Biomedical subjects

Frans J Oort

Publications and source records attributed to Frans J Oort.

25 records · Page 2Linked to original sources

PubMed2004

Satisfaction with the outpatient encounter: a comparison of patients' and physicians' views.

OBJECTIVE: To compare patients' and physicians' visit-specific satisfaction in an internal medicine outpatient setting, and to explain their respective views. DESIGN: Patients' and physicians' background characteristics were assessed prior to outpatient encounters. Immediately after the encounter, both patients and physicians completed a questionnaire assessing satisfaction with the visit. SETTING: The outpatient division of an academic teaching hospital. PARTICIPANTS: Thirty residents and specialists in general internal medicine, rheumatology, and gastroenterology, and 330 patients having a follow-up appointment with one of these physicians. MEASUREMENTS AND MAIN RESULTS: Patients' and physicians' visit-specific satisfaction was assessed using 5 Visual Analogue Scales (0 to 100). Patients' overall satisfaction was higher than physicians' satisfaction (mean 81 vs. 66), and correlation of patients' and physicians' overall satisfaction with the specific visit was medium sized (r= .28, P < .001). Patients' satisfaction ratings were associated with their previsit self-efficacy in communicating with their physician (P < .001) and with visiting a female physician (P < .01). Physicians' satisfaction was associated with patients' higher educational level (P < .05), primary language being Dutch (P < .001), better mental health (P < .05), and preference for receiving less than full information (P < .05). CONCLUSIONS: In an outpatient setting, patients' visit-specific satisfaction ratings were substantially higher than, and only moderately associated with, physicians' ratings of the same visit. The dissimilar predictors explaining patients' and physicians' satisfaction suggest that patients and physicians form their opinion about a consultation in different ways. Hence, when evaluating outpatient encounters, physicians' satisfaction has additional value to patients' satisfaction in establishing quality of care.

Adult↗

PubMed2004

Critical factors affecting quality of life of adult patients with anorectal malformations or Hirschsprung's disease.

OBJECTIVES: The first objective was to compare the quality of life of adult patients with anorectal malformations (ARM) or Hirschsprung's disease (HD) and to compare both groups with healthy people. And the second objective was to examine the factors that affect the quality of life of patients with ARM or HD, using a theoretical model in which patients' background characteristics explain quality of life via mediating disease-specific functioning and psychosocial functioning. METHODS: Three hundred and forty-one patients completed a questionnaire, which assessed sociodemographic characteristics, disease-specific and psychosocial functioning, and quality of life. Clinical factors were extracted from the medical records. RESULTS: Patients with ARM or Hirschsprung's disease did not differ in their quality of life. Compared to healthy people, both patient groups reported more limitations in their "overall" physical quality of life, but only patients with ARM reported impaired quality of life on several specific domains (e.g., physical role-functioning, pain). The model was largely accepted. Most striking were the strong effects of the psychosocial functioning factors in contrast to weak effects of the disease-specific "constipation" and "fecal continence" factors. CONCLUSIONS: The quality of life of patients with ARM or Hirschsprung's disease was found to be comparable. Compared to healthy people, both patient groups encountered "overall" physical health problems, but only patients with ARM reported additional pain and limitations in role functioning due to physical problems. It appeared that psychosocial functioning had the most important effect on the quality of life of patients with ARM or Hirschsprung's disease, while fecal incontinence and constipation had almost no effect on their quality of life.

Adaptation, Psychological↗

PubMed2003

Stress, satisfaction and burnout among Dutch medical specialists.

BACKGROUND: Stress and stress-related illnesses are increasing among medical specialists. This threatens the quality of patient care. In this study we investigated (a) levels of job stress and job satisfaction among medical specialists, (b) factors contributing to stress and satisfaction and (c) the effect of stress and satisfaction on burnout. METHODS: A questionnaire was mailed to a random sample of 2400 Dutch medical specialists. Measures included job stress, job satisfaction, burnout, personal characteristics, job characteristics and perceived working conditions. RESULTS: The final response rate was 63%. Of the respondents, 55% acknowledged high levels of stress, and 81% reported high job satisfaction. Personal and job characteristics explained 2%-6% of the variance in job stress and satisfaction. Perceived working conditions were more important, explaining 24% of the variance in job stress and 34% of the variance in job satisfaction. Among perceived working conditions, the interference of work on home life (odds ratio [OR] 1.54, 95% confidence interval [CI] 1.35-1.76) and not being able to live up to one's professional standards (OR 1.57, 95% CI 1.37-1.80) were most related to stress. Feeling poorly managed and resourced (OR 2.07, 95% CI 1.76-2.43) diminished job satisfaction. Burnout was explained by both high stress and low satisfaction (41% of variance explained) rather than by stress alone. INTERPRETATION: Our study showed a protective effect of job satisfaction against the negative consequences of work stress as well as the importance of organizational rather than personal factors in managing both stress and satisfaction.

Adult↗

PubMed2003

Three-mode analysis of multimode covariance matrices.

Multimode covariance matrices, such as multitrait-multimethod matrices, contain the covariances of subject scores on variables for different occasions or conditions. This paper presents a comparison of three-mode component analysis and three-mode factor analysis applied to such covariance matrices. The differences and similarities between the non-stochastic and stochastic approaches are demonstrated by two examples, one of which has a longitudinal design. The empirical comparison is facilitated by deriving, as a heuristic device, a statistic based on the maximum likelihood function for three-mode factor analysis and its associated degrees of freedom for the three-mode component models. Furthermore, within the present context a case is made for interpreting the core array as second-order components.

Analysis of Variance↗

PubMed2002

Goal orientations, perceived self-efficacy and study results amongst beginners and advanced students.

BACKGROUND: On the basis of previous research, it was expected that perceived self-efficacy and social comparison would contribute to pursued goals and that these goals would influence course grades. It was further expected that a task orientation would contribute to perceived self-efficacy, and that an ego orientation would contribute to social comparison. AIMS: The central question in the present study is whether the relationships between the above-mentioned motivational variables are as strongly developed in a particular area amongst beginners as they are amongst more advanced students. In view of the fact that beginners' knowledge concerning task requirements is restricted, we predicted that whilst relationships between these variables would be weak or absent in the case of beginners, they would be relatively strong amongst more advanced students. SAMPLES: The sample consisted of 150 students from a secondary school. METHODS: The participants answered questions about goal orientations, appraisals of self-efficacy, social comparison and about their personal goals. Course grades were used as a measure of study results. RESULTS AND CONCLUSION: It was found that amongst the beginners and the advanced students perceived self-efficacy contributed to pursued goals and these goals in turn contributed to course grades. The relations between these variables were clearly less strong for the beginners than for the advanced students. Furthermore, it was ascertained that a task orientation contributed only to perceived self-efficacy amongst the advanced students, suggesting that for these students motivational variables were operative whereas they were still undeveloped amongst the beginners.

Adolescent↗

PubMed2002

Sex differences in physician burnout in the United States and The Netherlands.

OBJECTIVE: to determine if there are sex differences in physician burnout in the Netherlands and, if not, to explore why they are present in the United States. METHODS: Separate physician surveys were conducted in the United States (n=2326) and the Netherlands (n=1426). Thirty-three percent of US respondents were female (adjusted response rate 52%); 18% of Dutch respondents were female (adjusted response rate 63%). Standardized mean sex differences (effect sizes) in burnout variables were calculated and compared crossnationally. RESULTS: US women experienced more burnout than US men did (28% v 21%, p<.01), but the sex difference in burnout among Dutch physicians was not significant. Women in both countries worked fewer hours than men did (48 v 56 US, 44 v 56 NL, difference in effect sizes of sex differences between US and NL, p<.001). Although women in both countries described less work control than men, the effect size of the sex difference in the United States was more than twice that in the Netherlands (.34 US v .15 NL, p<.01). Children, home support, and work-home interference were comparable between sexes in the United States. CONCLUSIONS: Gender parity in physician burnout in the Netherlands may be due to fewer work hours and greater work control of women compared to those in the United States.

Adult↗

PubMedDate not supplied

A comparison of 3 valuation methods for temporary health states in patients treated with oral anticoagulants.

BACKGROUND: The application of the time tradeoff (TTO) method in temporary health states may lead to less valid results because an unrealistic scenario is presented to patients. The chained TTO has been proposed to solve this problem. OBJECTIVES: To compare a chained TTO method with a conventional TTO method in the valuation of temporary health states, in terms of consistency and reliability. To compare both TTO methods with direct rating. PATIENTS AND METHODS: Eighty-four patients treated with oral anticoagulants were interviewed twice. During the 1st interview, values for 5 temporary health states were obtained with a rank ordering procedure, direct rating, and the chained TTO method. During the 2nd interview, either the 1st interview was repeated (n = 30) or health state values were obtained with the conventional TTO method (n = 54). Consistency was assessed by comparing the 3 valuation methods with the rank ordering procedure. Generalizability theory was used to assess reliability. RESULTS: The 3 methods produced significantly different valuations of health states. Chained TTO values were higher than values obtained with direct rating and the conventional TTO. Consistency and reliability did not differ across the 3 methods. CONCLUSION: The authors found no evidence for a difference in consistency and reliability between the chained TTO method and the conventional TTO method in the valuation of temporary health states. As direct rating is simpler to administer than both TTO methods, one could consider using direct ratings for the valuation of temporary health states. Biases associated with the conventional and the chained TTO method are discussed.

Administration, Oral↗