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PubMed1996

Relationship between hospital pharmacists' job satisfaction and involvement in clinical activities.

Job satisfaction among hospital pharmacists employed by a national hospital pharmacy management company was measured by using a mail questionnaire. A previously validated survey that measured pharmacists' job satisfaction was adapted for use in this study. Additional questions determined the pharmacist's clinical pharmacy training and participation in clinical pharmacy services. Questionnaires were mailed to all full-time hospital pharmacists employed by the pharmacy management company. Of the 606 mailed, deliverable questionnaires, 354 usable responses were returned, for a response rate of 58.4%. The respondent hospital pharmacists' level of job satisfaction showed a positive association with clinical pharmacy involvement. Of the nine items in the questionnaire that measured the pharmacists' involvement in clinical pharmacy services, seven items showed a positive relationship between involvement in that clinical activity and job satisfaction. Mean job satisfaction increased as the percentage of time spent performing clinical pharmacy activities increased. Job satisfaction decreased as time spent performing distributive functions increased. The percentage of time hospital pharmacists were engaged in clinical activities was significantly associated with job satisfaction.

Adult↗
PubMed2004

Influence of working conditions on job satisfaction in anaesthetists.

BACKGROUND: We studied job satisfaction, physical health, emotional well-being and working conditions in 125 Austrian and Swiss anaesthetists. METHODS: Responses to self-reporting questionnaires were evaluated. Dependent variables included job satisfaction, emotional well-being and physical health. Independent variables included age, sex, marital status, position and working conditions as assessed by the Instrument for Stress-related Job Analysis. RESULTS: Control over work shows a strong effect on job satisfaction in anaesthetists, for example influence on handling tasks (P=0.001), time control (P=0.002) and participation (P=0.001), whereas task demands and task-related problems did not have any effect. Anaesthetists in leading positions and specialists reported lower job satisfaction (P=0.012) than did anaesthetists in non-leading positions. Job satisfaction was associated with better physical health (P=0.001) and better emotional well-being (P=0.005). CONCLUSIONS: Our results suggest that a high level of job satisfaction in anaesthetists correlates with interesting work demands and the opportunity to contribute skills and ideas. To improve job satisfaction, more attention should be paid to improving working conditions, including control over decision-making, and allowing anaesthetists to have more influence on their own work pace and work schedule.

Adult↗
PubMed2002

The 'Medical Interview Satisfaction Scale' (MISS-21) adapted for British general practice.

BACKGROUND: The 29-item 'Medical Interview Satisfaction Scale' (MISS-29) was developed in the USA to assess patient satisfaction with individual doctor-patient consultations. It has been used in studies from British general practice. However, there is limited evidence for its psychometric properties in this population. OBJECTIVES: The present study was designed to examine the validity, reliability and applicability of the MISS-29 in British general practice populations. METHODS: The study was divided into two phases. The first investigated the properties of the MISS-29 in a UK general practice population and resulted in a modified MISS (MISS-21). The second investigated the properties of the MISS-21 in a wider UK general practice population. In phase 1, 150 patients over 16 years were recruited sequentially from patients attending a large group practice in suburban north London. Patients completed a questionnaire which collected demographic data and the MISS-29. In phase 2, 159 patients with a new problem were recruited from patients over 16 years consulting 18 GPs in north London, Essex and Suffolk. Patients completed a questionnaire while waiting to see the doctor; this collected demographic data and included six separate items, designed by the author, intended to measure patient satisfaction with previous consultations with the doctor. The patients completed the MISS-21 when they left the doctor's consulting room. RESULTS: The response rates for the phase 1 and phase 2 studies were 76.9 and 72.6%, respectively. Factor analysis, using principal component analysis with a varimax rotation, of the data collected in phase 1 resulted in a 21-item scale with the same four subscales as the original MISS-29. Correlations between subscales range from 0.46 to 0.65. Values of Cronbach's alpha between 0.67 and 0.92 suggest that the subscales are internally consistent under the conditions of the study. In phase 2, 92.1% completed all the items in the MISS-21 and there were no significant relationships between patients' demographic variables and the proportion of completed MISS-21 questionnaires, nor were there any differences in the proportion of completed MISS-21 questionnaires between type of practice or between practices serving different geographic populations, suggesting that the items were acceptable to patients. There were highly significant positive correlations (0.21-0.63) between scores on the MISS-21 and all aspects of satisfaction with previous consultations, providing supportive evidence for the construct validity of the MISS-21. CONCLUSION: This study has demonstrated that the use in British general practice of the 29-item MISS developed in the USA should be treated with caution. However, a new 21-item version with the same four subscales as the 29-item MISS was developed which has satisfactory internal reliability. The correlations between subscales suggest that they represent fairly discrete but overlapping aspects of satisfaction. Evidence is produced suggesting that patients have less difficulty completing the MISS-21 and that it is applicable for assessing satisfaction with the consultation in different practice types and populations in the UK. Limited data supporting the construct validity of the MISS-21 are presented. While this study does not provide a full assessment of the MISS-21, we believe it provides evidence for its psychometric properties, which suggests that it is a valid and reliable instrument for the assessment of patient satisfaction with individual consultations in British general practice.

Adult↗
PubMed2003

The relationship between primary care physicians' adherence to guidelines for the treatment of diabetes and patient satisfaction: findings from a pilot study.

BACKGROUND: Adherence to clinical guidelines improves health care outcomes, reduces expenditure and prevents the complication of unnecessary interventions. It is uncertain what effect the adherence to guidelines for treating diabetes has on patient satisfaction. Some authors have reported that the use of guidelines does not affect patient satisfaction with care, and have concluded that satisfaction is related to a physician's interpersonal skills, rather than to the quality of care. Others have reported that structured intervention programmes improve patient satisfaction with care. OBJECTIVE: The purpose of our study was to explore the association between adherence to clinical guidelines and satisfaction with care among diabetics. METHODS: The study population included 135 randomly sampled diabetes patients listed with 12 primary care physicians at two health plans in Israel, which together insure >80% of the population. Telephone interviews were conducted with the patients between August and November 2000, using structured questionnaires. Patients were asked to report on the extent to which their primary care physician treated them as indicated by the clinical guidelines of these health plans. They were also asked to rate their satisfaction with their primary care physician and the treatment of their disease. Bi-variate analysis was conducted using the chi-square statistical significance test. Multivariate analysis was conducted using logistic regression models. RESULTS: Adherence to guidelines for diabetes was associated with patient satisfaction with care, independently of the patient's ethnicity (first language), age, gender, education, medication (insulin versus other) and health plan affiliation. CONCLUSION: Patients who report being treated as recommended in practice guidelines were more likely to be satisfied with their care. This finding may encourage primary care physicians to adhere to clinical practice guidelines.

Adult↗
PubMed2003

Regular visitors are not good substitutes for assessment of elderly patient satisfaction with nursing home care and services.

BACKGROUND: Due to physical and psychological impairments, elderly patients residing in homes are often unable to participate in studies on satisfaction with care services. While their regular visitors provide interesting information, patient-visitor response concordance requires study. Our objective was to measure patient-visitor agreement on quality of care and accommodation. METHODS: A survey was conducted on elderly people in 13 nursing homes and their visitors. The 125 patient-visitor pairs completed the same Nursing Home Satisfaction Questionnaire (NHSQ) independently, for which reliability and internal validity have previously been explored. Satisfaction scores for room comfort, meal provision, information, and medical/nursing care were calculated. To estimate patient-visitor concordance, intraclass coefficients, a bias index, and Pearson's correlation coefficients were calculated. RESULTS: Patient satisfaction scores ranged from 57.8 (information) to 78.6 (room comfort), and visitor satisfaction from 67.9 (meal provision) to 85.9 (medical/nursing care). Mean visitor scores were higher for all scales, with a small-to-moderate index bias statistically significant for medical/nursing care (p <.001), information (p <.001), and meal provision (p =.006). Intraclass correlation coefficients were low for room comfort, information, and medical/nursing care scales (0.08 to 0.18), and nearly acceptable for the meal provision scale (0.46). CONCLUSIONS: Visitors were not able to provide information on elderly patients' satisfaction with nursing home. Their assessments were milder than patient assessments. The NHSQ is reliable for use in either population, but patient and visitor assessments should not be merged in satisfaction studies.

Access to Information↗
PubMed2006

Satisfaction with present life predicts survival in octogenarians.

We examined the effect of life satisfaction on survival over 10 years among 80-year-old and older same-sex twins of whom 320 individuals responded to the Life Satisfaction Index Z questionnaire in connection with the OCTO-Twin study. We treated participants as individuals in semiparametric Cox regression mixed-effects models (frailty) by adjusting the similarity of mortality risk within twin pairs by modeling it as a random variable. An exploratory factor analysis yielded three factors: Zest and Mood represented satisfaction with present life and Congruence represented satisfaction with past life. Those in the lowest quartile of factors of satisfaction with present life had an almost twofold risk for mortality compared with those in the highest quartile, even after adjustment for multiple confounders. Satisfaction with past life satisfaction showed no association with mortality.

Aged, 80 and over↗
PubMed1976

Psychological and social correlates of life satisfaction as a function of residential constraint.

Two questions were addressed in the present study: Do residential setting of varying levels of constraint influence life satisfaction? Do such settings involve different correlates of life satisfaction? A total of 129 male and female ambulatory residents were surveyed in settings of high and low constraint on the following measures: life, satisfaction, developmental task resolution, self-acceptance, perceived autonomy, activity level, health and educational level. Stepwise regression, covariance, and t-test analyses indicated: (1) life satisfaction and developmental task accomplishment were greater in the lower constraining setting; (2) the selected correlates resulted in multiple correlations of .675 and .590 with satisfaction; (3) differing sets of correlates significantly predicted satisfaction in each setting; health the most important in the high constraining setting and perceived autonomy and self-concept important to the low constraining setting; (4) developmental task success significantly predicted satisfaction in both settings.

Activities of Daily Living↗
PubMed1976

Satisfaction with life among persons sixty-five years and older. A causal model.

A fully recursive path model heuristically depicting a causative chain between financial situation, health satisfaction, satisfaction with standard of living, satisfaction with family life, and satisfaction with life as a whole was examined. The model was evaluated via path analysis, with parallel analyses conducted for each sex. The data used in this analysis were collected from a national probability sample of persons aged 18 and over living in noninstitutional dwelling units. This present study includes only those persons 65 years and older (N = 301). The model was shown to be an effective predictor of satisfaction with life for each sex. Satisfaction with family was found to make the greatest single impact on life satisfaction. Moreover, the model was determined to be generally consistent throughout.

Aged↗
PubMed1981

The effects of intra-individual and inter-spouse status inconsistency on life satisfaction among older persons.

Inter-spouse status inconsistencies have been largely ignored in gerontological literature related to life satisfaction. To test a series of hypotheses linking intra- and inter-spouse status inconsistency with life satisfaction, a sample of 570 married persons over 60 years of age, drawn from the 1975 to 1978 NORC General Social Surveys data, is evaluated by regressing the measures of life satisfaction on the independent variables in hierarchical fashion. The major findings include: (a) similar to past studies, higher status in general is associated with greater life satisfaction, but not all status factors correlated with life satisfaction; (b) differences between life satisfaction scores of those with high status inconsistencies and those with low inconsistencies are noted; however these differences are not statistically significant; (c) different status factors correlate with life satisfaction depending on the older person's involvement in organizations; and, (d) the negative effects of status inconsistency are not stronger among those older persons experiencing recent traumatic events.

Aged↗
PubMed1991

Stressful events and life satisfaction among elderly men and women.

The purpose of this study was to examine the interrelationships among stressful events, domain-specific assessments of life satisfaction, and global evaluations of life satisfaction. This research was guided by two competing theoretical formulations. According to bottom-up theory, older adults first assess feelings of satisfaction within specific life domains that are based in part on the experiences (i.e., stressors) they encounter in these areas. The domain-specific views are subsequently synthesized to form an overall sense of satisfaction with life as a whole. In contrast, the top-down theory suggests that a person's ongoing sense of satisfaction with life as a whole predisposes him or her to assess satisfaction with specific domains in ways that are congruent with his or her initial sense of global life satisfaction. Analysis of data provided by older participants in a nationwide survey tends to support the bottom-up perspective.

Aged↗
PubMed1994

Components of job satisfaction in psychiatric social workers.

A survey of 188 psychiatric social workers indicated an overall positive level of job satisfaction. Overall job satisfaction was found to be primarily determined by position satisfaction. The major correlate of position satisfaction was the professional respect received from other disciplines and not the specific tasks performed. These findings were interpreted as reflecting the obfuscating effect of hospital team interactions on job satisfaction. In these settings, the social workers were often so dependent on the quality of these team interactions to derive the variety, autonomy, and value in their work that it was difficult for them to keep subjectively clear the actual level of satisfaction with the work itself. Social work supervisors need to focus on developing a stronger sense of practice excellence and forging a subjective separation between task-derived achievement and interpersonal enjoyment. Results also showed the importance of educational and professional development opportunities in maintaining overall job satisfaction.

Adult↗
PubMed2004

Medical versus surgical abortion: comparing satisfaction and potential confounders in a partly randomized study.

BACKGROUND: The aim of the study was to compare satisfaction with medical and surgical abortion and to identify potential confounders affecting satisfaction. METHODS: 1033 women with gestational age (GA) < or = 63 days had either a medical (600 mg mifepristone followed by 1 mg gemeprost) or a surgical abortion (vacuum aspiration in general anaesthesia). The procedure was determined either by randomization (n = 111) or by choice (n = 922). Data on satisfaction, side effects and expectations were collected from questionnaires 2 and 8 weeks after termination. RESULTS: More women were very satisfied or satisfied after a surgical than a medical abortion both after choosing method (92% vs 82%, P < 0.0001), and after randomization (94% vs 68%, P < 0.001). Satisfaction was higher after choosing a medical procedure than after randomization to the same procedure; 82% and 68%, respectively, P < 0.05. Satisfaction with the medical procedure was inversely correlated with GA and the intensity of pain, nausea, vomiting and dizziness, while satisfaction with the surgical procedure was unaffected by these side effects. Fewer women with a failed medical than a failed surgical abortion were satisfied (17% vs 62%), P < 0.05. CONCLUSIONS: Satisfaction with both medical and surgical abortions is high, although higher with the surgical than the medical procedure, and higher after choosing method than after randomization.

Abortifacient Agents, Nonsteroidal↗
PubMed1999

The relationship between health status, social support and satisfaction with medical care among patients with systemic lupus erythematosus.

OBJECTIVE: To examine the effect of physical and mental health status and social support on patient satisfaction with health care in patients with systemic lupus erythematosus (SLE). STUDY DESIGN: Using a cross-sectional design, 220 SLE patients were recruited from rheumatology departments in two hospitals in the Montreal (Canada) area. Data comprised physician-rated indices of health status and patient-completed questionnaires. MEASURES: Independent variables included demographics, disease duration, physician-rated indices of disease activity (SLAM-R) and disease damage (SLICC/ACR), patient self-reported health status (SF-36), and perceived social support (ISEL). Patient satisfaction with medical care (PSQ-IV) was the dependent variable. ANALYSES: Univariate analyses were performed to describe the sample and examine univariate associations between the independent variables and patient satisfaction with medical care. A hierarchical multiple linear regression analysis was computed to determine the relative importance of physician-rated indices of health status, self-reported physical and mental health status and social support on patient satisfaction after controlling for demographic variables. RESULTS: A multivariate hierarchical regression computed to predict patient satisfaction included the following variables in the equation: age, education, income (step 1), disease duration, SLAM-R, SLICC/ACR (step 2), mental and physical health status (step 3), and perceived social support (step 4). Less education (P< 0.01), better self-reported mental (P< 0.05) and physical health status (P< 0.005) and higher perceived social support (P< 0.005) were significant predictors of patient satisfaction (R2 = 0.15, P< 0.0001). CONCLUSION: The findings suggest that self-reported physical and mental health status and social support are more important than clinical status variables in understanding patient satisfaction with medical care.

Adult↗
PubMed1994

Patient satisfaction with nursing care, evaluation before and after cutback in expenditure and intervention at a surgical clinic.

After a major cutback in the budget and staffing of a surgical clinic in southern Sweden there was intervention to improve the quality of nursing care and to evaluate the outcome. The intervention consisted of the implementation of: (1) nursing care organized in such a way that it would secure continuity of the nurse-patient relationship, (2) individually planned care by means of diagnostic reasoning, and (3) quality assurance for aspects believed to be connected with quality of care. Patient satisfaction before and after the intervention was assessed by means of a patient questionnaire survey (May 1991; n = 105 and May 1992; n = 137). Patient satisfaction improved significantly in variables related to nursing care viz. overall satisfaction and satisfaction with information and decision making; satisfaction with contact and staff-patient relationship; ward facilities and physical treatment or examinations; and satisfaction with physical nursing care. The results were interpreted to mean that the intervention may have counteracted any negative impact the reduced budget might have had such as the higher patient turn-over and the shorter in-patient periods, and thus seemed to have improved the quality of the nursing care in terms of patient satisfaction.

Continuity of Patient Care↗
PubMed1996

The relationship between meeting patients' information needs and their satisfaction with hospital care and general health status outcomes.

OBJECTIVE: The objective of this study was to determine if there is an association between meeting patients' information needs and their overall satisfaction with care and their general health status outcomes. STUDY DESIGN: This non-experimental study used data from hospital medical records as well as patient-completed surveys conducted two and eight weeks post discharge. The setting involved three community hospitals in the southeastern section of the US that provided care to a series of 167 acute myocardial infarction (Acute MI) patients. MEASURES: The independent variable was an index measuring how well patients' information needs were met. The dependent variables were patient satisfaction (ratings of satisfaction with care process, global satisfaction, and health benefit) and general health status outcomes (physical function, psychosocial function and quality of life). Covariates used as control variables to hold patient characteristics constant, included demographics (age, gender) and clinical measures of acute MI severity, comorbidity, angina (at eight weeks), and dyspnea (at eight weeks). ANALYSIS: Univariate analyses were employed to: (1) describe patients' characteristics; (2) determine the relative importance of meeting different types of information needs; and (3) identify information need areas most likely not to be met. Multivariate linear regression and logistic regression was used to evaluate the association between patients' ratings of meeting information needs with satisfaction and health outcomes, respectively, after controlling for covariates. RESULTS: The multivariate regression results show that meeting information needs are positively and significantly associated with both patient satisfaction measures (i.e., Ratings of Care Processes, p < 0.01; Global Satisfaction, p < 0.05, Perceived Health Benefit, p < 0.01) and one general health status measure (i.e. Quality of Life, p < 0.01). CONCLUSION: The results suggest that providers of care should ensure that they meet the information needs of patients with specific conditions because patients' perceptions of both quality of care and quality of life are associated with the clinicians' ability to transfer key information to their patients.

Aged↗
PubMed2004

The progress of reforms: job satisfaction in a typical hospital in Estonia.

OBJECTIVE: To evaluate the level of job satisfaction among the staff at an Estonian hospital and to describe factors related to their job satisfaction. DESIGN: Questionnaire survey. SETTING: Pärnu County Hospital in Estonia. STUDY PARTICIPANTS: All staff members of the Pärnu County Hospital (n = 673), except 56 staff members who were away from work during the study. RESULTS: Respondents (n = 473) indicated an average job satisfaction level of 3.86 +/- 0.81 on a 5-point scale. The efficiency of hospital management as measured by planning, relationships with supervisors, knowledge and communication regarding hospital goals, plans, quality of services, budgetary situation, and staffing problems was positively correlated with job satisfaction. Stress and unrealistic expectations were negatively correlated with job satisfaction. The feeling of being part of the organization was also correlated with job satisfaction. Recognition from supervisors and discussions with colleagues were found to be weakly correlated with job satisfaction. There were differences between occupational categories. CONCLUSION: The management of Pärnu County Hospital has been able to create good supervisory relationships with staff by providing sufficient information about the goals of the hospital, the quality of services, the budgetary situation, and staffing problems that arise. Stress levels reported are not excessive and staff are loyal to their hospital.

Estonia↗
PubMed2006

Is personality a determinant of patient satisfaction with hospital care?

OBJECTIVE: We investigated to what extent personality is associated with patient satisfaction with hospital care. A sizeable association with personality would render patient satisfaction invalid as an indicator of hospital care quality. DESIGN: Overall satisfaction and satisfaction with aspects of care were regressed on the Big Five dimensions of personality, controlled for patient characteristics as possible explanatory variables of observed associations. PARTICIPANTS: A total of 237 recently discharged inpatients aged 18-84 years (M = 50, SD = 17 years), 57% female, who were hospitalized for an average of 8 days. INSTRUMENTS: The Satisfaction with Hospital Care Questionnaire addressing 12 aspects of care ranging from admission procedures to discharge and aftercare and the Five-Factor Personality Inventory assessing a person's standing on Extraversion, Agreeableness, Conscientiousness, Emotional stability, and Autonomy. RESULTS: Agreeableness significantly predicted patient satisfaction in about half of the scales. After controlling for shared variance with age and educational level, the unique contribution of Agreeableness shrank to a maximum of 3-5% explained variance. When one outlier was dropped from the analysis, the contribution of Agreeableness was no longer statistically significant. CONCLUSION: Patient satisfaction seems only marginally associated with personality, at least at the level of the broad Big Five dimensions.

Academic Medical Centers↗
PubMed2003

Reliability and validity of instruments measuring job satisfaction--a systematic review.

BACKGROUND: Although job satisfaction research has been carried out for decades, no recent overview of job satisfaction instruments and their quality is available. Aim The aim of this systematic review is to select job satisfaction instruments of adequate reliability and validity for use as evaluative tools in hospital environments. METHODS: Systematic literature searches were performed in the Medline and PsycInfo databases. First, the construct of job satisfaction was operationalized by generating work factors from both theoretical studies and meta-analyses or reviews of empirical studies on job satisfaction. Secondly, emphasis was placed on the internal consistency, construct validity and responsiveness of these instruments.Twenty-nine job satisfaction instruments were retrieved in total. RESULTS: Seven instruments met the defined reliability and validity criteria. Of the seven, the 'Measure of Job Satisfaction' had an adequate content validity. Only the 'Job in General Scale' provided data about 'responsiveness' to change. CONCLUSION: Few instruments have shown both high reliability and high validity, but little is known about their evaluative potential.

Humans↗