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PubMed2005

Quality of life, quality of care, and patient satisfaction: perceptions of patients undergoing outpatient autologous stem cell transplantation.

PURPOSE/OBJECTIVES: To further expand the limited body of knowledge of the perceptions of quality of life (QOL), quality of care, and patient satisfaction among patients who receive high-dose chemotherapy with an autologous stem cell transplant (ASCT) on an outpatient basis. DESIGN: Descriptive longitudinal. SETTING: Nine clinical sites associated with a national oncology practice management network in locations across the United States. SAMPLE: 36 patients scheduled to receive high-dose chemotherapy with ASCT selected by nonprobability consecutive sampling. METHODS: Subjects completed the Functional Assessment of Cancer Therapy Bone Marrow Transplant (FACT-BMT) before high-dose chemotherapy, four to six weeks postchemotherapy, and six months postchemotherapy. An independent nurse researcher conducted telephone interviews about the treatment experience, perceptions of quality of care, and satisfaction with care. FACT-BMT data were analyzed using descriptive statistics and multivariate analysis of variance, and qualitative data about perceptions of care were analyzed using Giorgis methodologic reduction. Bivariate associations were made between overall degree of satisfaction with care and QOL as measured by the FACT-BMT. MAIN RESEARCH VARIABLES: Clinical outcome, QOL, patient satisfaction, and patient perceptions of care quality. FINDINGS: Mean FACT-BMT scores were lower one month post-treatment than at baseline and highest six months post-treatment. Subjects with progressive disease reported lower QOL at one and six months post-treatment, noted more complaints, and ranked their satisfaction with care lower than subjects with no evidence of disease. Subjects offered ASCT program improvement recommendations in the areas of communication, information, nursing care, ancillary needs assistance, ancillary agencies, and survivor support. CONCLUSIONS: In this study, the QOL of patients undergoing outpatient high-dose chemotherapy with ASCT decreased post-treatment but increased to levels higher than those found at pretreatment by six months. A good clinical outcome following high-dose chemotherapy and ASCT was associated with higher QOL and greater satisfaction with care. IMPLICATIONS FOR NURSING: Knowledge of the outpatient ASCT experience and its effect on QOL can be used to further refine the content and timing of educational and supportive interventions for patients undergoing ASCT. Information about patients satisfaction with treatment and perceptions of quality of care provides insight about their expectations and perceived needs and can be used to redesign outpatient ASCT programs.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2006

Comparison of resident and faculty patient satisfaction surveys in a pediatric ambulatory clinic.

BACKGROUND: Patient satisfaction is an important component of quality of care. To date, no studies have looked at differences in faculty and resident patient satisfaction in a pediatric practice. PURPOSE: The purpose was to compare physician measures of patient satisfaction among residents in training and faculty attendings. METHODS: We conducted satisfaction surveys containing 4 questions related to physician performance at a children's health clinic. We compared satisfaction scores across training levels of physicians. RESULTS: We analyzed 676 surveys. The 2nd-year and 3rd/4th-year residents had similar high scores on all questions compared to faculty preceptors. The 1st-year residents scored significantly lower than faculty preceptors, 3rd/4th-year residents, and 2nd-year residents on 1 question and the combined average of the 3 physician-specific questions. CONCLUSIONS: The 1st-year residents scored lower on patient satisfaction than physicians at higher levels of training. The 2nd-year and 3rd/4th-year residents achieved high satisfaction scores in a primary care clinic, comparable to scores of experienced practitioners.

Ambulatory Care↗
PubMed2005

What determines patient satisfaction with cataract care under topical local anesthesia and monitored sedation in a community hospital setting?

The Iowa Satisfaction with Anesthesia Scale (ISAS) is a reliable and valid tool to measure patient satisfaction with monitored anesthesia care. We used the ISAS to discover determinants of patient satisfaction with cataract care under topical local anesthesia and monitored sedation in a small community hospital. The ISAS (scored 1 to 6) was administered to 306 patients immediately after cataract surgery. All patients received topical local anesthesia and IV sedation administered by an anesthesiologist. Patient satisfaction was high: mean ISAS was 5.6 (sd 0.46; range: 3.3-6.0). The incidence of intraoperative and postoperative pain was 13% and 37%; other adverse events were infrequent (<5%). In multivariable logistic regression, significant predictors of satisfaction were postoperative pain (odds ratio [OR]: 4.84; 99% confidence interval [CI]: 2.21, 10.60), surgeon (OR: 0.21; 99% CI: 0.05, 0.91), and preoperative anxiety (OR: 1.17; 99% CI: 1.03, 1.34). ISAS mean scores (OR = 0.28; 99% CI: 0.13, 0.59) and preoperative anxiety (OR = 1.12; 99% CI: 0.99, 1.28) emerged as significant predictors of low rating of quality of experience. Our results indicate that the ISAS can be used to track patient satisfaction with monitored cataract care. Pain during and after cataract surgery is common and is a major reason for lower patient satisfaction with their cataract care.

Aged↗
PubMed2005

Patient reports of satisfaction after microvascular decompression and partial sensory rhizotomy for trigeminal neuralgia.

OBJECTIVE: There are no reports of patient satisfaction surveys after either a microvascular decompression (MVD) or a partial sensory rhizotomy (PSR) for trigeminal neuralgia. This study compares patient satisfaction after these two types of posterior fossa surgery for trigeminal neuralgia, because it is postulated that recurrences, complications, and previous surgical experience reduce satisfaction. METHODS: All patients who had undergone their first posterior fossa surgery at one center were sent a self-complete questionnaire by an independent physician. Among the 44 questions on four standardized questionnaires were 5 questions that related to patient satisfaction and experience of obtaining care. Patients were divided into those having their first surgical procedure (primary) and those who had had previous ablative surgery (nonprimary). RESULTS: Response rates were 90% (220 of 245) of MVD and 88% (53 of 60) of PSR patients. Groups were comparable with respect to age, sex, duration of symptoms, mean duration of follow-up, and recurrence rates. Overall satisfaction with their current situation was 89% in MVD and 72% in PSR patients. Unsatisfied with the outcome were 4% of MVD and 20% of PSR patients, and this is a significant difference (P < 0.01). Satisfaction with outcome was higher in those undergoing this as a primary procedure. In the primary group, satisfaction was dependent on recurrence and complication/side effects status (each P < 0.01), but this was not the case in the nonprimary group. Patients expressed a desire for earlier posterior fossa surgery in 73% of MVD and 58% of PSR patients, and this was highest in the primary group. The final outcome was considered to be better than expected in 80% of MVD and 54% of PSR patients, but 22% of the PSR group (P < 0.01) thought they were worse off. CONCLUSION: Patients undergoing posterior fossa surgery as a primary procedure are most satisfied and PSR patients are least satisfied, partly because of a higher rate of side effects.

Decompression, Surgical↗
PubMed2001

Investigation of patients' demand for community pharmacies: relationship between pharmacy services and patient satisfaction.

We performed an investigation on the patients' demand for community pharmacy based on the analysis of questionnaire responses on community pharmacy services from the patients at 32 pharmacies in Tokyo and Osaka. In the previous study, we developed seven evaluation indices for pharmacy services, and showed that the functions most sought by patients in the "ideal pharmacies" were "Attitude of pharmacy/pharmacist", "Convenient hours" and "Information management". The objective of this study is to determine the relationship between these pharmacy functions and patient satisfaction by analyzing responses from the same questionnaire survey. Overall satisfaction score with the "pharmacy used today" was employed as the dependent variable, while the six factors derived from the 26-item evaluation scale in the questionnaire by factor analysis were used as the independent variables. As a result of analysis, it was found that four variables had a significant positive correlation with patient satisfaction, one had a significant inverse correlation, and one showed no significant correlation (p < 0.05). These results suggest that: attitude of the pharmacists such as general attitude and specialized activities of pharmacy/pharmacist such as providing information and explanations, and convenience of hours are not only judged to be important by patients, but also influence their satisfaction; comfortable facilities and availability of OTC drugs, while rated relatively low by patients in terms of importance, do influence their satisfaction; and convenience of location does not influence patient satisfaction. It was also indicated that insufficient inventories of prescribed medications have an impact upon patient satisfaction. This investigation offers evidence to provide patient-based pharmacy services.

Adult↗
PubMed2003

Hospital efficiency and patient satisfaction.

The objective of this study was to investigate the relationship between efficiency and patient satisfaction for a sample of general, acute care hospitals in Ontario, Canada. A measure of patient satisfaction at the hospital level was constructed using data from a province-wide survey of patients in mid-1999. A measure of efficiency was constructed using data from a cost model used by the Ontario Ministry of Health, the primary funder of hospitals in Ontario. In accordance with previous studies, the model also included measures of hospital size, teaching status and rural location. Based on the results of this study, at a 95% confidence level, there does appear to be evidence to suggest that an inverse relationship between hospital efficiency and patient satisfaction exists. However, the magnitude of the effect appears to be small. Hospital size and teaching status also appear to affect satisfaction, with lower satisfaction scores reported among non-teaching and larger hospitals. This study did not find any evidence to suggest that hospital location (rural versus urban) or religious affiliation contributed to reports of patient satisfaction in any way not explained by the other measures included in the study. The findings imply that low patient satisfaction cannot be explained by excessive management concentration on efficiency. Managers should analyse some of the underlying causes of patient dissatisfaction before reconfiguring resources. It may be beneficial in larger hospitals to study the aspects of care that patients have reported they prefer in small hospitals.

Efficiency, Organizational↗
PubMed2005

Staff perceptions of job satisfaction and life situation before and 6 and 12 months after increased information technology support in dementia care.

We measured staff members' satisfaction with their work before and after increased information technology (IT) support in dementia care. Comparisons were also performed of perceived life satisfaction and sense of coherence. Data were collected before, and 6 and 12 months after implementation of the first part of an IT support project. Instruments used were the Satisfaction with Work Questionnaires, the Life Satisfaction Questionnaire (LSQ) and the Sense of Coherence (SOC) scale. The study was performed in a residential home for persons with dementia. The participants were 33 staff members. The IT technology included general and individualized passage alarms, sensor-activated night-time illumination, fall detectors and Internet communication. Results showed that staff members' job satisfaction and perceived quality of care improved in comparison with the control group. Personal development, workload, expectations and demands, internal motivation and documentation, as well as the total scores for "psychosocial aspects of job satisfaction" and "quality of care aspects", increased in the experimental group. There were significant interaction effects for the factors family relation, close friend relation (LSQ), the total SOC scale and the meaningfulness subscale. The study showed that IT support in dementia care increased staff members' satisfaction with their work in several ways.

Adult↗
PubMed2004

Subjective evaluation and overall satisfaction after tympanoplasty for chronic simple suppurative otitis media.

A questionnaire survey was conducted in 324 patients with chronic, simple, suppurative otitis media who had undergone tympanoplasty 6 months or more previously to investigate post-operative hearing, tinnitus, vertigo, occlusive feeling of the ear and otorrhea. In addition, the overall satisfaction with tympanoplasty was assessed by VAS value. Subjective hearing improvement was observed in 73.1% of the patients whose hearing was poor and in 50% of those whose hearing was good before the operation. The degree of satisfaction assessed by VAS value corresponded with the subjective hearing assessment. As to tinnitus, 66.2% of the patients became aware of the disappearance or alleviation of symptoms. In the case of patients who had tinnitus before the operation, the degree of awareness of tinnitus and the degree of satisfaction assessed by VAS value coincided. However, no changes in the VAS value were observed in those who did not have tinnitus before the operation. As for vertigo, 30.5% of the patients who had vertigo preoperatively became aware of the disappearance of the symptoms after the operation. The degree of satisfaction assessed by VAS value corresponded with the presence or absence, severity and frequency of vertigo. As to the fullness of the ear, alleviation of the symptoms was subjectively noted by 85.9% of the patients who had symptoms before the operation. The degree of satisfaction assessed by VAS value corresponded with the severity of the symptoms in those who had symptoms before the operation. As for otorrhea, the disappearance of the symptoms was subjectively noted by 85.5% of the patients who had otorrhea before the operation. The degree of satisfaction assessed by VAS value corresponded with the post-operative changes in otorrhea. Based on the above results, it was assumed that the patients placed greatest expectation on hearing improvement when they underwent tympanoplasty. VAS is considered a useful method to evaluate the degree of satisfaction of patients after surgery.

Adolescent↗
PubMed2005

Satisfaction with pharmacotherapy for approved and off-label indications--a Delphi study.

BACKGROUND: Prescribing for non-approved uses is widespread in the treatment of AIDS, cancer, and pediatric illnesses, but it is by no means limited to these areas. Few studies have been performed evaluating reasons for off-label prescribing. OBJECTIVE: To explore the satisfaction with drug therapy as one of the potential reasons for off-label uses by testing a hypothesis that the satisfaction with drug therapy for off-label indications is lower than for approved indications. METHODS: The study compared the satisfaction with drug therapy for known off-label indications with a control group of approved indications. Twenty-four of the first 50 single-ingredient drugs, according to their share in the drug cost budget of the Slovenian Compulsory Health Insurance, had 86 different off-label indications eligible for inclusion. A control group of 86 approved indications was randomly selected from the list of all possible approved indications for the same 24 drugs. A 2-round Delphi technique, involving an expert panel of physicians who are members of the drug regulatory agency, was used to evaluate the satisfaction with drug therapy for selected indications. RESULTS: After the second round of the Delphi study, the median scores of satisfaction with drug therapy for approved and off-label indications were 7.00 and 6.50, respectively (p = 0.001). CONCLUSIONS: The study shows that the satisfaction with available drug therapy for off-label indications is lower than for approved indications. The statistical association, biologic plausibility, and coherence with existing information, as well as the temporality of the association, provide supporting evidence that low satisfaction with drug therapy is one of the incentives for off-label use.

Databases, Factual↗
PubMed2003

Questions on life satisfaction for adolescents and adults with cystic fibrosis: development of a disease-specific questionnaire.

STUDY OBJECTIVES: The development and psychometric properties of an additional disease-specific module of the Questions on Life Satisfaction for adolescents and adults with cystic fibrosis (FLZ(M)-CF) are described. The Questions on Life Satisfaction (FLZ(M)) instrument allows the respondent to rate the subjective importance and her/his satisfaction with different domains of life. METHODS: A preliminary 16-item version of the scale was employed in a study with 243 German patients with cystic fibrosis (CF) [16 to 58 years of age; FEV(1), 15 to 121% of predicted], together with the "general life satisfaction" module and the "satisfaction with health" module of the FLZ(M). Item elimination according to the principle of least common variance resulted in the final nine-item version. RESULTS: Cronbach alpha for the FLZ(M)-CF was 0.80; the split-half reliability was 0.72. Convergent validity of the scale was indicated by Pearson correlations of r = 0.75 with the generic satisfaction with health scale of the FLZ(M), r = 0.30 with FEV(1)%, and r = - 0.26 with daily time for home therapy. The scale discriminated significantly between patients with and without need for assistance in daily life and between patients with and without a partner. CONCLUSIONS: The FLZ(M)-CF is a reliable and valid instrument, and it is short enough to be used as screening instrument. The combination of generic and disease-specific scales within the FLZ(M) allows comprehensive measurement of life satisfaction for patients with CF who are > 15 years old.

Adolescent↗
PubMed2004

Predictors of job satisfaction among physiotherapists in Turkey.

The aim of this study was to investigate the level of job satisfaction among physiotherapists, and to identify the best predictors of job satisfaction. A self-administrated questionnaire survey was conducted in September 2003. Data were collected from 198 physiotherapists in 13 health care settings (five university hospitals, seven government hospitals, and one municipality hospital) located in Ankara, Turkey. Respondents were asked to complete a 31-item job satisfaction questionnaire. The response rate was 79.8%. The percentage of satisfied physiotherapists was 45.5%. There were no significant satisfaction differences between genders or between age groups. There was a positive relationship between the global satisfaction and domain scores (all ps<0.01). Logistic regression analysis showed that the most important predictors of job satisfaction were: (1) Leadership (OR=1.03, 95% CI 1.01 to 1.06), (2) Interpersonal relationships (OR=1.03, 95% CI 1.00 to 1.05), (3) Advancement (OR=1.02, 95% CI 1.00 to 1.05), and (4) Salary (OR=1.02, 95% CI 1.00 to 1.04). Specific job satisfaction dimensions indicate that highest dissatisfaction levels occur in the area of salary and advancement. Areas of dissatisfaction are signals for change.

Adult↗
PubMed2006

Health care users' satisfaction in Brazil, 2003.

Evaluation of users' satisfaction with the health system brings back longstanding questions concerning the quality of services provided to the Brazilian population. The current study analyzes satisfaction with outpatient and inpatient care based on the results of the World Health Survey, conducted in Brazil in 2003. To explain satisfaction with various aspects of care through a small number of factors, the factor analysis technique was used, through principal components analysis (PCA). Multiple regression models identified associations between satisfaction scores and different sociodemographic variables. For outpatient care, waiting time showed the lowest degree of satisfaction, and in the case of hospitalization, freedom to choose the physician was the worst evaluated aspect. Three components were extracted from the PCA, related respectively to satisfaction with health professionals, health services, and health problem solution. Multiple regression analysis showed that having experienced some type of discrimination (on the basis of gender, age, poverty, social class, skin color, or type of disease) and being an exclusive user of the public National Health System involved a lower degree of users' satisfaction.

Adolescent↗
PubMed2002

Comparing the satisfaction of low back pain patients randomized to receive medical or chiropractic care: results from the UCLA low-back pain study.

OBJECTIVES: This study examined the difference in satisfaction between patients assigned to chiropractic vs medical care for treatment of low back pain in a managed care organization. METHODS: Satisfaction scores (on a 10-50 scale) after 4 weeks of follow-up were compared among 672 patients randomized to receive medical or chiropractic care. RESULTS: The mean satisfaction score for chiropractic patients was greater than the score for medical patients (crude difference = 5.5; 95% confidence interval = 4.5, 6.5). Self-care advice and explanation of treatment predicted satisfaction and reduced the estimated difference between chiropractic and medical patients' satisfaction. CONCLUSIONS: Communication of advice and information to patients with low back pain increases their satisfaction with providers and accounts for much of the difference between chiropractic and medical patients' satisfaction.

Adolescent↗
PubMed1992

Socio-cognitive skills as a determinant of life satisfaction in aged persons.

The purpose of this study was to explore the viability of a revised model of elderly life satisfaction, specifically evaluating the contribution of socio-cognitive skills. The role of such skills in relation to life satisfaction among aged persons has not been explored in research to date. Pilot data gathered from 60 community-living aged individuals indicated that numerous variables (e.g., subjective/objective health, education, financial satisfaction, role participation, subjective integration) significantly correlated with life satisfaction. However, the combined effects of two variables, persons' feelings of loneliness and isolation from their families and a measure of socio-cognitive skill, accounted for 49 percent of the variability in elderly life satisfaction. The effects of each on life satisfaction were unique however. Implications of these data and possible interventions for increasing elderly persons' life satisfaction are discussed.

Aged↗
PubMed2001

Treatment satisfaction with inhaled insulin in patients with type 1 diabetes: a randomized controlled trial.

OBJECTIVE: In patients with type 1 diabetes, glycemic control can be achieved as effectively with an inhaled insulin regimen, comprising preprandial inhaled intrapulmonary insulin plus a bedtime ultralente injection, as with a conventional subcutaneous insulin regimen involving two to three injections per day. Our objective was to compare patient satisfaction between inhaled insulin and subcutaneous insulin. RESEARCH DESIGN AND METHODS: Subjects with type 1 diabetes participated in a 12-week open-label trial and were randomized to either an inhaled insulin regimen or a subcutaneous insulin regimen. Subjects (n = 69) were asked to complete a 15-item self-administered satisfaction questionnaire, the Patient Satisfaction with Insulin Therapy (PSIT) Questionnaire, at baseline and week 12. Outcomes included mean percentage changes in global (overall) satisfaction and two subscales: convenience/ease of use and social comfort. RESULTS: The mean percentage improvement in overall satisfaction with inhaled insulin (35.1%, 95% CI 18.0-52.2) was greater than with subcutaneous insulin (10.6%, 4.7-16.5) (P < 0.01), as was the improvement in convenience/ease of use: inhaled insulin 41.3% (22.9-59.6) versus subcutaneous insulin 11.2% (4.1-18.3; P < 0.01). Improvement in social comfort was greater with inhaled insulin but was not statistically significant. The 12-week change in HbA(1c) was associated with improved overall satisfaction (r = -0.27, P = 0.04). CONCLUSIONS: Inhaled insulin may offer the first practical, noninvasive alternative to insulin injections. For patients with type 1 diabetes, inhaled insulin maintains glycemic control and provides greater overall satisfaction and convenience/ease of use than subcutaneous insulin.

Administration, Inhalation↗
PubMed2004

The perceptions of nurses in a district health system in KwaZulu-Natal of their supervision, self-esteem and job satisfaction.

BACKGROUND: Supervision has been identified as a major issue in quality of care. Although increasing attention is being given to supervision in the District Health System, there have been no studies describing the current situation. This article describes a survey done in two health districts in KwaZulu-Natal involving 319 nurses from all types of government health care settings. METHODS: This was a quantitative descriptive study that described the current supervision, job satisfaction and self-esteem in two (2) health districts, that is the Ugu and the uThukela health districts. The three variables were described using a mailed questionnaire. A total 319 nurses participated in this study. RESULTS: The majority of the nurses (53%) felt that positive supervision behaviours listed in a rating scale, occurred never or seldom. The average self-esteem score was very positive (83%), and the average job satisfaction score was 60%. Nurses were most satisfied with the factor reflecting "personal satisfaction about their contribution to the work" (72%) and the least satisfaction with the factor that has to do with "pay and prospects" (50%). While there was no relationship between any of the demographic variables and supervision, there was a low but significant relationship between supervision and job-satisfaction. A significant relationship was also found between the personal satisfaction factor of job satisfaction and self-esteem. CONCLUSION: As nurses form the backbone of the health services, it is incumbent that health service managers safeguard the nursing workforce. Targeted strategies are necessary to ensure retention of the nurses for the health care of the South African population.

Adult↗
PubMedDate not supplied

Hardiness and support at work as predictors of work stress and job satisfaction.

PURPOSE: To test a theoretically and empirically based model linking potential protective resources (hardiness, coworker and supervisor support) to the outcomes of work stress and job satisfaction and replicating the relationship of work stress to job satisfaction while accounting for the potential influence of negative affectivity. DESIGN: A cross-sectional research design using survey data collected from two convenience samples. SETTING: Two worksites: (1) a high-tech company and (2) a government agency. SUBJECTS: High-tech employees (N = 310; response rate, 73.8%) and government agency employees (N = 745; response rate, 49.7%). MEASURES: The Dispositional Resilience Scale measured hardiness and the Positive and Negative Affect Schedule measured negative affectivity. Coworker and supervisor support were measured using the Coworker Support Scale and the Supervisor Support Scale, respectively. The Perceived Work Stress Scale measured work stress, and a single item from the Job Satisfaction Scale assessed overall job satisfaction. RESULTS: A multiple-group path analysis examined the proposed model. Similar patterns of association were found for both samples and suggested a more parsimonious model without the path from negative affectivity to job satisfaction. The model supports the protective nature of hardiness and support at work with regard to work stress and job satisfaction. CONCLUSION: Explanations of relationships depicted in the model, practical implications for reducing work stress and enhancing job satisfaction, limitations and future directions are discussed.

Adult↗
PubMed1990

[Effects of body-satisfaction on social anxiety and self-disclosing behavior in adolescence].

The present study investigated effects of body-satisfaction on social anxiety and self-disclosing behavior, focusing on the relationship between body and self in adolescence. Thirty-six male and thirty-six female undergraduates talked with an interviewer of the same-sex or opposite-sex. Their interactions were video-taped. The following results were obtained: (1) body-satisfaction level had an effect on social anxiety and on the style of self-disclosing behavior, but not on the contents of disclosure, (2) the high body-satisfaction group was shy and passive with an interviewer of the opposite-sex, and this seemed to be common among late adolescents, (3) the low body-satisfaction group was anxious, shy, tense, and passive with an interviewer of the same-sex, (4) the low body-satisfaction group was both tense and active with an interviewer of the opposite-sex (these results suggest that a relationship exists between body-satisfaction and gender identity confusion), (5) body-satisfaction level had no effect on interpersonal distance.

Adolescent↗