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PubMed2006

Impact of organizational structure on nurses' job satisfaction: a questionnaire survey.

BACKGROUND: Nurses' job satisfaction is an important issue because of its impact on the quality of the nursing job. Therefore, it receives a lot of attention in the international nursing literature but insight into the sources of nurses' job satisfaction is yet insufficient, in particular for sources related to organizational structure. OBJECTIVES: We contribute by investigating the relationship between the organizational structure variables, formalization, centralization and specialization, and nurses' job satisfaction. This allows us to learn whether structural changes can help to improve satisfaction, and therefore nurses' work quality. DESIGN: Data were collected by questionnaires in a random sample of 764 non-managing nurses in three Belgian general care hospitals. We measured satisfaction by Stamps and Piedmont's work satisfaction index. Structure was also measured by an existing scale. RESULTS: The results support the negative effect of centralization and the clearly positive effects of specialization and formalization on nurses' job satisfaction. These effects differ according to the different dimensions of satisfaction. Furthermore, pay is the most important dimension of nurses job satisfaction but the dimension least influenced by organizational structure. CONCLUSIONS: The importance of the dimension pay in nurses' job satisfaction, which is not a function of organizational structure, is limiting hospitals in improving nurses' job satisfaction. However, organizational structure is related to the other dimensions of satisfaction. Especially, the fact that specialization and formalization are, contrary to our hypotheses, only positively related to satisfaction is important from a practice perspective and for further research. Furthermore, our data indicates that there is a need to refine one of the dimensions of Stamps and Piedmont index.

Adult↗
PubMed1998

The relation between health status changes and patient satisfaction in older hospitalized medical patients.

OBJECTIVE: To examine the relation between two patient outcome measures that can be used to assess the quality of hospital care: changes in health status between admission and discharge, and patient satisfaction. DESIGN: Prospective cohort study. SETTING AND PATIENTS: Subjects were 445 older medical patients (aged > or =70 years) hospitalized on the medical service of a teaching hospital. MEASUREMENTS AND MAIN RESULTS: We interviewed patients at admission and discharge to obtain two measures of health status: global health and independence in five activities of daily living (ADLs). At discharge, we also administered a 5-item patient satisfaction questionnaire. We assessed the relation between changes in health status and patient satisfaction in two sets of analyses, that controlled for either admission or discharge health status. When controlling for admission health status, changes in health status between admission and discharge were positively associated with patient satisfaction (p values ranging from .01 to .08). However, when controlling for discharge health status, changes in health status were no longer associated with patient satisfaction. For example, among patients independent in ADLs at discharge, mean satisfaction scores were similar regardless of whether patients were dependent at admission (i.e., had improved) or independent at admission (i.e., remained stable) (79.6 vs 81.2, p = .46). Among patients dependent in ADLs at discharge, mean satisfaction scores were similar regardless of whether they were dependent at admission (i.e., remained stable) or independent at admission (i.e., had worsened) (74.0 vs 75.7, p = .63). These findings were similar using the measure of global health and in multivariate analyses. CONCLUSIONS: Patients with similar discharge health status have similar satisfaction regardless of whether that discharge health status represents stable health, improvement, or a decline in health status. The previously described positive association between patient satisfaction and health status more likely represents a tendency of healthier patients to report greater satisfaction with health care, rather than a tendency of patients who improve following an interaction with the health system to report greater satisfaction. This suggests that changes in health status and patient satisfaction are measuring different domains of hospital outcomes and quality. Comprehensive efforts to measure the outcomes and quality of hospital care will need to consider both patient satisfaction and changes in health status during hospitalization.

Aged↗
PubMed1998

The Kaiser Permanente/USC Patient Consultation Study: patient satisfaction with pharmaceutical services. University of Southern California.

The impacts of two models of pharmacist consultation on patient satisfaction with pharmaceutical services relative to a control model were studied. Patients in the random-assignment and areawide studies of the Kaiser Permanente/USC Patient Consultation Study were asked to rate their satisfaction with six aspects of the service they received at the pharmacy. The patients were receiving pharmaceutical services under the Kaiser Permanente (KP) model of consultation, a state-mandated model, or a control model. They were assigned to risk categories according to their pattern of prescription drug use. Differences in satisfaction among the three consultation models for all patients and for each risk group and correlations between satisfaction items were determined. The KP and state models of consultation were associated with better satisfaction than the control model on five of the six satisfaction items. In the high-risk patient groups, the KP and state models were associated with higher levels of satisfaction than the control model. In the low-risk group, the state model was associated with higher levels of satisfaction than the control model; results for low-risk patients assigned to the KP model were inconsistent between the random-assignment study and the areawide study. Overall satisfaction appeared to be a suboptimal measure of satisfaction with consultation. Overall satisfaction was more closely related to satisfaction with waiting time and with whether the pharmacy staff was helpful and caring than with the three items reflecting satisfaction with the content of the consultation. Patients were more satisfied under the state model of pharmacist consultation or the KP model of consultation, which resulted in more-intensive counseling for fewer patients, than under a control model.

Ambulatory Care↗
PubMed1999

Measuring patient satisfaction for quality improvement.

BACKGROUND: Surveys used for health plan quality reporting are generally administered annually to health plan enrollees to assess satisfaction with both the health plan and health care services. Therefore, surveys may lack sensitivity to measure the effects of patient-focused, quality improvement initiatives that could demonstrate results in a shorter time period. OBJECTIVES: We describe the development and testing of a multidimensional, visit-specific measure of satisfaction with primary care that may be used in quality improvement. METHODS: Conducted in five adult and pediatric primary care sites serving a commercial, largely managed-care population, the survey includes the Medical Outcomes Study Visit-Specific Questionnaire, the American Board of Internal Medicine Patient Satisfaction Questionnaire, and locally developed items. We assessed the instrument's reliability, validity, and utility for quality improvement. RESULTS: For both adult and pediatric samples, three factors emerged: satisfaction with the provider, satisfaction with access, and satisfaction with the office. Satisfaction with the provider and with the office were independently correlated with overall satisfaction in both samples; satisfaction with access was significantly correlated with overall satisfaction only for adults. For adults, patients who disenrolled from the health plan were less satisfied with the office compared with patients who remained with the health plan. Finally, for adults, we detected significant differences across practice sites in terms of satisfaction with office and access; for children, there were intersite differences in terms of satisfaction with provider, office, and access. CONCLUSIONS: We have support for the reliability and validity of this instrument that has identified differences in satisfaction between practice sites that may be used for quality improvement.

Adult↗
PubMed2005

Home Healthcare Nurses' Job Satisfaction Scale: refinement and psychometric testing.

AIMS: This paper describes a study to further develop and test the psychometric properties of the Home Healthcare Nurses' Job Satisfaction Scale, including reliability and construct and criterion validity. BACKGROUND: Numerous scales have been developed to measure nurses' job satisfaction. Only one, the Home Healthcare Nurses' Job Satisfaction Scale, has been designed specifically to measure job satisfaction of home healthcare nurses. The Home Healthcare Nurses' Job Satisfaction Scale is based on a theoretical model that integrates the findings of empirical research related to job satisfaction. METHODS: A convenience sample of 340 home healthcare nurses completed the Home Healthcare Nurses' Job Satisfaction Scale and the Mueller and McCloskey Satisfaction Scale, which was used to test criterion validity. Factor analysis was used for testing and refinement of the theory-based assignment of items to constructs. Reliability was assessed by Cronbach's alpha internal consistency reliability coefficients. The data were collected in 2003. RESULTS: Nine factors contributing to home healthcare nurses' job satisfaction emerged from the factor analysis and were strongly supported by the underlying theory. Factor loadings were all above 0.4. Cronbach's alpha coefficients for each of the nine subscales ranged from 0.64 to 0.83; the alpha for the global scale was 0.89. The correlations between the Home Healthcare Nurses' Job Satisfaction Scale and Mueller and McCloskey Satisfaction Scale was 0.79, indicating good criterion-related validity. CONCLUSIONS: The Home Healthcare Nurses' Job Satisfaction Scale has potential as a reliable and valid scale for measurement of job satisfaction of home healthcare nurses.

Adult↗
PubMedDate not supplied

Satisfaction with medication: an overview of conceptual, methodologic, and regulatory issues.

OBJECTIVE: Patients' satisfaction with their medication or medical device has been of increasing interest over the past decade. This is reflective of the rise of the patient as consumer and the desire of pharmaceutical and device manufacturers to obtain feedback from the consumers about their products. Satisfaction with medication is more narrowly focused and should be distinguished from other aspects of satisfaction. The purpose of this article is to place the concept of patient satisfaction with medication in an appropriate theoretical context, to explore the challenges of performing this research, and to offer recommendations for the basis of satisfaction claims. METHODS: We reviewed the literature on satisfaction with medication or medical devices. We summarize and discuss the background, conceptual issues, and theoretical justification for studying satisfaction with medication. We offer examples of domains to be included and suggestions on how to develop a psychometrically sound satisfaction measure. We also address additional issues for consideration. RESULTS: Medication satisfaction is a type of patient-reported outcome, but is distinguished from other patient-reported outcomes-specifically health-related quality of life (HRQL) and self-reports of symptoms. The Theory of Reasoned Action provides one theoretical justification for the concept. The heuristic value of this theory leads to implications regarding the relation between satisfaction and adherence. In addition, the theory is consistent with the need to focus on the patient's beliefs and values concerning the impact of taking his/her medication. Although the beliefs will differ according to the specific drug-disease combination, the beliefs can often be categorized in several domains of satisfaction: symptom relief/efficacy, side effects, ease and convenience, impact on HRQL, general satisfaction, and additional domains specific to the given research question. CONCLUSION: Patient satisfaction instruments should be subjected to the same psychometrically rigorous standards and procedures as any other patient-reported outcome and should also be subject to the same regulatory standards as other patient-reported outcomes with respect to advertising and promotion.

Contraindications↗
PubMed2006

Moderate and severe erectile dysfunction equally affects life satisfaction.

PURPOSE: To explore the life satisfaction of patients with erectile dysfunction (ED) and to examine the relation between severity of ED and life satisfaction. MATERIALS AND METHODS: The study sample was recruited from patients who presented in an andrologic outpatient clinic complaining of ED. All patients underwent the basic clinical evaluation and were assessed by the International Index of Erectile Dysfunction (IIEF) and the Life Satisfaction Inventory (LSI). RESULTS: The study included 69 patients with ED (age range 22-71 years, mean 49.5, SD 13.7). The LSI appeared to have satisfactory internal consistency (Cronbach's alpha = 0.82). Men with ED had significantly lower satisfaction with their sexual life (t = -13.756, d.f. = 68, P = 0.000), but also significantly lower total score of satisfaction with their life (t = -2.793, d.f. = 68, P = 0.007) compared with available normative data from healthy population. However, when compared with controls, men with ED showed significantly higher satisfaction scores on their financial status (t = 5.075, d.f. = 68, P = 0.000) and on their leisure time activities (t = 4.029, d.f. = 68, P = 0.000). Regarding ED severity, mild ED affects patients' satisfaction with sexual life less than do moderate and severe ED. Interestingly, no difference was identified between moderate and severe ED groups. CONCLUSIONS: Men who seek help for ED have lower satisfaction with sexual life and lower satisfaction with their overall life compared with healthy people. Severity of ED seems to be an important factor, as men with moderate ED perceive the impact of ED on their life satisfaction equally with those with severe ED. ED patients gain more satisfaction from other domains of their life, provided they adopt coping behaviors that help compensate for their low overall life satisfaction. Furthermore, as ED patients do not differ from healthy people in their expressed subjective rating of quality of life (QoL), life satisfaction may be more sensitive than QoL assessment in the evaluation of the impact of ED on our patients' life.

Adult↗
PubMed2005

Determinants of patient satisfaction with outcome after rotator cuff surgery.

BACKGROUND: The outcome after rotator cuff surgery has been reported frequently with use of condition-specific measures, but patient satisfaction has not been well studied. The purpose of this study was to identify the determinants of patient satisfaction with the outcome after rotator cuff surgery. METHODS: A cohort of 311 patients undergoing rotator cuff surgery was studied prospectively. Two hundred and fifty-four patients had subjective follow-up for a minimum of one year, and fifty-seven patients had subjective and objective follow-up for a minimum of one year. Diagnoses included tendinitis or impingement (eighty patients), a partial-thickness rotator cuff tear (fifty-five patients), and a full-thickness rotator cuff tear (176 patients). The dependent variable was patient satisfaction with the outcome, graded ordinally on a scale of 1 to 10. Independent variables included demographic, surgical, objective follow-up, and subjective follow-up parameters. Univariate and multivariate analyses were performed to identify the determinants of satisfaction. RESULTS: Univariate analysis of demographic variables demonstrated no significant differences (p > 0.05) with respect to patient satisfaction. Analysis of the surgical variables showed significantly decreased satisfaction (p < 0.05) for patients who had debridement for a massive, irreparable cuff tear; those who had subscapularis tears; and those with larger supraspinatus and infraspinatus tears. Analysis of the objective variables at follow-up demonstrated significantly decreased satisfaction (p < 0.05) for patients with diminished and weakened forward elevation, impingement signs, and acromioclavicular joint pain and tenderness. Univariate analysis of subjective variables at follow-up showed significantly decreased satisfaction (p < 0.001) for patients with pain, functional difficulty, and work disability. Multivariate analysis demonstrated significantly decreased satisfaction associated with pain (p < 0.001) and dysfunction (p < 0.05). A significant relationship (p < 0.05) was detected between satisfaction and a willingness to recommend the surgery to another. A significant relationship (p < 0.05) was also found between satisfaction and the American Shoulder and Elbow Surgeons score. CONCLUSIONS: Subjective variables of symptoms and function have the most robust associations with patient satisfaction following rotator cuff surgery. Thus, in assessing the outcome of rotator cuff surgery from the perspective of patient satisfaction with outcome, we emphasize the importance of patient-derived subjective assessment of symptoms and function.

Arthralgia↗
PubMed2000

Consumers' satisfaction with primary health services in the city of Jeddah, Saudi Arabia.

OBJECTIVE: To study consumers' satisfaction and socio-demographic correlates of satisfaction with services provided by Primary Health Care Centres in the city of Jeddah. METHODS: Study subjects included the consumers visiting the Primary Health Care Centres during the study period. Four Primary Health Care Centres were randomly selected from Jeddah according to the geographical location. Seventy five subjects were selected systematically where every tenth Saudi aged 15 years or above was chosen. Data was collected via a self administered pilot tested questionnaire which included socio-demographic characteristics, as well as the overall and differential satisfaction with the different services and facilities in the selected Primary Health Care Centres rated on a scale of 1 - 5 points, the higher the score the higher the satisfaction. RESULTS: Male subjects constituted 60% of the visitors. More than half of the subjects were young 15-29 years of age, about 58% were married, 50% completed intermediate/secondary school, more than two fifths of the subjects were employees and more than three quarters have a monthly income of 6000 Saudi Riyals or less. The summary satisfaction score was 3.76 points and the overall satisfaction with the services provided was 2.45 points out of a maximum of 5 points. The highest satisfaction was for dental clinic (3.44 points) and the lowest for co- operation of the receptionist (1.95 point). Unskilled laborers showed the highest summary and overall satisfaction (4.31 and 2.71 points) and students showed the lowest satisfaction scores (3.54 and 1.89 points). Other socio-demographic variables were not significantly related to summary and overall satisfaction scores. CONCLUSION: Measuring satisfaction by asking one summary question tends to give a significantly higher satisfaction score compared to satisfaction score taking in consideration of all services offered. Certain service components need corrective intervention measures to make them more satisfactory to consumers.

Adolescent↗
PubMed1997

Changing nature of physician satisfaction with health maintenance organization and fee-for-service practices.

BACKGROUND: Managed care practice arrangements, or health maintenance organizations (HMOs), are sufficiently mature to examine whether physicians' level of satisfaction has changed as managed care has developed. This study compares Dane County, Wisconsin, physicians' satisfaction with HMO and fee-for-service (FFS) practices in 1986 with that of 1993 and examines factors that contribute to satisfaction in an HMO-dominated environment. METHODS: Cross-sectional surveys were mailed to all Dane County physicians in active practice in 1986 and 1993. Physician overall support for HMO development and satisfaction with work situation was measured with single items. Overall satisfaction and clinical freedom within HMO and FFS practices were measured using statistically reliable scales. RESULTS: Significantly more physicians were supportive of the development of HMOs in 1993 than in 1986, and more than two thirds of physicians in 1993 were satisfied in their current work situation. Primary care physicians were significantly more satisfied than subspecialists across most dimensions of satisfaction. Perceived clinical freedom and satisfaction with income continued to be major predictors of satisfaction in 1993 as in 1986. While physicians' satisfaction with HMO practice remained stable, their satisfaction with FFS practice was significantly lower in 1993 than in 1986. Satisfaction with Medicare practice, which was not measured in 1986, was significantly less than with HMO or FFS practice in 1993. CONCLUSIONS: Analyses suggest that primary care physicians are more satisfied than subspecialists with their HMO practice because of their greater satisfaction with HMO-generated income and the expanded clinical freedom they have in HMO practice. An across-the-board decline in satisfaction with FFS practice may be attributable to diminishing clinical freedom resulting from indemnity carriers' increasing micromanagement of patient care.

Cross-Sectional Studies↗
PubMed2002

Hysterectomy status and life satisfaction in older women.

OBJECTIVES: This cross-sectional, population-based study examines the long-term effect of hysterectomy on life satisfaction in 1177 women aged 55-94 years. METHODS: A 1992 mailed survey obtained information on menopausal history, including hysterectomy and oophorectomy status, and estrogen use. Two standardized measures ascertained general life satisfaction: the Life Satisfaction Index-Z (LSI-Z) and the Satisfaction with Life Scale (SWLS). A separate question asked participants to rate life satisfaction (better, the same, or worse) after menopause or hysterectomy compared with before. RESULTS: Twenty-three percent of the women reported hysterectomy with bilateral oophorectomy an average of 24 years earlier, and 26% reported hysterectomy with ovarian conservation an average of 28 years earlier. Women who were 20 or more years posthysterectomy or postmenopause were significantly more likely to rate their life satisfaction as better than were women 5 or fewer years posthysterectomy or postmenopause (p < 0.01). Among women with a hysterectomy, 53% with oophorectomy and 60% with ovarian conservation rated life satisfaction better after hysterectomy. Only 42.2% of women without a hysterectomy rated life satisfaction as better after menopause (p < 0.001). Differences persisted after adjustment for age and other covariates: p < 0.01 for hysterectomy with ovarian conservation and p < 0.001 for hysterectomy with bilateral oophorectomy vs. no hysterectomy. Even among women who had never used estrogen, a significantly greater proportion of those who had a hysterectomy with ovarian conservation rated their life satisfaction as better compared with women who did not have a hysterectomy (p < 0.05). There were no differences in standard life satisfaction scores (LSI-Z or SWLS) by hysterectomy status. CONCLUSIONS: There are no long-term adverse effects of hysterectomy on life satisfaction. When queried specifically, women report increased life satisfaction following hysterectomy. Relief from symptoms necessitating hysterectomy may be responsible for this increase. This difference may be specific to hysterectomy because there were no differences in general life satisfaction as assessed with standardized measures.

Adaptation, Psychological↗
PubMed2001

Consumer satisfaction with occupational health services: should it be measured?

OBJECTIVES: To find answers in the literature to the questions if, why, and how consumer satisfaction with occupational health services (OHSs) should be measured. METHODS: Publications about the concept of consumer satisfaction with health care and surveys of consumer satisfaction with occupational health care were reviewed. RESULTS: For care providers, surveys of consumer satisfaction can be useful to improve quality or as indicators of non-compliant behaviour among patients. For clients, satisfaction surveys can be helpful for choosing between healthcare providers. Satisfaction is made up of an affective component of evaluation and a cognitive component of expectations. Also, in occupational health care, patient satisfaction is measured by dimensions such as the humanness and competence of the care provider similar to health care in general. However, there are dimensions that are specific to occupational health-such as the perceived independence of the physician, unclear reasons for visiting an OHS, and the perceived extent of knowledge of OHS professionals about the patient's working conditions. Dimensions of client satisfaction are mostly similar to patient satisfaction but include more businesslike aspects. They are different for the two groups of client, employers and employees. To measure consumer satisfaction in occupational healthcare specific questionnaires must be constructed. To achieve the highest possible reader satisfaction guidelines are provided for construction of a questionnaire. CONCLUSIONS: Consumer satisfaction is a complex theoretical concept, but it is relatively easy to measure in practice and can be a valuable tool for quality improvement. Consumers' evaluations of occupational health services will become increasingly important due to changes in the organisation of occupational health care. Occupational healthcare providers are encouraged to measure the consumer satisfaction of their services.

Consumer Behavior↗
PubMed2003

Customer satisfaction in anatomic pathology. A College of American Pathologists Q-Probes study of 3065 physician surveys from 94 laboratories.

CONTEXT: Measurement of physicians' and patients' satisfaction with laboratory services has recently become a requirement of health care accreditation agencies in the United States. To our knowledge, this is the first customer satisfaction survey of anatomic pathology services to provide a standardized tool and benchmarks for subsequent measures of satisfaction. OBJECTIVE: This Q-Probes study assessed physician satisfaction with anatomic pathology laboratory services and sought to determine characteristics that correlate with a high level of physician satisfaction. DESIGN: In January 2001, each laboratory used standardized survey forms to assess physician customer satisfaction with 10 specific elements of service in anatomic pathology and an overall satisfaction rating based on a scale of rankings from a 5 for excellent to a 1 for poor. Data from up to 50 surveys returned per laboratory were compiled and analyzed by the College of American Pathologists. A general questionnaire collected information about types of services offered and each laboratory's quality assurance initiatives to determine characteristics that correlate with a high level of physician satisfaction. SETTING: Hospital-based laboratories in the United States (95.8%), as well as others from Canada and Australia. PARTICIPANTS: Ninety-four voluntary subscriber laboratories in the College of American Pathologists Q-Probes quality improvement program participated in this survey. Roughly 70% of respondents were from hospitals with occupied bedsizes of 300 or less, 65% were private nonprofit institutions, just over half were located in cities, one third were teaching hospitals, and 19% had pathology residency training programs. MAIN OUTCOME MEASURES: Overall physician satisfaction with anatomic pathology and 10 selected aspects of the laboratory service (professional interaction, diagnostic accuracy, pathologist responsiveness to problems, pathologist accessibility for frozen section, tumor board presentations, courtesy of secretarial and technical staff, communication of relevant information, teaching conferences and courses, notification of significant abnormal results, and timeliness of reporting). RESULTS: The database of 3065 physician surveys was derived from 94 laboratories. An average of 32.6 surveys (median 30) was returned per institution, with a range of 5 to 50 surveys per institution. The mean response rate was 35.6% (median 32.5%). The median (50th percentile) laboratory had an overall median satisfaction score of 4.4. The lowest satisfaction scores that were obtained all related to poor communication, which included timeliness of reporting, communication of relevant information, and notification of significant abnormal results. Statistically significant associations of customer satisfaction with certain institutional characteristics and laboratory performance improvement activities were identified. CONCLUSIONS: The importance of this satisfaction survey lies not in its requirement as an exercise for accrediting agencies but in understanding the needs of the customer (in this case the physician) to direct performance improvement in the delivery of quality anatomic pathology laboratory services.

Consumer Behavior↗
PubMed2001

Differences in dimensions of satisfaction with private and public dental care among children.

UNLABELLED: Measures of patient satisfaction have application in understanding patient behaviour, and in evaluating dental providers, services, and facilities. Further, differences in delivery systems may be reflected in variation between the component dimensions of satisfaction. AIM: The aim of this study was to compare perceptions of satisfaction with care provided by the School Dental Service (SDS) and private dentists. DESIGN: A three-stage cross-sectional survey was conducted during 1993-94. This analysis is based on Stage 2 of the study (n=2,792 participants, response rate=78.0%). SETTING: Schools in metropolitan Adelaide, South Australia. PARTICIPANTS: Parents and schoolchildren. INTERVENTIONS/METHODS: Mailed self-complete questionnaires. MAIN OUTCOME MEASURES: The Dental Satisfaction Index (DSI) and component subscales. RESULTS: Overall satisfaction using the DSI showed no significant difference between SDS users and users of private dental care. Parents of children using the SDS had lower satisfaction scores for 'general satisfaction', 'quality', 'access', and 'continuity', but had higher satisfaction scores for the dimensions of 'cost' and 'availability' (OLS regression; P<0.01). These patterns of satisfaction with dental care by provider group persisted after controlling for time since last visit, parental education level, insurance status, occupation and language spoken (OLS regression; P<0.05). This may reflect a counter-balancing of dimensions of satisfaction across provider groups resulting in no significant difference in the DSI. CONCLUSIONS: Overall satisfaction was high and did not vary by provider group, but there was variation in the component dimensions of satisfaction.

Attitude to Health↗
PubMed1992

Factors associated with job and career satisfaction among dental hygienists.

Information concerning dental hygienists' job and career satisfaction is dated and incomplete. Because satisfaction may be important in retention of dental hygienists, a survey of all active dental hygienists in private practices in North Carolina was performed to ascertain dimensions and levels of job and career satisfaction, as well as factors associated with these constructs. Of 2,099 eligible hygienists, 51 percent responded to a survey instrument containing 202 items addressing overall satisfaction, as well as satisfaction with a variety of work-related factors. Factor analysis was used to develop scales for job and career satisfaction, and for the work-related factors. Final reduced regression models indicated that the constructs of job and career satisfaction are separate and that each has distinct general and intrinsic dimensions. Models for general job and career satisfaction had R2 values of .45 and .27, respectively, and included a variety of work-related factors such as supervisory style and satisfaction with salary. Models for intrinsic job and career satisfaction were not as strong, with R2 values of .06 and .09, respectively. These models also included work-related factors such as satisfaction with hours of work, office safety arrangements, and supervisory style. These results suggest that general job and career satisfaction levels should be amenable to change through management interventions.

Adult↗
PubMed1996

Life style intervention in general practice: effects on psychological well-being and patient satisfaction.

The objectives of this study were to: (1) study if an opportunistic screening of coronary heart disease (CHD) risk factors among male attenders in general practice (GP) influenced the overall subjective satisfaction with life of persons labelled 'high risk' compared to other screened persons; (2) compare psychological well-being and patient satisfaction in a patient centred and self-directive (PCSD) intervention with conventional care (CC); and (3) evaluate patient satisfaction and psychological well-being among subjects with high CHD risk during a one year intervention study. Effects of 'labelling' were evaluated in 115 subjects with high CHD risk in comparison with a low risk reference population. The 22 participating GP centres were randomly allocated to follow either a PCSD intervention or a CC approach. An overall satisfaction with life question was employed and psychological well-being were measured using the General Health Questionnaire (20 item version). Satisfaction measures on health care aspects were also included. No difference of change between the high risk and the reference population was found concerning satisfaction with life after screening. No significant difference of change was found within or between the PCSD and the CC group concerning emotional well-being or overall satisfaction with life during one year intervention. Satisfaction with the care received was significantly better in the CC group as compared with the PCSD group (p = 0.02). Satisfaction with own efforts for improving health was, however, more pronounced in the PCSD group (p = 0.01). A substantial number (n = 61) of the participants reported distaste of being reminded of the risk of heart disease and no more than 60 of the participants were satisfied with their own efforts for improving health. Although no significant change of satisfaction with life and emotional well-being due to screening or intervention could be detected, clinicians should be aware that encouraging patients to change life style may lead to patients' annoyance of being reminded of the risk of disease and dissatisfaction with their own efforts. Increasing patient responsibility and self-determination may improve their satisfaction with their own efforts, but reduce satisfaction with medical care.

Adaptation, Psychological↗
PubMed2006

Job satisfaction among obstetrician-gynecologists: a comparison between private practice physicians and academic physicians.

OBJECTIVE: Physician job satisfaction has been the subject of much research. However, no studies have been conducted comparing academic and private practice physician satisfaction in obstetrics and gynecology. This study was undertaken to measure satisfaction levels for academic and private practice obstetrician-gynecologists and compare different aspects of their practice that contributed to their satisfaction. STUDY DESIGN: A survey was mailed to randomly selected obstetrician-gynecologists in Memphis, TN; Birmingham, AL; Little Rock, AR; and Jackson, MS. Physicians were asked to respond to questions concerning demographics and career satisfaction. They were also asked to assess the contribution of 13 different aspects of their practice in contributing to their job selection and satisfaction using a Likert scale. A score of 1 meant the physician completely disagreed with a statement regarding a factor's contribution or was completely dissatisfied; a score of 5 meant the physician completely agreed with a factor's contribution or was completely satisfied. Simple descriptive statistics, as well as the 2-sample t test, were used. Likert scale values were assumed to be interval measurements. RESULTS: Of the 297 questionnaires mailed, 129 (43%) physicians responded. Ninety-five (74%) respondents rated their overall satisfaction as 4 or 5. No significant difference was found between academic and private physicians when comparing overall job satisfaction (P = .25). When compared to private practice physicians, the aspects most likely contributing to overall job satisfaction for academic physicians were the ability to teach, conduct research, and practice variety (P = .0001, P = .0001, and P = .007, respectively). When compared with academic physicians, the aspects most likely contributing to job satisfaction for private practice physicians were autonomy, physician-patient relationship, and insurance reimbursement (P = .0058, P = .0001, and P = .0098, respectively). When choosing a practice setting, academic physicians found variety, teaching, and research to be more important (P = .0027, P = .0001, and P = .0001, respectively). In contrast, private practice physicians found autonomy, physician-patient relationship, coworkers, and geographic location to be more important (P = .0005, P = .0001, P = .0035, and P = .0016, respectively). CONCLUSION: Academic and private practice physicians are equally satisfied with their careers. However, teaching, research and variety contribute more to academic satisfaction, whereas autonomy, physician-patient relationship, and coworkers contribute more to satisfaction for the physician in private practice. This study may be used when counseling residents concerning their career options.

Adult↗
PubMed2001

Complications and patient satisfaction following expander/implant breast reconstruction with and without radiotherapy.

PURPOSE: To compare the rates of complications and patient satisfaction among breast cancer patients treated with mastectomy and tissue expander/implant reconstruction with and without radiotherapy. METHODS AND MATERIALS: As part of the Michigan Breast Reconstruction Outcome Study (MBROS), breast cancer patients undergoing mastectomy with reconstruction were prospectively evaluated with respect to complications, general patient satisfaction with reconstruction, and esthetic satisfaction. Included in this study was a cohort of women who underwent breast reconstruction using an expander/implant (E/I). A subset of these patients also received radiotherapy (RT). At 1 and 2 years postoperatively, a survey was administered which included 7 items assessing both general satisfaction with their reconstruction and esthetic satisfaction. Complication data were also obtained at the same time points using hospital chart review. Radiotherapy patients identified in the University of Michigan Radiation Oncology database that underwent expander/implant reconstruction but not enrolled in the MBROS study were also added to the analysis. RESULTS: Eighty-one patients underwent mastectomy and E/I reconstruction. Nineteen patients received RT and 62 underwent reconstruction without RT. The median dose delivered to the reconstructed breast/chest wall, including boost, was 60.4 Gy (range, 50.0-66.0 Gy) in 1.8- to 2.0-Gy fractions. With a median follow-up of 31 months from the date of surgery, complications occurred in 68% (13/19) of the RT patients compared to 31% (19/62) in the no RT group (p = 0.006). Twelve of 81 patients (15%) had a breast reconstruction failure. Reconstruction failure was significantly associated with experiencing a complication (p = 0.0001) and the use of radiotherapy (p = 0.005). The observed reconstruction failure rates were 37% (7/19) and 8% (5/62) for patients treated with and without radiotherapy, respectively. Tamoxifen was associated with a borderline risk of complications (p = 0.07) and a significant risk of reconstruction failure (p = 0.01). Sixty-six patients of the study group completed the satisfaction survey; 15 patients did not. To offset potential bias for patients not completing the survey, we analyzed satisfaction data assuming "dissatisfaction" scores for surveys not completed. In the analysis of patients with unilateral E/I placement, reconstruction failure was significantly associated with a lower general satisfaction (p = 0.03). Ten percent of patients experiencing a reconstruction failure were generally satisfied compared to 23% who completed E/I reconstruction. In addition, tamoxifen use was associated with a significantly decreased esthetic satisfaction (p = 0.03). Radiotherapy was not associated with significantly decreased general or esthetic satisfaction. CONCLUSION: Irradiated patients had a higher rate of expander/implant reconstruction failure and complications than nonirradiated patients. Despite these differences, our pilot data suggest that both general satisfaction and patient esthetic satisfaction were not significantly different following radiotherapy compared to patients who did not receive RT. Although statistical power was limited in the present study and larger patient numbers are needed to validate these results, this study suggests comparable patient assessment of cosmetic outcome with or without radiotherapy in women who successfully complete expander/implant reconstruction.

Adult↗