Patient satisfaction with nursing care and related hospital services at the National Hospital of Sri Lanka

Satisfaction of intensive care unit patients linked to clinical and organisational factors: A cross-sectional multicentre study

BACKGROUND

The satisfaction of critical care patients with the nursing care they receive is a key indicator of the quality of hospital care.

OBJECTIVES

The objectives of this study were to analyse the level of satisfaction of critical care patients in relation to the nursing care received and to determine the relationship between the level of satisfaction and sociodemographic, clinical, and organisational variables.

DESIGN

This was a prospective, descriptive correlational study.

SETTING AND METHODS

The population consisted of all patients discharged from the intensive care units (ICUs) of 19 hospitals in Spain between December 2018 and December 2019. The level of satisfaction was measured using the validated Nursing Intensive Care Satisfaction Scale, and sociodemographic, clinical, and organisational data were collected.

RESULTS

Participants' mean age (n = 677) was 59.7 (standard deviation: 16.1), and 62.8% of them were men (n = 426). Satisfaction with the nursing care received was 5.66 (SD: 0.68) out of a possible 6. The score for overall satisfaction presented statistically significant relationships with the hours of mechanical ventilation (p = 0.034), with the participant's perception of own health status (p = 0.01), with the participant's perceived degree of own recovery (p = 0.01), with the hospital's complexity level (p = 0.002), with the type of hospital (p = 0.005), and with the type of ICU (p = 0.004). Finally, the logistic regression model shows that the Nursing Intensive Care Satisfaction Scale score was not linked to age or sex but did have a statistically significant relationship with the perceived degree of recovery (p < 0.001) and the type of ICU (p=<0.001). The variables that predicted satisfaction were age, degree of recovery, and the type of ICU.

CONCLUSION

Several studies show that patient satisfaction is related to the patient's perceived health status and perceived degree of recovery, a finding that is confirmed in our study. Our study moves beyond these outcomes to show that the hours of mechanical ventilation and the characteristics of the hospital also have a significant relationship with patients' satisfaction.

Patient Satisfaction With Breast Cancer Care Delivery at the National Cancer Institute of Sri Lanka: Does Language Play a Role?

PURPOSE

This study sought to examine whether there was an association between language barriers and patient satisfaction with breast cancer care in Sri Lanka.

METHODS

A telephone-based survey was conducted in the three official languages (Sinhala, Tamil, or English) among adult women (older than 18 years) who had been treated for breast cancer within 6-12 months of diagnosis at the National Cancer Institute of Sri Lanka. The European Organisation for Research and Treatment of Cancer Satisfaction with Cancer Care core questionnaire was adapted to assess three main domains (physicians, allied health care professionals, and the organization). All scores were linearly transformed to a 0-100 scale, and subscores for domains were summarized using means and standard deviations. These were also calculated for the Sinhalese and Tamil groups and compared.

RESULTS

The study included 72 participants (32 ethnically Tamil and 40 Sinhalese, with 100% concordance with preferred language). The most commonly reported best aspect of care (n = 25) involved affective behaviors of the physicians and nurses. Ease of access to the hospital performed poorest overall, with a mean satisfaction score of 54 (30.5). Clinic-related concerns were highlighted as the worst aspect of the care (n = 10), including long waiting times during clinic visits. Sixty-three percent of Tamil patients reported receiving none of their care in Tamil and 18% reported experiencing language barriers during their care. Tamil patients were less satisfied overall and reported lower satisfaction with care coordination (P = .005) and higher financial burden (P = 0.014).

CONCLUSION

Ethnically Tamil patients were significantly less satisfied than their Sinhalese counterparts and experienced more language barriers, suggesting there is a need to improve access to language-concordant care in Sri Lanka.

Exploring the factors that influence healthcare providers care quality in Jordanian hospitals: the perspectives of nurses, pharmacists and physicians

Objectives

The key point of this investigation is to explore factors that influence healthcare providers’ quality care in government hospitals in Jordan, from the perspective of nurses, pharmacists and physicians.

Method

A qualitative technique (case study) was executed in this project. Semi-structured interviews (face-to-face) were used. The thematic analysis was applied in this study. The interviews were conducted with five physicians, five pharmacists and five nurses at different levels, including different specialists from Jordanian government hospitals.

Key findings

Four vital factor influencing of nu healthcare providers’ quality care were recognised in the sampled hospitals: manager ability and leadership support of staff, adequate and qualified hospital nurses and physicians, building a trusting work environment and good salaries and incentive.

Conclusions

This examination attempted to offer an in-depth comprehending factor that impacts healthcare providers’ quality care. Furthermore, it contributes to healthcare theory and practice by developing a conceptual framework that offers policymakers and managers a practical understanding of factors that influence healthcare providers’ quality care.

Patient satisfaction in the context of public–private partnerships

Purpose

This study aims to provide insights into the public–private partnerships (PPP) concept and its performance measurement in the health-care sector, identifying and refining critical success factors, including the perceived quality of health care, as evidenced by patient satisfaction and policy requirements for successful PPP implementation.

Design/methodology/approach

This theoretical study explores the existing literature on the relationship between service quality and patient satisfaction, to propose a culture-specific conceptual model interlinking the drivers of patient satisfaction with PPP. The in-depth theoretical research focuses on the qualitative performance indicators of PPPs, as well as their corresponding peripheral factors.

Findings

The research presents theoretical evidence that the concept of patient satisfaction can only be viewed through a multifactor perspective that incorporates demographics of patients, perceived service quality factors and emotions. It is found that significant improvements in service quality and patient satisfaction do, indeed, emphasize the effective role of PPP in hospitals.

Practical implications

The theoretical model is based on a comprehensive set of both cognitive and affective determinants. And considering these, as well as their causes, effects and interrelations, sets the foundations for testing and for further research to develop. Moreover, the outcomes of this study can be used as a theoretical base for the development of a PPP qualitative performance measurement framework.

Originality/value

This study attempts to fill the gap in knowledge on service quality and patient satisfaction as qualitative indicators for hospital performance after and toward PPP, while setting explicit factors and opening clear research avenues for further studies to follow.

Tradeoff between efficiency and perceived quality: evidence from patient-level data

Objectives

To estimate technical efficiency scores of District Headquarter Hospitals (DHQHs) for obstetric services and to explore the relationship between the efficiency of DHQHs and the patients’ satisfaction about the quality of services provided.

Design, Setting and Participants

Data from Health Facility Assessment (HFA) survey is used for efficiency measurement. The data on patient’s perceptions and other control variables are taken from Client Exit Interviews part of the HFA survey. Two-stage residual inclusion, Ordered Logistic Regression and Least square dummy variable techniques are used to investigate the relationship between technical efficiency and patients’ satisfaction level.

Main Outcome Measure(s) and Results

The average efficiency score for Pakistan’s DHQHs is 0.52, and not a single hospital is fully efficient. Moreover, the relationship between technical efficiency and patients’ satisfaction is found to be negative and statistically significant indicating that an increase in hospital efficiency tends to decrease patients’ satisfaction. The disaggregated analysis reveals that patients’ satisfaction associated with the healthcare provider attitude and communication is more affected by technical efficiency.

Conclusion

Patients’ satisfaction level is more sensitive to physician’s attitude and communication. This makes sense because the longer the consultation time, the more accurate the diagnosis would be. This, together with a comforting and confident physician, is likely to achieve better patients’ satisfaction.

Level of satisfaction of critical care patients regarding the nursing care received: Correlation with sociodemographic and clinical variables

BACKGROUND

The satisfaction of critical care patients regarding the nursing care received is a key indicator of the quality of hospital care. It is, therefore, essential to identify the factors associated with the level of satisfaction of critical care patients.

OBJECTIVES

To analyse the level of satisfaction of critical care patients in relation to the nursing care received and to determine the relationship between the level of satisfaction and the sociodemographic and clinical variables.

METHODS

This is a prospective and descriptive correlational study. The population were all patients discharged (January 2013 to January 2015) from three intensive care units of a third-level hospital (n = 200). The data on the satisfaction level were collected using the previously validated Nursing Intensive-Care Satisfaction Scale, and the sociodemographic and clinical data were recorded by means of a questionnaire.

RESULTS

Mean participants' age in the study (n = 200) was 65.9 years (standard deviation 13.4 years), with a 66% proportion of men (n = 132). There was a very high level of satisfaction regarding the nursing care received during the patients' stay in the intensive care unit, with a rating of 5.73 (standard deviation 0.41). There is no correlation between the level of satisfaction and the sociodemographic variables collected. However, there were statistically significant differences in the average score of the overall level of satisfaction (rho = 0.182, p = 0.010) with respect to the perception of the state of health.

CONCLUSION

Critical care patients expressed very high rates of satisfaction, for both the scale as a whole and each of the factors. A high level of satisfaction is strongly influenced by the perception of the state of health.

A multi-year SEM model predicting the impact of behavior attributes on overall patient satisfaction

Purpose

Pressure from competition; inflexible third-party reimbursements; greater demand from government, regulatory and certifying agencies; discerning patients; and the quest of healthcare entities for greater profitably place demands and high expectations for service quality impacting overall patient experience. Extending a prior multivariate, single-period model of varied medical practices predicting patient experience to a three-year time period to understand whether there was a change in overall assessment using data analytics. The paper aims to discuss these issues.

Design/methodology/approach

SEM was employed on a per year and aggregated, three-year basis to gain insights into qualitative psychometric constructs predicting overall patient experience and strength of the relationships.

Findings

Statistically significant differences were uncovered between years indicating the strength of the relationships of latent variables on overall performance.

Research limitations/implications

Study focused on data gathered from a questionnaire mailed to patients who visited various outpatient medical clinics in a rural community with over 4,000 responses during the three-year study period. A higher percentage of female respondents over the age of 45 may limit the generalizability of the findings.

Practical implications

Practitioners can gain a broader understanding of different factors influencing overall patient experience. Administrative processes associated with the primary care provider are inconsequential. Patients are not as concerned with patient flow as they are with patient safety and health.

Originality/value

This research informs healthcare quality management of psychometrics and analytics to improve the overall patient experience in outpatient medical clinics.

Patients' experiences and satisfaction about care provided by male nurses in medical surgical units in Islamabad, Pakistan: A pilot study

BACKGROUND

Nursing is predominantly a female profession and caring has been considered an attribute of female nurses, which could imply a noncaring image of male nurses.

AIM

To determine patients' experiences and satisfaction from care provided by male nurses in a private hospital in Islamabad, Pakistan.

METHODS

This cross-sectional study included a purposive sample of 50 patients admitted to medical surgical units for at least 2 days and who had at least three professional interactions with a male nurse. The Newcastle Satisfaction with Nursing Scale was used for data collection. Descriptive statistics were used for data analysis.

RESULTS

The total score for experience and satisfaction was 81 and 51, respectively. A statistically significant difference existed between experience and satisfaction scores of male and female participants, indicating that males were more pleased and satisfied with their experience of receiving care from male nurses compared to the female participants.

CONCLUSION

The male nurses were concerned for their patients, they were knowledgeable about the patients' condition and care, and provided them with clear explanations of the medical and nursing procedures. However, they seem to lack interpersonal relationship with patients and did not take initiative in understanding their patients.

Interrelationships among quality enablers, service quality, patients’ satisfaction and loyalty in hospitals

Purpose

The purpose of this paper is to clarify how enablers of quality management can secure the satisfaction and loyalty of patients through increasing service quality in hospitals.

Design/methodology/approach

The current study conducted a review of the existing literature to identify operational dimensions of the research variables. As a result of the review, 17 dimensions were identified; five European foundation for quality management enablers, five SERVQUAL service quality dimensions, four patients’ satisfaction elements and three patients’ loyalty components. To evaluate interrelationships among these 17 research dimensions, decision-making trial and evaluation laboratory technique was applied using experts’ opinions.

Findings

Several key relations were found among research dimensions. Research findings could provide a scientific insight for hospital managers to understand how they could increase the level of patients’ satisfaction and loyalty through high-quality services provided by quality management enablers.

Research limitations/implications

This study has been conducted based on the expert’s opinions from private hospitals located in Tehran and Alborz provinces, Iran. Although the results could be useful for hospital managers in different places and could provide them a valuable insight and knowledge, findings are limited to Iranian private hospitals.

Originality/value

It is taken for granted that patients’ satisfaction and loyalty could increase as a result of high-quality medical and treatment services in hospitals. On the other hand, offering excellent services meeting all the needs and expectations of customers could be consequence product of quality management enablers. Even though satisfaction and loyalty of customers, i.e. patients, is the primary target of quality management, there is little research in the literature as to how enablers of quality management can secure the satisfaction and loyalty through increasing service quality in hospitals. The gap is more critical because the specialized dimensions of four research variables have not been previously integrated into a coherent framework and interrelationships among them have not been studied and clarified in detail. The current study attempts to bridge this gap.

Determinants of patient satisfaction: a systematic review

AIM

A large number of studies have addressed the detection of patient satisfaction determinants, and the results are still inconclusive. Furthermore, it is known that contradicting evidence exists across patient satisfaction studies. This article is the second part of a two-part series of research with a goal to review a current conceptual framework of patient satisfaction for further operationalisation procedures. The aim of this work was to systematically identify and review evidence regarding determinants of patient satisfaction between 1980 and 2014, and to seek the reasons for contradicting results in relationships between determinants and patient satisfaction in the literature to design a further robust measurement system for patient satisfaction.

METHOD

This systematic review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. The search was conducted in PubMed, CINAHL, and Scopus in October 2014. Studies published in full in peer reviewed journals between January 1980 and August 2014 and in the English language were included. We included 109 articles for the synthesis.

RESULTS

We found several number of determinants of patient satisfaction investigated in a wide diversity of studies. However, study results were varied due to no globally accepted formulation of patient satisfaction and measurement system.

CONCLUSIONS

Health care service quality indicators were the most influential determinants of patient satisfaction across the studies. Among them, health providers' interpersonal care quality was the essential determinant of patient satisfaction. Sociodemographic characteristics were the most varied in the review. The strength and directions of associations with patient satisfaction were found inconsistent. Therefore, person-related characteristics should be considered to be the potential determinants and confounders simultaneously. The selected studies were not able to show all potential characteristics which may have had effects on satisfaction. There is a need for more studies on how cultural, behavioural, and socio-demographic differences affect patient satisfaction, using a standardised questionnaire.

Measuring patient satisfaction

Purpose

– The purpose of this study was to understand the different dimensions patients staying in a hospital perceived as important for satisfaction and how those dimensions affected their overall satisfaction levels.

Design/methodology/approach

– A scale comprising 21 items to measure patient experience in a hospital was developed based on literature review. After purification of the scale, a field survey was administered to patients who were discharged in the recent past from a public or a private hospital in the city. The data collected were analyzed using multivariate techniques.

Findings

– The data analysis highlighted four important dimensions of patient satisfaction. The four dimensions significantly and positively affected patient’s overall satisfaction level.

Research limitations/implications

– This research study was conducted in one of the four major metropolitan cities of India. Nonetheless, the study provides valuable insights into the patient satisfaction dimensions in an Indian context and how those dimensions affected patient’s overall satisfaction.

Practical implications

– Hospitals, in general, can use the study findings to measure and improve their operational performance.

Originality/value

– This study was not limited to one or few hospitals, but covered many hospitals in one of the four metropolitan cities of India. It provides a comprehensive picture of how many hospitals in the city fared in terms of satisfying their patients.