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PubMed2001

Relationships among perceived justice, customers' satisfaction, and behavioral intentions: the moderating role of gender.

This article tested the gender differences in the relationships between perceptions of justice, customers' satisfaction, and behavioral intentions. The sample consisted of 334 subjects (205 men and 129 women) surveyed in 38 hotels located in Spain. A questionnaire was used to measure distributive, procedural, and interactional justice as well as customers' responses of satisfaction and intentions. Analysis showed that the correlation between scores for distributive justice and customers' satisfaction as well as that between distributive justice and intentions were greater for men than for women. In contrast, the sex differences in the links of procedural and interactional justice to satisfaction and intentions were not significant.

Adult↗

PubMed1988

Importance of nurse caring behaviors as perceived by patients after myocardial infarction.

Our purpose was to identify nursing behaviors perceived as indicators of caring by patients who have had a myocardial infarction. A sample of 22 hospitalized patients were interviewed, with use of an open-ended question and the Caring Behaviors Assessment, to determine what things nurses said or did that conveyed caring to the patients during their stay in the coronary care unit (CCU). An analysis of the relative importance of each identified behavior revealed that nursing actions that focused on the physical care and monitoring of patients were seen as most indicative of caring. Teaching activities were also perceived as significant whereas extra, individualized aspects of care were viewed as less important in the critical care setting. No significant differences in perceptions were found on the basis of sex, age, education level, number of CCU admissions, or length of CCU stay. Critical care nurses should be aware that assessment activities and demonstration of professional competence are viewed by patients as significant expressions of caring.

Adult↗

PubMed1983

A study of family practice in New York City.

The purpose of this study was to describe the family physician's patient population in epidemiologic terms and to elucidate why a person would choose to see a family physician rather than other specialists in an urban area. The patient populations of family practices in New York City are described in terms of their demographic and practice attendance characteristics. Comparing their family physicians with other specialists, the patients rated their family physicians on the 12 aspects of care shown in the literature to be most important to patients in terms of physician consulting behavior (continuity, comprehensiveness, family care, rapport, low cost, convenience, interest, time with patient, support, personalized care, convenience of appointment and follow-up, and waiting time). Family physicians scored significantly better than other specialists on each aspect of care (P less than .0001). This study indicates that patients choose to consult family physicians rather than other specialists in New York City because patients view the family physician as performing better than other specialists those aspects of care most important to the patient. There is a need for further study to determine the attitudes of patients seeing other specialists.

Adolescent↗

PubMed1978

The Medical Interview Satisfaction Scale: development of a scale to measure patient perceptions of physician behavior.

Patient satisfaction is a variable of increasing interest to researchers, clinicians, and medical educators. Of several studies reviewed, only a few have shown evidence of careful methodology. Most surveys have focused on general evaluations of doctors and/or health care services or of a particular facility. The present article reports the development of a scale to measure patient satisfaction with an encounter with a physician or other primary care provider. Methods of item generation and pretesting are detailed. The overall reliability of the scale (Cronbach's coefficient alpha) is 0.93. The distribution of satisfaction scores is broader than that reported for other scales and approaches the normal in shape. Clinical and research applications of the scale are suggested.

Adult↗

PubMed1989

The case for using industrial quality management science in health care organizations.

In an effort to provide health care of optimal quality, providers traditionally assess or measure performance and then assure that it conforms to standards. In cases where performance fails to conform, providers attempt to modify or improve physician behavior. The analytic scope of this traditional paradigm may not be broad enough to allow modern health care organizations to provide optimal care. At a theoretical and practical level, many conceptual limitations inherent in the traditional approach are addressed in modern industrial quality science. A fundamental principle of industrial quality control is the recognition, analysis, and elimination of variation. Based on rigorous analysis of variation in outcomes and processes, industrial quality experts have developed principles and techniques for quality improvement. Health care organizations may well make important advances in the quality of care and service through the application of these principles and techniques.

Consumer Behavior↗

PubMed2000

Risk perception in consumer product use.

In the literature, at least two distinct connotations of risk can be found: so called objective risk, defined as the ratio of a particular number of accidents and a measure of exposure, and subjective risk, defined as the perception and awareness of risks by the person(s) involved. This article explores the significance of risk perception and awareness in understanding and clarifying how and why accidents involving consumer products occur. Based on empirical evidence from video-recorded reconstructions of accidents with consumer products, the risk perception and awareness of users in relation to featural and functional product characteristics, and their influence on actual product use culminating in an accident, is addressed. In contrast with what is usually assumed in the literature, the findings show that the majority of the subjects had no idea that they were running any risk of injuring themselves while they operated the product. In several accidents, the product either offered functionalities not anticipated in the design or did not adequately reflect its condition. The implications of the findings for design practice as well as for risk research are discussed.

Accidents↗

PubMed2005

Physician-parent communication as predictor of parent satisfaction with child development services.

The purpose of this study was to assess the level of parental satisfaction with services of a child development center and to evaluate the physician-parent dimensions of communication. A total of 90 parents to children with disability ranging in age from 6 months to 6 years participated in the study (84% response rate). Attitudes regarding parental communication with physicians were evaluated by 15 items clustered into three factors, which expressed different dimensions of communication: caring, collaboration and interest. Parents ranked their general satisfaction with the center's services relatively high as well as their evaluations of physician behavior of caring, collaboration and interest. Positive and statistically significant correlations were found between the studied communication dimensions and general satisfaction. However, collaboration was the only dimension that explained the variability on general satisfaction in a multivariate analysis. The collaboration of the physician with the parents was a key factor to explain parental general satisfaction with child rehabilitative services. Collaboration, which is associated with processes such as mutual decision making and sharing of responsibility, should be nurtured, in order to increase parents' general satisfaction with the services given.

Adult↗

PubMed1988

[Forensic-psychologic-psychiatric assessment from the viewpoint of perpetrators--data from a survey].

In this contribution, various aspects of the expert/culprit-relationship and of the communication behavior styles between the included persons within the scope of forensic-psychological-psychiatric expertise, are discussed. A survey is given on results gained with a questionnaire study (n = 93 culprits; Department of Forensic Psychiatry, Charité Berlin) of the most important expectations, of the social-relevant attitudes towards the assessment and physicians before the forensic investigation as well as of the experiences of own feelings, stress and of the culprit's reflections on the physician/proband relationship after the assessment. A good partnership relation between experts and culprits presupposes that the expert not only possesses a high profession but also the necessary interpersonal-social competence.

Adaptation, Psychological↗

PubMed1984

873 questions of Dutch dental patients: a challenge to dental health education.

2000 persons from an a-select sample of the Dutch population were sent a questionnaire in which the most important question was: "Did you have any questions on matters related to dentistry during the past year?" The question was by nature an open question, and the respondents were entitled to several answers. 640 questionnaires were sent back, of which 398 actually provided an answer to the request. Although the request was for questions only, there were also clear expressions of dissatisfaction. A coding system is described that was developed to classify the 873 answers, in which 751 were identified as questions and 122 as complaints. The problems are highly varied as to their contents. Most questions bear on the dentist's activities (35%). Most striking is that these questions can be answered by any dentist. The category on dental minded behavior accounts for 22% of the questions, that on various aspects of the dentist-patient communication and on fear accounts for 17%, and the category on financial problems in dentistry accounts for 16%. Bearing in mind that the composition of the group of 640 respondents differs from that of the entire Dutch population, the results should be interpreted with due care. The discussion includes a plea for more DHE-activities on an individual basis. Finally, it is shown what the use can be of a coding system of questions and complaints of patients in dental health care.

Adult↗

PubMed1985

What Massachusetts residents know about fluoridation.

The Massachusetts Department of Public Health conducted a comprehensive, statewide telephone health interview survey during 1980. Adult members of 1,091 households were interviewed. The purpose of this paper is to report the attitudes and knowledge of the Massachusetts residents surveyed regarding fluoridation, as well as the relation of their attitudes with demographic and socioeconomic variables, dental and other health behaviors, and outcome of fluoridation referenda. The majority, 60 percent, were in favor of community water fluoridation. As expected, groups that were most likely to favor fluoridation were parents, those who were better educated, and those with higher incomes. About three-fourths of those surveyed were correctly aware of the purpose of fluoridation. Public opinion about fluoridation, as measured by this survey, did not correspond with the outcome of fluoridation referenda held in 14 Massachusetts communities between 1980 and 1983, which showed that 61 percent of the voters were not in favor of fluoridation.

Adolescent↗

PubMed1994

[Certain behavior and attitudes of workers associated with dental care provided in the workplace].

Dental care at places of employment was assessed under the Polish edition of the International Collaborating Studies of Oral Health Outcomes. The study was focused particularly on the use of primary conservative dental care (accessibility of dental care in polyclinics provided by institutions), reasons why workers are not willing to see dentists in their polyclinics as well as the judgement of the quality of primary dental care (the degree to which this kind of care is available for and approved by workers, the extent of positive judgements of primary conservative dental care). The analysis indicated rather strong disapproval of dental care rendered by polyclinics with view to ill-functioning of polyclinics rather than to their existence.

Adult↗

PubMed2006

Effects of service provider attitudes and employment status on citizenship behaviors and customers' attitudes and loyalty behavior.

The relationship among job satisfaction, affective commitment, service-oriented organizational citizenship behaviors (OCBs), customer satisfaction, and customer loyalty were examined for a sample of 249 hairstylists and 1 of their corresponding customers. Employee satisfaction was positively related to service-oriented OCBs, customer satisfaction, and customer loyalty, whereas affective commitment was not related to these outcomes. The extent to which the predictor variables interacted with one another and the role of employment status on these relationships was also explored. High levels of job satisfaction or affective commitment resulted in more service-oriented OCBs for employees and self-employed workers, whereas high levels of both resulted in more service-oriented OCBs for owners.

Adult↗

PubMed2004

Cause-and-effect analysis of risk management files to assess patient care in the emergency department.

OBJECTIVES: Identifying the etiologies of adverse outcomes is an important first step in improving patient safety and reducing malpractice risks. However, relatively little is known about the causes of emergency department-related adverse outcomes. The objective was to describe a method for identification of common causes of adverse outcomes in an emergency department. This methodology potentially can suggest ways to improve care and might provide a model for identification of factors associated with adverse outcomes. METHODS: This was a retrospective analysis of 74 consecutive files opened by a malpractice insurer between 1995 and 2000. Each risk-management file was analyzed to identify potential causes of adverse outcomes. The main outcomes were rater-assigned codes for alleged problems with care (e.g., failures of communication or problems related to diagnosis). RESULTS: About 50% of cases were related to injuries or abdominal complaints. A contributing cause was found in 92% of cases, and most had more than one contributing cause. The most frequent contributing categories included failure to diagnose (45%), supervision problems (31%), communication problems (30%), patient behavior (24%), administrative problems (20%), and documentation (20%). Specific relating factors within these categories, such as lack of timely resident supervision and failure to follow policies and procedures, were identified. CONCLUSIONS: This project documented that an aggregate analysis of risk-management files has the potential to identify shared causes related to real or perceived adverse outcomes. Several potentially correctable systems problems were identified using this methodology. These simple, descriptive management tools may be useful in identifying issues for problem solving and can be easily learned by physicians and managers.

Causality↗

PubMedDate not supplied

The power of product integrity.

In the dictionary, integrity means wholeness, completeness, soundness. In products, integrity is the source of sustainable competitive advantage. Products with integrity perform superbly, provide good value, and satisfy customers' expectations in every respect, including such intangibles as their look and feel. Consider this example from the auto industry. In 1987, Mazda put a racy four-wheel steering system in a five-door family hatchback. Honda introduced a comparable system in the Prelude, a sporty, two-door coupe. Most of Honda's customers installed the new technology; Mazda's system sold poorly. Potential customers felt the fit--or misfit--between the car and the new component, and they responded accordingly. Companies that consistently develop products with integrity are coherent, integrated organizations. This internal integrity is visible at the level of strategy and structure, in management and organization, and in the skills, attitudes, and behavior of individual designers, engineers, and operators. Moreover, these companies are integrated externally: customers become part of the development organization. Integrity starts with a product concept that describes the new product from the potential customer's perspective--"pocket rocket" for a sporty, subcompact car, for example. Whether the final product has integrity will depend on two things: how well the concept satisfies potential customers' wants and needs and how completely the concept has been embodied in the product's details. In the most successful development organizations, "heavyweight" product managers are responsible for leading both tasks, as well as for guiding the creation of a strong product concept.

Consumer Behavior↗

PubMed2003

The one number you need to grow.

Companies spend lots of time and money on complex tools to assess customer satisfaction. But they're measuring the wrong thing. The best predictor of top-line growth can usually be captured in a single survey question: Would you recommend this company to a friend? This finding is based on two years of research in which a variety of survey questions were tested by linking the responses with actual customer behavior--purchasing patterns and referrals--and ultimately with company growth. Surprisingly, the most effective question wasn't about customer satisfaction or even loyalty per se. In most of the industries studied, the percentage of customers enthusiastic enough about a company to refer it to a friend or colleague directly correlated with growth rates among competitors. Willingness to talk up a company or product to friends, family, and colleagues is one of the best indicators of loyalty because of the customer's sacrifice in making the recommendation. When customers act as references, they do more than indicate they've received good economic value from a company; they put their own reputations on the line. And they will risk their reputations only if they feel intense loyalty. The findings point to a new, simpler approach to customer research, one directly linked to a company's results. By substituting a single question--blunt tool though it may appear to be--for the complex black box of the customer satisfaction survey, companies can actually put consumer survey results to use and focus employees on the task of stimulating growth.

Commerce↗

PubMed1983

Assessing residents' behavioral science skills: patients' views of physician-patient interaction.

Although residents' interactive skills within the physician-patient relationship are important in behavioral science training, these skills are often difficult to define and even more difficult to evaluate. Evaluation of these skills through direct observation by faculty miss the patient's perspective. Scales that have been developed to obtain the patient's perspective have generally been based on the researcher's definition of what is important in the physician-patient interaction, and few of these studies have adequate reliability and validity information. This study was conducted to identify physician behaviors that patients themselves consider to be important in the physician-patient interaction and then to develop a reliable, valid scale to evaluate residents' ability to perform these skills. Several factors were identified as important to patients in the physician-patient interaction, including being informed about their examination, treatment, and diagnosis, being treated by the physician in a respectful manner, and having the physician listen to their concerns and take their individual needs into consideration when prescribing treatment. A reliable and valid questionnaire was developed that can be used to assist faculty in assessing residents' skills in this area from the patient's perspective.

Clinical Competence↗

PubMed2006

School-based occupational therapy for children with fine motor difficulties: evaluating functional outcomes and fidelity of services.

Consultative occupational therapy services are becoming widely used in the school environment. However, few studies have evaluated the utility of and the process by which these services are delivered. This study examined whether the written communication and fine motor skills of 23 children with fine motor difficulties improved after receiving school-based occupational therapy from a program whose mandate was to deliver services according to a consultation model of service delivery. In addition, the study assessed the process of service delivery, including treatment fidelity, or the extent to which consultation services were implemented as intended. Statistically significant and practically meaningful improvement was found in written communication on the Vineland Adaptive Behavior Scales-Classroom Edition (VABS-C) and School Functional Assessment-Version 3.0 (SFA), and in fine motor skills on the SFA, but not on the VABS-C. An examination of the service delivery process revealed that therapists deviated from a purely consultative model, with 86% providing some direct therapy to children. Parents were mostly satisfied with services received, whereas teachers were indifferent or somewhat dissatisfied. Treatment fidelity is taken into consideration when discussing study findings. Recommendations to enhance school-based occupational therapy services delivered according to a primarily consultative model, and suggestions for future research, are provided.

Child↗

PubMed1991

Satisfaction with communication, medical knowledge, and coping style in patients with metastatic cancer.

Interviews were conducted with 77 patients aged 19-84, admitted to a medical oncology ward for assessment and modification of treatment. Satisfaction with information provided about tests, symptoms and treatment was assessed, together with satisfaction with care in general, factual knowledge concerning cancer and other medical conditions, and anxiety. Habitual style of coping with stress by information-seeking vs avoidance was measured using the Miller Behavioral Style Scale. Satisfaction levels were generally high. Patients reporting the highest level of satisfaction with information were more avoidant in their coping style than the remainder, and were also less anxious. Factual knowledge about cancer was in contrast greater among patients who were less satisfied with communication. These patterns were not dependent on age or education. It is argued that satisfaction with communication in medical settings is not a simple function of communication skills and the provision of adequately structured information, but that patients' tendencies to cope with stress by seeking out or avoiding information need to be taken into account.

Adaptation, Psychological↗