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PubMed1989

The quality of outpatient psychiatric care. A survey of patient satisfaction in a sectorised care organisation.

Patient satisfaction with outpatient psychiatric care in a sectorised care organisation was studied by means of a mailed questionnaire to a one-year population of patients. Response rate was 40.7%. The results showed a high general satisfaction with treatment. Satisfaction was highest in areas of treatment planning/treatment design, treatment accomplishment and relationship to staff. A somewhat lower level of satisfaction was noted concerning information and coinfluence of the patient. Level of satisfaction was not related to social and psychiatric background characteristics. Patients with longer time in therapy showed a higher level of satisfaction. Patients' ratings of the quality of information and coinfluence were related to both satisfaction with treatment and treatment outcome, pointing to the importance of these factors for course of treatment and treatment success. A comparison with patient satisfaction with in-hospital care revealed significant differences in favour of the outpatient group. It is concluded that surveys of patient satisfaction with care may be a important and useful tool in the evaluation of changes in care organisations and in the monitoring of quality assurance standards.

Adult↗
PubMed1991

The development of a patient satisfaction questionnaire in the ambulatory setting.

Patient satisfaction is of critical interest to medical care providers. The main objective of this study was to evaluate the psychometric properties of a patient satisfaction questionnaire. A preliminary 80-item questionnaire was created, and a random sample of 268 family practice patients participated. Subjects rated items on a 4-point Likert scale (strongly disagree, disagree, agree, strongly agree). Items were subjected to a principal components varimax rotated factor analysis and five factors (60 items) were extracted, accounting for 47.5% of the variance. These factors were: satisfaction with physician, dissatisfaction with practice management, physician availability, receptionist behavior, and wait time. Alpha reliability coefficients for factors 1-5 were: .96, .93, .89, .84, and .78, respectively. All items correlated highly with total scores on the respective factors. Factor intercorrelations were all significant (P less than .001) and in the expected direction. Patients with a higher level of education were significantly less satisfied about physician availability than patients without a high school education (P less than .05). Implications of the findings are discussed.

Adult↗
PubMed1991

Laboratory phlebotomy. College of American Pathologists Q-Probe study of patient satisfaction and complications in 23,783 patients.

Outpatients from 630 institutions participated in a phlebotomy module of Q-Probes, a quality assurance program of the College of American Pathologists, Northfield, Ill. This module assessed patient outcome measurements of complications, discomfort, and satisfaction with the phlebotomy procedure. Of the 29,700 ostensibly healthy individuals registered, 80.1% returned postcards containing measurements and assessments they made about the procedure and information recorded by the phlebotomist. The median time required for phlebotomy was 6 minutes, with 25% of patients requiring less than 5 minutes and 10% more than 21 minutes for completion of the procedure. The average number of phlebotomy attempts per patient was 1.03, with 95 patients (0.4%) experiencing three to 11 attempts. Ecchymoses occurred in 4048 (16.6%) attempts, with the median size of ecchymosis being 15.1 mm. On the average, an outstanding employee was identified by patients 46.6% of the time. The discomfort caused by the needle puncture was more than expected by 35.3% of patients. Although 98.6% of the patients were satisfied, 336 patients were dissatisfied with the procedure. We conclude that the technical skills of phlebotomists and patient satisfaction with phlebotomy are outstanding, but that patient discomfort from the procedure needs to be minimized.

Bloodletting↗
PubMed1991

Patient satisfaction with nursing care in Alexandria, Egypt.

The study assessed the satisfaction of medical and surgical patients in a university hospital in Egypt using the La Monica/Oberst Patient Satisfaction Scale. In spite of the nursing shortage in that hospital, the results indicated that patient satisfaction was high. The implications for nursing care are discussed in terms of the validity of the scale and the objectivity of clients when responding to the questionnaire.

Adult↗
PubMed1991

Patient satisfaction with gynecologic care provided by family practice resident physicians.

This study assessed the impact on patient satisfaction of second-year family practice residents participating in a one-month gynecology rotation at a university-owned satellite ambulatory care facility. Its purpose was to examine whether residents can be incorporated into university-operated satellite health centers for patient care and resident education without decreasing patient satisfaction. With the exception of one item on the patient satisfaction questionnaire, results showed no significant difference in patient satisfaction ratings between one family practice faculty physician and five family practice residents. This finding supports increased efforts to incorporate residents into academic ambulatory care satellites in limited direct patient care roles similar to those described in this report.

Evaluation Studies as Topic↗
PubMed1991

The relationship of physician medical interview style to patient satisfaction.

The results of previous studies on the relationship between patient satisfaction and specific interviewing behaviors have been difficult to generalize because most studies have examined small samples of patients at one clinical location, and have used initial or acute care visits where the patient and physician did not have an established relationship. The present collaborative study of medical interviewing provided an opportunity to collect interviews from 550 return visits to 127 different physicians at 11 sites across the country. Tape recordings were analyzed using the Roter Interaction Analysis System, and postvisit satisfaction questionnaires were administered to patients. A number of significant relationships were found between communication during the visit and the various dimensions of patient satisfaction. Physician question asking about biomedical topics (both open- and closed-ended questions) was negatively related to patient satisfaction; however, physician question asking about psychosocial topics was positively related. Physician counseling for psychosocial issues was also positively related to patient satisfaction. Similarly, patient talk about biomedical topics was negatively related to satisfaction, while patient talk regarding psychosocial topics was positively related. Furthermore, patients were less satisfied when physicians dominated the interview by talking more or when the emotional tone was characterized by physician dominance. The findings suggest that patients are most satisfied by interviews that encourage them to talk about psychosocial issues in an atmosphere that is characterized by the absence of physician domination.

Adult↗
PubMed1991

Patient satisfaction--does it matter?

The paper aims at answering the question: Has the measurement of patient satisfaction improved the quality of care? After concluding that there is no evidence in the literature, the paper proceeds to look at why the evidence is lacking. Four factors seem to explain it: the objectives, the focus and the originator of the patients satisfaction studies and measurements and difficulties related to the interpretation of the findings. The last part of the paper analyses why patient satisfaction should be taken seriously although we do not know whether its measurement improves the quality of care. They include the fact that the patients are partners in health care; they literally feel in their skin whether care is good or bad. They are also the best judges of certain aspects of care, such as amenities and interpersonal relations. The second reason is the transformation of health care from a sellers' market to a consumers' market where the satisfaction of the patients' needs is part of the definition of quality. Finally, there is the ideological reason that, in a democratic society, the patients should have the right to influence decisions and activities influencing them. Measurement of patient satisfaction realizes the principle of community participation in health care.

Health Services Research↗
PubMed1988

Patient satisfaction with dental care.

The feedback studies illustrate the fact that it is possible for the individual practitioner or member of a group practice to take positive steps to enhance satisfaction among his or her patients. Simply knowing about the general components of patient satisfaction is not enough; one needs to know about the views of one's own patients so that effective steps can be taken to improve them. The steps may include changes in office policies or procedures, facilities or staff changes, or even changes in the dentist's interpersonal approach. In any case, the evidence suggests that efforts to improve will be rewarded by more satisfied patients who will be more likely to stay as clients and, perhaps, more readily accept treatment and more frequently refer friends to the practice. The consistent role of dentists' interpersonal skills suggests that dental schools could contribute to patient satisfaction by providing more interpersonal skills development in their curricula. This was a major recommendation of the 1984 Future of Dentistry Final Report. The evidence presented in this chapter firmly supports that recommendation.

Anxiety↗
PubMed1988

Measuring patient satisfaction with life in a long-stay psychiatric hospital.

A survey of patient satisfaction with physical and social conditions was carried out in the long-stay wards of a large inner city psychiatric hospital in London, Britain. Patient satisfaction was assessed by means of an administered questionnaire which was developed specifically for this purpose. Factor analysis identified eight components of patient satisfaction. Of 143 eligible patients, 104 (73%) successfully completed the interview. Responses showed that patients were generally satisfied with life in the hospital, although levels of satisfaction varied significantly among wards. The factors causing greatest dissatisfaction related to failure to be treated as individuals and to feelings of isolation and apathy. Our findings showed that patients can express views about their conditions which should be useful in planning improvements in care. The questionnaire proved a simple and effective method of measuring satisfaction and may be useful to others concerned with improving the quality of the environment of patients.

Adult↗
PubMed1992

The outcome of arthritis: measures of function, X-rays damage, pain and patients' satisfaction.

The outcome of arthritis has several dimensions. These include mortality, morbidity, radiological measures of joint destruction, pain, and patients' satisfaction with therapy. Functional disability measured by health status questionnaires, is directly associated with long-term outcome and mortality. Long term clinical trials should incorporate functional indices as outcome measures. Studies measuring the outcome of arthritis should define clear end-points involving the determination of functional classes and this will allow standardised and sensitive end points. An example would be the time taken to reach a given functional class or increase from baseline by one functional class. Patients' satisfaction with treatment is a different dimension of response. There are considerable advantages in using an index of patients' satisfaction when determining the therapeutic efficacy in short term clinical trials. It gives a different indication of the response to treatment than conventional clinical and laboratory measures of disease activity. Alleviating pain and preservation of function remain the major therapeutic goals, and both reflect the outcome of arthritis. Outcome measures have shifted from laboratory markers and radiographic techniques to measures of health status, pain, and patients' satisfaction. These should become a routine part of patient assessment.

Arthritis↗
PubMed1991

Patient satisfaction on AIDS and oncology special care units and integrated units: a pilot study.

The authors assessed patients' satisfaction with their nursing care in seven hospitals. Five of the hospitals utilized the special care unit (SCU) method of delivering care to AIDS or oncology patients; three had SCUs for AIDS patients. All seven of the hospitals had integrated units (IUs) where general medical, oncology, and/or AIDS patients were received in various proportions. Satisfaction with nursing care was measured with the Risser Patient Satisfaction Instrument. Patient satisfaction with nursing care was shown to be a function of delivery method; AIDS and oncology patients on SCUs expressed greater satisfaction with their care than medical, oncology, or AIDS patients on IUs (p less than .001). Patient satisfaction with nursing care was greater among whites than nonwhites. Also, some major sociodemographic and case mix variables, such as age, employment status, and diagnosis, were not associated with patient satisfaction directly; in other instances, the associations initially seen did not hold when delivery method (SCU vs. IU) and race were controlled for in a linear regression analysis.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Patient satisfaction after insertion of an osseointegrated implant bridge.

The general and specific satisfaction of patients treated with a jawbone-anchored bridge was compared with their pretreatment satisfaction with dentures (condition 1, n = 31). Patients who asked for information on the osseointegration method but did not apply for treatment (condition 2, n = 32), and a group of patients that did not ask for information (condition 3, n = 10) were also questioned on their satisfaction with dentures. The results indicated that condition 1 subjects were both socially and physically substantially more satisfied with their bridge than with their earlier dentures. On all satisfaction measures condition 3 subjects indicated more satisfaction with dentures than either condition 1 or condition 2 subjects. There were no significant differences between the three groups on several personality characteristics (neuroticism, test-taking attitudes, internal/external control). Condition 3 subjects were less extrovert (socially oriented) than the other subjects. Condition 1 subjects made several suggestions towards improvement of the pre- and post-operation phase, concerning the amount of pain involved and the cleaning of the bridge, etc.

Consumer Behavior↗
PubMed1991

Understanding patient satisfaction and dissatisfaction with health care.

Patient satisfaction or dissatisfaction is a complicated phenomenon that is linked to patients' expectations, health status, and personal characteristics, as well as health system characteristics. This article presents a cross-sectional study of the relationship among these factors using data collected from a large sample of university employees. The primary hypothesis, that patients' expectations would be the best predictor of satisfaction, was supported by the data. Health status, personal characteristics, and health system characteristics were not strong predictors. The findings suggest that patients may base their evaluations on sophisticated expectations and that those expectations vary from one sociodemographic group to another. Implications for social work practice in health care are highlighted.

Adult↗
PubMed1989

Regular source of primary medical care and patient satisfaction.

As hypothesized, results indicate the greater the degree of continuity in the physician/patient relationship, the higher the level of patient satisfaction. The level of continuity was related to each of the five scale items individually and to the overall patient satisfaction scale. Even when patient background characteristics were controlled, continuity remained a key predictor of satisfaction with primary care received. This study demonstrates the importance of conceptualizing continuity on a continuum, or at least across several categories, rather than reducing it to an either/or construct. Important differences in patient satisfaction occur between and among patients who see the same physician for each episode of primary care, who attend a small group of physicians working together, who attend a clinic or medical center where a different physician may be seen on each occasion, and who do not have a regular source of care. To the extent that patient satisfaction is accepted as a worthwhile objective for the delivery of medical care, emphasis should be placed on providing the maximum feasible level of continuity. This goal is applicable to nurses and other members of the health care team as well as to physicians. It is certainly relevant for those in position to determine an institution's commitment to providing continuous care. For example, directors of prepaid medical plans are increasingly favoring arrangements that include some degree of continuity between physician and patient. Many medical schools that offer courses in patient management are expanding their emphasis on the value of continuity in the physician/patient relationship.(ABSTRACT TRUNCATED AT 250 WORDS)

Consumer Behavior↗
PubMed1989

Development and validation of an instrument to measure patient satisfaction with pharmacy services.

A research program was undertaken to develop and validate a multidimensional measure of patient satisfaction with pharmacy services. A self-administered questionnaire consisting of 44 Likert-type attitudinal items was adapted from the Patient Satisfaction Questionnaire developed by Ware et al. In an iterative scale development process, the adapted questionnaire and its revisions were evaluated in three successive studies conducted on convenience samples (n = 30, 313, 489) of individuals in attendance at family practice clinics in a southwestern city. Methods used to construct multi-item scales measuring separate dimensions of service included principal components factor analysis and item analyses. Acquiescent response set (ARS), the tendency to agree with statements of opinion regardless of content, was measured by the method of matched pairs of items. A partial correlation matrix which controlled for ARS was used as the data in a principal components factor analysis in an effort to reduce the biasing effect of ARS on factor analytic outcomes. Dimensions of satisfaction identified were Explanation, Consideration, Technical Competence, Financial Aspects, Accessibility, Drug Efficacy, OTC (over-the-counter) Product Availability, and Quality of the Drug Product. Questionnaire revision is suggested to confirm the validity of the latter two dimensions Future research should examine the relationship between separate dimensions of satisfaction and other patient attitudes and behaviors, and the convergence between this instrument and other measures of patient satisfaction with pharmacy services.

Adolescent↗
PubMed1990

Development of a questionnaire to assess patients' satisfaction with consultations in general practice.

The assessment of patient satisfaction has become an important concern in the evaluation of health services. Measures of satisfaction must be valid and reliable if they are to be used widely. This paper reports the development of a new questionnaire to assess patients' satisfaction with consultations together with initial tests of the questionnaire's reliability and validity. Principal components analysis of the patients' assessments of care revealed three factors of satisfaction: the professional aspects of the consultation, the depth of the patient's relationship with the doctor, and the perceived length of the consultation. The consultation satisfaction questionnaire is reliable under the conditions of this study and may have a role in research, medical education and audit.

Consumer Behavior↗
PubMed1991

Patient satisfaction with Mentor inflatable penile prosthesis.

Patient satisfaction with the Mentor inflatable penile prosthesis was assessed by sending a thirty-six-item questionnaire to 251 patients who had undergone implantation of the device by the senior author (D.C.M.). A total of 152 (61%) of the patients responded. Recovery time, satisfaction, reasons for dissatisfaction, perceptions of erection quality, and psychosexual parameters were evaluated. Eight-eight percent of the patients were engaging in regular sexual activity. Depending on the definition of satisfaction, 81-89 percent of the respondents reported that they were satisfied with the prosthesis. Sixty-eight percent of the survey group were satisfied with the length, width, and firmness of their prosthetic-induced erection. The majority of patients reported improvement in psychosexual functioning after implantation. Reasons for dissatisfaction included inadequate penile length, insufficient firmness, and difficulty with inflation and deflation of the penile cylinders.

Adult↗