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Yan J. An Analysis of Inpatient Satisfaction with Trust-related Factors of Public Secondary and Tertiary Hospitals in China. Qual Manag Health Care 2024; 33:166-175. [PMID: 38941583 DOI: 10.1097/qmh.0000000000000480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2024]
Abstract
BACKGROUND AND OBJECTIVES Patient satisfaction surveys are implemented as an essential quality improvement tool in healthcare markets. This study investigates patient satisfaction in public secondary and tertiary hospitals and identifies factors contributing to inpatient satisfaction, particularly trust-related factors, to eventually improve the quality of care in the healthcare system. METHODS A population-based cross-sectional survey was conducted between February and April 2021 in 31 Chinese provinces. Telephone interviews with computer assistance were used to gather data. Spearman Rank Correlation was used to analyze satisfaction with hospitalization services between secondary and tertiary hospitals. Multiple Linear Regression was used to determine the influencing factors of overall patient satisfaction. RESULTS Inpatients reported more satisfaction with inpatient care when doctors treated them respectfully (p < 0.01). Inpatients with higher self-identified social class reported higher satisfaction (p < 0.01). Inpatients who trust in most people in society (p < 0.01) and trust in the Chinese healthcare system (p < 0.01) reported higher satisfaction. Female inpatients reported higher overall satisfaction (p < 0.01). CONCLUSIONS The study of Chinese inpatients in secondary and tertiary hospitals highlighted the importance of respect from doctors, their self-identified social class, and their trust in influencing satisfaction during their hospital stay and called for additional research into policy measures.
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Affiliation(s)
- Jingjing Yan
- Author Affiliation: Department of Public Administration, College of Philosophy, Law & Political Science, Shanghai Normal University, Shanghai, China
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Bandoh DA, Dwomoh D, Yirenya-Tawiah D, Kenu E, Dzodzomenyo M. Prevalence and correlates of diarrhoea among children under five in selected coastal communities in Ghana. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:95. [PMID: 38926857 PMCID: PMC11210189 DOI: 10.1186/s41043-024-00582-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 06/09/2024] [Indexed: 06/28/2024]
Abstract
INTRODUCTION Diarrhoea is a preventable disease affecting children under five years disproportionately. Globally, thousands of children die from diarrhoea related diseases each year, most deaths occuring in sub-Saharan Africa where Ghana is located. Coastal communities bear the greatest brunt due to poor sanitary conditions. We assess the prevalence of diarrhoea in selected coastal communities along the eastern coast of Ghana. METHODS We conducted a cross-sectional study in Mumford, Opetekwei, Anyako, Anyauni and Ateteti communities in the Central, Greater Accra and Volta region respectively. We interviewed households with children under five years on the occurrence of diarrhoea and health seeking practices. We also used a checklist to assess the sanitary conditions of the household. Frequencies and proportions were generated. We determined significant differences using modified Poisson regression models at p < 0.05. Results were presented in tables and text. RESULTS The prevalence ratio of diarrhoea was 36% (95% CI 33-40%). Most cases were from Anyako community. All interviewed households in Mumford and Opetekwei used improved water sources whiles 94% in Atetetio used improved water sources. Children who were fully vaccinated had 32% lower prevalence of diarrhoea compared to those who were not (aPR: 0.68, 95% CI 0.55-0.84). CONCLUSION Diarrhoea prevalence was high inspite of the reported use of improved water sources and sanitation facilities by majority of households in the communities. Fully vaccinated children had a relatively lower prevalence of diarrhoea compared to children who were not fully vaccinated. We recommend in-depth analysis of the use of water and sanitation facilities in these settings to understand the reasons for the observed diarrhoea prevalence.
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Affiliation(s)
| | - Duah Dwomoh
- School of Public Health, University of Ghana, Legon, Accra, Ghana
| | | | - Ernest Kenu
- School of Public Health, University of Ghana, Legon, Accra, Ghana
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Alexandre F, Molinier V, Poulain M, Villiot-Danger E, Eichenauer B, Calvat A, Brandon L, Miffre C, Oliver N, Heraud N. [French survey of patients on current and future pulmonary rehabilitation programs]. Rev Mal Respir 2024; 41:399-408. [PMID: 38762393 DOI: 10.1016/j.rmr.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 04/25/2024] [Indexed: 05/20/2024]
Abstract
INTRODUCTION Over recent years, a growing number of studies have demonstrated the effectiveness of alternative models to centre-based pulmonary rehabilitation (PR) such as tele-PR or home-based unsupervised PR, offering perspectives for improved accessibility and adherence. Other studies have demonstrated the relevance and long-term benefits of maintenance PR programs. However, they remain poorly implemented in real-life settings. In order to encourage patient adherence to new PR models and to guide future orientations, we conducted a survey assessing patients' views on PR models and maintenance programs. METHOD The survey (37 questions) was circulated to COPD patients of the French national respiratory patient F.F.A.A.I.R network and in five specialised PR centres. RESULTS Among the 298 respondents, 75% had previously taken part in a PR program, mainly in hospital settings (91%), with a high degree of satisfaction. The main barriers to PR were being physically separated from their loved ones (21%) and fears of having to share a double room (47%). Regarding maintenance PR programs, patients expressed diversified opinions, in terms of ideal duration and frequency of follow-up, format of follow-up (home-based, telephone, videoconference) and type of professional involved. CONCLUSIONS Diversified PR settings offer perspectives to increase access and improve the effectiveness of current programs. Furthermore, comprehensive personalization (professionals involved, content, setting, duration) seems to be the key to success in concrete implementation and achievement of patient satisfaction.
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Affiliation(s)
- F Alexandre
- Direction de la recherche et l'innovation en santé Clariane France, 800, avenue Joseph-Vallot, 34700 Lodève, France.
| | - V Molinier
- Direction de la recherche et l'innovation en santé Clariane France, 800, avenue Joseph-Vallot, 34700 Lodève, France
| | - M Poulain
- Clinique du Souffle Inicea La Solane, Clariane, Ossèja, France
| | - E Villiot-Danger
- Clinique du Souffle Inicea Les Acacias, Clariane, Briançon, France
| | - B Eichenauer
- Clinique du Souffle Inicea Le Pontet, Clariane, Plateau d'Hauteville, France
| | - A Calvat
- Clinique du Souffle Inicea La Vallonie, Clariane, Lodève, France
| | - L Brandon
- Clinique du Souffle Inicea Les Clarines, Clariane, Riom-ès-Montagnes, France
| | - C Miffre
- Direction de la recherche et l'innovation en santé Clariane France, 800, avenue Joseph-Vallot, 34700 Lodève, France
| | - N Oliver
- Direction de la recherche et l'innovation en santé Clariane France, 800, avenue Joseph-Vallot, 34700 Lodève, France; Clinique du Souffle Inicea La Vallonie, Clariane, Lodève, France
| | - N Heraud
- Direction de la recherche et l'innovation en santé Clariane France, 800, avenue Joseph-Vallot, 34700 Lodève, France
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Huang EY, Park R, Park E, Firpo MA, Park AH. Comparing Satisfaction Among Providers Treating Both Pediatric and Adult Otolaryngology Patients. OTO Open 2024; 8:e141. [PMID: 38706557 PMCID: PMC11066763 DOI: 10.1002/oto2.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/16/2024] [Accepted: 04/07/2024] [Indexed: 05/07/2024] Open
Abstract
Objective Although pediatric otolaryngology providers are reported to garner lower patient satisfaction than adults, this difference is not well characterized. This study investigates whether patient satisfaction differences exist in providers who treat both pediatric and adult patients. Study Design Retrospective review. Setting Tertiary medical center. Methods In this cross-sectional study, Press Ganey surveys (PGS) completed by patients or parents on their first-time visit with 5 general otolaryngology providers from July 2014 to March 2022 were analyzed. Surveys were categorized by child (<18 years old) or adult and consisted of 14 items including 6 service domains of access, visit, nursing, provider, personal issues, and assessment. Analysis was performed with Walsh's t test and analysis of variance. Multivariable logistic regression, controlling for wait times and provider, evaluated the likelihood of highest satisfaction scores (HI-SCORES) based on age. Results A total of 2549 patients (135 pediatric, 2414 adults) completed the PGS on their initial visit. There was no significant difference in the mean overall satisfaction scores between pediatric and adult patients. Further analysis of service domains among pediatric patients found the mean score in the access domain to be higher for the 6- to 11-year-old age group (0-5 years old: 85.5 ± 20.5 [mean ± SD], 6-11 years old: 94.7 ± 11.5, 12-17 years old: 87.3 ± 15.4, P = .03). Pediatric patients did not have a significantly higher likelihood (odds ratio = 1.1, 95% confidence interval: 0.8-1.6, P > .05) of reporting HI-SCORES compared to adults after covariate adjustment. Conclusion There was no significant difference in patient satisfaction scores for providers who treat pediatric and adult patients utilizing the same facility and scheduling team.
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Affiliation(s)
- Emily Y. Huang
- Johns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Ryan Park
- Department of Otolaryngology–Head and Neck SurgeryUniversity of Utah School of MedicineSalt Lake CityUtahUSA
| | - Erica Park
- Department of Otolaryngology–Head and Neck SurgeryUniversity of Utah School of MedicineSalt Lake CityUtahUSA
| | - Matthew A. Firpo
- Department of SurgeryUniversity of Utah School of MedicineSalt Lake CityUtahUSA
| | - Albert H. Park
- Department of Otolaryngology–Head and Neck SurgeryUniversity of Utah School of MedicineSalt Lake CityUtahUSA
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Naeem B, Nasim J, Anwar A, Noor S, Arshad A, Zamrood Khan M, Ahmed M, Shah IA. Assessment of parental satisfaction with paediatric health services in public sector tertiary hospitals within a low-income setting using Patient Satisfaction Questionnaire (PSQ-18). BMJ Paediatr Open 2024; 8:e002418. [PMID: 38423744 DOI: 10.1136/bmjpo-2023-002418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 02/14/2024] [Indexed: 03/02/2024] Open
Abstract
INTRODUCTION Patient satisfaction is an integral part of healthcare quality, impacting treatment adherence, patient loyalty and healthcare utilisation. Parental satisfaction is particularly crucial as parents influence decision-making for their child's healthcare. OBJECTIVE The objective was to assess parental satisfaction levels (as measured by Patient Satisfaction Questionnaire-18 (PSQ-18)) related to paediatric healthcare services and identify specific factors significantly influencing parental satisfaction with paediatric healthcare services. METHODOLOGY This is a descriptive cross-sectional study that used a structured questionnaire based on the PSQ-18. The study was conducted in Faisalabad, Islamabad, Peshawar and Swat. Seven subscales measured satisfaction across various dimensions. RESULTS We found 882 suitable responses indicating a diverse participant demographic, with the largest group in the 6-12 years age category. The overall mean parental satisfaction score was 2.0±0.5 (40.0%). Notably, financial aspects scored highest at 2.8 (55%), followed by accessibility and convenience at 2.0 (40.5%). However, lower satisfaction scores in the interpersonal relationship (1.8±0.5) and technical quality (1.8±0.5) domains were recorded. Sociodemographic analysis indicated age, education and occupation significantly influenced satisfaction. Conversely, factors such as gender, residence and the presence of chronic disease did not significantly impact satisfaction levels. CONCLUSION The study offers valuable insights into paediatric patient satisfaction in Pakistan, emphasising the need for targeted interventions and improvements in specific domains to enhance overall healthcare quality.
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Affiliation(s)
| | | | - Amna Anwar
- Federal Medical College (FMC), Islamabad, Pakistan
| | - Sheh Noor
- Hayatabad Medical Complex, Peshawar, Pakistan
| | - Aqdas Arshad
- Mohi-ud-Din Islamic Medical College, Mirpur, Pakistan
| | | | | | - Imad Ali Shah
- National University of Science and Technology (NUST), Islamabad, Pakistan
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Hantzmon SV, Davenport CA, Das Gupta MN, Adekunle TA, Gaither SE, Olsen MK, Pinheiro SO, Johnson KS, Mahoney H, Falls A, Lloyd L, Pollak KI. Race differences in patient trust and distrust from audio-recorded cardiology encounters. PATIENT EDUCATION AND COUNSELING 2024; 119:108083. [PMID: 37989068 PMCID: PMC10842896 DOI: 10.1016/j.pec.2023.108083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/06/2023] [Accepted: 11/16/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVE Many have reported racial disparities in self-reported trust in clinicians but have not directly assessed expressions of trust and distrust in physician-patient encounters. We created a codebook to examine racial differences in patient trust and distrust through audio-recorded cardiologist-patient interactions. METHODS We analyzed data from a randomized controlled trial of audio-recorded outpatient cardiology encounters (50 White and 51 Black patients). We created a codebook for trust and distrust that was applied to recordings between White cardiologists and White and Black patients. We assessed differences in trust, distrust, and guardedness while adjusting for patient age, sex, and first appointment with the cardiologist. RESULTS Compared to White patients, Black patients had significantly lower expressions of trust ([IRR] [95 % CI]: 0.59 [0.41, 0.84]) and a significantly lower mean guarded/open score ([β] [95 % CI] -0.38 [-0.71, -0.04]). There was no statistically significant association between race and odds of at least one distrustful expression (OR [95 % CI] 1.36 [0.37, 4.94]). CONCLUSION AND PRACTICE IMPLICATIONS We found that coders can reliably identify patient expressions of trust and distrust rather than relying on problematic self-reported measures. Results suggest that White clinicians can improve their communication with Black patients to increase expressions of trust.
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Affiliation(s)
- Sarah V Hantzmon
- Cancer Prevention and Control Program, Duke Cancer Institute, Durham, NC, USA
| | | | - Maya N Das Gupta
- Cancer Prevention and Control Program, Duke Cancer Institute, Durham, NC, USA
| | - Temi A Adekunle
- Department of Psychology and Neuroscience, Duke University Trinity College of Arts and Sciences, Durham, NC, USA
| | - Sarah E Gaither
- Department of Psychology and Neuroscience, Duke University Trinity College of Arts and Sciences, Durham, NC, USA; Samuel DuBois Cook Center on Social Equity, Duke University, Durham, NC, USA
| | - Maren K Olsen
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA; Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, USA
| | - Sandro O Pinheiro
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Kimberly S Johnson
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Geriatric Research, Education, and Clinical Center (GRECC), Veterans Affairs Medical Center, Durham, NC, USA
| | - Hannah Mahoney
- Department of Population Health Sciences, Duke University, Durham, NC, USA
| | - Allison Falls
- Department of Psychology and Neuroscience, Duke University Trinity College of Arts and Sciences, Durham, NC, USA
| | - Lauren Lloyd
- Department of Psychology and Neuroscience, Duke University Trinity College of Arts and Sciences, Durham, NC, USA
| | - Kathryn I Pollak
- Cancer Prevention and Control Program, Duke Cancer Institute, Durham, NC, USA; Department of Population Health Sciences, Duke University, Durham, NC, USA.
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Al-Hilou M, Suifan T. The mediating effect of patient trust on the relationship between service quality and patient satisfaction. Int J Health Care Qual Assur 2023; ahead-of-print. [PMID: 37938922 DOI: 10.1108/ijhcqa-05-2023-0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
PURPOSE The prime aim of this research is to examine the mediating effect of patient trust on the relationship between service quality and patient satisfaction in Amman, Jordan. DESIGN/METHODOLOGY/APPROACH A convenience sample of patients visiting seven out of the 44 private hospitals in Amman was selected. In total, 385 questionnaires were distributed among patients, with a response rate of 91%. Of these, 35 were disregarded, and the data from the remaining 350 questionnaires were analyzed using SPSS. FINDINGS The results showed that service quality has a statistically significant effect on patient satisfaction. Furthermore, service quality has a statistically significant effect on patient trust, while there is also a statistically significant effect of patient trust on patient satisfaction. The findings also revealed that patient satisfaction partially mediates the relationship between service quality and patient satisfaction. ORIGINALITY/VALUE Generating more insights in the areas of service quality, patient trust and patient satisfaction while also extending the findings of earlier studies. The prior studies in the literature that focus on customers are given a more advantageous perspective by using Jordanian hospitals as a population to test the model of this research. The majority of past research on service quality, patient satisfaction and patient trust in the healthcare sector has been conducted in western nations.
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Purwaningsih P, Nasronudin N, Damayanti NA, Mahmudah M, Andarini S, Qomarudin B, Chalidyanto D, Yuwono SR, Septanto AN, Zulkarnain H. Development of a Hospital-Stakeholder Collaboration Tool Using Mixed Methods to Assess Stakeholder Perspectives for Hospital Service Improvement. Ethiop J Health Sci 2023; 33:1075-1086. [PMID: 38784495 PMCID: PMC11111266 DOI: 10.4314/ejhs.v33i6.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/10/2023] [Indexed: 05/25/2024] Open
Abstract
Background The purpose of this study was to develop the Hospital-Stakeholder Collaboration (HSC) Tool and Hospital Performance Factor (HPF) Tool to explore stakeholder perception and value for hospital service improvement. Methods This exploratory mixed-method study involved three steps: initial tool development (Step 1), validity testing (Step 2), and module development (Step 3). In Step 1, qualitative data collection through literature reviews, focus group discussions, and interviews with hospital management experts led to the creation of the preliminary tools. Step 2 involved qualitative analysis by α 5-member expert panel, followed by quantitative analysis with 36 respondents for validity (Pearson correlation, α = 0.05) and reliability (Cronbach's Alpha, α = 0.6) tests. Step 3 encompassed the final module development. Results The HSC tool contains 6 domains and the HPF tool contains 4 perspectives. The 6 HSC domains were: 1) stakeholder identification, 2) interactive dialogue, 3) commitment, 4) planning, 5) implementation, 6) change in action and behavior. The 4 HPF perspectives were: 1) stakeholder perspective, 2) financial perspective, 3) internal business process, and 4) staff and organizational capacity. The values of the HSC tool validity and reliability tests were around 0,0046 and around 0,995, respectively. Additionally, the values of the HPF tool validity and reliability tests were around 0,0062 and around 0,995, respectively. Conclusion This study offers a practical tool for needs assessment for the improvement of service by analyzing direct feedback from hospital stakeholders and measuring hospital performance factors.
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Affiliation(s)
- Purwaningsih Purwaningsih
- Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | | | | | - Mahmudah Mahmudah
- Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
| | - Sri Andarini
- Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Bagus Qomarudin
- Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
| | | | - Slamet Riyadi Yuwono
- Department of Nutrition, Polytechnic of Health Ministry of Health Surabaya, Surabaya, Indonesia
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Sobierajski T, Rzymski P, Małecka I, Augustynowicz E. Trust in Physicians in the Context of HPV Vaccination of Children from the Perspective of Social Exchange Theory: A Representative Study of Polish Parents. Vaccines (Basel) 2023; 11:1618. [PMID: 37897019 PMCID: PMC10611301 DOI: 10.3390/vaccines11101618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/04/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023] Open
Abstract
The vaccination of children against human papillomavirus (HPV) effectively prevents HPV infection and HPV-related cancers in women and men. However, HPV vaccination programs are met with vaccine hesitancy, which varies between countries. The coverage in Poland is low, although introducing nationally funded HPV vaccination for girls aged 12-13 in mid-2023 may increase it. The uptake of the HPV vaccine in adolescents is highly affected by parental decisions, which in turn can be influenced by interactions with the physician. The present representative study aimed to analyze the acceptance of the HPV vaccine among Polish parents (n = 360) and the level of trust in HPV vaccination in the pediatrician/general practitioner who takes care of their children aged 9-15 years. The data were gathered in September 2022 using computer-assisted telephone interviews. Most surveyed parents reported trusting their child's physician regarding vaccine recommendations (89.2%) and vaccinated their child with all or most of the vaccines recommended by a national vaccination guideline (94.7%). However, 13.3% declared themselves as moderate or strong vaccine opponents, a group characterized by high (83.4%) distrust in physicians. There was no difference in the awareness of HPV in groups varying in trusting the physicians, but parents who trusted them were more frequently aware of the HPV vaccine. Parental willingness to vaccinate their child against HPV was highly differentiated by the level of trust in the child's physician. The results highlight that trust in physicians is a critical factor shaping decisions for children's vaccination, stressing a continuous need to improve strategies to communicate with patients.
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Affiliation(s)
- Tomasz Sobierajski
- Center of Sociomedical Research, Faculty of Applied Social Sciences and Resocialization, University of Warsaw, 26/28 Krakowskie Przedmieście Str., 00-927 Warsaw, Poland
| | - Piotr Rzymski
- Department of Environmental Medicine, Poznan University of Medical Sciences, 60-806 Poznań, Poland;
- Integrated Science Association (ISA), Universal Scientific Education and Research Network (USERN), 60-806 Poznań, Poland
| | - Ilona Małecka
- Department of Preventive Medicine, Poznań University of Medical Sciences, 10 Fredry Str., 61-701 Poznań, Poland;
| | - Ewa Augustynowicz
- Department of Epidemiology of Infectious Diseases and Surveillance, National Institute of Public Health NIH—National Research Center, 24 Chocimska Str., 00-791 Warsaw, Poland;
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Dennison Himmelfarb CR, Beckie TM, Allen LA, Commodore-Mensah Y, Davidson PM, Lin G, Lutz B, Spatz ES. Shared Decision-Making and Cardiovascular Health: A Scientific Statement From the American Heart Association. Circulation 2023; 148:912-931. [PMID: 37577791 DOI: 10.1161/cir.0000000000001162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Shared decision-making is increasingly embraced in health care and recommended in cardiovascular guidelines. Patient involvement in health care decisions, patient-clinician communication, and models of patient-centered care are critical to improve health outcomes and to promote equity, but formal models and evaluation in cardiovascular care are nascent. Shared decision-making promotes equity by involving clinicians and patients, sharing the best available evidence, and recognizing the needs, values, and experiences of individuals and their families when faced with the task of making decisions. Broad endorsement of shared decision-making as a critical component of high-quality, value-based care has raised our awareness, although uptake in clinical practice remains suboptimal for a range of patient, clinician, and system issues. Strategies effective in promoting shared decision-making include educating clinicians on communication techniques, engaging multidisciplinary medical teams, incorporating trained decision coaches, and using tools (ie, patient decision aids) at appropriate literacy and numeracy levels to support patients in their cardiovascular decisions. This scientific statement shines a light on the limited but growing body of evidence of the impact of shared decision-making on cardiovascular outcomes and the potential of shared decision-making as a driver of health equity so that everyone has just opportunities. Multilevel solutions must align to address challenges in policies and reimbursement, system-level leadership and infrastructure, clinician training, access to decision aids, and patient engagement to fully support patients and clinicians to engage in the shared decision-making process and to drive equity and improvement in cardiovascular outcomes.
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Khullar D, Prasad K, Neprash H, Poplau S, Brown RL, Williams ES, Audi C, Linzer M. Factors associated with patient trust in their clinicians: Results from the Healthy Work Place Study. Health Care Manage Rev 2022; 47:289-296. [PMID: 35170482 DOI: 10.1097/hmr.0000000000000336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Patient trust in their clinicians is an important aspect of health care quality, but little evidence exists on what contributes to patient trust. PURPOSE The aim of this study was to determine workplace, clinician, and patient correlates of patient trust in their clinician. METHODOLOGY/APPROACH The sample used baseline data from the Healthy Work Place trial, a randomized trial of 34 Midwest and East Coast primary care practices to explore factors associated with patient trust in their clinicians. A multivariate "best subset" regression modeling approach was used, starting with an item pool of 45 potential variables. Over 7 million models were tested, with a best subset of correlates determined using standard methods for scale optimization. Skewed variables were transformed to the fifth power using a Box-Cox algorithm. RESULTS The final model of nine variables explained 38% of variance in patient trust at the patient level and 49% at the clinician level. Trust was related mainly to several aspects of care variables (including satisfaction with explanations, overall satisfaction with provider, and learning about their medical conditions and their clinician's personal manner), with lesser association with patient characteristics and clinician work conditions. CONCLUSION Trust appears to be primarily related to what happens between clinicians and patients in the examination room. PRACTICE IMPLICATIONS System changes such as patient-centered medical homes may have difficulty succeeding if the primacy of physician-patient interactions in inspiring patient trust and satisfaction is not recognized.
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Affiliation(s)
- Dhruv Khullar
- Dhruv Khullar, MD, MPP, Assistant Professor, Division of Health Policy and Economics, Department of Population Health Sciences and Division of General Internal Medicine, Department of Medicine, Weill Cornell Medical College, New York, New York. Kriti Prasad, BA, Medical Student, University of Minnesota, and Department of Medicine, Hennepin Healthcare, Minneapolis, Minnesota. Hannah Neprash, PhD, Assistant Professor, Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis. Sara Poplau, BA, Director of Operations, Office of Professional Worklife, Hennepin Healthcare Research Institute, Minneapolis, Minnesota. Roger L. Brown, PhD, Professor of Research Methodology and Medical Statistics, Schools of Nursing, Medicine and Public Health, University of Wisconsin-Madison. Eric S. Williams, PhD, Professor of Health Care Management, Culverhouse College of Business, University of Alabama, Tuscaloosa. E-mail: . Crystal Audi, BA, Research Assistant, Division of General Internal Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis, Minnesota. Mark Linzer MD, MACP, Vice Chair, Department of Medicine, Hennepin Healthcare and Professor of Medicine, University of Minnesota, Minneapolis
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Haji EA, Ebrahim AH, Fardan H, Jahrami H. Reporting Inpatients' Experiences and Satisfaction in a National Psychiatric Facility: A Study Based on the Random Forest Algorithm. J Patient Exp 2022; 9:23743735211069819. [PMID: 35005221 PMCID: PMC8733350 DOI: 10.1177/23743735211069819] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Understanding psychiatric inpatients' experiences is important to establish a culture of patient-centric care and promote trust in healthcare. This study aimed to evaluate nine dimensions of patients' experiences and investigate their association with patient satisfaction, revisit intention, and positive word-of-mouth (WoM) recommendation. Cross-sectional questionnaire data from five years of surveying (2016-2020) in the main psychiatric hospital in Bahrain were statistically analyzed, involving 763 psychiatric inpatients with an overall 65.6 ± 17.2 length of stay (days). The findings show that across the five years 2016-2020, the overall reported satisfaction was "very high" (4.75 ± 0.44) with no significant differences between these five years (F [4, 758] = 0.66, p = 0.620). The experience of confidentiality received the highest rating (4.72 ± 0.45). The experiences of ease of access, hospitality quality, and quality of responsiveness to one's needs significantly correlated with revisit intention (p ˂ 0.05). Patients with high satisfaction had greater potential for revisit intention (r [761] = 0.08, p = 0.027), which was associated with WoM recommendation (r [761] = 0.08, p = 0.033). Overall, men were less likely than women to experience convenient access to psychiatric wards. The findings of the Random Forest algorithm indicate the tendency of female patients with short-term stays to demonstrate lower satisfaction rates, and thus innovative approaches are needed when managing these groups' psychiatric problems.
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Affiliation(s)
- Eman A Haji
- Ministry of Health, Manama, Kingdom of Bahrain
| | - Ahmed H Ebrahim
- Ministry of Health, Manama, Kingdom of Bahrain.,College of Graduate Studies and Research, Ahlia University, Manama, Kingdom of Bahrain
| | | | - Haitham Jahrami
- Ministry of Health, Manama, Kingdom of Bahrain.,College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain
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Geng J, Chen X, Shi J, Bao H, Chen Q, Yu H. Assessment of the satisfaction with public health insurance programs by patients with chronic diseases in China: a structural equation modeling approach. BMC Public Health 2021; 21:1886. [PMID: 34663271 PMCID: PMC8524814 DOI: 10.1186/s12889-021-11947-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 09/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND China has successfully sustained its universal health insurance coverage over the past decade. Although patient satisfaction has been recognized as an important indicator to measure the performance of insurance programs in China, there is a lack of evidence on how patients with chronic diseases are satisfied with China's public health insurance programs and whether their satisfaction differs by type of insurance. We aimed to fill the evidence gap. METHODS We established a hypothetical model that comprised patients' awareness of insurance policies, the fulfillment of patients' expectations of insurance benefits, patients' perceived value of health insurance coverage, patients' satisfaction with health insurance programs, patients' complaints, and trust in health insurance programs. We performed a confirmatory factor analysis by using a structural equation modeling (SEM) approach to examine the hypothesized model. A model-testing survey in 10 tertiary hospitals was conducted between June and October 2018, with a valid sample of 922 insured patients with chronic diseases. RESULTS The SEM model, with good fit indices, showed that patients' awareness of health insurance policies, insurance program's fulfillment of expectations, and patients' perceived value of insurance coverage, positively predicted patient satisfaction (P < 0.01). The fulfillment of patients' expectations of insurance benefits was the major predictor of satisfaction with health insurance (coefficient = 0.593, P < 0.001), while the patients' perceived value of insurance coverage had the largest impact on their trust in health insurance (coefficient = 0.409, P < 0.01). Compared to patients with Urban-Rural Resident Basic Medical Insurance, Urban Employee Basic Medical Insurance enrollees had a higher degree of satisfaction with insurance on average (P < 0.01). Despite differences in the degree of satisfaction, the main findings from the SEM were also proved by the multi-group analysis. CONCLUSIONS Our findings highlight the importance of incorporating patients' perceived value as part of the ongoing efforts to increase satisfaction with health insurance by patients, especially those who have chronic diseases. Policymakers are also suggested to formulate evidence-informed reimbursement policies that meet patients' expectations.
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Affiliation(s)
- Jinsong Geng
- Medical School of Nantong University, Nantong, 226001, Jiangsu, China.
| | - Xiaowei Chen
- Medical School of Nantong University, Nantong, 226001, Jiangsu, China.,Library and Reference Department, The First Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, 310003, Hangzhou, China
| | - Jianwei Shi
- School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China
| | - Haini Bao
- Medical School of Nantong University, Nantong, 226001, Jiangsu, China
| | - Qian Chen
- Department of Ophthalmology, The Affiliated Hospital of Nantong University, Nantong, 226001, Jiangsu, China
| | - Hao Yu
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, 02215, USA
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