, assessing depression, social support, and perception of satisfaction with dialysis staff. Medical and treatment data, Karnofsky functioning and severity of illness scores, and behavioral and laboratory compliance measures were determined. There was no association between patient satisfaction with care and level of depressive affect. A relationship was found between patient satisfaction with care with their nephrologist and attendance at dialysis sessions. Patients who had a poor perception of satisfaction with their nephrologist had poorer attendance at dialysis sessions. There was no relationship between behavioral compliance and patient perception of ancillary HD staff. In addition, patient perception of satisfaction with staff was related to perception of social support, protein catabolic rate, and serum albumin concentration, all of which have been linked to survival. We conclude that a nephrologist has a crucial role in patient compliance. These results suggest interventions that improve patient perception of physician support may improve patient adjustment and possibly survival.

Adult↗
PubMed2003

Satisfaction with care in vascular surgery inpatient units.

OBJECTIVE: to identify and solve problems concerning satisfaction of inpatients in three different vascular surgery units. MATERIALS AND METHODS: a self-administered non anonymous questionnaire was submitted. Four dimensions of patients' satisfaction and a measure of overall satisfaction were evaluated. For each of them a logistic regression model was elaborated. RESULTS: one hundred and fifty-six eligible patients agreed to participate. For the "overall satisfaction" 56% rated the care received as excellent; patients completely satisfied for "treatment and related information" were 76%; for the "availability of staff" 96%, for "helpfulness and communication by staff" 56% and for "management of patient's complaint by medical staff" 86%. Logistic regression analysis showed, after adjustment for relevant background factors, a statistically significant difference among units of care for the overall satisfaction. CONCLUSIONS: the study highlighted the importance of considering in vascular units the patients' satisfaction as an essential component of quality of care independently of the severity of cases. The hospital management recognised the low level of communication by the staff as one of the hospital bottle-necks and tried to solve a logistic problem identified as responsible for a low score in the overall satisfaction in one unit.

Adolescent↗
PubMed2000

Functional impairment, depression, and life satisfaction among older hemodialysis patients and age-matched controls: a prospective study.

OBJECTIVE: To compare change over time in functional impairment, depression, and life satisfaction among older dialysis patients and age-matched controls. DESIGN: Prospective cohort study over 3 years. SETTING: Urban and rural communities throughout Georgia. SUBJECTS: One hundred thirteen prevalent renal failure patients on in-center hemodialysis and 286 controls. MAIN OUTCOME MEASURES: Ordinal functional impairment index and life satisfaction rating, and Center for Epidemiologic Studies Depression Scale. RESULTS: Dialysis patients, compared with controls, reported significantly more functional impairment at baseline, and also at follow-up after adjusting for baseline impairment and covariates. Dialysis patients had higher depression scores at baseline, and also at follow-up after adjusting for baseline depression and covariates. In contrast, dialysis patients reported lower life satisfaction at baseline than did controls, but the two cohorts were not significantly different on reported life satisfaction at follow-up, after adjusting for baseline life satisfaction and race. In both cohorts, functional impairment and depression were significantly related. CONCLUSION: Older dialysis patients' life satisfaction at a 3-year follow-up, which was similar to life satisfaction among age-matched controls, indicates the value of delivered dialysis care; the value of this care would be increased by reducing excess functional impairment in these patients.

Aged↗
PubMed2001

Antenatal, delivery and postnatal comparisons of maternal satisfaction with two pilot Changing Childbirth schemes compared with a traditional model of care.

OBJECTIVE: to investigate maternal satisfaction with two pilot schemes based on the Changing Childbirth initiative (DoH 1993) and to compare this with a traditional model of care. In addition, a limited number of clinical outcome measures were also assessed. DESIGN: a retrospective between-group design was used. Questionnaire data were collected from three groups (two pilot and one control) about the antenatal, labour and postnatal periods to establish both satisfaction with key objectives of the Changing Childbirth initiative (DoH 1993), and basic clinical outcomes. SETTING: a large Trust (see definition in main article) in Central England, that covered a wide range of socio-economic strata. PARTICIPANTS: the two pilot groups comprised 112 and 103 women respectively and were randomly drawn from GP practices within the Trust's catchment area. The third group of 118 women (Control) was selected from the Trust's obstetric unit. Women at high obstetric risk were excluded from this study. MEASUREMENT: a five-part questionnaire was devised that covered: (1) preferences for type of care, health-care professional, venue etc; (2) details of antenatal care provision and the participants' satisfaction with this; (3) labour, including clinical outcomes, labour and birth details and satisfaction with care; (4) postnatal care information, including satisfaction scores; and (5) information and advice given throughout the ante, delivery and postnatal periods and satisfaction with this. The questionnaires were administered six weeks postnatally. FINDINGS: although the two pilot groups had been set up to follow a one-to-one midwifery care model, the second group naturally evolved into providing care from within a small group of midwives. This variation did not lead to any differences in any of the outcome measures. The women in the obstetrician-led group were not dissatisfied with the care, information and treatment they received, but they were significantly less satisfied than either of the two pilot groups. The pilot groups also rated more highly the information and choice that they had, and felt that the midwives acted as partners in the process. These findings applied to the antenatal, delivery and postnatal periods. No differences in clinical outcomes were observed between the groups. CONCLUSIONS: midwifery-led care was much preferred to obstetrician-led care and did not lead to any deficits in clinical outcomes. The pilot scheme that adapted the initiative into small-group provision showed no reduction in satisfaction levels or other outcome measures. Since burn-out and stress have been identified as features of one-to-one midwifery provision, this model might have potential for offsetting this problem, while still maintaining the spirit of the Changing Childbirth policy. From the perspective of maternal well-being, both physical and psychological, the initiative reported here appears to have been highly successful.

Adult↗