Factors associated with the quality of mental health services and consumers' functionality using tertiary-based services

Satisfaction with healthcare services and related factors among Indonesian migrant workers in Taiwan: a cross-sectional survey study

PURPOSE

The purpose of this study was to identify factors associated with Indonesian migrant workers' satisfaction with healthcare services in Taiwan, and to compare their satisfaction of healthcare between Taiwan and Indonesia.

METHODS

This cross-sectional study collected data through self-reported questionnaires from 352 participants. Inclusion criteria of participants were legal Indonesian migrant workers aged 18-55 years who were willing to participate, and only those who had used healthcare services for inpatient, outpatient, or emergency care were included in the analysis (n = 241). We used the SERVQUAL model, based on the gap theory of service quality, to assess service quality applied to health care. Analytical methods included descriptive analyses, linear regression, and multinomial logistic regression.

RESULTS

Satisfaction with Taiwan's health care was high (mean = 4.23 of 5), and almost 70% reported that different dimensions of Taiwan's health care were better than those of Indonesia. Among the healthcare system factors, longer waiting time was related to lower empathic satisfaction (B=- 0.272), while getting more assistance from volunteers (B = 0.067) and friendliness of staff (B = 0.112) were related to higher tangible satisfaction. When comparing health care in Taiwan to that in Indonesia, longer waiting time was related to higher satisfaction with Indonesia's healthcare (in tangibility and in responsiveness); expensive health service payment was related to lower satisfaction in Taiwan' healthcare (OR = 0.432 in tangibility) or higher satisfaction of Indonesia' healthcare (OR = 5.079 in reliability); and language was related to better satisfaction of Indonesia's healthcare (OR = 5.277 in tangibility and OR = 10.443 in reliability). Meanwhile, easy explanation was related to lower satisfaction with Indonesia's healthcare (OR = 0.445 in assurance), and getting volunteer assistance (OR = 0.326 in the tangibility and OR = 0.272 in reliability), and staff friendliness (OR = 0.085 in reliability and OR = 0.216 in empathy) were related to lower satisfaction of Indonesia's health care. Education and other demographics also related to the comparison of satisfaction. Odds ratios with wide confidence intervals should be explained conservatively.

CONCLUSIONS

Individual and healthcare system factors of Indonesian migrant workers influenced the level of their satisfaction with healthcare services in Taiwan in the tangibility and the empathy dimensions. Healthcare providers should consider these factors to improve service quality and migrant worker satisfaction.

A qualitative study of evidence-based therapeutic process in mental health services in Ghana- context-mechanisms-outcomes

Background

Evidence-based clinical practice is an inherent component of mental health professional practice in developed countries. However, little is known about professional perspectives of evidence-based practice in mental in developing countries such as Ghana. This paper describes the processes involved in the delivery of best practice in Ghana. The paper reports on a realistic evaluation of mental health nurses and allied health professionals’ views on the evidence-based therapeutic process in Ghana.

Methods

A purposive sample of 30 mental health professionals (MHPs) was recruited to participate in semi-structured, in-depth interviews. Thematic analysis was used to analyse the data. A program theory of Context + Mechanism = Outcome (CMO) configuration was developed from the analysis.

Results

The thematic analysis identified two contexts, mechanism and outcome configurations (themes): 1) technical competency stimulates evidence-based mental health services, and 2) therapeutic relationship building ensures effective interaction. The study demonstrates that contextual factors (technical competencies and therapeutic relationship building) together with mechanisms (intentional and unintentional) help to promote quality in mental health service provision. However, contextual factors such as a lack of sign language interpreters yielded unintended outcomes including barriers to communication with providers for consumers with hearing impairment and those from linguistic minority backgrounds.

Conclusion

Government stakeholders and policymakers should prioritise policies, periodic monitoring and adequate financial incentives to support the mechanisms that promote technical competence in MHPs and the building of therapeutic relationship.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-06993-1.